32 
The estimated daily supply of milk in Norwalk was 3,500 quarts. 
Dealer H. furnished 450 quarts, or about one-eighth of the whole, 
whereas he had twenty-seven twenty-ninths of the scarlet fever 
cases on his route. 
H. bought his milk from three producers. There were no cases 
of disease in the family of the milk dealer nor in those of two of 
the producers, A. and B. but on the third producing farm. K., a case 
of scarlet fever was found. This farm was in the Bald Hill dis- 
trict. The district school had opened September 7 with a registra- 
tion of 23 pupils. On September 20 one of the pupils fell ill with 
scarlet fever; other cases followed, and the school was closed Octo- 
ber 19. In all there were 20 cases, all in school children or in those 
coming in contact with them. Two of the above cases, living near 
farm Iv., were exceedingly mild and frequently visited and played 
at this farm with K.'s son, a lad of 4 years. This son broke out with 
a scarlatinous rash October 24. 
Milk from this farm was carted to Norwalk and all of it sold to, 
and delivered by, dealer H., who placed the cans of milk from Iv. in 
his wagons with that from the other two producers, A. and B. No 
attempt was made to keep the cans separate, and, therefore, one day 
part of his customers might receive Iv/s milk and the next day it 
would be delivered to others. H. supplied about 300 families, of 
which 24 were invaded. The sale of this milk was stopped Novem- 
ber 7. The number of cases and the dates on which they occurred 
would indicate that the milk was not continuously infected. Dur- 
ing the outbreak several cases of sore throat occurred among users 
of H.’s milk, which may possibly have had some casual relation to 
the infectious milk.- 
It would seem that cases of scarlet fever belonging to a school 
outbreak and visiting a dairy farm, and possibly also the boy on the 
farm, infected from his playmates, were the source or sources ren- 
dering the milk infective. The relation here of the two outbreaks 
is of interest, the one spread by school contact being the original 
source of the milk epidemic. 
DIPHTHERIA. 
Diphtheria epidemics apparently due to milk began to be reported 
in 1877 and 1878 in England. In certain cases the suspected milk 
came from herds where cows were found suffering from an eruptive 
disease of the udder, and this was thought to be the source of the in- 
fection. In this connection Ivlein a conducted some experiments on 
cows with the Ivlebs-Loffler bacillus. He took healthy milch cows 
and inoculated them subcutaneously in the shoulder with 1 cubic cen- 
timeter of a broth culture of the Ivlebs-Loffler bacillus taken from a 
a Klein, Report Med. Officer, Loc, Govt. Board, London, 1889, p. 167. 
