“…In Miami, Florida, very few cases of rheumatic fever are reported despite the rather high frequency with which group A streptococci can be isolated from throat cultures made routinely throughout the year in school children (45). It is highly significant, however, that the antistreptolysin O titers observed in these children is very much lower than that seen in the same age group in the large cities of the temperate zones of the United States and that the magnitude of the rises reported is small compared with that of children infected with streptococci in areas where rheumatic fever is relatively common.…”