Diagnosis and Management of Acute Rheumatic Fever and Rheumatic Heart Disease. Acute Rheumatic Fever Diagnosis and Management.
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Acute Rheumatic Fever
Rheumatic Heart Disease
Acute Rheumatic FeverDiagnosis and Management
This presentation is intended to support the Curriculum for training health workers and others involved in the diagnosis and management of acute rheumatic fever and rheumatic heart disease.
It has been made possible thanks to the support of the Vodafone Group Foundation and the International Solidarity, State of Geneva, and the ongoing support of Menzies School of Health Research, Caritas Australia, Fiji Water Foundation, Cure Kids and Accor Hospitality.
ARF can be confirmed if certain signs and symptoms are present.
The Revised Jones Criteria (below) can help guide the diagnosis.
MAJOR Criteria - signs and symptoms more often associated with ARF
MINORCriteria- signs and symptoms that help support the diagnosis
Evidence of recent GAS Infection is required
The World Health Organisation set the international standard for diagnosis of ARF.
First episode or recurrent episode of ARF (no RHD):
ARF (with existing RHD):
** Individual country guidelines also exist **
Group A streptococcal infection
** Normal antibody titre ranges vary with age and geography **
A combination of signs and symptoms is required to confirm ARF
People with ARF do not always present to the health system with symptoms because
Health staff may not recognise the signs and symptoms of ARF
ARF may be confused with other illnesses, for example
Treat the acute illness
First dose of Benzathine penicillin G (start secondary prophylaxis)
Baseline echocardiogram (if available)
ARF alert on medical notes & computer systems (if applicable)
Education for person and family
Refer to local doctor / health facility
Long-term secondary prophylaxis plan
Medical officer review after one month, and
Repeat echocardiogram(if available)
The Jones Criteria is used to guide the diagnosis of ARF with a combination of MAJOR Manifestations, MINOR Manifestations and evidence of recent GAS Infection
A long-term Management Plan should be established to prevent recurrence of ARF and development or worsening of RHD
Probable ARF cases should also be monitored