Rheumatic Fever and Streptococcal Infection

This is an historical review of the development of our knowledge of the clinical picture, etiology, pathogenesis, and prevention of rheumatic fever and rheumatic heart disease over the past four centuries. Benedict Massell examines the major contributions of both clinicians and investigators to our current understanding of rheumatic fever as a separate disease form. Elucidating many facts about this dread disease, Massell examines the frequent epidemics in training camps during World War II, discusses our growing understanding of the pathogenesis and mechanisms by which streptococcal infections cause the disease, and shows the important progress made in prevention through the use of penicillin and other antibiotics. He includes a discussion of the many problems which can hinder our understanding and control of this disease, as well as recent promising developments in the clarification of the molecular structure of the streptococcal protein and the possible application of this information to the development of a safe and effective vaccine for the prevention of streptococcal infection.