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
Authors: ANGELO TARANTA
Journal: Annals of Internal Medicine (1964)

Article1 February 1964Rheumatic Fever in Children and AdolescentsIV. Relation of the Rheumatic Fever Recurrence Rate per Streptococcal Infection to the Titers of Streptococcal AntibodiesANGELO TARANTA, M.D., HARRISON F. WOOD, M.D., ALVAN R. FEINSTEIN, M.D., RITA SIMPSON, B.A., EDITH KLEINBERG, B.S.ANGELO TARANTA, M.D.Search for more papers by this author, HARRISON F. WOOD, M.D.Search for more papers by this author, ALVAN R. FEINSTEIN, M.D.Search for more papers by this author, RITA SIMPSON, B.A.Search for more papers by this author, EDITH KLEINBERG, B.S.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-2-47 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptOnly 3 per cent (2), or less (3), of Group A streptococcal infections are followed by rheumatic fever. The factors that must be present in this minority and absent in the majority of infections, to account for the difference in outcome, have not yet been determined. It has been postulated that only a portion of the population may be susceptible to rheumatic fever, possibly on a genetic basis (4). However, even patients whose susceptibility to rheumatic fever is known by virtue of a definite previous attack of the disease often fail to develop it again after a subsequent Group A...References1. TARANTAWOODFEINSTEINSIMPSONKLEINBERG AHFARRE: Rheumatic fever recurrence rate and antibody response to streptococcal infections. Clin. Res. 8: 225, 1960. Google Scholar2. RAMMELKAMPWANNAMAKERDENNY CHLWFW: The epidemiology and prevention of rheumatic fever. Bull. NY Acad. Med. 28: 321, 1952. MedlineGoogle Scholar3. SIEGELJOHNSONSTOLLERMAN ACEEGH: Controlled studies of streptococcal pharyngitis in a pediatric population. I. Factors related to the attack rate of rheumatic fever. New Eng. J. Med. 265: 559, 1961. CrossrefGoogle Scholar4. PAUL JR: The rheumatic family, in The Epidemiology of Rheumatic Fever, 3rd ed., American Heart Association, New York, 1957, p. 125. Google Scholar5. KUTTNERKRUMWIEDE AGE: Observations on the effect of streptococcal upper respiratory infections on rheumatic children. A three year study. J. Clin. Invest. 20: 273, 1941. CrossrefMedlineGoogle Scholar6. WOODSTOLLERMANFEINSTEINHIRSCHFELDRUSOFFTARANTAHAASEPSTEIN HFGHARIJHARCJA: A controlled study of three methods of prophylaxis against streptococcal infection 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 infection 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 epidemiologic 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. WOODFEINSTEINTARANTAEPSTEINSIMPSON HFARAJAR: Ibid. III. Comparative effectiveness of three prophylaxis regimens in preventing streptococcal infections and rheumatic recurrences. Ibid., p. 31. Google Scholar10. TARANTAKLEINBERGFEINSTEINWOODTURSKYSIMPSON AEARHFER: Ibid. V. Relation of the rheumatic fever recurrence rate per streptococcal infection to pre-existing clinical features of the patients. P. 58. Google Scholar11. 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EDSALLBANTONWHEELER GJBRE: The antigenicity of single, graded doses of purified diphtheria toxoid in man. Amer. J. Hyg. 53: 283, 1951. MedlineGoogle Scholar17. UHR JW: Immunization with antigen-antibody complexes, in Mechanisms of Antibody Formation, edited by HOLUB, M., and JAROSKOVA, L., Academic Press, New York, 1960, p. 157. Google Scholar18. RANTZBOISVERTSPINK LAPJWW: Etiology and pathogenesis of rheumatic fever. Arch. Intern. Med. (Chicago) 76: 131, 1945. CrossrefGoogle Scholar19. FISCHEL EE: The role of allergy in the pathogenesis of rheumatic fever. Amer. J. Med. 7: 772, 1949. CrossrefMedlineGoogle Scholar20. WINBLADMALMROSWILANDER SHO: Studies in the pathogenesis of rheumatic fever. The antistreptolysin titer in acute tonsillitis and rheumatic fever. Acta Med. Scand. (Supp.) 196: 533, 1947. Google Scholar21. DENNYWANNAMAKERRAMMELKAMP FWLWCH: The relation of antibody production to the development of rheumatic fever. Amer. J. Dis. Child. 80: 506, 1950. Google Scholar22. ANDERSONKUNKELMCCARTY HCHGM: Quantitative antistreptokinase studies in patients infected with Group A hemolytic streptococci: A comparison with serum antistreptolysin and gamma-globulin levels with special reference to the occurrence of rheumatic fever. J. Clin. Invest. 27: 425, 1948. CrossrefMedlineGoogle Scholar23. STETSON CA: The relationship of antibody response to rheumatic fever, in Streptococcal Infections, edited by MCCARTY, MACLYN, Columbia University Press, New York, 1954, p. 208. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ANGELO TARANTA, M.D.; HARRISON F. WOOD, M.D.; ALVAN R. FEINSTEIN, M.D.; RITA SIMPSON, B.A.; EDITH KLEINBERG, B.S.Affiliations: 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 combined meetings of the American Society for Clinical Investigation and the American Federation for Clinical Research, Atlantic City, New Jersey in May, 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, N. Y. 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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. 1 February 1964Volume 60, Issue 2_Part_2Page: 47-57KeywordsAdolescentsChildrenFellowshipsHeartPediatricsPopulation geneticsProphylaxisRheumatic feverStreptococcal infections ePublished: 1 December 2008 Issue Published: 1 February 1964 PDF downloadLoading ...