DISEASES COMMUNICABLE IN MILK 83 



two men that were first picked out. It seems that it was the custom of 

 the dairy to leave bottles at homes during the course of contagious dis- 

 eases and at the removal of quarantine to carry them back to the dairy 

 and sterilize them before using them. In winter the breakage was 

 considerable and so to avoid this loss the bottles were kept in a safe place 

 till the advent of warm weather when the whole batch was sterilized at 

 once. It transpired that about 1 week prior to the appearance of the first 

 case of diphtheria in Montclair the two men who were first removed 

 from the crew were sent down to a shanty to boil out the winter's stock 

 of infected bottles. They finished the job, returned to their quarters 

 and were milking as usual that evening; so the explanation of the out- 

 break is manifest. 



In December, 1902, in Montclair, N. J., the author investigated a 

 typhoid fever outbreak that appeared on the route of a dairyman whose 

 brother produced the bulk of the suspected milk but who also handled a 

 small amount that he purchased from a wholesaler whose supply came 

 from 10 different farms. Searching investigation at all of the 11 farms 

 under suspicion failed to reveal any cases of typhoid fever thereon or 

 that any employees had quit them for any reason. The dairyman 

 volunteered the information that he believed that it was the wholesaler's 

 milk that was infected for the disease was wholly confined to this pint- 

 bottle customers for which trade the wholesaler's milk was solely used, 

 the quart-bottle customers being entirely supplied from his brothers 

 farm. This led to a close reexamination of the wholesaler's business 

 but no apparent cause of infection was discovered nor were there any 

 cases of typhoid fever found on a retail route run by the wholesaler in 

 Newark, whereas inquiry in Bloomfield showed that the dairyman had 

 cases on his delivery route there. These facts, coupled with the admis- 

 sion on the part of the dairyman that he had not sterilized his bottles 

 thoroughly, led to the conclusion that the epidemic was caused by 

 infected bottles and to the withdrawal of the supply from town. The 

 outbreak which at the time was on the increase stopped within 2 weeks 

 thereafter. The reason why not a single quart-bottle customer in either 

 of the two affected towns developed the disease was a mystery. It was 

 ultimately solved by the discovery that a case of typhoid fever had come 

 to Montclair from New York City and pending removal to the local 

 hospital had remained in a household where the dairyman daily left 

 and took away three pint bottles. The bottles that were removed were 

 not sterilized but merely washed out, filled and served to other families. 

 Had the case been reported to the board of health as the law required or 

 had the dairyman faithfully sterilized the bottles the epidemic never 

 would have occurred. 



Infection of Milk in Delivery. Milk may be infected on the delivery 

 route. At Clifton, a suburb of Cincinnati, Ohio, in 1906, the milk of a 



