Current status of rheumatic fever control programs in the United States.

A study was undertaken to assess the current status of rheumatic fever control programs administered by State health agencies. Questionnaires, sent to 29 State health departments that had been identified previously as having rheumatic fever control programs, were completed by 27. Only 11 (61 percent) of the 18 States with a registry in 1977, or 41 percent of those replying, indicated that the registry was operational in 1980. A lack of adequate funds was cited by all States as a reason for discontinuing the program. Half of the States that closed down their registries related this to loss of funds previously provided by Section 314D funds (Public Law 95-626). Two-thirds of the replying States indicated, however, that they still provided prophylactic antibiotics for secondary rheumatic fever prophylaxis, free or at a reduced cost.Previous studies have indicated that rheumatic fever registries operated by State health departments in-accurately reflect the actual incidence and epidemiology of this sequel of group A streptococcal infections. Since a decreasing incidence of the disease, as reported to registries, was a primary reason for discontinuing the registries, the author concludes that a potentially effective public health program in preventive medicine can be discontinued for inadequately documented reasons.