Acute Rheumatic Fever: Forgotten but Not Gone

The decline in the incidence of acute rheumatic fever in North America and Western Europe since the end of World War II has been truly phenomenal. Indeed, in the past 20 years alone, the annual incidence rate among school-age children in major cities has dropped by more than 90 percent. The great rheumatic fever sanitariums of yesteryear have now closed their doors or been reassigned to other missions, and the admission of a patient with a possible case of acute rheumatic fever to the wards of our teaching hospitals occasions a hurried call for the most senior clinicians to adjudicate . . .