What is the US prevalence of acute rheumatic fever (ARF)?

Updated: Dec 10, 2020
  • Author: Robert J Meador, Jr, MD; Chief Editor: Herbert S Diamond, MD  more...
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The incidence of an acute rheumatic episode following streptococcal pharyngitis is 0.5-3%. The peak age is 6-20 years. Although the incidence of ARF has steadily declined, the mortality rate has declined even more steeply. Credit can be attributed to improved sanitation and antibiotic therapy. Several sporadic outbreaks in the United States could not be blamed directly on poor living conditions. New virulent strains are the best explanation.

In Hawaii, the incidence of ARF has remained several times higher than in the continental United States, particularly among ethnic Polynesians. Unusual group A streptococci emm types that are uncommon in the continental United States appear to play a significant role in the epidemiology of ARF in Hawaii. [12]

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