Wyber Rosemary, Bowen Asha C, Ralph Anna P, Peiris David
MBChB, MPH, FRACGP, The George Institute for Global Health, NSW; END RHD Head of Strategy, Telethon Kids Institute, WA; Senior Adjunct Research Fellow, University of Western Australia, WA.
BA, MBBS, DCH, FRACP, PhD, Head, Skin Health Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, WA; Associate Professor, University of Western Australia, WA; Paediatric Infectious Diseases Specialist, Perth Children@s Hospital, WA; Honorary Fellow, Menzies School of Health Research, Charles Darwin University, NT.
Aust J Gen Pract. 2021 May;50(5):265-269. doi: 10.31128/AJGP-02-21-5852.
Acute rheumatic fever (ARF) is an abnormal immune reaction following Streptococcus pyogenes (Strep A) infection of the throat, and likely the skin. Primary prevention is the prompt and appropriate antibiotic treatment of Strep A infection, and it can reduce the risk of developing ARF and subsequent rheumatic heart disease.
This article explores current recommendations for primary prevention of ARF in Australia.
People at increased risk of ARF should be offered empirical antibiotic treatment of Strep A infections to reduce this risk. People at increased ARF risk include young Aboriginal and Torres Strait Islander people in remote Australia as well as those with a personal or family history of ARF and people from migrant communities in urban areas, including Māori and Pacific Island people. Risk-stratified primary prevention can reduce the inequitable burden of ARF and rheumatic heart disease in Australia.
急性风湿热（ARF）是咽喉部感染化脓性链球菌（A 组链球菌）后可能继发于皮肤感染后的一种异常免疫反应。一级预防是对 A 组链球菌感染进行及时且恰当的抗生素治疗，这可降低患急性风湿热及后续风湿性心脏病的风险。
本文探讨澳大利亚目前针对急性风湿热一级预防的建议。
应给予急性风湿热风险增加人群经验性抗生素治疗 A 组链球菌感染，以降低此风险。急性风湿热风险增加人群包括澳大利亚偏远地区的年轻原住民和托雷斯海峡岛民，以及有急性风湿热个人或家族病史者和城市移民社区人群，包括毛利人和太平洋岛民。基于风险分层的一级预防可减轻澳大利亚急性风湿热和风湿性心脏病的不公平负担。
