TYPHOID FEVER IN DISTRICT OF COLUMBIA. 
63 
Honorable men will not object to regulations calculated to promote the purity of 
their product and the health of their customers, and as many of the most serious faults 
are the result of ignorance rather than intentional neglect, the difficulties will be 
materially lessened by proper education and trade competition. 
Our otvn studies closely confirm Doctor Kober’s observations and 
give further evidence of the danger from contaminated milk. 
The typhoid bacillus may reach the milk in any one of many ways. 
Usually it is by direct or indirect contact with cases of the disease. 
Often convalescents or persons in the first stages of typhoid fever milk 
the cows or handle the milk. Sometimes the same hands that nurse 
the sick, milk the cows. Sometimes the infection is carried to the milk 
indirectly through Avater or by means of the cleansing rags and other 
fabrics that have become contaminated with the dejecta. Most of the 
195 outbreaks described b}^ Doctor Kober Avere traced to cases of 
typhoid fever on the dairy farms. MTien one remembers hoAv 
readily the typhoid-fever infection is communicated from person to 
person by direct or indirect contact, it is easy to understand hoAv 
readily the infection may be conveyed from the sick to the milk. 
The question of “bacillus-carriers’^ is a live problem AA^hen applied 
to milk. ^Vhen AA^e remember that many people harbor the typhoid 
bacillus Avithout being sick, in fact AAuthout ever haAung had the dis- 
ease, and that persons may discharge great numbers of the bacilli for 
months and in some instances for years after apparent recovery, it is 
easy to understand how the milk may become infected, and yet a 
searching inquiry fail to find the source of the danger. This empha- 
sizes the fact that the feAA^er persons AA^ho come in contact Avith 
milk the better, -and those AA^ho have actually to handle the milk 
should exercise scrupulous cleanliness and be under strict medical 
supervision. 
The use of pure Avater for cleaning cans and bottles can not be too 
strongly emphasized. It can be readily understood hoAv a feAv 
typhoid bacilli, finding their way from AA^ater into a bottle, can, or vat 
of Avarm milk, may in this very favorable culture medium multiply 
very rapidly and so contaminate the milk to a dangerous degree. 
Neufeld ® considers that, next to water, milk plays by far the most 
important role in the epidemiology of tjrphoid fever. 
Schiider ^ collected statistics of typhoid epidemics, 110 of which 
AA^ere due to milk, against 462 due to Avater. 
The English literature in particular contains many references to 
milk as a vehicle of spreading the disease. 
“ Neufeld, F.: Typhus. Handbuch der pathogenen Mikroorganismen, by W. Kolle 
and A. AYassermann, vol. 2, p. 204. 
& Schiider. Zeitschr. f. hyg., Bd. 38, 1901, p. 343. 
