Table 1.

Categories of acute rheumatic fever (ARF)—New Zealand (NZ)-modified version of the Jones Criteria.

Diagnosis	Requirements	Category
Initial Episode of ARF	Chorea, or 2 major or 1 major and 2 minor manifestations plus evidence of a preceding GAS infection *	Definite ARF
Initial Episode of ARF	1 major and 2 minor with the inclusion of evidence of a preceding GAS infection* as a minor manifestation (Jones, 1956)	Probable ARF
Initial Episode of ARF	Strong clinical suspicion of ARF, but insufficient signs and symptoms to fulfil diagnosis of definite or probable ARF	Possible ARF
Recurrent ARF	ARF in a case with known past history of ARF or RHD	Recurrent ARF (not eligible for study)

From NZ Guidelines for Rheumatic Fever 2014 [212]. Major manifestations: Carditis (including evidence of subclinical valvulitis/carditis on echocardiogram), Polyarthritis or aseptic monoarthritis (with or without a history of NSAID use), Chorea (can be stand-alone for ARF diagnosis), Erythema marginatum, Subcutaneous nodules. Minor manifestations: Fever, Raised ESR or CRP, Polyarthralgia, Prolonged P-R interval on ECG. * Elevated or rising antistreptolysin O or other streptococcal antibody is sufficient for a diagnosis of definite ARF. A positive throat culture or rapid antigen test for GAS alone is less secure as 50% of those with a positive throat culture will be carriers only. Therefore, a positive culture alone demotes a case to probable or possible ARF.