A report on the influence of milk in spreading zymotic disease : with a tabular analysis of forty-eight outbreaks / by Ernest Hart.
- Ernest Abraham Hart
- Date:
- 1897
Licence: Public Domain Mark
Credit: A report on the influence of milk in spreading zymotic disease : with a tabular analysis of forty-eight outbreaks / by Ernest Hart. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
25/26 page 23
![streets and eating ices from vendor F. were the only members to be atiackedin their respective households. A servant girl who visited the infected district each Sunday, and who partook of ices also, was the only one of her mistress’s family attacked. Reference.—Practitioner, 1882, vol. ii, p. 141. 34.—lorisv lltE. KEATTITCKY. F.S.A. Date of Outbreak: March to May, 1893. Reporters: Drs. Hailey and Tuley. Total Number of Cases: 54. Deaths: 3. Number of Cases amongst Drinkers of suspected Milk: 44. Percerdage to Total Cases: 82. Number of Families taking the Milk invaded: About 30. Sanita nj Circumstances of Farm or Dairy from which Milk was derived.—Fairly good, save that droppings, etc., from cows wex'e swept out into a pond at the back of stable, about 12 feet below. Exciting Cause of Outbreak.—WaXer xxsed. in cooling cans after they were washed, some watei' being left in the cans when milk poured in. Eberth bacillus found in this water. Circumstances implicating Milk.—The epidemic ceased after stopping sale of milk. Facts showing Special Incidence of Disease.—One case was the only one in the family who would not drink boiled milk. /?e/erence.—Report to State Board of Health. 3.->.-KEI.SO <SC'OTl.41NI». Date of Outbreak: ma.y to August. 1893. Reporter: Dr. Oliver, County M O.H. Total Number of Cases: 73. Deaths: 8. Number of Cases amongst Drinkers of Suspected Milk: 63. Percentage to Total Cases: 86. Number of Families Supplied by Milkman ; 48. Number of such Families Invaded: 45. Percentage: 04. Sanitary Circumstances of Farm or Dairy from which Milk was Derived.— I,eakage from drains to well, the water of the latter being contaminated wit h sewage. Drains faultily laid, and one completely choked, the sewage 1 ar'king up, escaping by way of holes made in a drain for rain-water pipe connections, tlie sewage thus set free reaching the farm well. Stoppage only discovered after the ground had been laid bare in searching for possible defects of drainage and suspected direct pollution of well. Exciting Cause of Outbreak.—by which tlie milk received its specific infective property held to be unquestionably by way of the con- laminated water supply. Two cases of illness on farm premises diagnosed as being enteric fever only after the occurrence of a third case in mid- June. Circumstances implicating Milk.—Of the 18 cases first occurring only i was of a non-consumer of the milk. In the first three weeks tlie cases numbered 15. is, and 22 respectively; of 48 households taking the milk only 3 e.scapcd invasion by enteric fever. Fourteen days after stoppage of the milk supply the attacks became less numerous, and from the end of the fourth to the close of the twelfth week only 7 cases occurred. Facts showing Special Incidence of Disease.—Three persons, not being regular customers of the dairy farm attacked by the fever, had each only one draught—namely, one a drink from the polluted well in passing, the other two a single drink of the milk. iie/erence.—Annual Report for 1893 of Medical Officer of Health. 36.—PAISLEY. Date of Outbreak: July, 1893. Reporter: Dr. Munro, Co. M.O.H. Total Num- ber of Cases: 86. Number of Cases amongst Drinkers of Suspected Milk : 86. Percentage to Total Cases: 100. Exciting Cause of Oaffireat-.—Enteric fever in home of ice-cream vendor. Putient in contact with business. Circumstances implicating Milk.—X\\ cases among persons eating the ice cream. Reference.—^ninsu Medical Jouenal, 1894, vol. ii, p. 829. 37.—STOCKPOUT. Date of Outbreak: July, 1893. Reporter: Dr. Porter, M.O.H. Total Number of Cases: 9. Death: x. Number of Cases amongst Drinkers of Suspected Milk: 9. Percentage to Total Cases : 100. Number of such Families invaded: 9. Sanitary Circumstances of Farm or Dairy from which Milk was derived.— Milk cans rinsed at two farms—in the one with water from a dirty-looking pool in a field where the cattle grazed, in the other with water from a shallow well in proximity to a privy midden, and close to a slop water channel of imperfect construction. Exciting Cause of 0«<6reafc.—Probably infection ot milk on vendor's pre- mises by dust from a specifically-infected privy pit. Circumstances implicating Milk.—Among an extensive round of consumers of the milk taken direct from the farms to their houses no cases vf fever occurred, the attacks all being in the homes of customers buying milk over the counter of the vendor’s shop. Reference.—Special Report of the Medical Officer of Health. Public Health, December, 1893, January, 1894. 33.-SIIILDOY AMI EAHT THICKI.EY. CO. lIlTRII.tll. Date of Outbreak: Ju]y to September, 1893. Reporter: Dr R. Bruce Low, L G B. Total Number of Cases: 45. Number of Cases amongst Drinkers of Suspecterl Milk: 45. Percentage to Total Cases : 100. Number of Families supplied by Milkman: n-j. Number of such Families invaded: 26. Per- centage: 17.6. Sanitary Circumstances of Farm or Dairy from which Milk was derived.