Recurrence of acute rheumatic fever (ARF) can be diagnosed with 3 minor criteria and essential criteria only when?
Acute Rheumatic fever we use modified Jones Criteria: Latest update 1st rheumatic fever outbreak: -2 major criteria or -1 major + 2 minor Rheumatic fever relapse (recurrent IU): -2 major criteria or -1 major + 2 minor or -3 minor Low-risk population Major criteria: Carditis(clinical or subclinical) Ahritis(polyahritis only) Chorea Erythema marginatum Subcutaneous nodule Minor criteria: Polyahralgia Fever(>38.5degreee c) Elevations of ESR (>60 min in the 1st hour) and/or CRP >3mg/dl (or > as indicated by the reference value) Prolonged PR interval, corrected for age(only when there is no carditis) Criteria moderate to high risk population Major criteria: Carditis(clinical or subclinical) Ahritis(polyahritis polyahralgia and/or monoahritis) Chorea Erythema marginatum Subcutaneous nodule Minor criteria: Monoahralgia Fever(>38.5degreee c) Elevations of ESR (>60 min in the 1st hour) and/or CRP >3mg/dl (or > as indicated by the reference value) Prolonged PR interval, corrected for age(only when there is no carditis) Proven evidence of prior infection with GAS(positive oropharyngeal culture, positivity in rapid tests for the detection of streptococcal antigens, high titres of antistreptococcal antibodies) LATEST MODIFICATION IN MODIFIED JONES CRITERIA Jones criteria was established in 1992, last reviewed in 2015 Changes in the last review(2015), by AHA include: Stratification of susceptible individuals into 2 groups, based on epidemiological risk to acquire the disease. Low risk group has incidence of RF <2/100,000 school children(5-14)/year or a prevalence of chronic rheumatic carditis in any age group < or equal to 1/1000 per year. Communities that exhibit levels above these have moderate to high risk for acquiring the disease. Recommending using Jones criteria to diagnose rheumatic fever relapses. Diagnosis of Rheumatic fever recurrences/ Relapse: For patients who have already had the initial RF outbreak, minimum number of criteria to be met: 2 major criteria or 1 major and 2 minor ones (as in the initial outbreak), 3 minor criteria as a disease recurrence diagnosis, Regardless of the risk group to which the patient belongs.
ARF incidence <2 per 100,000 school - age children per year
ARF incidence >2 per 10,000 school-age children per year
All- age RHD prevalence of < 1 per 1000 population
Any incidence / prevalence of RHD
JIPMER 2018