THE MILK SITUATION IN THE DISTRICT OF COLUMBIA. 51 



Commissioners, the investigations being conducted in cooperation 

 with Dr. William C. Woodward, health officer. A board of officers 

 was detailed to convene on July 2, 1906, for the purpose of investi- 

 gating the origin and prevalence of typhoid fever in the District. 

 The results of the investigations by this board have been published. 1 

 The board is still continuing its work, and a supplemental report, 

 constituting the fourth of the series, is understood to be now in prepa- 

 ration for the press. 



The board reported among its findings that the milk supplied to the 

 citizens of the District has been, for the most part, old, dirty, and warm, 

 there being no endeavor to maintain a cold temperature, especially 

 from the farm to the city dairy and while in transit on the delivery 

 wagons from the dairy to the householder. Of 172 samples tested 

 during the warmer months only 16 were found to have a temperature 

 of 50 F. or lower, and only 29 contained less than 500,000 bacteria 

 per cubic centimeter, the average bacterial content assuming the 

 enormous proportion of 22,134,289 per cubic centimeter. The great 

 bulk of the milk sold in Washington during the summer months 

 would, therefore, have been condemned in New York and prohibited 

 from sale in Boston. The investigations of the board evidenced the 

 fact that many of the dairies were unsuitably located in close prox- 

 imity to stables and other insanitary surroundings. No attempt was 

 made, except in a single instance, to screen the premises against flieg, 

 which are now recognized as a prolific source of contamination. The 

 employees coming into contact with the milk had dirty hands, soiled 

 clothing, and the milk was kept inordinately long before reaching the 

 consumer, a period of almost 24 hours being occupied customarily in 

 its handling at most of the dairies. 



Of the 866 cases of typhoid fever investigated by the board about 

 10 per cent were attributed to infection conveyed by milk in the 

 course of pronounced outbreaks among the customers of three milk 

 dealers. In this connection the important fact developed that a local 

 dealer whose record showed conspicuously the smallest number of 

 cases of typhoid fever proportionate to the amount of milk dispensed 

 was the only one at the time who sterilized his bottles and pasteur- 

 ized the milk sold. 



The board has unqualifiedly recommended the pasteurization of 

 milk with a view to destroying any possible infection therein and at 

 the same time not impairing its food value, this being in its judg- 

 ment the most practical manner of preventing the conveyance of 

 typhoid fever infection by milk. 



The fact that the board found, in the case of 17 out of 38 dairies 

 inspected, that some of the milk received between 8 and 10 o'clock in 

 the morning did not leave the dairy until the following morning, 

 showed, in its judgment, a lack of proper systematic cooperation 

 between the shipper, the common carrier, and the city dealer, which 

 concerted action should by all means be exerted in reducing to a 

 minimum the interval of time elapsing between the. milking and the 

 actual delivery to the consumer. 



Dr. Kober presented to the International Medical Congress, at 

 Paris in 1900, the history of 195 outbreaks of typhoid fever, 99 of 

 scarlet fever, and 36 of diphtheria, all traceable to the milk supply. 



1 Bulletins Nos. 35, 44, and 52, Hygienic Laboratory, Public Health and Marine-Hospital 

 rvice, issued in February, 1907, May, 1908, and October, 1909, respectively. 



Service 



