SCARLET FEVER MILK-BORNE OUTBREAKS 



301 



Reporter and reference. — Sir H. D. 

 Littlejohn, M.D. (Med. Off. of Health). 

 Annual Rep. for City of Edinburgh, 

 1899, p. 34. 



Bdlnburgli, 1899 {SepUtnber). 



Total number of cases — 18 in 15 



families. 



Number of polluted milk sources i 



Number of milkmen ... 8 



Circutnstances implicating the milk 

 supply. — In this case scarlet fever 

 occurred in the daughter and maid- 

 servant of the farmer who supplied the 

 milk. 



Probable exciting cause. — Human 

 source. 



Reporter and reference. — Sir H. D. 

 Littlejohn, M.D. (Med. Off. of Health). 

 Annual Rep., 1899- 1900, p. 36. 



Bdinbursb, 1899 {December). 

 Total number of cases . . 42 



Circumstances implicating the milk 

 supply. — A girl who was employed in 

 milking at the farm supplying the 

 milk suffered from an illness not to be 

 differentiated from scarlet fever, and 

 a young man engaged in the dair>' 

 suffered from sore throat. The out- 

 break in Edinburgh arose several days 

 after the first sjTnptoms in the girl. 



Probable exciting cause. — Hiunan 

 source. 



Reporter and reference. — Sir H. D. 

 Littlejohn, M.D. (Med. Off. of Health). 

 Annual Rep., 1899- 1900, PP- S^, 39- 



Bristol, 1900. 



Total number of cases . . 66 



Three distributors supplied 269 houses, 



42 houses attacked, one house in 



every 64. 

 Number of polluted milk sources i 

 Number of milkmen ... 3 



Circumstances implicating the milk 

 supply. — On the dairy farm supplying 

 the milk to the three distributors there 

 was at the time of the outbreak a boy, 



having access to the milk vessels, who 

 was suffering from an unrecognised ill- 

 ness which was compatible with a mild 

 (ambulant) attack of scarlet fever, and 

 within a week 2 brothers sickened 

 with well-marked scarlet fever. The 

 cows were healthy. 



Probable exciting cause. — Human 

 source. 



Reporter and reference. — Dr Davies 

 (Med. Off. of Health). Jour, of 

 Hygiene, vol. i.. No. 3, p. 388. 



Buffalo, U.S.A., 1899. 



Total number of cases . . 57 

 Number of families supplied by 



milkman 26 



Number of such families invaded 26 



Percentage 100 



Circutnstances implicating the milk 

 supply. — Two outbreaks of scarlet fever 

 occurring in 1899 in Buffalo were traced 

 to an infected milk supply. The first 

 outbreak was that of 57 children, the 

 second was less severe, and numbered 

 only 20 cases. The channel of infec- 

 tion was well traced out in the former, 

 and it was found that on the impli- 

 cated dairy premises there were 2 

 cases of desquamating scarlet fever. 

 One was a child aged 9, and the other 

 a young man aged 19 who did the 

 milking, and in other ways assisted in 

 the dair>' during his illness. The 57 

 cases were almost simultaneous in 

 occurrence, and the severity of the 

 attack appeared to depend upon the 

 quantity of the implicated milk con- 

 sumed. 



Probable source of infection. — Human. 



Repwrter and reference. — Jour. Ann. 

 Med. Assoc, 1900, vol. i., p. 151 (Dr 

 E. Wende). 



Cheadle and Oatley, ChesMre, 1900 



{jipril and May). 



Total number of cases . . 52 

 Number of polluted milk sources I 

 Number of milkmen ... 2. 



