Acute rheumatic fever (ARF) is an illness caused by infection with Group A Streptococcus (a type of bacteria). Episodes of ARF can cause permanent damage to the heart valves, which is known as rheumatic heart disease (RHD). People with ARF and RHD need many years of injections to prevent or stop worsening damage to their heart.
Since 2 October 2015, ARF and RHD have been notifiable in NSW. This means doctors diagnosing people with these conditions should notify NSW Health. This allows NSW Health to see how many people have ARF and RHD and make this information available to health services and the community. ARF is notifiable in all people in NSW. RHD is notifiable in people under the age of 35 years in NSW.
15 ARF notifications in 2024
8 RHD notifications in 2024
A notification rate is a way of measuring how often a health condition is reported in a population group over time. The ARF notification rate in all people in NSW was 0.18 per 100,000 people in 2024. The RHD notification rate in people aged less than 35 years in NSW was 0.22 per 100,000 people in 2024.
People may have more than one episode of ARF. In 2024, 14 people had their first episode of ARF while 1 person had a recurrent episode.
ARF can progress to RHD when permanent damage to the heart valve occurs. Of people notified with ARF in NSW, 21 (23%) also had a RHD notification. Out of the 21 people also diagnosed with RHD, 10 (48%) were diagnosed with RHD between 0-3 months after their ARF diagnosis which is called a concurrent diagnosis.
For people notified with RHD, the majority (77%) have not been notified as having a previous diagnosis of ARF. People may not have had a previous diagnosis of ARF for a number of reasons, these include if people did not visit the doctor when sick or the doctor thought the person was more likely to have a different illness. Other reasons include that the ARF diagnosis may not have been notified to NSW Health as it occurred before ARF was notifiable or the clinician did not send through a notification.
The average ARF notification rate in Aboriginal and Torres Strait Islander people was 24 times higher than in non-Indigenous people between 2016-2024. For RHD, the average rate was 10 times higher in Aboriginal and Torres Strait Islander people.
1Some people were notified with ARF more than once between 2020-2024.
Data for this report was extracted from the Notifiable Conditions Records for Epidemiology and Surveillance, NSW Ministry of Health on 17 September 2025. Population data including population by LHD, population by Aboriginal and Torres Strait Islander status and NSW population were obtained from the Australian Bureau of Statistics via the Secure Analytics for Population Health Research and Intelligence System (SAPHaRI).
