Reference: 2014-001 - Acute Rheumatic Fever increase in Western Australia

Researchers: Philippa Chidgzey (KPHU); Janice Forrester, Pauline Martin, Lynette Masuda, Bec Morgan-Dann (WA RHD Control Program); Stephanie Trust, David Atkinson, Rhona Dawson (Kimberley Aboriginal Medical Services Council); James Ramsey, Narissa Wieland, David Andrews (Princess Margaret Hospital); Claire Waddington (Telethon Institute for Child Health Research); Stephanie Davis (Australian National University); Peta Williams, Jeanette Ward (Kimberley Population Health Unit)

Funding:

Project summary: Acute Rheumatic Fever (ARF) is an illness that may result following an infection with bacteria named Group A Streptococcus (GAS). There are many different types (strains) of GAS. The circulating strains change over time, and it is also known that some strains are more likely than others to cause ARF. ARF affects the skin, bones and brain, but most importantly can affect the heart, which can result in an illness termed Rheumatic Heart Disease (RHD). RHD means that the heart valves do not work properly and then blood is not pumped properly, and this can make a person feel tired and short of breath. If the RHD is very severe, a person may need heart surgery, have a stroke or may die. Unfortunately in Australia, ARF and RHD now mostly affects Aboriginal and Torres Strait Islander people(5).

ARF is a condition that the government in Western Australia monitors (via a process called notification) as it can be prevented through medications and improved living conditions. Doctors need to tell the health department when they think a person is affected by ARF. Over the past year, doctors have reported many more cases of ARF across WA, but mostly in Perth, Broome and Fitzroy Crossing. Similarly, the main children’s hospital in WA, Princess Margaret Hospital, has also reported that they are seeing more severe cases of ARF. This may mean that there is a more harmful strain of the GAS bacteria infecting children.

The reasons for this possible increase in the number of people getting ARF are not known (examples of possible reasons are: greater awareness of the requirement to report ARF; a strain of GAS is circulating that is more likely to cause ARF; or that the environmental conditions contributing to ARF have been worse over the outbreak period).

We would like to investigate whether there really are more cases of ARF occurring in WA. We would do this by looking at ARF notification data and data from ARF related hospitalisations to establish the baseline rate of ARF in WA since 2001. We would compare current numbers of ARF cases with numbers of cases from previous years to establish whether a true increase has occurred (a disease outbreak). If we establish that an outbreak is occurring, then control measures may be put in place to prevent more people developing ARF and RHD.

Progress: Ongoing