308 APPENDIX I 



nursing the sick, or are suffering themselves from some 

 mild infection while continuing their duties, or are con- 

 valescent from disease, and thus infect the milk in han- 

 dling it. 



It is quite conceivable how animals, in wading in filth 

 and sewage-polluted water, may infect the udder, and 

 through it the milk, with the germs of typhoid fever. 

 We can also appreciate how infected water may convey 

 the germs when used for washing the utensils or in de- 

 liberate adulterations. Infection may also take place 

 through the agency of scrubbing brushes, dishcloths, 

 flies, and exposure to infected air. 



MILK-60RNE TYPHOID JFEVEE EPIDEMICS 



Of the 195 epidemics of typhoid fever tabulated by 

 Dr. Kober, there is evidence in 148 of the disease hav- 

 ing prevailed at the farm or dairy. In 67 instances 

 the infection probably reached the milk by percolation 

 of the germs into the well water with which the utensils 

 were washed; in 16 of these the intentional dilution 

 with water is a matter of evidence. In 3 instances the 

 Bacillus colt communis and the typhoid germs were 

 demonstrated in the suspected water. In 7 instances 

 infection is attributed to the cows wading in sewage- 

 polluted water and pastures; in 24 instances the dairy 

 employees also acted as nurses ; in 10 instances the pa- 

 tients while suffering from a mild attack, or during the 

 onset of the disease, continued their work; and those 

 who are familiar with the personal habits of the average 

 dairy hands will have no difficulty in surmising the man- 

 ner of direct digital infection. In one instance the milk 

 tins were washed with the same dishcloth used among 

 the fever patients. In 2 instances dairy employees 



