354 PATHOGENIC BACTERIA IN MILK 



We may now consider briefly several typical sore throat 

 outbreaks, which practically stand alone, and have a less intimate 

 relationship to scarlet fever. 



Milk-borne Sore Throat Outbreaks 



1. In the oft-quoted Aberdeen outbreak of sore throat traceable 

 to milk which occurred in 1881, about 300 individuals were affected 

 and some 90 out of the 1 10 families supplied with the implicated 

 milk. No case occurred in any family not supplied with this milk. 

 The disease commenced with severe rigors, which were followed 

 by high fever. The throat and tonsils were mainly affected, though 

 there was no false membrane produced. Three deaths occurred. 

 It was believed that the virus gained access to the milk from the 

 water supply. 



2. In the same year, Dr Wilson reported a similar epidemic 

 among the boys at Rugby School. Some 90 boys were attacked 

 in three school-houses supplied by one milkman, who did not supply 

 any other houses in the school. But he supplied houses in the 

 town, and of these nearly 50 per cent, were attacked with sore throat. 

 Inquiry showed that some of the milk used had been obtained 

 from a cow suffering from mastitis, and Dr Wilson attributed the 

 outbreak to this cause.^ A similar outbreak took place in Edin- 

 burgh in 1888, and was investigated by Cotterill and Woodhead. 



3. At Dover in 1884 there was a sudden and severe outbreak 

 of sore throat in a localised area of good-class houses, affecting 205 

 persons, who all pbtained milk from one particular farm. The 

 chief symptoms were local inflammation of the throat, enlargement 

 of lymphatic glands in neck, and vesicular eruptions preceding and 

 accompanying the inflammation. In 19 streets out of 42 invaded 

 every house supplied with the implicated milk was attacked. There 

 was generally an exact correspondence between the milk supply 

 and the houses invaded by the disease. The number of persons 

 attacked in each invaded house averaged 2-5. In one house the 

 servants had the implicated milk, and all suffered, whilst the family 

 had a special supply from the same dairyman, and did not 

 suffer. The " nursery milk " from the same dairyman was also 

 free from disease, and children in certain families having this special 

 supply were free from the infection, whilst the adults using the 

 mixed supply were attacked. The dairyman obtained his supply 

 from 12 cows of his own, and from three farms in the country. 



1 Brit. Med. Jour., 1881, vol. i., p. 657 ; vol. ii., p. 415. 



