Acute rheumatic fever is a systemic inflammatory disease occurring as a sequel to beta haemolytic streptococcal infection. The clinical presentation  can be vague, complex and difficult to diagnose. The modified Duckett-Jones criteria to establish the diagnosis arose from research in North America and Europe during the first part of the 20th century and may not apply in other parts of the world.

It is thought that 0.3-30% of untreated group A beta haemolytic streptococcal infection progress to develop acute rheumatic fever.

Prevention of rheumatic fever and diagnosis and treatment of acute Streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics.

Gerber MA, Baltimore RS, Eaton CB, Gewitz M, Rowley AH, Shulman ST, Taubert KA.

Circulation. 2009 Mar 24;119(11):1541-51. Epub 2009 Feb 26