A local principal is pleased to see free throat swabbing being delivered at some of Rotorua's low decile schools but wants to see the initiative expanded to all schools, regardless of decile.

The Western Heights Health Centre offers a throat swabbing service at seven schools in an effort to identify and treat strep throat.

If left untreated, step throat can turn into rheumatic fever which can then lead to rheumatic heart disease, a life-threatening illness. The centre visits Western Heights Primary School, Selwyn School, Aorangi Primary School, Kaitao Middle School, Rotorua Intermediate, Sunset Primary School and Glenholme Primary School, all of which have deciles no higher than three.

While the centre also offers free after-school clinics, Rotorua Principals' Association president and Ngakuru School principal Grant Henderson would like to see throat swabbing for all schools.

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He said people could not assume children attending low decile schools were the only ones living in environments which could lead to untreated strep throat turning into rheumatic fever.

"Hopefully the DHB do look at a strategy for rheumatic fever that goes across all the schools. I think it would be great and help eliminate the disease."

Western Heights Health Centre nurse Mary McLean said parents needed to be vigilant with the weather getting colder, as that was when there was an increase in sore throats.

The free after-school clinics run from 3pm to 6pm Monday through to Thursday, and 3pm to 5pm on Fridays for those aged 4 to 19.

"We try and treat strep throat so people don't get rheumatic fever."

Kaitao Middle School principal Rory O'Rourke said the service was important because it identified children who were at risk of developing rheumatic fever.

It was a great initiative and should continue every year, he said.

Lorraine Taylor, principal of decile 9 school Lynmore Primary, said throat swabbing clinics did not come to the school, but they sent out health information to parents.

Ms Taylor said it would be good if the service was offered at all schools, though it came down to funding.

Lakes District Health Board community paediatrician Dr Johan Morreau said the message was for parents to take their child to a doctor if they had a sore throat.

"Rheumatic fever is a serious but preventable illness."

He said fewer than six people in Rotorua got rheumatic fever each year, but the Lakes DHB had high rates compared with the rest of the country.

"It mainly affects Maori and Pacific children and young people aged 4 to 19, especially if they have had other family members who have had rheumatic fever."

He said occasionally people outside this age group develop the disease.

"The problem is that if these children and young people have had rheumatic fever damage to their heart valves, then the impact can be lifelong."

Dr Morreau said they had done a number of things to reduce the likelihood of both catching rheumatic fever and having repeated bouts.

These included a rheumatic fever co-ordinator, a registered nurse who educated families and children with rheumatic fever, along with co-ordinating the care of young patients at hospital, he said.

There was also a Rheumatic Fever Prevention Healthy Homes Service, which assisted with improving the household conditions of families living in Rotorua. "Cold and overcrowded houses put families at risk of diseases like rheumatic fever."

He said since the service began in March 2015, more than 65 households had been assessed and the resulting help provided had included support to access insulation, curtains, floor coverings, assistance with heating sources, support to access Work and Income entitlements, beds and bedding, support with private rental relocation, and fast-tracking for social housing. Referrals would be accepted for families living in the Western Heights and Rotorua city areas. Families must meet Ministry of Health criteria.

A Rapid Response Sore Throat service was also provided by the Western Heights Health Centre, visiting schools in the area. Dr Morreau said if a child was given antibiotics for a sore throat, it was important for them to be taken for the whole 10 days they were prescribed for.

Rotorua mother Wikitoria Tawhai said all three of her sons had been throat swabbed about a week-and-a-half ago, after two of them had traces of strep throat. She said one was swabbed at school by a nurse and the other two got their swabs at the Western Heights Health Centre clinic.

-For details of clinics visit https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/sore-throat/sore-throat-clinics/sore-throat-clinics-lakes-area.