Rheumatic fever: clinical and laboratory manifestations in a New Zealand community

The clinical features of acute rheumatic fever as seen in Wairoa County 1962--76 are described. The types of cases seen comprised 107 definite first attacks, 78 definite recurrences, and 117 first attacks and 34 recurrences which did not satisfy strict diagnostic criteria. The incidence of the major manifestations, carditis, polyarthritis and chorea were 53 percent, 56 percent and 11 percent in definite first attacks, and 81 percent, 26 percent and 8 percent in definite recurrences, respectively. The ratio of recurrences to first attacks was high (58 percent). The Wairoa population exhibits factors thought to contribute to a high risk of recurrence--young age distribution, non-Caucasian ethnicity, avoidance of parenteral prophylaxis and frequent carditis in the first attack.