Milk-borne Septic Sore Throat and Scarlet Fever and Their Relation to Beta Hemolytic Streptococci

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Abstract
A short review of the present status of Streptococcus epidemicus as a sp. is given. Evidence is presented that neither capsule for-mation nor moist growth on blood media holds sufficiently to be used in designating a sp., and that at present the strains of hemolytic streptococcus from septic sore throat not otherwise placed by agglutinin absorption should be termed Strep. hemolyticus. Strains of hemolytic streptococci from milk-borne epidemics of scarlatina and of septic sore throat, and from other sources, were studied to determine their serologic relationship to the authors'' type strains from scarlatina and erysipelas, and to each other. Strains from septic sore throat in the 3 Massachusetts outbreaks of 1928 fell by agglutinin absorption partly into the authors'' largest scarlatina group, type I and subtype I, and partly into 2 other groups. These 2 newly discovered agglutinative groups are called epidemicus (or septic-sore-throat) types I and II. Septic-sore-throat and scarlatina strains may occur in the same epidemic, composed of cases classed mostly as scarlatina. A scarlatina type of organism may be recovered from cases recorded clinically as constituting a septic sore throat outbreak. Exotoxins of similar quality as regards neutralization ability, but of varying quantity, were produced by all of these type strains. It is concluded that milk-borne epidemics of septic sore throat and of scarlatina may be caused, respectively, by one or several agglutinative types of hemolytic streptococci: When scarlatina predominates, usually the epidemic strain belongs to one of the common scarlatina agglutinative types; when septic sore throat predominates, the epidemic strain may be one of several agglutinative types, respectively.

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