MILK AND TYPHOID FEVER 



315 



milk from flies, dust, or other contamination after it has been 

 sterilised. 



The specific germ of typhoid fever will not only grow in milk, 

 but in milk products. It will live in butter for many days, and in 

 cheese for a shorter period.^ 



It has been suggested that the milk of cows drinking infected 

 water may contain the B. typhosus. This is not possible, although 

 the germ might well be eliminated by the alimentary canal, and 

 then indirectly obtain access to the milk. 



These diverse modes of primary pollution are well illustrated 

 in the abstracts which follow. Before proceeding to the abstracts 

 it is well to remember that milk-borne epidemics of typhoid are, 

 of course, not so common nor so clearly proved in certain ways as 

 water-borne epidemics. Few people drink milk as compared with 

 the many who have opportunity of coming within the infective area 

 when the water supply is polluted. Dr Cooper-Pattin of Nor\\'ich 

 has pointed out that the number of persons drinking raw milk 

 varies from about 28-30 per cent^ The following table is derived 

 from 656 cases of typhoid fever notified at Norwich during the 

 years 1895, 1896, and 1897 : — 



Schuder has recently published a statement based on a study 

 of 638 epidemics of typhoid fever occurring in different countries, 

 from which he finds that 70-8 per cent, of such epidemics are spread 

 by drinking infected water, 17-0 per cent of them by drinking in- 

 fected milk, and 3-5 per cent, by other forms of food. The remain- 

 ing 9 per cent are caused by clothes, etc., worn by typhoid patients, 

 latrines, dust, etc. Of epidemics spread by infected milk, he finds 

 that in 29 per cent the utensils used in dairying had been washed 

 with infected water. Schuder holds that dejecta and urine are the 

 media in which the typhoid germ remains for long periods virulent* 



* See also Lafievre typhoide, by MM. Brouardel and Thoinot. Paris, 1895. 

 ^ " Enteric Fever at Norwich. A triennium of Typhoid." — Trans. Epidemio- 

 logical Society of London^ vol. xvii. (1898), p. 112. 

 ^ Zeit.f. Hyg. u. Infect.^ 1902, vol. xxxviii., p. 343. 



