Pharyngeal Carriage of Group C and Group G Streptococci and Acute Rheumatic Fever in an Aboriginal Population

Lancet. 2000 Sep 30;356(9236):1167-9. doi: 10.1016/S0140-6736(00)02765-3.


Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) represent an autoimmune response to group A streptococcal pharyngitis. In the Aboriginal population of the Northern Territory of Australia, some of the highest rates of ARF in the world have been reported, although throat carriage rates of group A streptococcus in this population are extremely low and symptomatic group A streptococcal pharyngitis is uncommon; by contrast, carriage rates of group C and G streptococci are high. Therefore, we questioned the involvement of these groups in ARF and showed that they have the potential to elicit an autoimmune response that may trigger ARF.

Publication types

  • Letter

MeSH terms

  • Adult
  • Antibodies, Bacterial / isolation & purification
  • Autoimmunity
  • Carrier State / immunology*
  • Carrier State / microbiology
  • Child
  • Enzyme-Linked Immunosorbent Assay
  • Humans
  • Microscopy, Electron, Scanning
  • Northern Territory / epidemiology
  • Oceanic Ancestry Group*
  • Pharyngitis / immunology
  • Pharyngitis / microbiology*
  • Rheumatic Heart Disease / epidemiology*
  • Rheumatic Heart Disease / microbiology
  • Serotyping
  • Streptococcus / classification*
  • Streptococcus / isolation & purification


  • Antibodies, Bacterial