Northland health officials are gearing up for an increase in potentially fatal rheumatic fever as winter starts to bite.

Every time your child has a sore throat, it could be serious. That's the message a Northland health specialist has for parents and caregivers as the risk of strep throat, which can lead to rheumatic fever, increases over winter.

While the rate of rheumatic fever has decreased over the past few years - with 15 admissions for first-time episodes of rheumatic fever in 2014 compared to six in 2017 - Dr Jose Ortega, Northland District Health Board public health medicine specialist, was concerned the cases of rheumatic fever would increase over winter.

"Cold damp homes and overcrowding increase risk of Strep A throat infections," he said.

"All Northland providers of throat swabbing know winter presents a higher risk, there is an increased vigilance in assessment of sore throats and timely treatment."

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Rheumatic fever is a serious illness caused by a group A streptococcal infection such as a sore throat.

The rates in Northland have previously been compared to that of a third world country but a variety of initiatives including throat swabbing in all decile 1 to 4 schools in the region, free throat-swabbing at selected pharmacies, and initiatives like Manaia PHO's Manawa Ora Healthy Homes, have been credited for the drop in cases. Officials do not want the situation to get worse again.

Melanie Dalziel, regional co-ordinator for Manawa Ora, said the programme was developed in 2015 purely looking at families with rheumatic fever or at high risk of rheumatic fever but has evolved to a service for a range of vulnerable families. She said winter was "not very pleasant" for families living in cold, damp and overcrowded homes.

"[It means] more time off work, more time out of school for children, generally more stress and pressure placed on the whanau."

Dalziel said the core focus of the programme is to provide a warmer, drier and healthier home. They educate whānau on how to achieve that and also provide curtains, beds, bedding, heaters, and more.

"Generally families are a lot more happier (in a warm, dry home). Children aren't having to miss school as much. They're very, very appreciative.

"We're not just providing the blankets and beds, it's about the knowledge that goes with that. You can give people things but it's not unless you tell them why you are giving them things and how you can make your\e own environment a healthier one. It's a two parcel approach."

Ortega said reducing rheumatic fever was a priority for Northland DHB and while programmes ran throughout the year, primary care partners were very aware there are more presentations of sore throats during winter so children with sore throats are given priority.

"Every time your child has a sore throat it could be serious. Don't ignore it, take them to a doctor or nurse straight away and ask for a throat swab to get it checked."

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For more advice visit www.northlanddhb.org.nz/your-health/health-resources/rheumatic-fever-2