REPORT ON A TYPHOID EPIDEMIC. 



BV DAVID \VIIJU:R HORN, Ph.D. 



On September i2lh, [915, the Board of Healtli of Chelten- 

 ham Township, Montgomery County, Pennsylvania, became 

 aware of the presence in that vicinity of a rapidly growing 

 number (jf cases of typhoid fever. Tiie cases were located 

 not only in Cheltenham Township, but also in Moreland and 

 Abingdon Townships and in Jenkintown. The writer was 

 employed on September i4tli, l)y the Board of Health of Chel- 

 tenham, to locate as quickly as possible the probable source of 

 the infection, in order that proper measures against the fur- 

 ther spread of the disease might be taken. 



The outset of the disease was typical of a milk-borne 

 epidemic. The accompanying diagram shows clearly the 

 differences between milk-borne and water-borne typhoid, in 

 "rather exaggerated cases of two of these types of epidem- 

 ics. "■" Other factors that were considered are included in the 

 following report, which was written on the 14th of September 

 and submitted in this form to the Cheltenham Health Board. 

 It was read before the Delaware County Institute of Science 

 on September 27, rgts. 



R EPORX 



The sudden onset of typhoid fever in Cheltenham and 

 vicinity is indicative of a milk-borne typhoid. All cases 

 appeared within a week or less, and all reported have been in 

 families using milk from Overlook Farms. The fact that no 

 previous case of typhoid fever was known to the authorities 

 of Overlook Farms or to the Board of Health, to which these 

 cases could be traced, suggested strongly that a case of 

 " walking typhoid " or else a " typhoid carrier " was proba- 

 l)ly rtsponsible for the epidemic. The fact that typhoid fever 

 had never previously been traced to Overlook F'arms milk, 

 along with the fact that the milk has come from the same 

 sources for years, suggested that the typhoid was more likely 



*\Vliippk-, Typhoid I'ever. Xew York, 1908, p. 2iu. 



