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October 1957

Streptococcal Disease and Rheumatic Fever in Air Force Recruits: II. Prophylaxis with Tandem Oral Penicillin

Author Affiliations

U.S.A.F., Parks Air Force Base, Calif.; San Francisco

AMA Arch Intern Med. 1957;100(4):614-619. doi:10.1001/archinte.1957.00260100098011

The efficacy of penicillin in the prevention of streptococcal infections and rheumatic fever is a well-documented fact.1-4 Exposure of large numbers of service recruits to virulent streptococci has been followed by massive outbreaks of epidemic acute rheu- matic fever with its attendant serious cardiac sequelae.5 A previous report recounted the epidemiology and clinical picture of epidemic acute rheumatic fever as it was experienced in the first half of 1955 at a large Air Force basic training center in Northern California.6 It is the purpose of this paper to relate and discuss an approach to the practical aspects of streptococcal disease and rheumatic fever prevention, with particular reference to a tandem oral penicillin method of prophylaxis.

Background  While rheumatic fever attack rates are notoriously inaccurate, Northern California has never been noted as a particularly vulnerable area. When, however, 58 well-documented cases of acute rheumatic fever were accumulated in

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