The presence of group A streptococci in the upper respiratory tract (URT) may reflect either true infection or a carrier state. In either state, the patient harbours the organism, but only in the case of a true infection does the patient show a rising antibody response. In the carrier state there is no rising antibody response. It is thought that a patient with a true infection is at risk of developing RF and of spread- ing the organism to close contacts, while this is not thought to be the case with carriers (1, 5, 10). Therefore, many professionals feel that only patients with true infections need to be.