Egoroff, Natasha

Bloomfield H

Gondarra W

Yambalpal B

Guyula, Terrence

Forward D

Lyons G

O'Connor E

Sanderson L

Dowden M

Williams, Desley

de Dassel J

Coffey, Pasqualina

Dhurrkay E R

Gondarra V

Holt D C

Krause, Vicki

Currie, Bart

Griffiths K

Dempsey Karen

Glynn-Robinson A

2023-08-23

OBJECTIVES: We describe the public health response to an outbreak of acute rheumatic fever (ARF) in a remote Aboriginal community. METHODS: In August 2021, the Northern Territory Rheumatic Heart Disease Control Program identified an outbreak of acute rheumatic fever in a remote Aboriginal community. A public health response was developed using a modified acute poststreptococcal glomerulonephritis protocol and the National Acute Rheumatic Fever Guideline for Public Health Units. RESULTS: 12 cases were diagnosed during the outbreak; six-times the average number of cases in the same period in the five years prior (n=1.8). Half (n=6) of the outbreak cases were classified as recurrent episodes with overdue secondary prophylaxis. Contact tracing and screening of 11 households identified 86 close contacts. CONCLUSIONS: This outbreak represented an increase in both first episodes and recurrences of acute rheumatic fever and highlights the critical need for strengthened delivery of acute rheumatic fever secondary prophylaxis, and for improvements to the social determinants of health in the region. IMPLICATIONS FOR PUBLIC HEALTH: Outbreaks of acute rheumatic fever are rare despite continuing high rates of acute rheumatic fever experienced by remote Aboriginal communities. Nevertheless, there can be improvements in the current national public health guidance relating to acute rheumatic fever cluster and outbreak management.

National Centre for Epidemiology and Population Health, Australian National University, Australia; Miwatj Health Aboriginal Corporation, Australia; Centre for Disease Control, Northern Territory Health, Australia. Electronic address: Natasha.Egoroff@anu.edu.au.

Miwatj Health Aboriginal Corporation, Australia; Centre for Disease Control, Northern Territory Health, Australia. Electronic address: hilary.bloomfield@miwatj.com.au.

Miwatj Health Aboriginal Corporation, Australia. Electronic address: gondarrad@miwatj.com.au.

Miwatj Health Aboriginal Corporation, Australia. Electronic address: brando.yambalpal@miwatj.com.au.

Centre for Disease Control, Northern Territory Health, Australia. Electronic address: terrence.guyula@nt.gov.au.

Miwatj Health Aboriginal Corporation, Australia. Electronic address: demi.forward@miwatj.com.au.

Miwatj Health Aboriginal Corporation, Australia. Electronic address: gemma.lyons87@gmail.com.

Miwatj Health Aboriginal Corporation, Australia; Centre for Disease Control, Northern Territory Health, Australia; Rheumatic Heart Disease Australia, Australia. Electronic address: emer.oconnor@miwatj.com.au.

Miwatj Health Aboriginal Corporation, Australia. Electronic address: lou.sanderson@miwatj.com.au.

One Disease, Australia. Electronic address: michelle.dowden@onedisease.org.

Centre for Disease Control, Northern Territory Health, Australia. Electronic address: desley.williams@nt.gov.au.

Centre for Disease Control, Northern Territory Health, Australia. Electronic address: jessica.dedassel@nt.gov.au.

Centre for Disease Control, Northern Territory Health, Australia. Electronic address: pasqualina.coffey@gmail.com.

Miwatj Health Aboriginal Corporation, Australia. Electronic address: dhurrkayr@miwatj.com.au.

Miwatj Health Aboriginal Corporation, Australia. Electronic address: veronica.gondarra@miwatj.com.au.

Menzies School of Health Research, Charles Darwin University, Australia. Electronic address: deborah.holt1@cdu.edu.au.

Centre for Disease Control, Northern Territory Health, Australia. Electronic address: vicki.krause@nt.gov.au.

Menzies School of Health Research, Charles Darwin University, Australia; Rheumatic Heart Disease Australia, Australia. Electronic address: bart.currie@menzies.edu.au.

Menzies School of Health Research, Charles Darwin University, Australia; University of New South Wales, Australia; University of Melbourne, Australia. Electronic address: kalinda.griffiths@unsw.edu.au.

Miwatj Health Aboriginal Corporation, Australia. Electronic address: karen.dempsey@miwatj.com.au.

National Centre for Epidemiology and Population Health, Australian National University, Australia. Electronic address: anna-jane.glynn-robinson@anu.edu.au.

Aust N Z J Public Health. 2023 Aug 23;47(5):100077. doi: 10.1016/j.anzjph.2023.100077.

https://pubmed.ncbi.nlm.nih.gov/37625204/?otool=iaurydwlib

https://hdl.handle.net/10137/12536

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An outbreak of acute rheumatic fever in a remote Aboriginal community.

Journal Article

Publication