“…However, this does not apply to our population, since in Israel during the last two decades the rheumatogenic types have remained constant and relatively high (18%-33% of all positive throat cultures; A. Beck, personal communication). Some observers have reported a declining incidence of carditis [3,10,12,14], suggesting that RF is becoming a milder disease. However, Denny [7] questioned this last finding based on data derived from various countries in different areas of the world [1,11,18].…”