Rheumatic heart disease (RHD) and acute rheumatic fever (ARF) for health professionals

Acute rheumatic fever and rheumatic heart disease are closely related preventable diseases associated with poverty and disadvantaged populations.

Rheumatic heart disease develops after repeated episodes of acute rheumatic fever (ARF). ARF is an illness caused by a reaction to a bacterial infection with Group A Streptococcus, and mainly occurs during childhood and adolescence. In South Australia, ARF and RHD occur mostly among young Aboriginal and Torres Strait Islander people.

Visit the Rheumatic heart disease RHD Acute rheumatic fever ARF for community information on ARF and RHD.


Clinical diagnosis and management

The 2020 guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease (3rd edition), developed by Menzies School of Health Research and the Heart Foundation, is the main source of information to guide all aspects of ARF and RHD across Australia.

Free, accredited e-learning from basic through to advanced level education on all aspects of the prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease is available through Menzies and the Heart Foundation.

Clinicians should note that there was an increase in ARF cases in the Eyre Peninsula in 2025. If you are working in this area, please have a high level of suspicion for ARF and refer to the Australian guidelines (page 96-97) for guidance on making a diagnosis.

Notification of rheumatic fever and rheumatic heart disease

Rheumatic fever and rheumatic heart disease are notifiable diseases in South Australia under the South Australian Public Health Act 2011. These diseases must be notified to the Communicable Disease Control Branch within three days of suspecting or confirming a diagnosis on 1300 232 272 during business hours or using the notification form.

SA Rheumatic Heart Disease (RHD) Register

The SA Rheumatic Heart Disease (RHD) Register aims to improve the management of patients with ARF and RHD by assisting clinics with identifying individuals with poor adherence to secondary prophylaxis, monitoring patient movements, and providing health professional education and training.

Consent is not required to enrol people on the SA RHD Register.

Snapshot of ARF and RHD in SA

“Don’t miss out on the things you love” calendar

Together with the Aboriginal community in South Australia, the SA Rheumatic Heart Disease Control Program has developed a calendar (PDF 8278KB) to be used as an educational tool for people with rheumatic fever and/or rheumatic heart disease. It aims to improve knowledge about rheumatic fever and rheumatic heart disease through simple messages and testimonials.

A support resource (PDF 2130KB) has also been developed to guide clinicians through the use of the calendar as an education tool.

To order copies of the calendar for your patients, email your details to rhd@sa.gov.au

Reducing the pain of penicillin injections

People diagnosed with ARF or RHD require long term regular injections of long acting penicillin, every three to four weeks. This is known as secondary prophylaxis and prevents disease progression.

To support people living with ARF and RHD in SA, there is a fact sheet for health professionals detailing recommended strategies to reduce the pain of delivering Bicillin-LA® injections (PDF 273KB), and a handout for patients informing them of the options available to reduce the pain of their injection (PDF 157KB).

Model Standing Drug Orders

A Model Standing Drug Order (SDO) for the delivery of benzathine penicillin (Bicillin-LA) has now been approved for implementation at health services if appropriate.

This is a model standing drug order. The procedure to adopt this at your health service is within the standing drug order.

This SDO should only be implemented if your health service has its own local procedure/guideline in place for managing anaphylaxis including access to adrenaline.

Contact us

Please contact the SA RHD Control Program for more information, clinical questions or questions about the SA RHD Register.

Email: rhd@sa.gov.au

Phone: (08) 7425 7146