Between February 1987 and September 1988, there were eight published reports of outbreaks or increases of acute rheumatic fever cases in civilian as well as in military populations in the United States. This is a change from the past decade. Because rheumatic fever is no longer a reportable disease to local or state health departments, we thought it important to attempt to ascertain the extent of this middle 1980s resurgence. We contacted 56 physicians by telephone, all of them pediatric cardiologists. Essentially, all practice in large referral medical centers.