90 THE MILK QUESTION 



epidemic may include several thousandy/During the past 

 four years the city of Boston has suffered severely. 



RECENT MILK-BORNE EPIDEMICS IN GREATER BOSTON 



1907 Diphtheria 72 cases 



1907 Scarlet fever 717 



1908 Typhoid fever 400 



1910 Scarlet fever 842 



1911 "Tonsillitis" 2064 



4095 



Other cities have also been sufferers, but milk-borne 

 outbreaks are not always reported as such. Health officers 

 frequently tell me that they have just had or are just hav- 

 ing a milk-borne outbreak of typhoid fever; sometimes 

 scarlet fever; more rarely diphtheria. However, these out- 

 breaks are not always reported, for they are becoming 

 "twice-told tales." It is, therefore, probable that more 

 cases of sickness are due to infected milk than appear in the 

 official returns. Further, it is evident to students of the 

 subject that many a milk-borne outbreak escapes recog- 

 nition. Small outbreaks of two or three cases in villages 

 and towns are often passed over as trivial occurrences. 

 However, two cases of typhoid fever in Podunk, with a 

 population of one thousand persons, is equivalent to two 

 thousand cases in a city with a population of a million. 

 Not infrequently small villages may have five, seven, or 

 eight cases of sickness caused by infected milk. Proportion- 

 ately this would be an epidemic of untold magnitude in a 

 metropolitan city. 



The character of milk-borne epidemics 



The diseases which most commonly occur in epidemic 

 form as the result of infected milk are: typhoid fever, scar- 

 let fever, diphtheria, sore throat. These outbreaks some- 

 times affect only a small group of people, perhaps two or 

 five individuals, or they may be extensive enough to in- 



