Oliver J, Upton A, Jack SJ, et al. - Initiation of acute rheumatic fever (ARF) is considered involving group A Streptococcus (GAS) pharyngitis. Persons of certain ethnic and socioeconomic groups are more frequently affected by ARF in New Zealand. Comparison of GAS pharyngitis estimates (1,257,058 throat swab samples) with ARF incidence (792 hospitalizations) was performed in Auckland during 2010–2016. Researchers detected GAS pharyngitis in similar proportions across ethnic groups (≈19%) among children 5–14 years of age in primary healthcare clinics. Children of Pacific Islander and Māori ethnicities had moderately elevated relative risk for GAS pharyngitis compared with those of European/other ethnicities, however, children of Pacific Islander and Māori ethnicity vs those of European/other ethnicity exhibited highly elevated risk for ARF. This suggests much higher ethnic disparities among children with ARF vs among those with GAS pharyngitis indicating that ARF is driven by factors other than rate of GAS pharyngitis.