Rheumatic fever and rheumatic heart disease in the Hamilton health district: II. Long term follow-up and secondary prophylaxis.

An analysis is made of follow-up and prophylaxis of 289 first attacks of acute rheumatic fever occurring over a ten year period in under 30 year olds in the Hamilton health district, New Zealand. Hospital clinics originally undertook to follow 84.4% of patients but after ten years, regular contact was maintained with 45% of this group while general practitioners maintained contact with 32% of their group. Fifty percent of all cases (and 77% of cases occurring in the past five years) are on regular benzathine penicillin usually administered by the district nursing service. Co-ordination with extramural services and the use of the computer based register as means of improving follow-up and prophylaxis are advocated, with more attention being given to defaulters.