Rheumatic Fever in Children and Adolescents: A Long-term Epidemiologic Study of Subsequent Prophylaxis, Streptococcal Infections, and Clinical Sequelae: V. Relation of the Rheumatic Fever Recurrence Rate per Streptococcal Infection to Pre-existing Clinical Features of the Patients
Authors: ANGELO TARANTA
Journal: Annals of Internal Medicine (1964)

Article1 February 1964Rheumatic Fever in Children and AdolescentsV. Relation of the Rheumatic Fever Recurrence Rate per Streptococcal Infection to Pre-existing Clinical Features of the PatientsANGELO TARANTA, M.D., EDITH KLEINBERG, B.S., ALVAN R. FEINSTEIN, M.D., HARRISON F. WOOD, M.D., ESTHER TURSKY, R.N., RITA SIMPSON, B.A.ANGELO TARANTA, M.D., EDITH KLEINBERG, B.S., ALVAN R. FEINSTEIN, M.D., HARRISON F. WOOD, M.D., ESTHER TURSKY, R.N., RITA SIMPSON, B.A.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-2-58 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe rheumatic fever attack rate per streptococcal infection is quite constant and low, approximating 3 per cent in a number of epidemiologic reports (2). The only well-established exception occurs in patients who have already had rheumatic fever in whom the attack rate or, more specifically, the recurrence rate per infection is considerably higher. It was 16.5 per cent, for instance, in the population studied at the Irvington House Prophylaxis Clinic (3). In this population a positive relationship was found between the magnitude of the streptococcal antibody response and the rheumatic fever recurrence rate per infection (4, 5). This rate may also...References1. TARANTAFEINSTEINWOODSIMPSON AARHFR: Relationhip of rheumatic fever recurrence rate to clinical features in the patients. Circulation 22: 82, 1960. Google Scholar2. RAMMELKAMPWANNAMAKERDENNY CHLWFW: The epidemiology and prevention of rheumatic fever. Bull. NY Acad. Med. 28: 321, 1952. MedlineGoogle Scholar3. WOODFEINSTEINTARANTAEPSTEINSIMPSON HFARAJAR: Rheumatic fever in children and adolescents: a long-term epidemiologic study of subsequent prophylaxis, streptococcal infections, and clinical sequelae. III. Comparative effectiveness of three prophylaxis regimens in preventing streptococcal infections and rheumatic recurrences. Ann. Intern. Med. 60: (Feb. Supp.) 31, 1964. AbstractGoogle Scholar4. TARANTAWOODFEINSTEINSIMPSONKLEINBERG AHFARRE: Rheumatic fever recurrence rate and antibody response to streptococcal infections. Clin. Res. 8: 225, 1960. Google Scholar5. TARANTAWOODFEINSTEINSIMPSONKLEINBERG AHFARRE: Rheumatic fever in children and adolescents: a long-term epidemiologic study of subsequent prophylaxis, streptococcal infections, and clinical sequelae. IV. Relation of the rheumatic fever recurrence rate per streptococcal infection to the titers of streptococcal antibodies. Ann. Intern. Med. 60: (Feb. Supp.) 47, 1964. AbstractGoogle Scholar6. WOODSTOLLERMANFEINSTEINHIRSCHFELDRUSOFFTARANTAHAASEPSTEIN HFGHARIJHARCJA: A controlled study of three methods of prophylaxis against streptococcal infections in a population of rheumatic children. I. Streptococcal infections and recurrences of acute rheumatic fever in the first two years of the study. New Eng. J. Med. 257: 394, 1957. CrossrefMedlineGoogle Scholar7. FEINSTEINWOODEPSTEINTARANTASIMPSONTURSKY ARHFJAARE: A controlled study of three methods of prophylaxis against streptococcal infections in a population of rheumatic children. II. Results of the first three years of the study, including methods for evaluating the maintenance of oral prophylaxis. New Eng. J. Med. 260: 697, 1959. CrossrefMedlineGoogle Scholar8. WOODSIMPSONFEINSTEINTARANTATURSKYSTOLLERMAN HFRARAEGH: Rheumatic fever in children and adolescents: a long-term epidemiological study of subsequent prophylaxis, streptococcal infections, and clinical sequelae. I. Description of the investigative techniques and of the population studied. Ann. Intern. Med. 60: (Feb. Supp.) 6, 1964. LinkGoogle Scholar9. RANTZRANDALL LAE: A modification of the technic for determination of antistreptolysin titer. Proc. Soc. Exp. Biol. Med. 59: 22, 1945. CrossrefGoogle Scholar10. CHRISTENSEN LR: Methods for measuring activity of components of streptococcal fibrinolytic system, and streptococcal desoxyribonuclease. J. Clin. Invest. 