MILTON J. ROSENAU 415 



eight out of twenty-seven samples of market milk tested. It was long assumed that 

 B. abortus could not be pathogenic for man in view of the frecjuency with which this 

 virus is found in milk and the infrequency of the infection in man. However, it has 

 recently been disclosed that some strains are pathogenic, and about 100 cases of this 

 disease in man have been recorded. The interesting bacteriological and immunolog- 

 ical relationships are being studied. 



Epidemic arthritic erythema. — An outbreak of this infection occurred at Haver- 

 hill (Mass.), in January, 1926, involving eighty cases, with no deaths. It was studied 

 by Place, Sutton, and Willner.' The disease resembles dengue clinically, has a sharp 

 onset with a chill, fever, headache, and toxic manifestations. The eruption resembles 

 that of dengue, is measly or rubilliform, and affects especially the extremities. Pain 

 and swelling in the larger joints are common features. The period of incubation is 

 two to three days. All except one of the cases cited drank raw milk from the same 

 dairyman. The source of the infection was not traced. Place and his associates have 

 isolated a gram negative, non-spore-bearing bacillus which seems to be the cause of 

 the trouble. A similar outbreak occurred during May-June, 1925, at Chester (Pa.), 

 involving four hundred cases with no deaths. This epidemic was first diagnosed as 

 dengue.^ 



Foot-and-mouth disease. — Foot-and-mouth disease is an infection primarily of 

 cattle and secondarily of man. It is caused by a filterable virus, and is noteworthy 

 for being the first ultramicroscopic virus of animals to be discovered (Loefiler and 

 Frosch, 1898). The infection is transmitted to man through the ingestion of raw milk, 

 buttermilk, cheese, or whey from diseased cows. Children are not infrequently in- 

 fected by drinking unboiled milk when the disease is prevalent in the neighborhood. 

 In man the disease is mild. The symptoms resemble those observed in animals: There 

 is fever, sometimes vomiting, painful swallowing, heat and dryness of the mouth, fol- 

 lowed by an eruption of vesicles in the buccal and mucous membranes, and very 

 rarely by similar ones on the fingers. The vesicles are about the size of a pea; they 

 soon break, leaving small erosions, which rapidly heal. The disease is seldom fatal ex- 

 cept occasionally in very weak children. 



Diarrheal infections. — Milk may be responsible for gastro-intestinal troubles, some 

 of which are specific. Bacillus enteritidis and its congeners grow well in milk and are 

 the cause of milk-borne outbreaks of food infection. Fresh-milk products are also re- 

 sponsible. 



Dysentery has been traced to milk in a number of instances. Dysentery bacilli 

 grow well in milk, and infected milk is one of the common causes of infantile diarrheas. 



Milk is usually too acid for the vibrio of cholera. 



One of the chief causes of the high infant mortality is summer diarrheas, but even 

 these are not all due to stale, dirty, and bacteria-laden milk. Many of the diarrheal 

 diseases of infancy are true cases of bacillary dysentery, which is transmitted in a 

 great variety of ways. However, the improvement in the milk supply for babies has 

 directly, and in large part indirectly, resulted in a decrease in infant mortality in recent 

 years. 



' Place, E. H., Sutton, L. E., and Willner, O.: Boston M. b° S. J., 194, 285. 1926. 

 2 Report (unpublished) by Armstrong, C: U.S. Puh. Health Sen., July 18, 1925. 



