FOODS AND PUBLIC HEALTH 5 



authorities for thirty-one years because she refused to submit to treat- 

 ment that would have rid her of the germs. Typhoid Mary did not handle 

 milk supplies, but the results can be imagined if she had. 



Carriers can be detected by simple laboratory tests, but the only safe 

 way to handle them is to require that they submit to treatment to clear 

 up the condition, or else to put them under quarantine. The instance 

 was cited above of a milker who infected one milk supply, and later 

 obtained employment under an assumed name at another dairy farm and 

 infected that milk supply. Typhoid Mary also assumed other names as 

 she worked in different homes. 



Improved sanitation, including careful public supervision of water and 

 milk supplies, has greatly reduced the number of typhoid fever cases 

 over most of the United States, and especially in New England. Fewer 

 cases mean fewer carriers, and consequently less danger of infected food 

 and milk; but there is still sufficient risk to justify the consumer being 

 very careful of the cleanliness of the milk he buys for his family. 



Scarlet Fever 



Scarlet fever is contracted from infected milk more often than the 

 public realizes. In a publication from the Massachusetts State Depart- 

 ment of Public Health (7) there is a table which lists three such epi- 

 demics: one of 15 cases in Pembroke and Marshfield in 1928, one of IS 

 cases in Framingham in 1929, and one of 127 cases in Plymouth in 1929. 

 Eighty-seven milk-borne epidemics were reported in the United States 

 between 1893 and 1928 (2). An epidemic in Boston and neighboring 

 communities (4) in 1907 illustrates the way in which milk can spread 

 scarlet fever and other epidemic diseases. 



The epidemic included 717 cases, of which 486 (68 percent) occurred 

 within six days. More than 80 percent of the cases in each community 

 were in families supplied with milk by a certain dealer. The cases were 

 among customers who purchased bottled milk, and none of the milk sold 

 wholesale appeared to be infected. Investigation showed that an em- 

 ployee in the bottling plant had had an illness that was strongly sug- 

 gestive of scarlet fever, and cases of scarlet fever existed in the families 

 of other employees. 



Milk-borne epidemics of scarlet fever come from human sources. So 

 far as is known, cows do not have the disease (2). It has been suspected 

 that cows afflicted with streptococcus mastitis sometimes liberate germs 

 into their milk that may produce a disease resembling scarlet fever in 

 man, but there is no definite proof; and even if there were, it would still 

 be possible that the cows' udders had been infected from persons carry- 

 ing the germs. It is not as easy to detect carriers of scarlet fever germs 

 as it is to detect typhoid carriers. An instance in the writer's experi- 

 ence illustrates this point. In one of the larger cities in Colorado there 

 was a dairy run by a wealthy man, as a hobby. The dairy plant, herd, 

 and equipment were as nearly perfect as money and intelligent manage- 

 ment could make them, and the utmost care was taken to produce milk 

 of unusually excellent quality. Because of the demand at the time for 

 raw milk, the whole product of the farm was sold as such to customers 

 who could afford to pay for high-quality certified milk. In spite of all 

 the care, a scarlet-fever epidemic occurred among the customers of this 

 dairy, and investigation disclosed that one of the milkers had had scarlet 



