ADDENDUM 195 



Examinations of bread as vended in New York have also 

 been carried out 1 . The method of examination employed was 

 to scrape the crust of the loaf on to sterile paper. The scrapings 

 were placed in a sterile test tube to which was added 20 c.c. of 

 salt-free broth. The mixture was shaken 25 times and plated 

 on agar and Conradi medium in amounts of O'l, O'5, ro and 2 c.c. 

 These amounts were also added to lactose neutral-red fermenta- 

 tion tubes for B. coli group enumerations. Three loaves which 

 were claimed to be free from human handling until wrapped up 

 yielded 600,200,280 bacteria (agar 2 days at 37 C.) respectively 

 while all were free from B. coli in 5 c.c. Three similar loaves 

 from the same batch were given to three different groups of men 

 to handle and were then examined. All three loaves still showed 

 absence of B. coli but the numbers of organisms (2 days agar at 

 37 C.) were respectively 15,140, 1080 and 1360. 



Six other samples of unwrapped bread showed bacteria 

 varying from 2720 to 325,500 per loaf while B. coli was isolated 

 from four of them in I c.c. of the emulsion. A single sample of 

 wrapped bread yielded no B. coli in 5 c.c. and 800 bacteria per 

 loaf. 



Furst 2 heavily inoculated bread with emulsions of various 

 bacteria and studied their viability under different conditions. 

 He found that such bacteria lived much longer in the crumb 

 than on the crust, B. typliosus, B. paratyphosus (3 and two 

 dysentery bacilli (Flexner and <y strains) living as long as 10 to 

 25 days on the former and only I to 8 days on the latter. On 

 white bread these bacilli survived for considerably longer periods 

 than on German black bread. 



While it is obvious that bread handled by an infectious 

 person may serve as a vehicle for the transmission of disease 

 there is little or no definite evidence showing that such trans- 

 mission has taken place in specific instances. 



Furst (loc. cit.) studied an outbreak of typhoid fever, for the 

 most part of mild type, which occurred in an institution for 

 children in August 1913 and considered that it was spread by 

 contaminated bread. The bread was obtained from a bakery in 



1 The Medical Officer, Jan. 9th, 1915. 



2 Munch, med. Woch., 1914, LXI, p. 1442. 



132 



