This report details the successful outcomes of a school-based rheumatic fever primary prevention programme set up in 2002 in Whangaroa, Northland, New Zealand. Prior to the intervention, rheumatic fever (RF) notifications in children aged 5–14 years in Whangaroa (424 per 100,000) exceeded those for all of Northland, New Zealand, and international notification rates. A hui held in Whangaroa in June 2001 agreed on the following approach: 3 times weekly swabbing of school children with sore throats; referral of positive cultures to the medical centre; oral amoxycillin for 10 days; education about the importance of sore throats (i.e. that infection with group A Streptococcus pyogenes can lead to the development of severe postinfectious sequelae such as RF and rheumatic heart disease); and a community-owned partnership approach. The intervention began on 25 February 2002; the last case of rheumatic fever was notified 8 days later.
