BACILLI OF THE COLON-TYPHOID-DYSENTERY GROUP 699 



ary contamination of the meat either by a carrier or by another agency 

 exactly as this may occur in typhoid transmission. 



The clinical picture of this variety of paratyphoid infection is funda- 

 mentally different from the one just described. Topical bacillary meat 

 poisoning comes on within less than twenty-four hours after the ingestion 

 of the meat. Its onset is acute with a rapid rise in temperature and the 

 accompanying systemic symptoms which this implies. There is usually 

 great prostration, rapidity of the pulse and localized symptoms referable 

 to the gastro-intestinal canal, namely, nausea, vomiting and painful 

 diarrhea. Some of these cases have been compared with cholera in the 

 severity of their courses. The mortality has not usually been very high, 

 although in one epidemic it was as high as 7 per cent. The organisms 

 may in these cases also be found in the blood stream by culture, but not 

 as regularly as in the typical typhoid fever-like form. At death they 

 may be found in the spleen and intestines. 



From the epidemiological point of view, it is always important, when 

 a group of persons after a traceable common meal is seized with acute 

 gastroenteritis, to make an epidemiological survey, study the time and 

 place of the common meal, follow up the- subsequent histories of others 

 who were present at this meal, and, if possible, secure for bacteriological 

 study some of the meat, milk, etc., consumed. 



Preventive Measures. Measures for the prevention of the typhoid- 

 like forms of paratyphoid fever are identical with those advised for the 

 prevention of typhoid. The carrier problem is practically the same and 

 it seems logical to assume that the percentage of carriers compared with 

 that of typhoid carriers is approximately similar to the ratio of incidence 

 between the two diseases. 



In regard to the meat poisoning epidemics, preventive measures 

 must be chiefly aimed at the sanitary control of slaughter houses and 

 care in food preparation. Concerning the slaughter house survey, this 

 must go farther than simply controlling the health of animals before 

 slaughter, since, as we have seen above, many organisms of these types 

 may be found in the normal intestines of animals. Though studies in 

 this direction have not been made with sufficient extensiveness, it is still 

 suggested by our general knowledge of this subject that an unduly long 

 interval between evisceration and slaughter, especially in warm weather, 

 may lead to invasion and multiplication, in the tissues, of organisms 

 from the bowels, which may render the meat of a previously healthy 

 animal, unsafe. Removal of the intestines promptly after slaughter 

 would be the most important preventive measure that reasoning would 

 indicate. 



