r)0 
the diminution in the amount of typhoid fever in 'the District of 
Columbia was due to the improvement in the quality of the drinking 
Avater as the result of sand filtration. Positive proof of this can not 
noAv be established. However, a careful study of typhoid fever in 
the District of Columbia for the next three to five years will throw 
much light on the role played by the Potomac PiA^er water in previous 
years. 
BECOMMENDATIONS. 
We recommend: 
1. That all cases of typhoid feA^er and all cases of suspected typhoid 
feA^er shall be treated as contagious and dangerous to the community. 
This should include isolation, placarding, the prompt disinfection of 
the discharges, the patient’s bedding, etc. 
2. That laboratory facilities be provided free of cost to aid phy- 
sicians in the early diagnosis of typhoid fever and also to determine 
when persons who have had the disease no longer menace the public 
health by discharging typhoid bacilli. 
3. That all milk not ‘‘ certified ” or “ inspected ” ® shall be pasteur- 
ized, under official surA^eillance, especially during the typhoid feA^er 
season. 
d. The enactment of a laAv prohibiting the handling or sale of milk 
or milk products in any dAvelling or in any structure so situated as to 
render contamination of these products especially liable. 
5. The enactment of a hnv prohibiting the care of a case of typhoid 
fever in any house Avhere foods or beA^erages liable to convey the in- 
fection are sold or prepared for sale. 
6. That in order to furnish a water supply of a satisfactory grade 
of purity throughout the year, additional storage reserAmirs shall be 
constructed, or a coagulant (alum) shall be used during periods of 
high turbidity. 
« For the definition of “ certified ” or “ inspected ” milk, see “ The classifica- 
tion of market milk,” hy A. I). Melvin, Hygienic Laboratory Bulletin No. 41, p. 
551). 