63: 263, 1949. Google Scholar11. HARRISHARRIS STN: The measurement of neutralizing antibodies to streptococcal hyaluronidase by a turbidimetric method. J. Immun. 63: 233, 1949. MedlineGoogle Scholar12. . Jones criteria (modified) for guidance in diagnosis of rheumatic fever, report of Committee on Standards and Criteria for Programs of Care of the Council on Rheumatic Fever. Mod. Conc. Cardiov. Dis. 24: 291, 1955. MedlineGoogle Scholar13. FEINSTEINSPAGNUOLOWOODTARANTATURSKYKLEINBERG ARMHFAEE: Rheumatic fever in children and adolescents: a long-term epidemiological study of subsequent prophylaxis, streptococcal infections, and clinical sequelae. VI. Clinical features of streptococcal infections and rheumatic recurrences. Ann. Intern. Med. 60: (Feb. Supp.) 68, 1964. LinkGoogle Scholar14. FEINSTEINSPAGNUOLO ARM: The clinical patterns of acute rheumatic fever: a reappraisal. Medicine 41: 279, 1962. CrossrefMedlineGoogle Scholar15. BLANDJONES EFTD: Rheumatic fever and rheumatic heart disease: a twenty year report on 1,000 patients followed since childhood. Circulation 4: 836, 1951. CrossrefMedlineGoogle Scholar16. FINDLAY L: The Rheumatic Infection in Childhood. William Wood & Company, New York, 1932. Google Scholar17. MASSELL BF: Factors in the pathogenesis of rheumatic fever: a study of streptococcal infections and rheumatic recurrences. J. Maine Med. Ass. 53: 88, 1962. MedlineGoogle Scholar18. FEINSTEINSPAGNUOLO ARM: Mimetic features of rheumatic fever recurrences. New Eng. J. Med. 262: 533, 1960. CrossrefMedlineGoogle Scholar19. RANTZBOISVERTSPINK LAPJWW: The etiology and pathogenesis of rheumatic fever. Arch. Intern. Med. (Chicago) 76: 131, 1945. CrossrefGoogle Scholar20. STETSON CA: The relationship of antibody response to rheumatic fever, in Streptococcal Infections, edited by MACLYN MCCARTY, Columbia University Press, New York, 1954, p. 208. Google Scholar21. JOHNSONSTOLLERMANGROSSMANMCCULLOCH EEGHBJH: Streptococcal infections in adolescents and adults after prolonged freedom from rheumatic fever. I. Results of the first three years of the study. New Eng. J. Med. 263: 105, 1960. CrossrefMedlineGoogle Scholar22. FISCHEL EE (cited by STOLLERMAN, G. H.): Use of antibiotics for prevention of rheumatic fever. Amer. J. Med. 17: 757, 1954. CrossrefMedlineGoogle Scholar23. TARANTA A: Factors associated with the rheumatic fever attack rate following streptococcal infections. Arthritis Rheum. 4: 303, 1961. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Irvington-on-Hudson, New YorkFrom Irvington House, Irvington-on-Hudson, New York, and the Departments of Medicine and Pediatrics and The Rheumatic Diseases Study Group, New York University School of Medicine, New York, New York.Part of this work was supported by the National Heart Institute grant H-1595 (C-1-6), American Heart Association, New York Heart Association, Westchester Heart Association, Wyeth Laboratories, Sullivan County Heart Chapter, and the Genesee County Heart Chapter.Part of the work done by Dr. Taranta was during his tenure of an Advanced Research Fellowship of the American Heart Association.This paper was presented in part at the Annual Meeting of the American Heart Association, St. Louis, Missouri, October, 1960 (1).Dr. Taranta is currently with the Department of Medicine and Irvington House Institute, New York University School of Medicine, New York. Drs. Wood and Feinstein are with the Department of Pediatrics and the Department of Internal Medicine, respectively, Yale University School of Medicine, New Haven, Connecticut.The data on which this paper is based were collected in the Irvington House Prophylaxis Clinic which was conceived, organized, and directed in its first year of operation by Dr. Gene H. Stollerman.Requests for reprints should be addressed to Angelo Taranta, M.D., Department of Medicine and Irvington House Institute, New York University School of Medicine, New York. 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Classification of Human Disease by Clinical BehaviorALVAN R. FEINSTEIN, M.D. 1 February 1964Volume 60, Issue 2_Part_2Page: 58-67KeywordsAdolescentsAntibody productionChildrenEpidemiologyFellowshipsHeartPediatricsProphylaxisRheumatic feverStreptococcal infections Issue Published: 1 February 1964 PDF DownloadLoading ...