Acute rheumatic fever in Mississippi: a survey of hospitalized cases, 1964 to 1973.

The incidence of acute rheumatic fever in Mississippi was estimated by reviewing the hospital charts of Mississippi residents with a discharge diagnosis of acute rheumatic fever from 1964 through 1973. The average annual incidence was 1.5 cases/100,000 population for primary attacks and 0.4 cases/100,000 population for recurrent attacks. The annual incidence was highest for the group aged 19 to 14 years, with 4.8 cases/100,000 population for primary attacks and 1.4 cases/100,000 population for recurrences. These rates are significantly lower than rates reported from similar surveys in Nashville, Baltimore, New York City, and the Navajo reservation. Age-adjusted rates of primary and recurrent attacks were higher for blacks than for whites, but the proportion of attacks that were recurrences did not differ by race. The proportion of attacks that were severe (cardiomegaly, pericarditis, or congestive heart failure) was significantly greater for blacks than for whites. No significant change in incidence was detected in the ten-year period. Among persons with primary attacks, only 18% are known to have had an antecedent pharyngitis and consulted a physician. Only 21% of persons with secondary attacks are known to have been receiving chemoprophylaxis.