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This debate presents a nice example of conventional teachings that carry a
lot of weight despite a paucity of evidence.

1.  “GAS is unusual in infants and toddlers.”
This is nothing more than a self-fulfilling tenant.  If you don’t look for
it, you won’t find it.

2.  “Infants and toddlers don’t get rheumatic fever.”
RF is rare, but autoimmune diseases as a group are not.  GAS has already
been associated with neurologic, cardiac and renal autoimmune disorders.  We
don't know the dormancy period nor the cascade of triggers.  GAS in infancy
might very well be a risk factor.  We just don't know.

3.  “They’re just carriers.”
This is particularly worrisome.  It's based on an overly constricted idea as
to what the signs and symptoms of Strep are supposed to be.

Just trying to maintain a questioning attitude,
D.J. Scherzer, MD
PEM
Nationwide Children's
Columbus, OH

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