MILK-BORNE TYPHOID 209 



sitting-room. At the end of the fourth week in September she was 

 convalescent, and began to help at once in the distribution of the 

 milk. Two other children of the family sickened and passed through 

 the fever. The mother nursed all three patients, and continued to 

 milk the cows and attend to the distribution of the milk. In 

 October and November some 13 cases of typhoid fever occurred 

 in seven families dealing with the infected cottage, and from these 

 primary cases a number of persons, over a somewhat wide area, were 

 infected by contact. By most careful observation and reasoning, Dr 

 Taylor arrived at the conclusion that the milk became contaminated 

 in the kitchen of this cottage, from the typhoid patients there 

 being nursed.* 



2. Infection from Washing Milk Vessels with Polluted Water. — At 

 Clifton, Bristol, in October 1897, an outbreak affected 244 persons, 

 31 of whom died. Ninety-six per cent, of the patients consumed sus- 

 pected milk. It happened that a brook received the sewage of thirty- 

 seven houses, the overflow of a cesspool serving twenty-two more, the 

 washings from fields over which the drainage of several others was 

 distributed, and the direct sewage from at least one other, and then 

 flowed directly through a certain farm. In September it seems that 

 some excreta from a man suffering from typhoid fever gained access 

 to the brook. The water of this stream supplied the farm pump, and 

 the water itself, it is scarcely necessary to add, was highly charged 

 with putrescent organic matter and micro-organisms. This water 

 was used for washing the milk-cans from this particular farm, 

 otherwise the dairy arrangements were efficient. Part of the milk 

 was distributed to fifty-seven houses in Chfton ; in forty-one of 

 them cases of typhoid occurred. Another part of the milk was 

 sold over the counter; twenty households so obtaining it were 

 attacked with typhoid fever, and a number of further infections 

 arose in the course of a third delivery.f 



3. Infection from Water added to Milk. — At Moseley, in 1873, 

 96 persons in fifty families contracted typhoid fever from milk. 

 Boy at milkman's house feU ill of typhoid fever, suffered there for a 

 fortnight and died. Two wells were polluted from a privy into which 

 typhoid excreta had been thrown. The water of the well was added 

 accidentally or intentionally to the milk. Dr Ballard summed up 

 his view of the causation in this outbreak as follows : — (1) Two 

 wells upon adjoiniug premises occupied by milk sellers became 

 infected early in November with the infectious matter or virus of 

 enteric fever, through the soakage from a privy into them of 

 excremental matters containing that matter of infection. (2) 

 Through the medium of water drawn from these wells the milk 



* EeHn. Med. Jour., 1858, pp. 993-1004. 



t Tram. Epidem. Soc. of London, vol xvii., pp. 78-103 (Dr D. S. Davies). 



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