TYPHOID FEVER MILK-BORNE OUTBREAKS 



331 



244 

 31 



supply. — On 6th and 7th September, 

 25 of the cases of enteric, which were 

 all those of children, had partaken of 

 ice cream sold by an Italian vendor 

 at a fair. The two remaining sufferers 

 were believed to have eaten "chip- 

 potatoes" purchased from the same 

 vendor at the same time. The vendor 

 in question was found to have an ice 

 cream factory in a low district of the 

 city of Liverpool, and there was at the 

 time of the fair a case of typhoid fever 

 in his house. 



Probable exciting cause. — Human 

 source. 



Reporter and reference. — Dr E. W. 

 Hope (Med. Off. of Health). Annual 

 Rep. on Health of Liverpool., 1897. 



Clifton, Bristol, IBSn {October-Decemher). 



Total number of cases 



Deaths 



Number of cases amongst 



drinkers of suspected milk . 234 

 Percentage on total cases . 95-9 



Number of families supplied by 



milkman 139 



Number of polluted milk sources i 

 Number of milkmen ... 3 



Circumstances implicating the milk 

 sup>ply. — This epidemic was distinctly 

 traceable to 3 different milk deliveries, 

 which had become polluted by the 

 contamination of the main source. At 

 the farm from which the suspected 

 milk was derived, the necessary water 

 for dairying purposes was obtained 

 from a pump which drew water from 

 a shallow well situated only a few feet 

 from a stream known as Ashton 

 Brook, which flowed through the farm 

 and close to the buildings. This 

 brook appears to have become con- 

 taminated with the excreta of a work- 

 man who suffered about the middle of 

 September from some kind of illness 

 not to be differentiated from typhoid 

 fever. His blood gave a distinctive 

 Widal reaction (Klein), and other 



symptoms were similar to those of 

 typhoid. The outbreak began early 

 in October, and was distributed along 

 the track of three milk deliveries which 

 had received portions of the farm in 

 question. There was an excess of 

 attack among children under 15 years 

 of age. {See chart, p. 381.) 



Probable exciting cause. — Human 

 source, through polluted water used 

 for dairying purposes. 



Reporter and reference. — Dr D. S. 

 Davies (Med. Off. of Health). Trans. 

 Epidemic Soc. of London^ vol. xvii., pp. 

 78-103. 



Glasgow, 1898 {November). 



Total number of cases . . 43 



Number of polluted milk sources i 



Number of milkmen . . . i 



Circumstances implicating the milk 

 sup>ply. — The sister of the shopgirl of 

 the milkman suffered from unrecog- 

 nised typhoid fever in the middle of 

 September. The shopgirl contracted 

 the disease from her sister or from the 

 milk itself, which it is possible that 

 she may have infected. Milk from the 

 same farm and delivered by the same 

 van -driver, but not passing into con- 

 sumption through the dairy in question, 

 caused no illness. The 43 cases arising 

 from the infected dairy occurred in two 

 main groups, within a fortnight. 



Probable exciting cause. — Indirectly 

 from human source. 



Reporter and reference. — Dr A. K. 

 Chalmers (Med. Off. of Health). 

 Report, 1898. 



Edinburgh, 1890 (June ana July). 



Total number of cases — 14 in 11 

 families. 



Number of families supplied by milk- 

 man invaded. — Only a small pro- 

 portion. 



Number of polluted milk sources i 



Number of milkmen ... 2 



Circumstances implicating the milk 

 sup)ply. — The only common link 



