Acute Rheumatic Fever (Arf) Form - Notification Form For Clinicians - Queensland Government Page 2
Download a blank fillable Acute Rheumatic Fever (Arf) Form - Notification Form For Clinicians - Queensland Government in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Acute Rheumatic Fever (Arf) Form - Notification Form For Clinicians - Queensland Government with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2If an Aboriginal, Torres Strait or Pacific Islander child presents with joint pain, redness or swelling,
ARF should be the first consideration. ARF does not necessarily include arthritis or carditis.
1
Applying the modified JONES CRITERIA for the diagnosis of Acute Rheumatic Fever
Initial episode of ARF
Recurrent episode of ARF
2 Major manifestations
2 Major manifestations
or
or
1 Major and 2 Minor manifestations
1 Major and 2 Minor manifestations
or
3 Minor Manifestations
plus evidence of a preceding GAS infection
plus evidence of a preceding GAS infection
Sydenham’s chorea alone is enough to confirm ARF
2
RISK GROUPS
High risk populations for ARF include:
- Aboriginal and Torres Strait Islander Australians living in rural and remote parts of Australia,
- possibly some Aboriginal and/or Torres Strait Islander groups living in urban settings,
- Maori and Pacific Islander people, and
- some migrant groups from high risk areas.
All other individuals are low risk.
3
ASO & Anti-DNaseB levels and PR Interval are dependent on patient’s age.
Upper limits of normal (ULN) as per the Australian Guideline.
Age
ASO titre
Anti-DNaseB
Age
PR Interval
group
titre
group
in seconds
1 - 4
170
366
3 - 12
0.16
5 - 14
276
499
12 – 16
0.18
15 - 24
238
473
17+
0.20
25 - 34
177
390
= 35
>
127
265
4
DATE FIELDS are consistent with the National Notifiable Disease Surveillance System (NNDSS)
requirements
ARF NOTIFICATION: Please FAX page 1 of this form to your nearest Public Health Unit
(PHU will inform the ARF/RHD Register & Control Program, Queensland)
Phone
Phone
Fax
Fax
Metro North (Brisbane North Office) 3624 1111
3142 1800
Metro North (Moreton Bay Office)
3624 1199
3142 1826
Metro South (Brisbane South Office) 3000 9148
4744 9100
Mt Isa and Gulf
3000 9130
4744 9124
Cairns
South West
4656 8100
4226 5555
4031 1440
4654 2651
Central Queensland (Rockhampton) 4920 6980
Sunshine Coast
5409 6600
4920 6865
5409 6635
4652 6000
Townsville
4753 9000
Central West
4652 6099
4753 9056
Darling Downs (Toowoomba)
West Moreton (Ipswich)
3413 1200
4631 9888
4632 8563
3413 1221
Gold Coast
Wide Bay (Bundaberg)
4150 2728
5668 3700
4151 2222
2262 2703
Wide Bay (Hervey Bay)
4120 6000
Mackay
4911 0400
4150 2722
4911 0498
Reference: The Australian guideline for prevention, diagnosis and management of acute
nd
rheumatic fever and rheumatic heart disease (2
edition, 2012)
For more information visit
V6 January 2013
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form R-1304 - Sales Tax Exemption Certificate For Certain Purchases And Leases For The Federal Government Or The U.s. Department Of Navy - 2007
Financial
Form R -1304 - Sales Tax Exemption Certificate For Certain Purchases And Leases For The Federal Government Or The U.s. Department Of Navy
Financial
Form W-4 - Employee Withholding Allowance Certificate For Maryland State Government Employees Only - 2015
Business
Related Categories
Parent category: Legal