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Post streptococcal

rheumatic fever policy in


US and Kazakhstan

Ainur Abdrakhmanova
US
Contacts with recent or
current clinical evidence of
GAS infection

Laboratory tests

Positive Negative

Treatment No treatment
Asymptomatic household contacts

No laboratory Laboratory evaluation


evaluation

Multiple Outbreak of Family


episodes of ARF, PSGN, history of
symptomatic GAS ARF
GAS pharyngitis pharyngitis
for prolonged
period despite
therapy
Asymptomatic acquisition of GAS may pose
some risk of nonsuppurative complications
(ARF, Scarlet fever, STSS, Acute GN,
PANDAS)

of patients with ARF


had no history of
recent streptococcal
infection
had minor respiratory
tract symptoms that
were not brought to
medical attention
Rates of GAS carriage

50% for sibling 20% for parent


contacts contacts

More than half of contacts who acquire GAS become ill.


Chronic streptococcal carriers

Thought not to be
Positive throat culture for important in the
GAS spread of GAS to
individuals who
No clinical findings
live and work
around them
Kazakhstan
The code of the Republic of Kazakhstan regarding
health of people and health care system, Chapter
24, Article 148:

3. Patients with infectious and parasitic disease, people suspected of


having infectious and parasitic diseases, carriers should be isolated
and treated, people who were in contact with them should be
monitored and if it is necessary should be also isolated and treated.

4. Patients with chronic infectious and parasitic disease, people


suspected of having chronic infectious and parasitic diseases,
chronic carriers imposing threat to surrounding people should be
temporarily suspended from the work according to the labor
legislation of the Republic of Kazakhstan
Reference
Gerber M. A. et. 2009. Prevention of rheumatic fever and diagnosis
and treatment of acute streptococcal pharyngitis. American Heart
Association.
Pichichero M. Compications of streptococcal tonsillopharyngitis.
Retrieved from
https://www.uptodate.com/contents/complications-of-streptococcal-
tonsillopharyngitis
Pickering L.K., Baker C.J., Kimberli D.W., Long S.S. 2012. Red book:
Report of the committee on infectious diseases. Group A
Streptococcal Infections, p. 668 679. American Academy of
pediatrics.

Retrieved from
https://online.zakon.kz/Document/?doc_id=30479065#pos=223;-199