More than 50 Tai Tokerau tamariki have been treated already this year for the type of sore throat that can cause rheumatic fever - and serious health risks.
A throat-swabbing programme is underway in six Far North schools, and others around the North Island, after a similar project - pioneered in Kaeo in 2002 - eradicated the disease in that community.
The co-ordinator of the Far North prevention programme, Waka Williams, says the Strep A bug that can lead to heart damage is showing up in at least three children a week.
He says all of them have been given antibiotics to avert that risk.
Mr Williams says the aim is to get rheumatic fever levels in Maori down to the same level found in the Pakeha population - where the disease is extremely rare.
The Tai Tokerau region had 18 cases of rheumatic fever last year: the highest number since records began in 1986.