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Heredity, infection and chemoprophylaxis in rheumatic carditis: an epidemiological study of a communal settlement

Published online by Cambridge University Press:  15 May 2009

A. Michael Davies  and
Eliahu Lazarov
A. Michael Davies
Affiliation:
Department of Preventive Medicine, Hebrew University-Hadassah Medical School, Jerusalem, Israel
Eliahu Lazarov
Affiliation:
Department of Preventive Medicine, Hebrew University-Hadassah Medical School, Jerusalem, Israel
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1. Children and their parents in a communal settlement (kibbutz) were followed for 14 months with special regard to the influences of streptococcal carrier rate, streptococcal infections, chemotherapy and heredity on the pattern of rheumatic heart disease.

2. Children with proven or probable heart disease showed the same streptococcal carrier rates as controls in spite of continued chemoprophylaxis with oral penicillin.

3. A single injection of penicillin, given to all kibbutz members on the same occasion, reduced the streptococcal carrier and infection rates to zero and maintained a marked drop for 3 months. Thereafter, the rates rose to higher levels than before. Courses of sulphamethoxypyridazine (‘Lederkyn’) given first to the total population and then to children only, caused only temporary interruption in the attack rate.

4. The prevalence of rheumatic heart disease in children of parents themselves affected was 2½ times greater than in controls exposed to the same environmental risks.

5. Affected children were more susceptible to streptococcal infections than controls with identical exposure.

Grateful thanks are due to Miss Pearl Weiskopf, B.Sc., for the statistical analysis. Without the close collaboration of Dr J. Yauluss, Nurses Tova and Ziva and the members of Kibbutz S this study would have been impossible. Thanks are also due to Lederle Laboratories Department of Cynamid International and their Israeli agent, Dr L. Goldshmidt, for the gift of ‘Lederkyn’, and to Mrs Rachel Kosh for help beyond the call of her secretarial duties.

Type
Research Article
Information
Journal of Hygiene , Volume 58 , Issue 3 , September 1960 , pp. 263 - 276
Copyright
Copyright © Cambridge University Press 1960

References

Annotation, (1955). Heredity and rheumatic fever. Lancet, i, 496.Google Scholar
Breese, B. B. & Disney, F. A. (1958). Failure of penicillin and sulphonamide to prevent beta-hemolytic streptococcal infections. J. dis. Child. 95, 359.CrossRefGoogle Scholar
Bywaters, E. G. L. (1959). Factors other than streptococcal infection in the aetiology of rheumatic fever. Rheumatic Fever: Epidemiology and Prevention, p. 94. Oxford: Blackwell.Google Scholar
Cruickshank, R. & Glynn, A.A. (eds.) (1959). Rheumatic Fever: Epidemiology and Prevention. Oxford: Blackwell.Google Scholar
Davis, J. & Schmidt, W. C. (1957). Benzanthine penicillin G. Its effectiveness in the prevention of streptococcal infections in a heavily exposed population. New Engl. J. Med. 256, 339.CrossRefGoogle Scholar
Diamond, E. F. (1957). Heredity and environmental factors in the pathogenesis of rheumatic fever. Pediatrics, 19, 908.CrossRefGoogle Scholar
Gauld, R. L. & Read, F. E. M. (1940). Studies of rheumatic disease. III. Familial association and aggregation in rheumatic disease. J. clin. Invest. 19, 393.CrossRefGoogle ScholarPubMed
Holmes, M. C. & Lermit, A. (1955). Transport and enrichment media in the isolation of haemolytic streptococci from the upper respiratory tract. Mon. Bull. Minist. Hlth. Lab. Serv. 14, 97.Google ScholarPubMed
Johnson, E. E., Mathews, M. J. & Stollerman, G. H. (1959). The use of weekly oral doses of sulfamethoxypyridazine for rheumatic fever prevention. J. Pediatrics, 54, 468.CrossRefGoogle ScholarPubMed
Markowitz, M. (1957). Observations on an epidemic of streptococcal infections and recurrences of rheumatic fever among children treated with penicillin. Pediatrics, 19, 257.CrossRefGoogle Scholar
Maxted, W. R. (1953). The use of bacitracin for identifying group A haemolytic streptococci. J. clin. Path. 6, 224.CrossRefGoogle ScholarPubMed
Morris, A. J. & Rammelkamp, C. H. Jr (1957). Benzathine penicillin G in the prevention of streptococcic infections. J. Amer. Med. Ass. 165, 664.CrossRefGoogle ScholarPubMed
Poskanzer, D. C., Feldman, H. A., Beadenkopf, W. G., Kuroda, K., Drislane, A. & Diamond, E. L. (1956). Epidemiology of civilian streptococcal outbreaks before and after penicillin prophylaxis. Amer. J. publ. Hlth., 46, 1513.CrossRefGoogle Scholar
Price, W. H., Lee, R., Harshman, S., Schaub, I., Matanoski, G., Ibler, I., Lachanie, R., Ferencz, C., Guild, H., Bramley, G. & Weaver, K. (1958). An ecologic analysis of distinct biochemical and immunological responses in rheumatic fever. Bact. Proc. M. 124.Google Scholar
Quinn, R. W., Denny, F. W. & Riley, H. D. (1957). Natural occurrence of hemolytic streptococci in normal school children. Amer. J. publ. Hlth., 47, 995.CrossRefGoogle ScholarPubMed
Saslaw, M. S. (1958). The hereditary factor in rheumatic fever in Florida. Southern med. J. 51, 213.CrossRefGoogle ScholarPubMed
Schulz, I. & Frank, P. F. (1958). The prophylactic use of sulfamethoxypyridazine (Kynex) during a streptococcal epidemic. Amer. J. med. Sci. 236, 779.CrossRefGoogle Scholar
Smilansky, M., Weintraub, S. & Hanegbi, Y. (1960). Child and Youth Welfare in Israel, p. 99. Jerusalem: Henrietta Szold Institute.Google Scholar
Spiro, M. E. (1956). Kibbutz, Venture in Utopia. Boston: Harvard University Press.Google Scholar
Stevenson, A. C. & Cheeseman, E. A. (1956). Heredity and rheumatic fever. Some later information about data collected in 1950–51. Ann. Hum. Genetics, 21, 139.CrossRefGoogle Scholar
Stoppelman, M. R. H. (1959). The occurrence of beta haemolytic streptococci in children given chemoprophylaxis and controls. Rheumatic Fever: Epidemiology and Prevention, p. 150. Oxford: Blackwell.Google Scholar
Wehrle, P. F., Feldman, H. A. & Kuroda, K. (1957). Effect of penicillin V and G on carriers of various groups of streptococci in a children's home. Pediatrics, 19, 208.CrossRefGoogle Scholar
Wilson, M. J. (1940). Rheumatic Fever. New York: The Commonwealth Fund.Google Scholar
Wilson, M. J. & Schweitzer, M. (1954). Pattern of hereditary susceptibility in rheumatic fever. Circulation, 10, 699.CrossRefGoogle ScholarPubMed
Zanen, H. C., Ganor, S. & van Toorn, M. J. (1959). A continuous study of hemolytic streptococci in the throats of normal children, adults and aged men. Amer. J. Hyg. 69, 265.Google ScholarPubMed