Is there a resurgence of acute rheumatic Fever in Canada?

Recent reports of acute rheumatic fever (ARF) outbreaks in the continental United States have caused alarm. A survey of Canadian pediatric cardiologists was undertaken to determine whether they were aware of an increase in ARF or, more specifically, rheumatic carditis. Ninety per cent of active pediatric cardiologists responded. In 1987, 48 cardiologists reported having seen 48 patients with ARF. Seventy-five per cent of respondents had seen no cases or only one case in the 12 previous months. Seventy-six per cent of respondents had noticed no increase in the number of cases since 1983. The rate of ARF reported by the cardiologists increased from east to west (p = .003), with an overall Canadian rate of 0.19 cases per 100 000 population. Rheumatic carditis and rheumatic fever remain rare. There is no evidence of a Canadian outbreak, but close monitoring is warranted.