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Objective The aim of this study is to evaluate echocardiographic evidence of latent rheumatic heart disease and Group A β hemolytic Streptococcus carriage in family members of acute rheumatic fever patients and asses the importance of screening for this conditions. Methods Children with diagnosis of acute rheumatic fever aged between 5 and 18 years and their family members and household relatives were screened with echocardiography for latent rheumatic heart disease and Group A β hemolytic Streptococcus carriage with throat culture test. Results In the study period, 46 index cases and their 124 relatives were evaluated. Echocardiographic screening of 22 (17.7%) family members revealed latent rheumatic heart disease.Ten (8.1%) cases had positive throat culture results for Group A β hemolytic Streptococcus and 2 of them, 20% of all culture positive cases, had latent rheumatic heart disease findings in echocardiographic evaluation. Conclusions The family members of children with rheumatic heart disease have increased relative risk for rheumatic heart disease. Screening programs for throat culture test and echocardiographic evaluation of household, family members and relatives, of children with acute rheumatic fever should be planned for determination of definite or latent rheumatic heart disease and asymptomatic Streptococcal throat carriage and if detected, Group A β hemolytic Streptococcal carriage should be treated to decrease the risk of recurrent acute rheumatic fever for index case.