APPENDIX I 309 



■were connected with the night-soil service, and in 

 another instance the milk had been kept in a closet in 

 the sick room. 



In the recent exhaustive investigation conducted by 

 the Public Health and Marine-Hospital Service the com- 

 mission definitely traced 85 of the 866 cases of typhoid 

 fever in the District to the use of infected milk. 



MILK-BOENE SCARLET FEVEB EPIDEMICS 



Of the 99 epidemics of scarlet fever the disease pre- 

 vailed in 68 instances at the dairy or milk farm. In 6 

 instances persons connected with the dairy either lodged 

 in or had visited infected houses. In 2 instances the 

 infection was conveyed by means of infected bottles or 

 milk cans left in scarlet fever houses. In 17 instances 

 the infection was conveyed by persons connected with 

 the milk business while suffering or recovering from the 

 disease, and in at least 10 instances by persons who 

 acted as nurses while handling the milk. In 3 instances 

 the milk had been stored in or close to the sick room. 

 In 1 instance the cans had been wiped with an infected 

 cloth. (In 19 instances the infection was attributed to 

 disease of the milk cows, such as puerperal fever and 

 inflammation of the udder and teats; but these out- 

 breaks were probably not genuine scarlet fever, but a 

 so-called streptococcus or staphylococcus infection, the 

 symptoms of which closely resemble those of scarlet 

 fever.) 



MILK-BOBNE DIPHTHERIA EPIDEMICS 



Of the 36 outbreaks of diphtheria, there is evidence 

 that the disease prevailed at the dairy or farm in 13 

 instances. In 3 instances the employees continued to 



