MILK-BORNE DIPHTHERIA 213 



the number of bacilli present on that day in the milk amounted to 

 32 per c.c. Scrapings from vesicles on the sixth day were inoculated 

 into two calves, which then suffered from a like disease." * 



During 1890 and 1891, Dr Klein repeated these experiments 

 on milch cows, and in two further instances, out of six cows, an 

 eruption was produced on the udder and teats, and in one of these 

 positive cases the B. diphtheria was found in the milk about a week 

 after inoculation. 



It must be admitted that positive results did not always follow 

 these experimental researches. Loffler, Abbott, Bitter, and others, 

 including many veterinarians, criticised the experiments, and held 

 that there was no conclusive evidence that diphtheria was a bovine 

 disease. Since that time some twenty milk-diphtheria outbreaks 

 have been investigated, with the result that, with one or two 

 exceptions, the infectivity of the milk was certainly derived from 

 human sources and not from bovine. In the Croydon outbreak in 

 1890, at Worcester in 1891, and at Glasgow in 1892, evidence was 

 obtained which appeared to support Klein's views. 



Up to the present it may, however, be said that the evidence 

 forthcoming points in the direction of human rather than bovine 

 infection as the origin of the diphtheria bacillus in milk. 



An interesting investigation has recently been made by Dean and 

 Todd, respecting a small outbreak of diphtheria occurring in 1901/f* 

 In this outbreak several individuals suffered from diphtheria, and 

 several others in the same households suffered from sore throat, 

 probably diphtheritic. These individuals obtained their milk from 

 two cows suffering from a contagious eruptive disease of the udder, 

 from which Dean and Todd isolated a bacillus indistinguishable from 

 Klebs Loffler bacillus of diphtheria. The case was a very interesting 

 one. But the whole matter of bovine diphtheria is sub judice. 



It was then in 1878, that evidence was forthcoming in support 

 of the view that diphtheria, like typhoid fever, might on occasion be 

 spread by means of milk. In that year, Mr W. H. Power made an 

 inquiry into an outbreak of diphtheria in North London, chiefly in 

 Kilburn and St John's Wood. There were as many as 264 persons 

 attacked, and 38 died. The infection invaded some 118 different 

 households. The epidemic was most severe in May (first four weeks), 

 when about 190 cases occurred. The outbreak terminated abruptly. 

 The area infected, and time of infection, clearly showed that there 

 was some factor at work over a circumscribed area, and operative 



* See A Treatise on Hygiene and Public Health (Stevenson and Murphy), vol. ii., 

 pp. 161-164 (Klein). Also Local Government Board Report, 1889, p. 167 et seq. 



f Jour, of Hygiene, April 1902 (vol. ii., No. 2, p. 194). Experiments on the 

 relation of the Cow to Milk Diphtheria, by George Dean, M.B., and Charles Todd, 

 M.D. 



