Rheumatic heart disease in Australia

Updated 30 October, 2026

First published 20 October, 2023

A brief overview and short history of rheumatic heart disease in Australia

Rheumatic heart disease is not commonly seen across wider Australia, but the rates of disease in some communities are among the highest in the world.

What is rheumatic heart disease?

Rheumatic heart disease is damage to one or more valves in the heart resulting from an illness called acute rheumatic fever.

It starts with a germ called group A streptococcus (or Strep A). Strep A can infect the throat and cause skin sores. Strep A infections are common and easily treated with antibiotics.

However, some people are not treated, and they can develop an illness following the Strep A infection. This illness is acute rheumatic fever. It is an autoimmune response which means the body’s immune system can damage parts of the body as well as fighting the Strep A infection. Acute rheumatic fever can include inflammation in the joints, skin, brain and heart.

If the heart is affected, the heart valves can be left scarred, and this is rheumatic heart disease. The heart valves do not open or close as they should which interrupts the flow of blood through the heart. This damage is permanent and there is no cure.

RHD in Australia

Rheumatic heart disease used to be common throughout the world, including in Australia. In the 1940s and 50s it was a very common reason for hospital admission among children. The figure below shows hospital admissions to the Royal Children’s Hospital in Melbourne between 1937 and 2013 due to acute rheumatic fever and rheumatic heart disease combined. Admissions were high in the 1930s and 40s; but they declined quickly during the 1960s (and stayed low) because socioeconomic conditions and access to healthcare improved, and penicillin to treat Strep A infections became widely available.

Source: Oliver et al, J Paediatr Child Health, 2020

Despite a reduction in the general population, some groups still experience high rates of rheumatic heart disease, particularly communities where socioeconomic conditions are neglected and access to health care is difficult. Populations still at risk of rheumatic heart disease include some First Nations communities, and people who have come from other countries where rheumatic heart disease is still common, including the Pacific region.

The map below highlights areas where rheumatic heart disease is common (darker green), which includes northern and central Australia.

Source: Australian Institute of Health and Welfare, 2025

Today in Australia there are two distinct groups living with rheumatic heart disease: older Australians who were affected before the 1960s, and populations, predominantly First Nations groups, still at high risk. The figure below shows the difference in hospital admissions between the two groups, by age.

Source: Katzenellenbogen et al, Clinical Epidemiology, 2019

Most non-Indigenous people living with rheumatic heart disease are over the age of 60 (right). In contrast, young First Nations people are still commonly affected by both acute rheumatic fever and rheumatic heart disease (left). The highest rates of acute rheumatic fever are seen in children aged between five and 14 years, because Strep A infections are very common at this age.

The burden of disease often spans a person’s lifetime, starting with acute rheumatic fever in childhood and progressing to rheumatic heart disease and its complications throughout adulthood.

Rheumatic heart disease is a disease of inequality. According to the 2025 report by the Australian Institute of Health and Welfare, of the people recorded on disease registers:

• 82% lived in remote areas.

• 78% were First Nations peoples.
• About 28% were under the age of 25 years.
• 66% were female.

The graph below shows the rate of rheumatic heart disease diagnosis for all Australians, based on age. First Nations people (dark blue) are diagnosed at much higher rates across all ages than all Australians combined (pale blue).

What is the Heart Foundation doing?

Research in Australia focuses on early detection and effective treatments for rheumatic heart disease. A Strep A vaccine will help prevent people developing the disease, but it will not address the underlying socioeconomic factors that place people at risk.

The Heart Foundation is engaged in a range of advocacy and research projects designed to support the end of rheumatic heart disease in Australia, including:

• Supporting the National clinical practice Guidelines to build capacity among the health workforce and ensure best-practice care.
• Giving voice to people living with rheumatic heart disease through the Champions4Change Program.

• Ensuring that all communities have access to washing facilities through the Remote Community Laundry Project
• Funding research to explore new ways of understanding, preventing and managing rheumatic heart disease.

To learn more about rheumatic heart disease in Australia:

• Explore videos on TakeHeartTV.
• Read about the Deadly Heart Trek.