A few years ago, my colleagues and I conducted a systematic review of data relating to the global burden of group A streptococcal diseases.1,2 Population-based data on rheumatic heart disease prevalence from 1985 through 2002 were included. We estimated that there were a minimum of 15.6 million people in the world with rheumatic heart disease, with 282 000 new cases each year and 233 000 resultant deaths each year; however, we also noted that the estimates of the number of cases in school-aged children in China (176 500) and Asia Other (102 000; Asia excluding South-Central Asia and China) were based on very few studies, none of which used echocardiography to confirm the presence of rheumatic heart disease lesions. Moreover, 5 of the 6 studies included in the Asia Other estimate came from 1 country, the Philippines. We therefore urged caution in interpreting these data from Asia, other than South-Central Asia, and concluded that there was an urgent need for more population-based data from this part of the world. In the 5 years since that review was compiled, more data have emerged to clarify the burden of rheumatic heart disease in Asia, which will be summarized here. Clinical Perspective p 2753 The previous report included Medline searches and other searches to retrieve articles from 1980 to 2002 with population-based studies of rheumatic heart disease prevalence. To update these data for the present study, a Medline search was conducted with the terms rheumatic fever or rheumatic heart disease and Asia . The abstracts of all articles retrieved from 2003 through November 2007 were reviewed, and the manuscripts of relevant articles were reviewed in full. Population-based studies of the prevalence of rheumatic heart disease in school-aged children were used to update the regional prevalence estimates from the previous review. Additional studies …