78 MILK AND THE PUBLIC HEALTH chap. 



outbreak, while it also illustrates the value of bacteriological 

 examinations of all handling milk. The outbreak was in 

 certain parts of Sydney, Australia, and is reported by W. G-. 

 Armstrong.^ The cause of this outbreak of some 40 cases 

 was a man, A. M., who was taken into the employment 

 of the milkman (S. M.) to milk and to distribute the 

 milk. A few days before starting his work he had suffered 

 slightly from sori; throat accompanied by swollen glands in 

 the neck. Starting the day after his employment by S. M. 

 and continuing for twelve days, cases of diphtheria sickened 

 amongst S. M.'s customers, and ceased two days after he was 

 recognised as having diphtheria bacilli in his throat. In all, 

 this man and six other persons residing in the dairy premises 

 were found to be harbouring Klebs-Loffler bacilli in their 

 throats. None of these persons were appreciably indisposed, 

 but a culture of the organisms from A. M.'s throat was proved 

 virulent to guinea-pigs. 



Four days before these examinations took place G-. P., 

 a milker employed by S. M., left the latter's employment, and 

 went to work as a milker for another milk-vendor (A. B.). 

 He had been specially associated with A. M. while at the 

 former dairy. Four days after starting to work for A. B. a 

 case of diphtheria occurred among A. B.'s customers. In all, 

 5 cases occurred among the customers within a week. After 

 being in A. B.'s employment for six days G. P. returned to 

 S. M.'s dairy in the same capacity of milker and milk dis- 

 tributor. His return started further diphtheria cases amongst 

 the customers of S. M., 4 persons being affected. Four days 

 after his return to S. M. diphtheria bacilli were found in his 

 throat, and he was excluded from the dairy. 



Apparently in neither of the infecting persons could a 

 -diagnosis of diphtheria have been made without bacteriological 

 means. 



The identification of the diphtheria bacillus in milk is a 

 matter of great difficulty, and this bacillus, so far as the writer 

 has been able to ascertain, has only been isolated from milk 

 on the following occasions : 



Bowhill ' isolated a virulent diphtheria bacillus from milk 



1 PuUic. Health, 1909, xxii. p. 149. 

 " Vderbiary Record, 1899, xi., April. 



