62 CITY MILK SUPPLY 



cow was tuberculous and showed her to be suffering from an extensive 

 and acute inflammation of one quarter of the udder and that the milk 

 from this quarter was contaminated with pus and blood. Microscopical 

 examination of the milk showed numerous polymorphonuclear leukocytes 

 and many streptococci in fairly long chains of 16 to 10 elements. At- 

 tempts to isolate the streptococci failed. In the opinion of the veteri- 

 narian the cases of illness reported on the milk route of A were due to the 

 infected milk of B's cow for the following reasons: 



1. All the 55 cases of illness in 31 homes occurred on A's milk route. 



2. In 23 of these 31 homes, those who become ill consumed milk from 

 bottles known to have been filled with the product of B's dairy. 



3. The distribution of 28 quart bottles filled with milk from B's dairy 

 will account for illness in eight homes where the milk from quart bottles 

 was consumed. Only 13 quart bottles filled with milk from other dairies 

 were distributed on the date in question. 



4. All cases of illness were of similar character and occurred on the 

 same date. . 



5. No more cases of illness occurred after milk from the infected udder 

 was discarded. 



6. Cases of illness occurred in both the families of A, the distributor, 

 and B, the dairyman. 



7. No other common food supply to cause the illness in 31 homes was 

 found. 



Out of a total of 82 qt. of milk distributed by dealer A on the 15th, 

 74 pt. of milk and 41 qt. of milk were accounted for and it was found that 

 364 people ate at the tables where this milk was served, 323 of whom 

 drank the milk or used it in coffee or on cereals. Of this number 268 

 remained well and 55 or 20.5 per cent, took sick. 



The repeated acute attacks of gastro-enteritis that occurred among 

 the residents at, and visitors to a farm in the Phillipine Islands over a 

 period of 3 years were shown by Barber to be due to a toxin elaborated 

 by a white staphylococcus that occurred in almost pure culture in the 

 udder of a cow, that was apparently in good health at all times except for 

 a single attack of garget that occurred after the cases of gastro-enteritis 

 had begun. The fresh milk was harmless and the toxin was produced 

 only after the milk had stood some hours at room temperature. Persons 

 using the milk continuously apparently developed some tolerance to the 

 toxin. Two children used the milk regularly but never had attacks. 

 Adults had light attacks and in one or two instances developed cases of 

 chronic intestinal trouble. Visitors to the farm and Filippino employees 

 had the worst cases. On discontinuance of the milk of the infected cow 

 all trouble ceased. 



Gastro-enteritis Caused by Fecal Contamination. Some diarrheal 

 infections may be derived from perfectly healthy animals that are handled 



