THE MILK SITUATION IN THE DISTRICT OF COLUMBIA. 273 



TYPHOID. 



The milkers affected with or convalescent from this disease should be abso- 

 lutely excluded from the dairy. On account of the infectiousness of the excreta 

 from such individuals, it might be good practice to keep them away from the 

 handling of milk for at least four to six weeks after convalescence. 



When typhoid fever occurs in the families of milkers or attendants, the greatest 

 care should be exercised in the disposition of the excreta and handling of the 

 bed linen and other clothes coming in contact with the patient. The bowel 

 movements and urine should be disinfected with 4 per cent chloride of lime or 5 

 per cent carbolic-acid solution and buried. The bed linen and other clothes 

 should be soaked in 1 to 10,000 bichloride solution or 5 per cent carbolic-acid 

 solution and then thoroughly boiled. Special attention should be given to the 

 exclusion of flies from the sick room and also from the dairy. The other mem- 

 bers of the family should be permitted in the dairy only if intelligent and after 

 having been thoroughly instructed in regard to cleanliness and other details. 

 The milking utensils should not be brought into the house, and should always 

 be washed with cloths and brushes that have not come in contact in any way 

 with things from the typhoid patient. Samples of the water used should be 

 sent to the city laboratory in boiled bottles for examination. 



SCARLET FEVER. 



Milkers should neither have nor come in contact with scarlet-fever cases. 

 After scarlet fever the scales on the hands carry the contagion for about four 

 weeks and sometimes longer. Scarlet-fever cases during convalescence should 

 not be permitted to come in contact with the handling of milk in any way until 

 the scaling has been completed and they have been given an antiseptic bath, 

 such as a 1 to 10,000 bichloride of mercury solution and their hands anointed 

 with 5 per cent carbolic salve. 



When scarlet fever occurs in the families of the farmers, milkers, or other 

 attendants, the house should be quarantined. This means that no member of 

 the household or other person must leave that house and mingle with attendants 

 in the dairy in any manner or form while the quarantine exists. The sale of 

 milk and cream from the quarantined premises is not permitted unless the cows 

 are taken care of, the milking done, and the utensils handled by individuals 

 entirely disassociated with the quarantined family. The quarantine is ter- 

 minated only after a thorough disinfection of the premises and the patient in 

 the manner indicated under " Tuberculosis." 



DIPHTHERIA. 



Milkers affected with diphtheria or sore throat should be excluded from the 

 dairy. They should not be permitted to return to the care of cows, milking, and 

 handling of utensils until from 10 to 14 days after an attack of diphtheria. 

 Throat cultures should be made to determine the absence of diphtheria bacilli 

 before the patient is pronounced well. In cases of simple sore throat the patient 

 should be examined by a physician before he is permitted to reenter upon his 

 work. When diphtheria occurs in the families of milkers and dairy attendants, 

 the house should be quarantined until the disease has been properly terminated 

 by throat cultures and disinfection of the premises. 



SMALLPOX. 



When smallpox occurs in milkers, attendants, and their families, a strict quar- 

 antine must be established at once. The members of the families not affected 

 should be vaccinated and the quarantine should be continued for about 20 days. 

 This means that the milk and cream produced on these premises shall not be 

 sold for domestic use if handled by individuals who come in contact with such 

 a smallpox case and are still under quarantine. In such cases the milking 

 must be done, the utensils handled, and the cows taken care of by individuals 

 entirely disassociated with the quarantined family. All milkers and attendants 

 should be vaccinated to prevent such outbreaks. 



MEASLES. 



Milkers should neither have nor come in contact with measles cases. Measles 

 cases during convalescence should not be permitted to come in contact with the 

 handling of milk in any way until the scaling has completed and they have 



82444 S. Doc. 863, 61-3 18 



