Prevention of Initial Attacks of Rheumatic Fever

The fluorescent antibody (FA) technique was investigated as a means of rapidly identifying group A streptococci in throat cultures of a random sample of elementary school children in Dade County, Fla. Correlation between FA and conventional bacteriological techniques was more than 90 percent in 735 samples tested. The FA technique identified more group A organisms than the conventional procedure. Also, FA results were available within 24 hours, while conventional procedures often required 5 or more days to establish the group specificity. Prompt recognition of group A streptococci by the FA method permitted reporting results of throat cultures to parents and physicians within 24 hours, while the children were still ill. Adequate treatment was administered to all of the subjects who were notified early. But when reporting of bacterial findings depended on conventional cultural methods, only 45 percent of the children with positive cultures received treatment. The project demonstrated that overt illness probably will be treated in children whose throats yield group A organisms if notification is prompt. By early and adequate treatment, the incidence of rheumatic fever episodes should decline significantly.