To the Editor.—In response to Dr. Austrian's comments, I admit to being by nature a pessimist but not a defeatist. Studies are already in progress along the lines that he suggests.
Our series now consists of 17 episodes of pneumococcal bacteremia in children with sickle cell anemia. The serotypes are as follows: type 1, one; type 3, one; type 4, one; type 6, five; type 12, one; type 14, four; type 18, one; type 23, two; and type 24, one.
Thus, it appears that certain serotypes are definitely appearing to be more common. We are examining the specific antibody response of the children with sickle cell anemia and documented pneumococcal infections to see if the response is comparable to that of normal children.
Secondly, we are doing a cross-sectional survey of a large number of our children to determine specific pneumococcal antibody profiles. These data will then provide the