358 PATHOGENIC BACTERIA IN MILK 



Table " A " shows in the first place that the percentage of 

 households supplied by X in that area falls very far short of 85 per 

 cent of the total, being a little over 14 per cent, and even if 

 allowance is made for considerable losses of customers the incidence 

 of disease would be out of all proportion to his supplies. Further, 

 area " A " shows that while the incidence of throat illness is 29 per 

 cent amongst X's customers, it is only 2 per cent amongst all 

 the remaining dealers. In area " B " the respective percentages of 

 throat illness are : — X's 14-2, others o-o. It should be added, that 

 the bacteriological examination of milk from X's dairy threw no 

 light on the subject. Dr Warry concludes from a consideration 

 of the whole of the circumstances: — (i) That sore throat disease 

 of a septic character existed almost exclusively in the northern 

 part of Hackney. (2) That this disease differed greatly from 

 ordinary catarrhal sore throat or follicular tonsillitis, being of a 

 septic character, and suggestive of being caused by some article 

 of diet (3) That nearly all the cases of sore throat in question 

 had occurred in the households supplied by a particular milk vendor. 

 (4) That this milk supply was " X's," and that in some way his 

 milk was the cause of the septic sore throat disease. 



7. A sore throat outbreak at Brighton in November 1901 

 was investigated by Dr Newsholme. It was complicated with a 

 simultaneous infection of scarlet fever, but reference will only be 

 made here to the sore throat illness. In all there were 18 persons 

 affected, 14 of whom were girls under 17 years of age, scholars at 

 a private school. The remaining 4 were teachers and servants. 

 Out of a total of 29 persons in the school, 18 were affected. The 

 chief symptoms were high temperature, rapid pulse, tonsillitis with 

 fibrinous exudation locally, except on the soft palate. In two cases 

 there was an evanescent rash lasting only a few hours and without 

 desquamation. There were no deaths. The illness was not as far 

 as could be judged scarlet fever, and diphtheria was negatived both 

 bacteriologically and clinically. Dr Newsholme was able after 

 minute inquiry to trace the cases at the school to one of their 

 number, who had come into the way of infection derived from a 

 milk supply contaminated by infectious disease in three families 

 connected with the dairy. One of the points of particular interest 

 in this outbreak is the relationship between simultaneous out- 

 breaks of scarlet fever and sore throat, and the secondary 

 infections arising.^ 



"^ Jour, of Hygiene^ 1902, vol. ii., pp. 150-169. Annual Report of Medical 

 Officer of Health of Brighton, 1 90 1 . 



