DIPHTHERIA MILK-BORNE OUTBREAKS 



347 



Number of such families invaded i8 



Percentage 45 



Number of polluted milk soiu-ces i 



Circutnstances implicating the milk 

 supply. — This outbreak occurred at 

 Rugby School, three houses being 

 attacked with some 30 cases in each 

 house. These houses alone were 

 served with the infected milk. The 

 milk of a cow suffering from " garget " 

 was mixed with milk from healthy cows. 



Apparent exciting cause. — (?) Cow 

 disease. 



Reporter and reference. — G. Wilson, 

 M.D. (Med. Off. of Health). BHt. 

 Med. Jour., 1881, vol. ii., p. 415. 



Hendon, 1882. 



Total number of cases . . 35 



Deaths 3 



Number of cases amongst 



drinkers of suspected milk . 30 



Percentage on total cases . . 86 

 Number of families supplied 



by milkman .... 86 



Nimiber of such families invaded 1 3 



Percentage 15 



Number of polluted milk sources i 



Number of milkmen . . . i 



Circutnstances implicating the milk 

 supply. — Sewage gained access to 

 dairy pond, the water of which was 

 used for washing dairy utensils. 

 Certain families habitually using the 

 milk in a boiled state wholly escaped 

 invasion. Disease specially in evid- 

 ence where taken in large quan- 

 tities and used in an unboiled state. 

 Evidence that immediately before out- 

 break milk from particular dairy was 

 "ropy or stringy." In some cases it 

 was returned by the customers on 

 account of this feature. Some attri- 

 buted this to unclean utensils, others 

 to cow disease of some kind. The 

 fanner himself adopted the latter theory-. 

 No " garget " was found, or any udder 

 disease in any of the herd supplying 

 the milk. 



Probable exciting cause. — Contamin- 

 ated water supply. 



Reporter and reference. — W. H. 

 Power, F.R.S. Loc. Gov. Bd. Rep., 

 1883-84, pp. 42-48. 



Devonport, 1882 (December). 



Total number of cases . -31 



Deaths 5 



Ntunber of cases amongst 



drinkers of suspected milk . 27 



Percentage on total cases . . 87 

 Nimiber of families supplied by 



milkman 256 



Number of such families invaded 18 



Percentage 7 



Circutnstances implicating the milk 

 sujfply. — Dr Parsons formed the 

 opinion that the facts of this outbreak 

 were consistent with contamination of 

 milk by infective material of partial 

 amount, and of occasional occurrence. 

 Cause of infection may have been 

 some condition of farm or dairy 

 premises, or by milk-cans being wiped 

 out with cloths which hung up in 

 dairy yard and which might have 

 contracted impurities from the atmos- 

 phere. The outbreak was limited 

 to persons in good social position. 

 Distributing milk-shop had a case of 

 diphtheria next door, the >^rds to the 

 two houses being closed in by high 

 walls, and the air being thus stagnated. 



This outbreak affected 18 house- 

 holds, in 8 of which there were multiple 

 cases. All the patients were of good 

 social position. Twentj'-seven of the 

 31 patients derived their milk supply 

 from a particular dairy. The dairy 

 supplied about 500 families, so that 

 those attacked with diphtheria formed 

 a small percentage of the whole. 

 Twenty of the 31 cases were above 

 the age of childhood. 



Probable exciting cause. — Indirectly 

 from human source. 



Reporter and reference. — H, F. 

 Parsons, M.D. Loc. Gov. Bd. Rep-, 



