Although acute rheumatic fever is rare in industrialised countries, it is a significant cause of disease among Aboriginal and Torres Strait Islander children. Prevalence of rheumatic heart disease is also high among these populations, with significant rates of procedures and death among young adults.
People who have had acute rheumatic fever previously are much more likely than the wider community to have subsequent episodes. These recurrences of acute rheumatic fever may cause further cardiac valve damage. Hence rheumatic heart disease steadily worsens in people who have multiple episodes of acute rheumatic fever. Because of its high prevalence in developing countries, rheumatic heart disease is the most common form of paediatric heart disease in the world. In many countries it is the most common cause of cardiac mortality in children and adults aged less than 40 years.