<prompt> Recurrence of acute rheumatic fever ARF can be diagnosed with 3 minor criteria and essential criteria only when?ARF incidence 2 per 100,000 school - age children per yearARF incidence 2 per 10,000 school-age children per yearAll- age RHD prevalence of 1 per 1000 populationAny incidence prevalence of RHD  <response>: Acute Rheumatic fever we use modified Jones Criteria: Latest update 1st rheumatic fever outbreak: -2 major criteria or -1 major 2 minor Rheumatic fever relapse recurrent IU: -2 major criteria or -1 major 2 minor or -3 minor Low-risk population Major criteria: Carditisclinical or subclinical Ahritispolyahritis only Chorea Erythema marginatum Subcutaneous nodule Minor criteria: Polyahralgia Fever38.5degreee c Elevations of ESR 60 min in the 1st hour andor CRP 3mgdl or as indicated by the reference value Prolonged PR interval, corrected for ageonly when there is no carditis Criteria moderate to high risk population Major criteria: Carditisclinical or subclinical Ahritispolyahritis polyahralgia andor monoahritis Chorea Erythema marginatum Subcutaneous nodule Minor criteria: Monoahralgia Fever38.5degreee c Elevations of ESR 60 min in the 1st hour andor CRP 3mgdl or as indicated by the reference value Prolonged PR interval, corrected for ageonly when there is no carditis Proven evidence of prior infection with GASpositive oropharyngeal culture, positivity in rapid tests for the detection of streptococcal antigens, high titres of antistreptococcal antibodies LATEST MODIFICATION IN MODIFIED JONES CRITERIA Jones criteria was established in 1992, last reviewed in 2015 Changes in the last review2015, by AHA include: Stratification of susceptible individuals into 2 groups, based on epidemiological risk to acquire the disease. Low risk group has incidence of RF 2100,000 school children5-14year or a prevalence of chronic rheumatic carditis in any age group or equal to 11000 per year. Communities that exhibit levels above these have moderate to high risk for acquiring the disease. Recommending using Jones criteria to diagnose rheumatic fever relapses. Diagnosis of Rheumatic fever recurrences Relapse: For patients who have already had the initial RF outbreak, minimum number of criteria to be met: 2 major criteria or 1 major and 2 minor ones as in the initial outbreak, 3 minor criteria as a disease recurrence diagnosis, Regardless of the risk group to which the patient belongs. 