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H. A. Valkenburg, M. J. Haverkorn, W. R. O. Goslings, J. C Lorrier, C. E. de Moor, W. R. Maxted, Streptococcal Pharyngitis in the General Population. II. The Attack Rate of Rheumatic Fever and Acute Glomerulonephritis in Patients Not Treated with Penicillin, The Journal of Infectious Diseases, Volume 124, Issue 4, October 1971, Pages 348–358, https://doi.org/10.1093/infdis/124.4.348
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Abstract
Rates of attack for rheumatic fever and for acute glomerulonephritis were calculated for patients with streptococcal pharyngitis who were seen by their physician and for people who did not consult a physician for their sore throat. A total of 27 general practices were involved that covered a total population of 57,500 people of all ages. In the two sample studies that comprised 1,720 people, between 7% and 25% had pain on swallowing, but only 0.3% and 0.7% of the respondents had streptococcal pharyngitis with a significant antistreptolysin O response. The annual incidence of rheumatic fever was 19 per 100,000, and of acute glomer-ulonephritis, 20 per 100,000 population. Rates of attack for rheumatic fever varied between 0.14% and 1.70%; for acute glomerulonephritis the rates varied between 0.03 % and 4.44 %. Only 9 % of the patients with streptococcal sore throat saw a physician. Furthermore, 89% of the carriers of Group A streptococci and 76% of the patients with streptococcal pharyngitis accompanied by a significant change in antistreptolysin O would not have sought medical advice because they did not experience pain on swallowing.
