A 93 per cent drop in Northland's rheumatic fever cases in the past two years has been credited to various initiatives focused on sore throats.

Northland District Health Board figures for the past three financial years show the number of first time episodes of rheumatic fever have gone from 15 in 2014, to five cases in 2015 and only one case recorded this year - a 93 per cent decrease in the last two years.

Rheumatic fever can develop after a strep throat - a throat infection caused by a Group A Streptococcus bacteria - and can lead to serious health issues, including heart disease.

Northland's Medical Officer of Health Dr Clair Mills said it is likely the focus on early identification and management of strep throat, greater access for at-risk children to free treatment via schools and pharmacies, and an extensive national and regional communications strategy have contributed to the decline.

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"As well as a reduction in the number of new cases of rheumatic fever, we see that families are more aware of the importance of treating sore throats and preventing rheumatic fever. However, there is no room for complacency because many of the risk factors that contribute to rheumatic fever, such as poor housing, still exist in Northland," she said.

Northland's rheumatic fever rate was compared to that of a third world country in previous years. In 2014 the region had the third-highest rate of rheumatic fever in the country.

Dr Mills said the school-based throat swabbing programme, which is in all Decile 1-4 schools in Northland, removes the barriers families might face.

"One of the key advantages of the school programmes is that they are free, universal and don't depend on factors over which children themselves have no control - such as cost, and the logistics of getting an appointment and transport to a doctor or nurse."

The school based throat swabbing programme is delivered by six Maori health providers. It is run with drop-in throat swabbing in three pharmacies, free GP services for under 13-year-olds, and the Sore Throats Matter publicity campaign.

Lyn Foster, community health services manager at Hokianga Health, credited the decline to an increase in awareness and the various initiatives aimed at tackling the illness.

She said it was positive to see zero cases in Hokianga this year and only one case in the whole of Northland.

"I think it's great. It's absolutely positive to see people know that sore throats can lead to rheumatic fever."

Ms Foster said Hokianga Health ran the throat swabbing programme in 13 schools twice a week.

She said over the five years the health provider had been running the programme she had noticed a change in attitudes.

"People really know [sore throats lead to rheumatic fever], it's in their face. Even now in the school holidays when the programme is not running the parents know if their kid has a sore throat to take them to the GP and it's the same with the kids. The child will come forward and say 'I've got a sore throat'."