Abstract
In Reply .—I agree with Tanz and Shulman that there is a need for an operational definition of the GAS carrier state, and, in fact, I have proposed an operational definition similar to the one they have used. 1 I also agree that it is not necessary to routinely identify carriers, but there are some circumstances in which identification and termination of the carrier state would be desirable. 1 These situations would include the following: families in which there is an inordinate amount of anxiety about GAS; families with a history of rheumatic fever; families in which ping-pong spread of GAS has been occurring; outbreaks of GAS pharyngitis in closed or semiclosed communities; and cases in which tonsillectomy is being considered only because of chronic carriage of GAS.
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