DIPHTHERIA MILK-BORNE OUTBREAKS 



349 



Percentage on total cases . . 82 

 Number of families supplied by 



milkman 210 



Number of such families in- 

 vaded 21 



Percentage 10 



Number of polluted milk sources i 



Number of milkmen . . . i 



Circumstances implicating the milk 

 supply. — Dr Bruce Low concluded 

 that this recrudescence of diphtheria 

 (following a "school" epidemic) was 

 due to a pollution of the milk supply 

 probably from human sources. These 

 51 cases were limited alike in locality 

 and social status of sufferers, the latter 

 being of better class altogether and 

 quite unlike the earlier epidemic. All 

 the cases at the end of November and 

 in the first three weeks of December, 

 and all the deaths in this period, 

 occurred in persons consuming milk 

 from one source. 



Probable exciting cause. — Indirectly 

 from human source. 



Reporter and reference. — R. B. Low, 

 ^LD. Loc. Gov. Bd. Rep., 1888, pp. 

 123-132. 



Devonport, 1888. 



Total number of cases . . 61 

 Deaths 17 



Circumstances implicating the milk 

 supply. — Of the 61 cases of diphtheria 

 it was possible to get particulars as to 

 milk supply from 50 : 47 of this number 

 obtained their milk from a common 

 source. The first 35 of the 61 cases 

 obtained their milk from this source. 

 Eight of the cows at the implicated 

 dair\' showed signs of "cow-pox" — 

 small scabs and ulcers at the base of 

 the teat. 



Probable exciting cause. — Undeter- 

 mined. 



Reporter and reference. — Quoted by 

 Thome Thome in his Milroy Lectures 

 in 1 89 1, p. 162. The investigation was 

 made by the Medical Officer of Health, 

 Dr May. 



Croydon, 1890 (October). 



Total nimiber of cases . . 191 



Deaths 38 



Number of cases amongst 



drinkers of suspected milk . 123 



Percentage on total cases . . 65 

 Number of families supplied by 



milkman 124 



Percentage 40 



Number of polluted milk sources i 



Number of milkmen ... 2 



Circumstances implicating the milk 

 supply. — In this case teat eraptions 

 were discovered upon the cows yielding 

 the milk supply. Dr Klein reported 

 these eruptions to be similar to those 

 met with in diphtheria outbreaks traced 

 to milk of diseased cows. The milk 

 was from one source supplied by one 

 dair\-, the customers of which suffered 

 to the extent of 40 per cent, of house- 

 holds supplied. Same milk formed 

 one-seventh of the supply of another 

 dairy, the customers of which suffered 

 in 10 per cent, of households taking it. 

 Cases ceased to arise when the im- 

 plicated milk was stopped. 



Apparent exciting cause. — (.?) Cow 

 disease. 



Reporter and reference. — Dr Philpot 

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

 Officer of Health, and Brit. Med. Jour., 

 1891, vol. i., p. 470. 



Worcester, 1891 (Novembtr). 



Total number of cases . . 6 



Deaths j 



Number of cases amongst 



drinkers of suspected milk . 6 



Percentage on total cases . . loo- 

 Nimiber of families supplied by 



milkman i 



Niunber of such families invaded i 



Percentage ick> 



Number of polluted milk sources i 



Number of milkmen . . . i 



Circumstances implicating the milk 

 supply. — Cows yielding supply had a 

 pustular eruption of the teat, and were 