— Room used for storing milk had one large window opening on to three nncovered privy middens, furthest 33 feet away, nearest23 feet; also 13 feet away an imperfectly trapped gulley in yard communicating with sewer. Inside store room a sink pipe passed direct to sewer. Exciting Cause of Outbreak —Three undoubted cases of typhoid fever oc- curred on dairy premises in July and August. Milk stored all night in room exposed to emanations from sewer, which ventilated directly into room ; room also open to infection from privy midden, on which were cast the untreated bowel discharges of the dairy fever patients through- out their illness. Circumstances implicating Milk —The 45 cases were part of a much larger prevalence regarded as due to sower emanations and the like. All the 45 I ases were in consumers of the milk. In one locality where the milk went to 127 customers, 14 2 per cent, were attacked, as compared with less than 3 per cent, of 93 customers of another dairyman. Facts showing special Incidence of Disease.—Attacks in adult males rela- tively more frequent than in females ; this perhaps accounted for by the fact that the dairyman was also a publican, and frequently served tlie milk over the bar to add to spirits consumed there by young colliers and others. Reference.—D.eport to Local Government Board. 3!*.—B.4MIOY. €0. CORK. Date Of Outbreak: August, 1893. Reporter: Dr. J. Welply. Total Number of Cases: 69. Deaths: 6. Number of Cases amongst Drinkers of Suspected Milk:^ 60. Percentage to Total Cases: 87. Number of Fain lies supplied by Milkman and Number of such Families Invaded: Of 24 farms which dealt with the creamery, 12 became infected Sanitary Circumstances of Farm or Dairy from which Milk was Derived: Not good ; original ca«e of fever imported from a distance. Exciting Cause of Outbreak.-—Axx imported case of enteric fever, which was nursed by a milker. The milk thus contaminated was sent to a creamery. Ttie separated milk from the latter was used in the houses in which the fever appeared. Circumstances implicating .ViH-.—Almost perfect correspondence cxist''d between the area of milk distribution from the creamery and the extent of the fever. Of the farms which did not deal with the creamery (about 180 in number), on only 2 did typhoid fever appear, and the persona who suffered on these had taken food in one of the invaded houses, so that Uieywcre indirectly affected from the common source. On tlie other hand, of the much smaller number (about 24) that had dealings with the creamery, 12 sufl'ered, and from i of these a labourer’s house had the in- fection conveyed to it. This house was surrounded by farms not sending milk to creamery, and from these fever was absent. Outside of the limited area dealing with the butterfactory there was not. as far as known, a case of typhoid fever. Twelve farms escaped the epidemic, though they got separated milk from the creamery, but on some of these ttie milk was not used without boiling, and on others it was given only to young cattle and pigs. Reference.—Lancet, vol. i, 1894. 40. -L.LUUE'I’II. Date of Oidbreak: March and April, 1894, Reporter: Dr. Verdon, M.O.H. Total Number of Cases: 59. Deaths: 10. Number of Cases amongst Drinkers of Suspected Milk: 55. Percentage to ToUd Cases: 93. Number of Families supplied by Milkman: Several thousands of customers. Sanitary Circumstances of Farm or Dairy from which Milk was Derived.— Tank in milk storehouse yard much polluted hy the dipping into it of pails from stables and cowhouses, as well as of brushes used for washing the van wheels, etc. Next to this tank stood the cauldron in which was boiled the water for can-washing. Exciting Cause of Outbreak—Thon^Yit oi as being the access in someway of polluted water from the storehouse yard tank to the milk churns. Circumstances implicating Milk.—All but four of the attacks were in con- sumers of the one milk supply, the patients residing in ditl’erent parts of different sanitary areas. ’The milk from one small section of the business only in question, as close investigation proved. Stoppage of the supply immediately followed (allowing for incubation period) by complete col- lapse of the outbreak. Facts showing Special Incidence of Disease—Milk specially taken at one house for use of a particular inmate. He alone was attacked. In another street the only customer was attacked. J?«/erencc—Special Report of Medical Officer of Health. British Medi- cal Journal, vol. i, 1894, p. 1148. 41.—B.AI'IP. Dale of Outbreak; April, 1894. Reporter: Dr. J. Brown, M.O H. Total Num- ber of Cases: 33. Deaths; 5. Number of Cases amongst Drinkers oj Suspected Milk: 30. Percentage to Total Cases: 91. Nuinber of Families supplied by Milkman; 30. Number of such Families invaded: 13. Per- centage: 43. Sanitary Circxtmslances of Farm or Dairy from which the Milk was derived.— Dairy farmer, who milked the cows, also the night-soil scavenger; and probably conveyed the germs of the disease into Ins own household Circumstances implicating Milk.—Of the households invaded, 11 obtained milk from the same source. The supply being stopped, the outbreak came to an end. JSe/erence.—Annual Report for 1894. 42 —TORRIIAY. Date of Outbreak: July, 1894. Reporter: Dr. Karkeek, M.O.H. Total Nxm- ber of Cases: 36. Deaths: 8. Number of Cases amongst Drinkers of Suspected Milk: 29. Percentage to Total Cases: 81. Number of such Families invaded: 24. Sanitary Circumstances of Farm or Dairy from which Milk was Derived.— Members of the farmer’s family (who had recently come) had typhoid fever, and by some mismanagement the milk probably got specifically contaminated. Farm water supply poor in quality. Exciting Cause of Outbreak —Development of typhoid fever within a week of the coining of the family from Exeter, first in the farmer, and later on in his children. Circumstances implicating Milk.—T\\o history of the epidemic showed most unquestionably the relation of the disease to the particular milk service; and 80 per cent, of the cases were in consumers of the implicated milk. /ie/erence.—Report of Medical Officer of Health.](https://iiif.wellcomecollection.org/image/b22339966_0027.jp2/full/800%2C/0/default.jpg)
