326 



PATHOGENIC BACTERIA IN MILK 



Number of families supplied by 



milkman i88 



Number of such families invaded 122 



Percentage 65 



Number of polluted milk sources i 



Circumstances implicating the milk 

 supply. — Pollution of well by ditch, 

 "an open sewer," from cess-pool. 

 Pump defective, and ditch fouled by 

 slop water and privy refuse of two 

 cottages. Case of typhoid at the farm 

 whose soiled linen was washed at the 

 pump. Mother of patient engaged in 

 milking cows, etc., as well as nursing 

 patient. First 15 invaded houses all 

 used implicated milk, and all but one of 

 first 37 houses did likewise. Of 289 

 cases only 31 in persons not definitely 

 known to have consumed this milk, but 

 probably some of them did also at odd 

 times. Milkman particularly in ques- 

 tion had two sources of supply, one as 

 above, and a second at a farm to which 

 no exception could be taken. Nine- 

 teen cases of typhoid occurred in the 

 consumers of milk from this second 

 farm. Though the milks were not 

 mixed, the same can measure was 

 used. The houses earliest served by 

 the contaminated measure had the 

 bulk of the 19 cases. Various cases 

 occurred showing a remarkable inci- 

 dence of the disease on the drinkers 

 of the implicated milk. 



Probable exciting cause. — Human 

 source. 



Reporter and reference. — Dr Iliffe 

 (Med. Off. of Health). Special Rep. 

 of Medical Officer. 



Cambridge, Mass., U.S.A., 1886 



{November ana December). 



Total number of cases 



73 



Circumstances implicating the milk 

 supply. — Son of farmer had typhoid in 

 September, and was nursed by his 

 father whilst he continued his usual 

 duties, superintended the milking, and 

 prepared the milk for market. On 



1st November the son was convalescent 

 and able to assist his father in work 

 on the farm. A few days after ist 

 November the privy vaults were cleared 

 out, and the contents (including the 

 undisinfected typhoid excreta), were 

 thrown out on the ground near by 

 and covered with earth. On i8th 

 November the epidemic broke out. 

 Contamination of milk by means of 

 water, dust, or milker's hands. Com- 

 munity of milk supply was clearly 

 proved. 



Reporter and reference. — Dr C. 

 Harrington. Boston Med. and Surg. 

 Jour., vol. ii., p. 49. 



Nottingham, 1887. 



Number of cases 



31 



Circumstances implicating the milk 

 supply. — The interest of this outbreak 

 was that the customers were partly 

 supplied by cart and partly by can 

 from a certain farm, the former by 

 the farmer, the latter by 3 milk vendors. 

 A disproportionate number of the 

 attacks were among the households 

 supplied by the cart, 19 exclusively by 

 the cart, and 3 exclusively by the can. 

 In households supplied by the 3 milk 

 dealers, there was a marked absence 

 of cases of typhoid. Concluded that 

 the milk was infected by person or 

 persons engaged in its distribution by 

 the cart — most likely a particular 

 employe from the Union. 



Apparent cause. — Human infection. 



Reporter and reference. — Dr B. A. 

 Whitelegge. Medical Officer's Rep., 

 1881. 



Stirling, 1889. 



Total number of cases . 40-50 



Deaths 4 



Number of cases amongst 



drinkers of suspected milk . all 

 Percentage on total cases . .100 



Circumstances implicating the milk 

 supply. — Water supply polluted. Cases 

 of typhoid at the farm-house by which 



