SHORTER ARTICLES 



87 



SHORT EH AETICLES 



THE EPIDEMIC OF TYPHOID 

 FEVER AT PAW ALTO. 



In the spring f 190S, the university 

 community at Palo Alto was startled 

 to find that in about two days upwards 

 of one hundred and thirty students 

 and about a hundred other people — 

 most of them living in the town of 

 Palo Alto, but a considerable number 

 also in fraternity houses on the uni- 

 versity campus — were attacked by ty- 

 phoid fever. The Students' Guild, the 

 cooperative hospital association of 

 Stanford University, immediately' set 

 to work upon the problem of furnish- 

 ing hospital service, while the depart- 

 ment of hygiene of the university and 

 the board of health of the town of 

 Palo Alto devoted themselves to the 

 investigation of possible causes for the 

 outbreak. 



The university town, with a popula- 

 tion of about four thousand, was en- 

 tirely new and its health conditions 

 were ordinarily of the very best, there 

 being no slums, cesspools or foulness 

 of the ordinary sort. Every sanitary 

 precaution had been taken in the lodg- 

 ing of students. The water supply was 

 above suspicion, being drawn from 

 deep-driven wells. The whole difficulty 

 was finally traced to a single small 

 daily, the milk of which had been the 

 source of the infection. 



A full account of all elements con- 

 cerned in this case has been published 

 in a pamphlet for free distribution, by 

 Professor J. C. L. Fish, of Stanford 

 University, president of the Board of 

 Health of Palo Alto, together with 

 analyses of reported cases by Dr. C. D. 

 Mosher, and a discussion of the source 

 of infection of the milk supply by Dr. 

 William F. Snow. In view of the les- 

 son to be derived from this case and 

 from the nearly parallel outbreak at 



Cornell University which preceded it, 

 an account of the method of infection 

 may be found interesting and useful. 



The report shows that there were no 

 cases of typhoid fever in Palo Alto, so 

 far as known, between 1894 and 1903. 

 On investigation it was found that the 

 one thing in common which connected 

 the different houses in which cases 

 were reported, was the milk supply. On 

 further investigation it was found that 

 the milk man got a portion of his milk 

 from a Portuguese dairy about five 

 miles from the university on a little 

 brook tributary to Los Trancos Creek. 

 Samples of the water used in washing 

 the cans and cooling the milk were ex- 

 amined by bacteriologists and found 

 to contain large quantities of the 

 bacillus coli communis, the well-known 

 bacillus of typhoid fever. 



The investigation of the sources of 

 infection at the Portuguese dairy reads 

 like the plot of a tragedy. The scene 

 is laid in the month of December, 1902, 

 at Stanford University and Palo Alto 

 and the immediate vicinity. The 

 dramatis prrsonce are taken from 

 homes all over the country. The 

 Serpa house, where the trouble begins, 

 is situated on the banks of the Madera 

 Creek, three miles above Mayfield. A 

 cousin, from San Francisco, comes to 

 visit the Serpas. Soon after his ar- 

 rival lie complains of feeling ill, and 

 .Mrs. Serpa nurses him; she does not 

 consider him sick enough to demand 

 the services of a physician. One week 

 later the relative is better, but Mrs. 

 Serpa is quite sick herself and Serpa 

 calls in a doctor, who pronounces the 

 case one of typhoid fever. A few days 

 more and two of the Serpa children are 

 taken ill with symptoms identical with 

 those of the mother and the cousin. 

 Serpa now becomes thoroughly fright- 



