v ACUTE INFECTIOUS DISEASES 83 



On November 18, 1907, the blood of Mrs. H. gave a 

 positive reaction to Widal's test, but typhoid bacilli were not 

 found in the urine or faeces when examined, November 18 

 and 29. On December 20 typhoid bacilli were isolated from 

 her excreta. 



Between September 1906 and the end of November 1907 

 28 cases of typhoid fever occurred at Brentry. Of the 11 

 female inmates attacked 3 were employed in the kitchen, 2 

 as dining-room maids, and 3 in the tea-house, all having 

 access to milk. The 3 other female inmates attacked were 

 in receipt of a daily extra supply of one pint of milk, as they 

 were nursing. They were the only inmates receiving this 

 additional supply. The baby (hand-fed) of one of these three 

 women was also attacked. Practically all the male cases also 

 had access to milk. 



4. An Example of Infection from contaminated Milk Cans. 

 An outbreak * of typhoid fever occurred in Somerville and 



Cambridge, Massachusetts, in the autumn of 1907. There 

 were 61 cases, and most of them obtained milk directly or in- 

 directly from the same dealer. Investigation of the dairies 

 from which the milk supply was derived showed that to one 

 or more of them were sent cans from a place where milk 

 was bottled, and these cans were washed by a man who 

 was nursing a sufferer from enteric fever. He was uncleanly 

 in his habits and very careless in his work, and it is prob- 

 able that infective material from the person whom he nursed 

 was conveyed by his hands directly into the cans and into the 

 milk. 



5. An Example of Infection from specifically polluted Water 

 used for Dairy Purposes. In a considerable number of milk- 

 borne typhoid fever outbreaks the source of infection of 

 the milk has been almost certainly specifically infected water 

 used either for washing the cans or occasionally for direct 

 addition as an adulterant to the milk. Complete proof cannot 

 be furnished owing to the extreme difficulty of isolating the 

 typhoid bacillus from water, but this does not at all invalidate 

 the other accumulated evidence. The following is a good 

 example of this method of infection, while it is given in some 

 detail as illustrating the valuable graphic method of recording 



1 PuUic Health, 1908, xxi. p. 2. 



