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The prophylaxis required to control an epidemic of Streptococcus pyogenes throat infection in a junior detention centre has been reported. In a further epidemic an attempt was made to determine the minimum amount of penicillin required to control the outbreak. Oral penicillin (0.5 g) given as a single daily dose for 10 days to all boys after entry proved effective. The added risk of relatively deprived adolescent boys developing rheumatic fever is stressed.

This communication presents the concept that recurrent infections of the lingual tonsils, lateral pharyngeal lymphoid bands and lymphoid follicles on the posterior pharyngeal wall, occurring with the same periodicity, is a cyclic clinical and immunological entity. These patients lacked resistance to the normal flora of the nasopharynx and pharynx. They were accordingly treated with a mixed respiratory bacterial vaccine, administered intradermally and according to a formulated program, to improve resistance or immunity of the lymphoid tissue. These patients showed definite improvement by this method of therapy. It is suggested that the effectiveness of therapy was accomplished through the immunological process of cell-mediated immunity. The immunobiologic development of cell-mediated immunity by T thymic-dependent cells and humoral immunity by B cells is briefly discussed.