During an epidemic of scarlet fever among the nursing staff of the Presbyterian Hospital in 1924 and 1925, there occurred several cases of pharyngitis from which Streptococcus scarlatinae was isolated.1 These scarlatinal infections of the throat, not accompanied by a rash, were similar clinically to concurrent throat infections caused by non-toxin-producing strains of Streptococcus pyogenes, and occurred among persons who had shown negative skin reactions with scarlatinal toxin previous to their illness. Such persons were presumably immune to scarlatinal infection. In another series of cases studied, prophylactic doses of scarlatinal antitoxin administered to contacts with scarlet fever had not only prevented scarlet fever but had prevented these scarlatinal throat infections sine exanthemate. From our observations it appeared that the immunity against Streptococcus scarlatinae was essentially antitoxic, and that antitoxin would prevent throat infection. Antitoxin in large amounts prevented both throat infection and the rash. Just sufficient antitoxin might be
STEVENS FA, DOCHEZ AR. THE EPIDEMIOLOGY OF SCARLATINAL THROAT INFECTIONS SINE EXANTHEMATE. JAMA. 1926;87(26):2137–2139. doi:10.1001/jama.1926.02680260005001
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