TYPHOID CARRIERS 103 



Vaccination seems to be a very satisfactory measure in bringing about the dis- 

 appearance of typhoid bacilli in the dejecta of carriers. 



For laboratory diagnosis, blood cultures during the first week and 

 agglutination tests during the second week and onward are the practical 

 methods. 



Along with the, agglutination tests the urine and faeces should be cultured on 

 Endo's plating medium and later transferred to Russell's medium for cultural 

 identification. The positive identification, provided the culture so isolated shows the 

 cultural characteristics of typhoid, is made by testing the bacilli for agglutination 

 with a known typhoid serum. Instead of the usual blood cultures one may use the 

 clot in the Wright U-tube for culturing and the serum remaining after centrifugaliza- 



K$b 









FIG. 34. Bacillus of typhoid fever, stained by Loffler's method to show flagella. 

 (X 1000.) (Williams.) 



tion for the Widal test (clot culture). B. typhosus appears in the blood in relapses. 

 Kayser considered that about 27% of cases of typhoid in Strasburg were caused by 

 raw milk, 17% by contaminated water, 17% by contact with typhoid, and 10% were 

 due to typhoid carriers. Other cases were due to infected food, and about 13% were 

 of origin impossible to determine. These latter may have been due to unrecognized 

 typhoid carriers. He does not attach the same importance to fly dissemination as 

 do American authors. 



Contact infection is the great factor in perpetuating typhoid fever 

 but this agency shows diminishing cases each year provided water and 

 milk supplies are safe. The leading European cities as a result of a safe 



