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Acute rheumatic fever (ARF), an autoimmune reaction to Group A Streptococcus (Streptococcus pyogenes; Strep A) infection, can cause rheumatic heart disease (RHD). New formulations of long-acting penicillins are being developed for secondary prophylaxis of ARF and RHD.

The heart failure epidemic is growing and its prevention, in order to reduce associated hospital readmission rates and its clinical and economic burden, is a key issue in modern cardiovascular medicine. The present consensus document aims to provide practical evidence-based information to support the implementation of effective preventive measures.

Jonathan Rosemary Carapetis AM Wyber AM MBBS FRACP FAFPHM PhD FAHMS MBChB MPH FRACGP PhD Executive Director; Co-Head, Strep A Translation; Co-Founder

Rheumatic heart disease affects more than 40.5 million people worldwide and results in 306,000 deaths annually. Echocardiographic screening detects rheumatic heart disease at an early, latent stage. Whether secondary antibiotic prophylaxis is effective in preventing progression of latent rheumatic heart disease is unknown.

Building on the foundation of the first RHD forum, over 150 interested participants met to discuss critical issues on the RHD landscape.

Sensitivity and positive predictive value of cardiac auscultation compared with echocardiography is poor, regardless of the expertise of the auscultator.

The reduction in ARF recurrence indicates that the RHD control program has improved secondary prophylaxis; a decline in RHD incidence is expected to follow.

Vaccine prevention of GAS infections and their immunological complications has been a goal of researchers for decades.

The desire for an effective vaccine arises from the large burden of disease caused by the bacterium, particularly rheumatic fever and rheumatic heart disease.

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) occur at very high rates among Aboriginal and Torres Strait Islander people.