SCARLET FEVER MILK-BORNE OUTBREAKS 



303 



3 farms 3 children had been ill ; a girl 

 of 16 had sore throat, another girl of 

 12, and a boy of 14 followed a few 

 days later with a similar affection, 

 namely, swelling of the glands in the 

 neck, and general malaise. One of 

 them had a slight rash. After the 

 recovery from acute condition they 

 assisted in handling of milk. The 

 outbreak was very sudden, and 

 suddenly declined from a time dating 

 a few days after the milk supply from 

 this farm was stopped. The fatality 

 was high, as many as 1 1 deaths occur- 

 ring. The distribution of the cases of 

 scarlet fever was localised to the dis- 

 tribution of the milk in question. 



Probable exciting cause. — Milk 

 infected from human sources. 



Reporter aud reference. — Dr Morse. 

 State Board of Health Rep., Massa- 

 chusetts, p. 561, 1 90 1. 



Stroud, 1901. 



Total number of cases . . 13 

 Number of polluted milk sources i 

 Number of milkmen . . . i 



Circumstances implicating the milk 

 supply. — From 1 5th November 1900, to 

 24th January 1901, there were 14 cases 

 of scarlet fever. Between 1 4th and 2 1 st 

 Februar}' there were 1 3, all of whom got 

 their milk from one farmer. At this 

 particular farm there was a boy who 

 helped to milk the cows in the evening. 

 He had a sore throat and enlarged 

 glands in the neck. No desquamation 

 was detected. The cows were healthy 

 although one had recently calved ; 

 "chaps and warts" were present on 



many of the udders. The 13 cases 

 occurred in 9 (or 15 per cent.) of the 

 houses supplied by this farmer. The 

 incubation period was very short, being 

 apparently 24 hours or even less. 

 Although the illness of the boy was 

 so slight it appears that it started the 

 outbreak. 



Probable exciting cause. — Human in- 

 fection of milk. 



Reporter and reference. — Dr J. M. 

 Martin (Med. Off. of Health), Stroud, 

 R.D.C. Public Health, 1901-02, pp. 

 138-142. 



Sunderland, 1903 {April), 



Total nimiber of cases . . 112 



Number of families affected . 70 

 Number of families supplied by 



implicated farm . . . 329 



Percentage of infected families . 21-2 



Circutnstances implicating the milk 

 supply. — The notification of scarlet 

 fever in Sunderland during six weeks 

 is given in table at foot of page. 



During the week ending 28th March 

 an unusual number of cases of scarlet 

 fever were noticed among the families 

 supplied with milk by Mr M. of 



Inquiries were at once instituted, 

 and it was found that there had been 

 no cases of scarlet fever occurring in 

 the families of the persons who had to 

 do with the handling of the milk. 

 There are 9 or 10 milkers, and 3 men 

 who deliver the milk, and they and all 

 the persons in their households, were 

 found to be free from any ailment or 

 sj-mptom suggesting scarlet fever. A 

 child was, however, discovered with its 

 hands peeling, in the family of one of 



