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Acute rheumatic fever. A vanishing disease in suburbia

M A Land, A L Bisno

    JAMA
    |February 18, 1983
    PubMed

    Insights

    Acute rheumatic fever (ARF) incidence in Memphis-Shelby County was low overall, but significantly higher in inner-city Black children aged 5-17. Suburban white children showed a much lower ARF rate.

    Area of Science:

    • Epidemiology
    • Public Health

    Background:

    • Acute rheumatic fever (ARF) is a serious complication of untreated streptococcal infections.
    • Understanding ARF incidence is crucial for public health strategies and resource allocation.

    Purpose of the Study:

    • To determine the incidence of acute rheumatic fever (ARF) in Memphis-Shelby County from 1977 to 1981.
    • To identify demographic and geographic disparities in ARF rates.

    Main Methods:

    • Retrospective analysis of hospital records.
    • Physician and neurologist surveys (n=327) via mail and telephone.
    • Case identification using modified Jones criteria.

    Main Results:

    • Overall ARF incidence was 0.64 cases per 100,000 population annually.
    • The highest incidence rate (3.74 per 100,000) was observed in Black children aged 5-17 in the inner city.
    • White children in suburban and rural areas had a significantly lower rate (0.49 per 100,000).

    Conclusions:

    • ARF incidence has fallen to very low levels in some US populations, particularly suburban white children.
    • Prevention and diagnostic strategies need to consider the declining and disparate incidence of ARF.
    • Targeted public health interventions may be necessary for high-risk populations.

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