THE CASPER PROJECT-AN ENFORCED MASS-CULTURE STREPTOCOCCIC CONTROL PROGRAM

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Abstract
A program for reducing the incidence of streptococcic disease was instituted in a system of primary schools involving 6,460 children. All children with symptoms of respiratory infection were inspected daily; a culture was made from the nasopharynx of every child with signs of streptococcic infection; any child found infected with betahemolytic streptococci was excluded from school until antibiotic therapy had been started or (if such therapy was refused) until a negative culture was obtained. The program was found to be workable without any disruption of school routines. The co-operation of parents was excellent, and the project was financed without difficulty. On the basis of experience in the past, 18 and 27 new cases of rheumatic fever would have been expected for the school years 1955-1956 and 1956-1957 respectively; instead, only 3 and 2 cases were found. Enforced treatment or exclusion of school children infected with streptococci was found to be practicable. It was effective in reducing the incidence of rheumatic disease and valuable as a community educational effort.

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