Updated National Guidelines strengthen fight against Rheumatic Fever in Aotearoa New Zealand

Health New Zealand | Te Whatu Ora (Health NZ) has released the Aotearoa New Zealand Guidelines for the Prevention, Diagnosis, and Management of Acute Rheumatic Fever and Rheumatic Heart Disease 2024, marking a major step forward in our national response to these preventable illnesses.

The guidelines incorporate the latest clinical evidence and expert consensus to support early detection and better outcomes, particularly for Māori and Pacific children and young people who continue to experience the highest rates of Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD) in Aotearoa New Zealand.

“Acute Rheumatic Fever is a serious, but often preventable illness that starts with something as simple as a sore throat,” says Deborah Woodley, Director of Starting Well at Health NZ.

“We know early and accurate diagnosis, followed by appropriate treatment of Strep A, can prevent life-long health complications. These updated guidelines will give clinicians greater confidence to identify risk, intervene early, and help protect the tamariki and rangatahi who need it most.”

ARF is an abnormal autoimmune response caused by untreated or partially treated Strep A throat infections. It can result in permanent heart valve damage known as rheumatic heart disease, a condition with life-long impacts on health, education, and wellbeing.

In 2023/24, 194 people were hospitalised for the first time with ARF in Aotearoa New Zealand.

The new guidelines offer:
• Refined diagnostic criteria and clearer clinical pathways
• Revised antibiotic protocols and risk stratification
• Guidance on delivering culturally safe and whānau-centred care
• A streamlined resource combining past updates into one accessible, comprehensive guideline, including seven newly developed chapters

“We’ve designed these guidelines to be practical, clear, and accessible,” says Deborah Woodley.

“Every throat swab, every prescription, every patient conversation; they all contribute to protecting our most affected communities. This is a system-wide challenge, and it takes all of us.”

The update has been developed in partnership with the University of Auckland, guided by the Rheumatic Fever Roadmap 2023–2028, and informed by clinicians, researchers, community voices and whānau with lived experience of ARF and RHD.