78 CITY MILK SUPPLY 



examples of this having happened can be cited, yet instances are known 

 where cities have forbidden the delivery of milk from certain farms 

 whereon the cows had access to heavily polluted streams. 



Commonly infection at the farm is caused by some one living thereon 

 contracting the disease and either directly himself or indirectly through 

 his attendants infecting the milk. It is of prime importance to inculcate 

 cleanly habits among those engaged in dairying. They should be told 

 frankly that nasal discharges, saliva, feces and urine are all likely to be 

 infectious and that decency and safety alike require them to refrain from 

 spitting on the hands at milking and from blowing the nose with the 

 fingers. Above all the necessity of washing the hands after attending 

 to the toilet should be impressed upon them. The part played by feces, 

 fingers and flies in distributing infection should be carefully borne in 

 mind. Of epidemics originating at the farm a brief account of a few 

 will serve as examples. 



Milkers caused an outbreak at Brookline, Mass. Two of the dairy- 

 man's children came down with diphtheria and were removed to a hospital. 

 No diphtheria bacilli were found in other members of the household. 

 Three weeks later cases of diphtheria began to appear in Brookline in 

 four of the seven or eight families that used the milk. Reexamination 

 of the members of the family and of others handling the milk showed 

 virulent diphtheria bacilli in the throats of three men, of whom two were 

 at the time milking the cows. 



Persons who nursed the sick and also cared for the milk caused 16 

 cases of typhoid fever at Washington, D.C.,in 1905; half of the cases were 

 in the family on the farm. 



A mother who nursed members of her family sick with typhoid fever 

 and also milked the cows caused 55 cases of that disease at Philadelphia 

 in 1903. 



Milk may be infected at the farm through contact with milk utensils 

 such as brushes, strainer cloths, cans, coolers, separators, etc., which 

 have been infected either by the sick or those nursing them. At 

 Providence, R.I., 1895, 31 cases of typhoid fever and three deaths were 

 caused by a mother who was nursing the sick, washing the strainer cloths 

 and utensils. At Lynn, Mass., in 1906, 31 cases of typhoid fever came 

 from a boy ill with the disease washing the bottles. A person who washed 

 the cooler of a dairy and at the same time cared for a child sick with 

 diphtheria caused 72 cases of that disease in 1907 in Milton, Dorchester 

 and Hyde Park, Mass. 



Water supplies on farms and in milk plants are often held responsible 

 for typhoid fever outbreaks. Water that is used for washing utensils, 

 cooling the milk or diluting it, may be the source of trouble. The 

 outbreaks that have been attributed to washing utensils with polluted 

 water are very many. Fourteen cases at Swampscott, Mass., in 1905 



