262 MILK AND ITS HYGIENIC RELATIONS 



were not obtained from them. The epidemic ceased when the 

 milk from this cow was pasteurised. 



Epidemics of scarlet fever and typhoid fever have been traced 

 to infection from the milk supply in a number of cases. Such 

 infection usually occurs from the presence of the organisms in one 

 of the milkers, or in one of the inhabitants at the farm. Cases 

 are given both by Savage and Trask, and others have occurred 

 in recent years. Thus Header reports an outbreak of 139 cases of 

 scarlet fever, and 282 cases of sore throat, which may have been 

 a mild form of the disease. The source of infection was traced 

 to one of the milkers, and the large number of cases arose from 

 the fact that the contaminated milk was mixed with a large volume 

 of other milk. 



These epidemics occur in spite of all observance of apparently 

 adequate precautions. Pathogenic streptococci have been shown 

 above to occur in ' certified ' milk. Winslow, in describing the 

 severe epidemic of tonsillitis which occurred in Boston, Mass., in 

 1911-12, says : ' I am at a loss to suggest any other precautions 

 that could have been taken to guard against infection with human 

 germs of disease that were not taken in this instance. Excellent 

 regulations were drawn up for the exclusion of contagion, the 

 milkers and the cattle carefully inspected, the dairy was admirably 

 arranged, and the whole process controlled by laboratory examin- 

 ations under the direction of bacteriologists and sanitarians of the 

 highest standard. If in spite of such precautions the milk becomes 

 infected, any raw milk supply may at any time become infected ; 

 and this I believe to be the lesson not only of this outbreak, but 

 of many that have preceded it in all parts of the world. It is 

 practically impossible to exclude mild and unrecognised cases of 

 disease of the process of milk production. The larger the supply 

 the greater, of course, is the danger, but even a small supply must 

 meet it at some time. Thus a cough over the pail, a finger inside 

 the can as it is lifted, and the danger is imminent. There is in 

 my judgment but one safeguard against such outbreaks proper 

 pasteurisation.' 



There is little to add to this summary of the position : owing 

 to the risks of subsequent contamination, however, pasteurisation 

 is safest when carried out in the home. 



REFERENCES IN CHAPTER XV 

 A. Streptococci 



BERGEY, ' The Prevalence of Streptococci in Cows' Milk,' Amer. Med. 



1901, i. 122. 

 BRUNING, ' Untersuchungen der Leipziger Marktmilch/ Jahrb. f. Kinderh. 



1905, Ixii. i. 



CAMPBELL, ' Leucocytes in Milk,' Bureau of Animal Ind., Bull. 117, 1909. 

 DAVIS. See Rosenow and Davis. 



