32 THE MILK SITUATION IN THE DISTEICT OF COLUMBIA. 



DISEASES RESULTING FROM CONTAMINATED MILK. 



The important part played by milk in the spread of certain diseases 

 has been realized for many years, principally in connection with 

 typhoid fever, scarlet fever, diphtheria, tuberculosis, dysentery, and 

 other gastro-intestinal disorders. The colon bacillus has, besides, 

 often been found to be the actual cause of appendicitis, chronic peri- 

 tonitis, and abscesses of the liver. 



Park is authority for the statement that certain pathogenic bac- 

 teria, known as streptococci, which excite tonsilitis (a single epidemic 

 of which involved 600 cases of sore throat in Stockholm), are prob- 

 ably the cause of septic inflammation of the udder. Many leucocytes 

 and streptococci are present in the normal milk of a healthy cow, 

 these bacteria being more numerous, though, in the milk of diseased 

 than in that of healthy cows. No satisfactory method has yet been 

 devised for distinguishing the pathogenic from the nonpathogenic 

 streptococci in milk. 1 



As has already been set forth, milk, not only while in the cow's 

 udder but up to the time of its delivery to the consumer, receives 

 from its surroundings bacteria of various kinds. These organisms 

 come from the teats of the cow, from the uncleanly condition of the 

 exterior of its body, from the dust and dirt of the stable, from the 

 hands of the milkers and others handling the milk, from the pails 

 and cans used in milking, storing, and transporting the product, 

 the bottles and other receptacles employed in its delivery to the 

 consumer, and from various other sources. 



Evidence has, furthermore, been accumulated during the last 50 

 years tending to show that milk may receive from man the specific 

 organisms of certain infectious diseases, and that these organisms 

 may produce the disease in susceptible individuals drinking the raw 

 milk. 



While cows are known to be exempt from typhoid fever, and these 

 germs are not customarily found in milk freshly drawn, the typhoid 

 bacillus may reach milk in unexpected ways, notably by the milk 

 coming into contact with persons who are in the first stages of 

 typhoid fever or convalescing from the disease, and very frequently 

 through the agency of "bacillus carriers" that is to say, persons 

 who are shown to be entirely healthy, but who, having experienced 

 a precedent attack of typhoid fever, or through contact with patients, 

 are known to be expelling typhoid germs. Persons who have had 

 the disease continue, as has been definitely shown in certain instances, 

 to discharge great numbers of the bacilli for months, and, remarkable 

 as it may seem, in some cases for years after apparent recovery. 

 This emphasizes the importance of having as few persons as possible 

 come in contact with the milk, and of insuring that those who actu- 

 ally handle the milk shall exercise scrupulous cleanliness and be 

 under strict medical supervision. In view of the numerous epidemics 

 from milk-borne diseases which have been recorded, the necessity for 

 compulsory notification of all infectious and contagious diseases is 

 so apparent that milk should not be permitted to leave a farm dairy, 

 or be shipped therefrom, during the existence of any of these diseases 



1 The Significance of Leucocytes and Streptococci in Milk, by William Whitfield Miller, 

 assistant surgeon, Public Health and Marine-Hospital Service, Bulletin No. 56, Hygienic 

 Laboratory, Public Health and Marine-Hospital Service, March, 1909, page 498, 



