108 
ICE CREAM. 
The history of the cases in regard to the eating of ice cream within 
the thirty days prior to onset of illness was as follows: Yes, 395; no, 
138; not determined, 9. 
Eighty-six of the cases gave a history of having eaten ice cream 
which was purchased from street vendors. Ten other cases, with 
onsets of illness distributed over a period of about two months, ate 
ice cream at a certain bakery. Among the persons who work at 
this bakery a case of typhoid fever developed in the summer of 1907 
and two cases in the summer of 1908. This bakery does quite a large 
business in a section of the city in which typhoid fever each year is 
somewhat disproportionately prevalent. The possibility of some 
one at this bakery being a bacillus carrier occmred to us and speci- 
mens of stools and urine from all persons at the bakery were examined 
bacteriologically; but all were negative for the typhoid bacillus. 
No cases this year could be traced to ice cream, but in view of the 
bad sanitary conditions under which much of the ice cream in Wash- 
ington is handled (particularly by street vendors) this year, as last, 
a certain number of scattering cases probably were caused by infec- 
tion in ice cream. 
RAW SHELLFISH. 
The following table gives the history of the cases in regard to the 
eating of raw oysters and clams from time to time during the thirty 
days prior to the onset of illness: 
Shellfish 
Yes 
No. 
Not deter- 
mined. 
Oysters 
33 
495 
14 
Clams 
18 
510 
14 
The small number of cases giving a history of having eaten un- 
cooked shellfish shows that shellfish this year, as was the case in 
1906 and 1907, could not have been the means of transmitting the 
infection to any considerable number of cases. Furthermore, dur- 
ing the season — June, July, August, and September — when typhoid 
fever is most prevalent in the District of Columbia comparatively 
few raw oysters or clams are eaten. 
