116 THE MILK QUESTION 



Bacillus carriers. From two to four per cent of all per- 

 sons who have typhoid fever become chronic bacillus car- 

 riers; that is, they continue to discharge typhoid bacilli in 

 their faeces or urine. A bacillus carrier may enjoy robust 

 and vigorous health, so that it is impossible to detect these 

 persons except by a bacteriological examination. 



Recently a number of nnlk-bome outbreaks of typhoid 

 fever have been traced to infection from bacillus carriers. 

 One of the first instances was reported by Albert. This out- 

 break occurred in October, 1907, at Cedar Falls, Iowa, in 

 which thirteen cases occurred in the three f amiUes supplied 

 with the suspected milk. The man who owned the cow and 

 did the milking had had typhoid fever one year previous 

 to the outbreak. Typhoid bacilli were demonstrated in 

 his urine. 



Lumsden and Woodward reported an outbreak which 

 occurred in Washington, D.C., in September and October 

 of 1908. Fifty-four cases occurred in this epidemic. The 

 victims were among the customers of two different dairy- 

 men, both of whom, however, received a part of their milk 

 supply from a certain farm. All the evidence pointed to 

 this farm as the source of the infection in the milk. No 

 history of recent illness on the farm could be ascertained. 

 A search for bacillus carriers among the persons on the farm 

 was made and one was discovered. The bacillus carrier 

 proved to be a woman who had had an attack of typhoid 

 fever about eighteen years before the time of the outbreak. 

 Typhoid bacilli were found in large numbers in her fseces. 



ScheUer traced a typhoid fever outbreak near Konigs- 

 berg, Germany, to a woman excreting typhoid bacilli in her 

 stools and urine. This woman had had an attack of typhoid 

 fever seventeen years before and was the source of infec- 

 tion for the outbreak. 



Numerous other similar outbreaks have been studied in 

 recent years. This represents one of the hidden dangers 

 and one of the greatest diflSculties in obtaining raw milk 



