Streptococcal control in grade schools

Streptococcal infection has been reduced by some school-centered programs. This controlled study evaluates the relative effectiveness and cost of four different school programs: (1) Each day, throat specimens from children with sore throats were cultured. (2) Each week, all children were inspected and specimens from those with signs of pharyngitis were cultured. (3) Specimens from all students were cultured once each month. (4) Same as protocol 3, but students with positive cultures were excluded from school until they began receiving therapy. Schools using protocols 1 and 4 had substantial reduction in streptococcal prevalence. The monthly "all-student program" was most economical in terms of volunteer time, classroom interruption time, and money. The school culturing program may have contributed to a significant decline of rheumatic fever in the county during the study.