Streptococcal infections among children in a residential home: III. Some factors influencing susceptibility to infection

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Abstract
Children in a residential home whose tonsils had been removed had lower attack rates for streptococcal sore throat than tonsillectomized children. Tonsillectomy did not have a consistent effect on respiratory tract illness. Tonsillectomy has a similar effect on the outcome of individual exposures to streptococcal infection; the difference was more marked for illness than for simple colonization. The apparent benefit from tonsillectomy could not be attributed to the ageing of the child, and was considered real. Its magnitude did not seem, however, great enough to justify a policy of extensive tonsillectomy, particularly in view of the possible risks to the child. A child who had been ill with infection due to one streptococcal type rarely became ill when re-exposed to the same type. In addition there was some evidence in children with tonsils of an immunity, perhaps short lived, which was clearly not type-specific.