Pharyngeal carriage of group C and group G streptococci and acute rheumatic fever in an Aboriginal population

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 rat es of ARF in the world have been reported, although throat carriage rates o f group A streptococcus in this population are extremely low and symptomati c group A streptococcal pharyngitis is uncommon; by contrast, carriage rate s of group C and G streptococci are high, Therefore, we questioned the invo lvement of these groups in ARF and showed that they have the potential to e licit an autoimmune response that may trigger ARF.