Before antibiotics strep was often the precursor to rheumatic fever and scarlet fever - once the strep infection took hold it spread and could cause a variety of damage to the heart, joints, and other parts of the body. Death was always a significant possibility with these ailments.
Penicillin became prevalent in the treatment of strep in the 1950's and 60's. As a child I had a number of "strep throat" episodes. This usually involved diagnoses at home via "white bumps" on your tonsils by mom. Then a trip to the doctor to get a "swab test" where a cotton swab was whipped over your tonsils and sent off to a lab. Finally you received a prescription for, at least in my case, penicillin.
With my own children this model was accelerated (1980's and early 1990's). Often doctors would simply prescribe amoxicillin for any child who even remotely complained of a sore throat or ear ache.
Today my grandchildren are bombarded with antibiotics (often much more potent than penicillin and amoxicillin) almost weekly it seems.
I have written about what I think about this process in "Antibiotics - Scourge on Humanity."
So what about Pandas?
Basically, the short form is this: Pandas is thought to be a low-level strep infection that triggers neurological problems like tics and Obsessive Compulsive Disorder (OCD).
A typical "Pandas" story is found here. Basically a "normal" child suddenly and inexplicably goes "wacky" - tics, OCD, mood swings, depression, all sorts of "mental health" problems. The solution, after much struggle by health practitioners to diagnose it, is typically long-term antibiotics to treat strep. These children typically have a some sort of history with strep. The remarkable thing is that the antibiotics fix the neurological problems very quickly - antibiotics typically do not treat neurological disorders in any way.
So the thinking is that the strep is causing some sort of damage to the brain.
There are many interesting points about this.
First off, this is a relatively new disorder - only identified in the medical literature during the last 15 years or so. The first cases were children who were thought initially to have Tourette's Syndrome.
Pandas is not a "recognized disease" in that no direct cause/effect relationship has been established - the link to strep is only suspected at this point. The diagnostic process is complex - see this link.
Secondly, strep has been a scourge of humanity for millenia - yet Pandas has only been known for a very short time.
Third, strep was not previusly associated with neurological problems.
Fourth, OCD can apparently be triggered by strep and such cases cured by antibiotics.
Fifth, it only seems to affect children.
Various theories abound about how strep might be involved in Pandas.
See this at the NIH.
See this at the Australian ADHD site.
But the bottom line is that no one knows.
What i find troubling is that this is something "new"...
Could it be the result of too many antibiotic prescriptions over the last several decades mutating strep into something new?
Its hard to say...
Treating children for long periods with antibiotics in my mind is a very bad things for several reasons (see my recent post, for example, related to "Fecal Transplants").
There's a good site here for parents who suspect their child suffers from Pandas.
The bottom line is that this is a new and serious problem.
Prior to this I had never heard of bacteria-related medical problems triggering these kinds of neurological problems in children.
Since its new I also have to wonder what role modern "medical science" has played in its creation.