252 CITY MILK SUPPLY 



sore throats, but his data does not indicate that these throats are in any 

 way dangerous to milk consumers. However, some sore throats are so, 

 for they may in reality be diphtheritic or of an infectious streptococcal 

 nature. Diphtheria is certainly carried by milk and there is some 

 evidence to indicate that employees of milk plants who were working 

 when they had septic sore throat infected the milk with that disease. 

 So, even mild throat affections may be of importance and need attention. 



Some of the certified dairies pay a good deal of attention to the health 

 of their employees. Campbell states that the certified dairies around 

 Chicago began the medical inspection of their employees in November, 

 1912, and since then employees coming into contact with the milk have 

 been examined at least once a month, except during the recent epidemic 

 of aphthous fever when other arrangements had to be made. Only those 

 who have been vaccinated are employed. Applicants for employment 

 are questioned as to recent illness, as to whether they have had diphtheria, 

 typhoid fever, or are subject to frequent tonsillitis. They are also asked 

 whether they have recently been in contact with a sick person. Each 

 applicant is examined for disease of the eyes, skin of the face, neck, arm 

 and hands and the condition of the finger nails is noted. He is also given 

 a careful physical examination for tuberculosis. Applicants showing signs 

 of conjunctivitis, tuberculosis, syphilis or other venereal diseases, or any 

 suppurative process or any disease of an infectious character, are rejected. 



A card index of every employee on each farm is kept; the points re- 

 corded are the replies to 27 questions and the findings of physical exami- 

 nations. A separate card index is kept of the monthly medical examina- 

 tion; 10 items are recorded, among them being the temperature, pulse, 

 condition of the eyes, of the skin and of the throat. 



Since November, 1912, 775 primary medical examinations, 1,975 

 medical examinations and 315 throat cultures have been made. Of the 

 primary examinations 38 per cent, were of persons of foreign birth. 



In most milk plants the superintendent has to rely on the uncertain 

 method of accepting the man's own opinion as to whether he is fit to work 

 or not. Typhoid and paratyphoid fevers are the communicable diseases 

 most likely to be spread through the urine and feces. With these mala- 

 dies, too, symptoms may be misleading or lacking so that the mildly sick 

 do not attract attention and continue at work till the route is plainly 

 infected which usually leads to their discovery. Also, there are carriers 

 of diphtheria and probably of scarlet fever. So, every effort should be 

 made to reduce as far as may be the danger from these diseases -by in- 

 structing the employees as to the infective nature of the several dis- 

 charges and by teaching them to keep their hands away from their faces 

 and to wash after using the toilet. It is also important that they be 

 made to understand that the milk should not come into contact with the 

 hands; probably most of the men exercise proper care in this matter but 



