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Update on Rheumatic Fever prevention and control

He mōhiohio hōu mō te ārai me te whakahaere i te kirikā rūmātiki

Tuesday 12 February 2019

This seminar–style course provides an essential update on key aspects of rheumatic fever, notably the burden caused by acute rheumatic fever (ARF) and chronic rheumatic heart disease (RHD), risk factors, group A streptococcal (GAS) infections, microbiology, immunology, prevention and treatments. It will cover current initiatives and novel approaches that New Zealand is well placed to refine and implement. This course will offer participants the opportunity to hear nationally and internationally renowned experts on rheumatic fever, share ideas, and debate options for combating this serious public health problem.

Topics covered

  1. Burden of rheumatic fever (ARF and RHD)
  2. Causes of rheumatic fever
  3. Prevention of rheumatic fever
  4. Treatment and management of ARF and RHD

Style of course

This is a seminar–style course and will be based on short presentations from a range of international and New Zealand speakers. There will be ample opportunity to ask questions and discuss future directions.

There will be an informal social event at the end of the day for participants to meet the contributors.

Who should attend?

This course is aimed at all those involved in rheumatic fever prevention and control, clinical management, surveillance and research and all those with an interest in this disease and child health. These groups includes communities affected by Rheumatic Fever, clinicians involved in disease diagnosis and treatment, staff who provide case follow–up and prophylaxis, those working on school–based and community–based interventions, and those involved in prevention policy and programme evaluation and research. No previous knowledge of rheumatic fever or epidemiology is necessary.

By the end of this course participants should have:

  • A good understanding of the burden of ARF and RHD in NZ and internationally.
  • Knowledge of new research on risk factors for disease and opportunities for prevention.
  • An understanding of wider preventative and management opportunities, including vaccine development.
  • The ability to assist with developing and implementing strategies to reduce New Zealand’s high rates of rheumatic fever.

Draft timetable

Time Session Presenter(s)
8:30am Registration  
Setting the scene; the personal and population burden of ARF and RHD (Chair Dr Julie Bennett)
9:00am Mihi opening and welcome  
Living with rheumatic fever – a personal experience Tiana Topia-Aporo
Global burden of ARF and RHD Dr David Watkins – via Zoom
Australian burden of ARF and RHD Prof Jonathan Carapetis
Update on epidemiology and burden of ARF in NZ Prof Michael Baker
10:15am Morning tea  
Causes of rheumatic fever (Chair Dr Jason Gurney)
10:45am Modifiable risk factors – results from the NZ case-control study Prof Michael Baker
GAS immunology – pathophysiology, diagnosis, prognosis Dr Nikki Moreland
Group A Strep emm-type characteristics – do they matter? Dr Debbie Williamson
GAS exposure and progression to ARF and RHD Dr Jane Oliver
Role of skin infections and scabies Dr Simon Thornley
Discussion of the causes of ARF and RHD All session speakers/delegates
12:15pm Lunch break  
Prevention of rheumatic fever (Chair Associate Prof Nigel Wilson)
1:00pm Working towards the Group A Strep vaccine Prof Jonathan Carapetis & Dr Nikki Moreland
Household improvements to prevent ARF and other childhood infections Associate Prof Nevil Pierse
Strep titre cut offs for diagnosing ARF Dr Susan Jack
School based sore throat management – where to from here? Dr Pip Anderson
Comparison of BOP ARF findings from schools and GP alone models, and observations on gender, S.salivarius probiotic and GAS Dr John Malcolm
Discussion of primary prevention of ARF All session speakers/delegates
2:30pm Afternoon tea  
Treatment and management of rheumatic fever and rheumatic heart disease (Chair Prof Michael Baker)
3:00pm The significance of echocardiographic detected RHD Dr Rachel Webb
Improving the formulation of Benzathine Penicillin G and its delivery Dr Dianne Sika-Paotonu
Economics of rheumatic fever prevention Jeff Cannon
Update on the NZ Rheumatic Fever Prevention Programme Dr Niki Stefanogiannis / Matafanua Hilda
Discussion of treatment and management of ARF and RHD All session speakers/delegates
4:00pm Interactive session – ending rheumatic fever All speakers/delegates
4:50pm Summary of the day and closing Dr Dianne Sika-Paotonu
5:00pm Refreshments  

Teaching staff

  • Professor Jonathan Carapetis is a Pediatrician and Director of the Telethon Institute for Child Health Research at the University of Western Australia, Perth. He has many years’ experience as a leading researcher on Rheumatic Fever.
  • Professor Michael Baker is a Public Health Physician and Professor of Public Health at the University of Otago, Wellington and Co–director of He Kainga Oranga/Housing and Health Research Programme. He will help facilitate the seminar and speak about risk factors for Rheumatic Fever.
  • Dr Nikki Moreland is a NZ Heart Foundation Senior Research Fellow at the Maurice Wilkins Centre, University of Auckland. She will provide an overview of current knowledge about the immunology of Rheumatic Fever.
  • Dr Debbie Williamson is a Clinical Microbiologist at the Doherty Institute in Melbourne and a Senior Lecturer at the University of Melbourne. She will discuss GAS emm-type characteristics in relation to the development of ARF.
  • Dr Simon Thornley is a Public Health Physician and epidemiologist at the University of Auckland, Auckland University of Technology and Auckland Regional Public Health Service.
  • Dr Pip Anderson is Public Health Physician at Countries Manukau District Health Board. She will provide an update on RF prevention through sore throat management in schools.
  • Dr Jane Oliver is a postdoctoral research fellow at the University of Melbourne and Murdoch Children's Research Institute, having recently completed her PhD at the University of Otago Wellington. In Melbourne she continues her research into acute rheumatic fever in addition to investigating novel ways to prevent the spread of Buruli ulcer.
  • Dr John Malcolm is a Paediatrician with Bay of Plenty DHB based in Whakatane, Hon Clinical Senior Lecturer University of Auckland and the University of Otago. He will compare BOP ARF findings from schools and GP alone models, and report observations on gender, S. salivarius probiotic and Group A Streptococcus (GAS).
  • Associate Professor Nevil Pierse is a statistician and Deputy Director of He Kainga Oranga/Housing and Health Research Programme. He will present an overview of housing improvement to prevent ARF and other childhood infections.
  • Dr Susan Jack is a Public Health Physician and Senior Lecturer in the Department of Preventive and Social Medicine at the University of Otago, Dunedin.
  • Dr Niki Stefanogiannis is a public health physician and Deputy Director of Public Health at the Ministry of Health. She, with Matafanua Hilda Fa'asalele will discuss the Ministry's approach to reducing and managing rheumatic fever and rheumatic heart disease.
  • Matafanua Hilda Fa'asalele has been the Chief Advisor Pacific Health, at the Ministry of Health for 6 years. Matafanua has over 30 years experience in the health sector and has led the work in the Ministry for the RHF Awareness Raising Campaign, and the Pacific RHF Community Funding. In her current role Matafanua works with all Pacific Health Providers across New Zealand, and leds some of the Ministry engagement with the Pacific sector and communities.

Course cost and registration

$300 early bird, $400 after 20 December 2018.

A 50% discount is available to full–time students, those unwaged and University of Otago staff.