I9I3.] TYPHOID FEVER BY VACCINATION. 231 



conditions, drank the same water, ate the same food, and did the 

 same work. 



In the State of Wsiconsin, the bacteriologist of the State Labo- 

 ratory of Hygiene has administered the vaccine in two outbreaks, 

 one occurring in a county hospital, and the other in a small village. 

 At the institution one hundred and six persons were vaccinated. 

 One case of typhoid fever occurred amongst those who received the 

 vaccine, but within such a short time that it was evident that the 

 person had been infected before vaccination was practiced. The 

 case was atypical and of the mildest type, resulting in recovery, 

 showing that the vaccine exercises a favorable effect when given 

 during the period of incubation. During an epidemic in the town of 

 Warrens, Wis., one hundred and sixteen persons were vaccinated. 

 The epidemic ceased at once, and since that time only one case of 

 typhoid fever has been reported among the vaccinated. 



The method is of the greatest use in institutions, especially hos- 

 pitals. It has long been known that nurses were more liable to 

 typhoid fever than other people, as the result of direct exposure. 



Dr. Spooner began the inoculation of nurses in the Massachusetts 

 General Hospital, and reported that for the first time in the history 

 of the institution no nurses had suffered from typhoid fever during 

 the year. The practice has, since October, 1912, been extended 

 by him to twenty-three hospitals in Massachusetts. In all, 1,361 

 individuals have been treated. In the same hospitals there have 

 been six hundred and seventy- four persons exposed but not vacci- 

 nated. Among the vaccinated there have been three cases of typhoid 

 and para-typhoid fever. Among the uninoculated there have been 

 seventeen cases of typhoid and para-typhoid fever. It is evident 

 that a large amount of protection was furnished by the inoculation 

 among those especially exposed to the disease. 



In the State of Wisconsin we advise that whenever a case of 

 typhoid fever occurs in a family the other members of the family 

 shall receive the protective inoculations. It is impossible to give 

 exact figures of the results, but several very striking instances have 

 been reported to us. 



