Acute Rheumatic Fever and Rheumatic Heart Disease: Public Health Insights from Coroners' Inquests

This editorial reviews the state of clinical knowledge about acute rheumatic fever (ARF) and rheumatic heart disease (RHD). It uses the lenses of public health and coronial law to consider the pathology which is significantly over-represented in the First Nations Peoples of Australia, Aotearoa New Zealand and the Pacific. Noting that it is comparatively rare for deaths from natural illness to be scrutinised by coroners, it identifies the importance of a series of inquests, heard in New South Wales, the Northern Territory, Western Australia and Queensland between 2012 and 2022, that scrutinised deficits in health care that contributed to deaths from ARF and RHD, including in custody and within remote Indigenous communities. It argues that it is important that further inquests into RHD deaths be held to evaluate whether there have been suitable responses to the lessons that have needed to be learned for the diagnosis and treatment of ARF and RHD, including as to implementation of previous coroners' recommendations, especially within First Nations communities.