214 BACTERIOLOGY FOR NURSES 



the disease. Plymouth received its water from a mountain stream 

 which drained an almost uninhabited watershed. The infection 

 was traced to a man who had spent his Christmas holidays in 

 Philadelphia, had contracted the disease there, and had returned 

 home in January. During his sickness the excreta were not dis- 

 infected but were thrown oh the banks or into the frozen stream. 

 In March a thaw came and the entire mass was washed into the 

 brook and on into the water main. Three weeks later the disease 

 began to appear in the town with such rapidity that some days as 

 many as 100 new cases were reported. In all there were 114 deaths. 

 The epidemic proved at least that freezing alone for a short period 

 is not sufficient to destroy the organism. 



Milk-borne epidemics, like those due to water, have a sudden 

 onset and then subside rather sharply. Up to 1907 statistics 

 showed 317 epidemics caused by infected milk; Most milk out- 

 breaks are reported from England or America. The custom of 

 boiling the milk in many other countries undoubtedly affords them 

 a certain amount of protection against typhoid infection. Milk- 

 borne epidemics usually have certain definite characteristics. As 

 a rule contamination comes from a case or a carrier on the farm 

 and the outbreak is localized to the area receiving milk from 

 that farm. Usually people of the better class and those who 

 drink milk raw are affected, and several cases may occur simul- 

 taneously in one house. Milk products have been responsible 

 for a certain number of outbreaks; oysters and other shellfish 

 have also contributed their quota. Vegetables such as celery, 

 lettuce, and water cress grown on land fertilized with fresh night 

 soil may account for a few cases. 



Flies have been justly condemned as spreaders of the disease. 

 They breed in fecal and decomposing masses of all kinds and de- 

 posit the organisms they accumulate on the food they walk over. 

 In a recent experiment typhoid bacilli were isolated from five out 

 of eighteen flies captured in the privy and on a fence near the sick 

 room of a typhoid patient. 



A number of cases occur due to lack of knowledge of caring 

 for the sick. The danger of fomites containing living bacilli 



