GERMS IN RELATION TO MILK 35 



The germs of typhoid fever, diphtheria and scarlet fever* 

 (rarely of cholera, dysentery, malta fever, from goat's milk, and 

 smallpox) occasionally find their way into milk, owing to the milk 

 coming in contact with human patients suffering from these diseases, 

 or with their surroundings, or from contamination of milk or milk 

 utensils with water harboring the germs of typhoid fever. \ Also, 

 by wading in filth containing the bowel and urinary discharges of 

 human beings, cows may contaminate their udders with germs of 

 typhoid fever and thus convey them to milk. 



Other agencies by which disease germs may be carried to 

 milk and by which many cases of typhoid fever, diphtheria and scar- 

 let fever have been communicated to man are as follows : by attend- 

 ants in the sick room coming in contact with milk, by dish cloths, 

 brushes and other articles coming in contact with the sick and milk 

 utensils as well, by contact of milk with flies, dust, and by contact 

 of milk with persons handling human excrement. 



The chief source of milk infection is from patients at the 

 farm, dairy or shop. Persons in the first stages of disease, or 

 again those who carry the germs about with them after they recover, 

 are especially likely to infect milk. Thus so-called " typhoid car- 

 riers " may disseminate germs for years from the bowels, and in the 

 urine, etc. The germs of diphtheria occasionally remain in the 

 throat for months after recovery, " diphtheria carriers." The 

 method of sampling milk by tasting — so as to contaminate the milk 

 by the mouth, or utensils touching the mouth — is of course a source 

 of infection. Returned bottles from houses holding cases of con- 

 tagious disease are a menace. Ice cream may be a source of typhoid 

 germs, as freezing does not kill them. Typhoid germs also grow 



* Physicians are required by law to report all cases of infectious disease to 

 the local board of health. It should also be made mandatory that physicians 

 state the name of the milk dealer supplying the patient with milk, in the case 

 of every report of infectious disease, as is done in Mt. Vernon, N. Y. In this 

 way endemics originating in milk contamination with human infections could 

 be readily traced. 



f For " Typhoid Fever Case Card," see Appendix, p. 355. 



