82 CITY MILK SUPPLY 



bottle epidemics are not rare by any means. What the danger from 

 this source is should be clearly understood. Not every can or bottle 

 that goes into premises harboring contagion is infected. In fact probably 

 but few of them are and those are the ones with which the victim of the 

 disease or perhaps his attendants come into direct or indirect contact; 

 the others escape infection. Perhaps the likelihood of infection is greatest 

 where the patient is coming down with the disease or is convalescing 

 for in these stages he is about and helping himself. However, if bottles 

 are handled by the patient's nurse or are carried into the sickroom there 

 is danger throughout the illness. There are but two safe courses for 

 the milkman to pursue. The better is to insist on leaving no bottles 

 during the illness but instead to pour the milk into a covered container 

 furnished by the householder. The other way is to leave bottles as 

 usual but to carry none away till the sickness is over and then to make a 

 special trip for them and disinfect them thoroughly by themselves. 

 The objections to this way of doing are twofold, namely: (1) that many 

 bottles accumulate at the residence, to the annoyance of the house- 

 holder, and to the cost of the dairyman ; and (2) that there is some danger 

 in returning infected bottles to the dairy. The board of health of Mont- 

 clair, N. J., has met the danger of infected bottles in a commendable way 

 by informing the dairymen concerned, of the presence of contagion as soon 

 as the board itself is notified by the attending physician of the case. It is 

 recognized that this mitigates the evil rather than prevents it for in the 

 prodromal stage, while the case is under observation by the physician 

 it may be infectious and do damage. However, this notification protects 

 both dairymen and the public to a considerable extent, and it is to be 

 regretted that it has not been generally adopted. 



As an example of an epidemic, caused by infected cans that at 

 Savannah, Ga., in 1907, will suffice. Sixty-three of the 95 cases appeared 

 on the route of a wholesaler who supplied, among others, a depot that 

 was located in a bake shop over which there was a case of typhoid fever. 

 The cans were returned unsterilized and so used, to supply other cus- 

 tomers. 



Of late years many epidemics have been traced to the use of infected 

 bottles. In Montclair, N. J., in 1901, cases of diphtheria suddenly 

 appeared on one of the most prominent dairy routes of the town. Cul- 

 tures were taken from the throats of the entire dairy crew and two of 

 them proved positive. The crew was isolated and delivery of the milk 

 suspended for 3 days. New cases ceased to appear within 2 days after 

 the dairy was closed. In all there were 57 cases, 22 in Montclair and 

 35 in neighboring towns. The crew remained isolated for 3 weeks during 

 which period virulent bacilli were found at one time or another in the 

 throats of 17 of the men. At no time were any of the men ill or did they 

 exhibit clinical symptoms other than a reddening of the throats of the 



