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Rheumatic Fever in Children and Adolescents: A Long-term Epidemiologic Study of Subsequent Prophylaxis, Streptococcal Infections, and Clinical Sequelae: IV. Relation of the Rheumatic Fever Recurrence Rate per Streptococcal Infection to the Titers of Streptococcal Antibodies

ANGELO TARANTA, M.D.; HARRISON F. WOOD, M.D.; ALVAN R. FEINSTEIN, M.D.; RITA SIMPSON, B.A.; and EDITH KLEINBERG, B.S.
Ann Intern Med. 1964;60(2_Part_2):47-57. doi:10.7326/0003-4819-60-2-47
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Only 3 per cent (2), or less (3), of Group A streptococcal infections are followed by rheumatic fever. The factors that must be present in this minority and absent in the majority of infections, to account for the difference in outcome, have not yet been determined. It has been postulated that only a portion of the population may be susceptible to rheumatic fever, possibly on a genetic basis (4). However, even patients whose susceptibility to rheumatic fever is known by virtue of a definite previous attack of the disease often fail to develop it again after a subsequent Group A

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