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An outbreak of streptococcal sore throat and rheumatic fever in a Royal Air Force Training camp; significance of serum antibody to M-associated protein

Published online by Cambridge University Press:  15 May 2009

Jean P. Widdowson
Affiliation:
Cross-Infection Reference Laboratory, Central Public Health Laboratory, Colindale Avenue, London NW9 5HT
W. R. Maxted
Affiliation:
Cross-Infection Reference Laboratory, Central Public Health Laboratory, Colindale Avenue, London NW9 5HT
C. W. Newrick
Affiliation:
R.A.F. Institute of Pathology & Tropical Medicine, Halton, Aylesbury, Bucks
D. Parkin
Affiliation:
R.A.F. Institute of Pathology & Tropical Medicine, Halton, Aylesbury, Bucks
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Summary

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A large outbreak of streptococcal sore throat in a Royal Air Force Training Camp resulted in five cases of rheumatic fever among the 16- to 18-year-old apprentices, and one case in a 33-year-old airman. The most prevalent type of group A streptococcus isolated from throat swabs was M-type 5 and there was serological evidence that at least four of the rheumatic fever (R.F.) cases were due to this type.

Among the patients with uncomplicated throat infection the anti-streptolysin O (ASO) and anti-deoxyribonuclease B (anti-DNAase B) responses were in general rather low, even where there was evidence of protective antibody against type 5. However, a combination of the results of the ASO and anti-DNAase B tests gave an estimate of the extent of streptococcal infection 15–25% higher than did either test alone.

The titres of antibody to M-associated protein (MAP) were ≥ 60 in all the r.f. patients, and in about 50% of the other patients with ASO titres ≥ 200. This figure is unusually high compared with data from several other outbreaks of streptococcal infection due to different serotypes and also greatly exceeds comparable figures for cases of sporadic sore throat and acute glomerulonephritis.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1974

References

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