TYPHOID FEVER MILK-BORNE OUTBREAKS 



329 



Probable exciting cause. — Hiunan 

 source. 



Reporter — Dr Bruce Low (Loc. Gov. 

 Bd. Rep.). 



Stockport, 1893 {July). 



Total number of cases . . 9 



Deaths i 



Number of cases amongst 



drinkers of suspected milk . 9 

 Percentage on total cases . .100 

 Number of families supplied by 



milkman invaded ... 9 



Number of polluted milk sources i 



Circumstances implicating the milk 

 sup>ply. — Probably infection of milk 

 arose on the vendor's premises by 

 dried dust from a specifically infected 

 privy-pit. Among an extensive round 

 of customers of the milk in question 

 taken direct from the farms to their 

 houses no cases occurred. The attacks 

 were all at the houses of customers 

 buying milk over the counter of the 

 vendor's shop. 



Probable exciting cause. — Human 

 source. 



Reporter and reference. — Dr Porter 

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

 December 1893, and January 1894. 



Kelso, 1898 {May-Augusf). 



Total number of cases . . 73 



Deaths 8 



Niunber of cases amongst 



drinkers of suspected milk . 63 



Percentage on total cases . . 86 

 Niunber of families supplied by 



milkman 48 



Number of such families invaded 45 



Percentage 94 



Number of polluted milk sources i 



Number of milkmen . . . i 



CircumstarKes implicating the milk 

 supply. — Well water greatly contami- 

 nated with farm sewage. Well water 

 used for dairying purposes. Two 

 cases of illness on farm premises 

 diagnosed as enteric fever only after 



the occurrence of a third case in June. 

 Of the first 18 cases only one was of 

 a non-consumer of the implicated milk. 

 Of 48 households taking the milk only 

 three escaped invasion by enteric fever. 

 Three irregular customers had one 

 drink of implicated milk and con- 

 tracted the disease. 



Probable exciting cause. — Human 

 source. 



Reporter and reference. — Dr Oliver 

 (County Med. Off. of Health). Annual 

 Rep.^ 1893. 



Bacap, 1894 (^April'). 

 Total number of cases . . 33 



Deaths 5 



Number of cases amongst 



drinkers of suspected milk . 30 

 Percentage on total cases . . 91 

 Nimiber of families supplied by 



milkmen 30 



Niunber of such families invaded 13 



Percentage 43 



Number of polluted milk sources i 

 Number of milkmen . . . i 



Circumstances implicating the milk 

 suptply. — Dairy farmer, who milked 

 the cows, also acted as night-soil 

 scavenger, and probably conveyed the 

 germs of the disease into his own 

 household. The supply was stopped 

 and the outbreak ceased. 



Reporter and reference. — Dr Brown 

 (Med. Off. of Health). Annual Rep., 

 1894. 



Buffalo, U.S. A., 1894, 1895, 1896. 

 Total number of cases . . 51 



Circumstaftces implicating the milk 

 sup>ply. — These were three small 

 epidemics of typhoid fever occurring 

 in 1894, 1895, and 1896, and affecting 

 respectively 19 patients, 18 patients, 

 and 14 patients. In each of the three 

 outbreaks the implication of the milk 

 was definitely traced, and the milk 

 was contaminated in each case firom 

 human sources, namely, persons 

 suffering from enteric fever. 



