DISEASES COMMUNICABLE IN MILK 69 



caused serious epidemics. The vibrio requires a neutral or slightly alka- 

 line medium for growth and apparently for this reason milk has played 

 a less prominent part in its spread than has other food, since, as in typhoid 

 fever, the lactic organisms exert a protective action. Alexandrine and 

 Sampeto found that the limit of acidity the vibrio will stand in milk is 

 less than 1 per cent, calculated as lactic acid. In their experiments the 

 cholera vibrios lived in ordinary milk at room temperature 11 to 63 

 hours or until prohibitive acidity had been reached. At 98.7F. the 

 vibrios usually disappeared in 6 to 8 hr. Kendall, Day and Walker found 

 that in pure culture the vibrios produced acid coagulation of milk by the 

 end of the third day. 



Simpson, the health officer of Calcutta, reported that nine cases of 

 cholera occurred on a ship there, 10 of whose men had obtained milk from 

 a native. One drank but little of the milk and escaped, four died of 

 cholera and five were very sick with diarrhea. Eight others who had con- 

 densed milk only and who did not touch the suspected milk were not ill. 

 Dejecta from a cholera patient found access to a water tank near the 

 dairy and the milkman confessed diluting his milk one-fourth with water 

 from the tank. 



Heine and others have shown that the cholera spirillum soon dies out 

 in butter and he failed to find the organism after 1 or 2 days in cheese. 



The paucity of well- authenticated epidemics of this disease attribut- 

 able to milk, together with the other facts that have been given regarding 

 the limited life of the vibrios in milk and its products, indicate that 

 relatively milk is not an important factor in disseminating the disease. 



Diphtheria. Diphtheria is caused by B. diphtheria and is spread in the 

 secretions of the mouth and nose. Droplet infection and infection from 

 objects mouthed or handled either by those ill with the disease or by 

 bacillus carriers are common modes of infection. Milk is often the medium 

 through which the contagion is spread. The first epidemic in the United 

 States attributed to milk seems to be that in the cities of Maiden and 

 Melrose, Mass., in 1886. Hart and Busey, and Kober list 28 milk-borne 

 epidemics and Trask 23, making 51 in all; many others must have oc- 

 curred. Of Trask's outbreaks, 15 occurred in the United States and 

 eight in Great Britain. 



Scarlet Fever. Scarlet fever seems to be spread in the secretions of 

 the nose, throat and respiratory passages and in purulent discharges from 

 the ears. Hart and Busey, and Kober list 74 epidemics due to milk; to 

 these maybe added 51 gathered by Trask, making 125 in all. Of Trask's 

 51 outbreaks 25 were in this country and 26 in Great Britain. The first 

 recorded outbreak attributed to milk in the United States appears to be 

 that at Putnam, N. Y., in 1890. 



Septic Sore Throat. Is a malady that is characterized by a sudden 

 onset, high and irregular fever, inflammation of the fauces, marked en- 



