Acute rheumatic fever

Source: Repatriation Medical Authority Statements of Principles as held by the Veterans Health Centre. SoPs are amended and replaced regularly; always confirm the current instrument at rma.gov.au before relying on it.

RH No. 53 of 2019 · BoP No. 54 of 201910 factors

Meaning of acute rheumatic fever: For the purposes of this Statement of Principles, acute rheumatic fever: (a) means a systemic, inflammatory autoimmune disease that follows laboratory confirmed infection with beta-haemolytic streptococcus; and (b) excludes post-streptococcal reactive arthritis.

Reasonable Hypothesis (RH) — Statement of Principles No. 53 of 2019

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting acute rheumatic fever or death from acute rheumatic fever with the circumstances of a person's relevant service:

(1)
having a group A beta-haemolytic streptococcal infection of the skin or the pharynx within the three months before the clinical onset of acute rheumatic fever;
(2)
for acute rheumatic fever manifesting as isolated chorea or as indolent subclinical carditis only, having a group A beta-haemolytic streptococcal infection of the skin or the pharynx within the nine months before the clinical onset of acute rheumatic fever;
(3)
having a group C or G streptococcal infection of the pharynx within the three months before the clinical onset of acute rheumatic fever;
(4)
experiencing crowded living or working conditions within the one year before the clinical onset of acute rheumatic fever;
(5)
having dental caries within the one year before the clinical onset of acute rheumatic fever;
(6)
inability to obtain appropriate clinical management for acute rheumatic fever;

Aggravation-only factors: the factors in subsection 9(6) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Balance of Probabilities (BoP) — Statement of Principles No. 54 of 2019

4 factors

At least one of the following factors must exist before it can be said that, on the balance of probabilities, acute rheumatic fever or death from acute rheumatic fever is connected with the circumstances of a person's relevant service:

(1)
having a group A beta-haemolytic streptococcal infection of the pharynx within the three months before the clinical onset of acute rheumatic fever;
(2)
for acute rheumatic fever manifesting as isolated chorea or as indolent subclinical carditis only, having a group A beta-haemolytic streptococcal infection of the pharynx within the nine months before the clinical onset of acute rheumatic fever;
(3)
experiencing crowded living or working conditions within the one year before the clinical onset of acute rheumatic fever;
(4)
inability to obtain appropriate clinical management for acute rheumatic fever;

Aggravation-only factors: the factors in subsection 9(4) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Acute rheumatic fever — DVA SoP factors