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September 1967

Clinical Dilemmas in the Use of Penicillin in Streptococcal Illness

Author Affiliations

Concord, Mass
From the Emerson Hospital, Concord, Mass, and the Acton Medical Associates, Acton, Mass. Dr. Harvey is also affiliated with Boston University School of Medicine.

Am J Dis Child. 1967;114(3):244-252. doi:10.1001/archpedi.1967.02090240058002

IN A COMPANION article,1 we have presented evidence that the carrier state, with or without preliminary illness, can lead to type-specific immunity to streptococcal infection. We had guessed that this might be true from our clinical observations of the 150 families in a research program.2-4 Our expectations have been confirmed by the precise identification possible by the Lancefield precipitin technique of M protein determination: illness does not result from the carried type, but from a new type, against which no immunity has been established. The existence of anti-M protein antibodies in the sera of known carriers has been demonstrated by means of the long-chain test of Stollerman and Ekstedt.5 Persons who have harbored a specific type for a number of weeks or months develop these antibodies, in contrast to those whose experience with it is brief, and presumably this development of type-specific antibodies is one factor in

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