SCARLET FEVER MILK- BORNE OUTBREAKS 



295 



Reporter and reference. — Dr J. B. 

 Russell (Med. Off. of Health). Lancet, 

 1888, vol. ii., p. 1079. 



Pollokshields, Glasgow, 1888 (June). 



Total number of cases . . 70 

 Number of cases amongst 



drinkers of suspected milk . 70 

 Percentage on total cases . .100 

 Number of polluted milk sources i 

 Number of milkmen . . . i 



Circumstances implicating the milk 

 supply. — Cases of scarlet fever had 

 occurred in the persons of the servant 

 and children of the farm supplying the 

 milk. 



Probable exciting cause. — Human 

 source. 



Reporter and reference. — Dr Car- 

 michael. Brit. Med. Jour., 1888, vol. 

 ii., p. 33. 



Ne-wcastle-on-Tyne, 1888 (June). 



Total number of cases . . 74 

 Number of cases amongst 



drinkers of suspected milk . 61 



Percentage on total cases . . 82 



Number of polluted milk sources i 



Number of milkmen . . . i 



Circumstances implicating the milk 

 5up>ply. — Three children in the family 

 of one man attending cows suffered 

 from an illness not to be differentiated 

 from scarlatina. All the 61 cases 

 occurred in the space of 13 days. 



Probable exciting cause. — Human 

 source. 



Reporter and reference. — Dr H. 

 Armstrong (Med. Off. of Health). 

 Public Health, 1888-89, P- 156. 



Macclesfield, 1889 {fanuary). 



Total number of fS^^^J^V^.^'^^ 38 



cases j Diphtheria . 2 



vSore throat . 83 

 Number of families supplied by 



milkman 103 



Number of such families invaded 100 



Circumstances implicating the milk 

 supply. — The scarlet fever was accom- 

 panied by cases of severe sore throat, 

 the more serious cases ha\'ing a 

 diphtheritic tendency. The incidence 

 of attack on persons drinking most 

 milk was well shown by Dr Parsons. 



Larger proportion of milk indicates 

 that more is imbibed, occasions of 

 exposure to any poison in the milk 

 are more numerous, and a larger 

 proportion of what is taken has not 

 undergone any process, as of cooking, 

 which would destroy or impair its 

 activity. About an equal number of 

 persons were attacked at years above 

 and below 15. The severity of illness 

 depended on the amount of milk con- 

 sumed as a rule. The scarlatina 

 showed little tendency to spread in 

 the households into which it had been 

 introduced, the rash was ill-defined, 

 desquamation was scanty, kidney 

 complications were rare, and alimen- 

 tary disturbance was well marked. 



Probable exciting cause. — Undeter- 

 mined. 



Reporter and reference. — Dr Parsons. 

 Loc. Gov. Bd. Rep., 1889, pp. 89-111. 



Upton and Macclesfield, 1889 



(February). 



Total number of cases . . 129 

 Number of cases amongst 



drinkers of suspected milk . 123 



Percentage on total cases . . 93 

 Number of families supplied by 



milkman 100 



Niunber of such families invaded 58 



Percentage 58 



Number of polluted milk sources i 



Circumstances implicating the milk 

 supply. — Well water at farm polluted 

 with sewage. Milk-cans rinsed out 

 with cold water from this well. Dr 

 Parsons thinks, however, that the 

 outbreak was due to the milk of a 

 cow which had recently calved and 

 later on developed vesicular sores on 

 the teats, and became emaciated. Of 



