54 KPIDKMIC DISEASES TRANSMITTED BY MILK. 



from the throat, while the man gave negative results. Bacilli 

 persisted in the throat of the woman for three weeks in spite 

 of constant effort to clear up the infection. No history of 

 previous clinical diphtheria could be established, nor were clin- 

 ical manifestations recognizable. The fact that the woman 

 frequently milked the cows, handled the milk and delivered it, 

 is of interest. Upon the discovery of the bacilli carriers at 

 the dairy, the local authorities took measures to prevent further 

 contamination of the milk. 



Scarlet fever. Knowledge of the details concerning the in- 

 fection of milk with scarlet fever is restricted some\vhat by 

 the fact that there is no general agreement as to the causative 

 agent of the disease. It is believed that the infectious material 

 resides in the throat, nasal secretions and skin (21). There 

 is, though, good epidemiological evidence that milk infection 

 with scarlet fever occurs frequently (32). 



Milk-borne scarlet fever assumes a mild type (21). News- 

 holme (23) calls attention to the fact that " scarlet fever may 

 be caused by infected milk containing the contagium in such 

 an attenuated form or minute quantity that no symptoms 

 manifest themselves except as anomalous sore throat with 

 fever." 



Investigation of the source of .milk supply responsible for 

 trouble, will reveal some rather close connection between a 

 case of the disease and the milk. It may be a case in the 

 house; bottles returned from a sick-room ; a convalescent, or 

 a nurse, or a patient's milking or handling milk. 



The importance of milk as a carrier of scarlet fever is estab- 

 lished by convincing evidence. Harrington (13) has reported 

 a very extensive milk-borne scarlet fever epidemic that occurred 

 in Cambridge, Boston, and Summerville, Massachusetts. In 

 five days, 485 cases were reported among the customers of one 

 large dairy company. During a period of three weeks from 

 the beginning of the trouble, 717 cases were reported in the 

 district, of which 84 % were among the patrons of the dairy. 

 The source of infection was traced to a man employed by the 

 dairyman to taste milk, and who used the same spoon in sam- 

 pling each lot of milk. The daughter of this man was in the 



