Rural Hygiene

by Henry N. Ogden

Diseases caused by milk.

Many infectious diseases are propagated by milk, not only among children, whose chief food is found in this supply, but also among those of more mature age who, though drinking only a small quantity, are apparently more easily affected. Four diseases are particularly to be noted in connection with the consumption of milk, namely, typhoid fever, scarlet fever, diphtheria, and tuberculosis.

Typhoid fever from milk.

One of the most striking illustrations of the spread of typhoid fever through milk occurred this last year in the city of Ithaca, New York. The city proper lies in a valley between two hills, the milkmen having their farms on both sides of the valley to the east and west, on the hill slopes. One milkman on the west, with a large route, delivered his own milk only in part and bought an additional supply from a farmer on the east. In the family of the latter occurred a case of typhoid fever in September, pronounced by the local physician to be sunstroke, but evidently typhoid fever, since other cases of secondary infection developed in the same family and were then pronounced typhoid. The milk from this east-side farm was taken down the hillside and turned over to the west-side farmer, who distributed his own milk in his trip from his farm across the valley, his route being so timed as to allow him thus to dispose of all his own milk. Having then loaded up with the east-side supply, he started back across the valley, distributing the milk which was evidently polluted, since on his return route house after house developed typhoid fever, with no cases on the first part of the route and with no other cases in town except those on this milk route. Forty-four cases developed in all, with two deaths.

The Reports of the Massachusetts State Board of Health give a number of cases of the same sort, all showing that milk is easily infected by persons suffering from even mild attacks of typhoid fever, attacks so slight as perhaps not to be recognized or to be worth submitting to a physician, but which are responsible for bacteria passing from the hands or mouth to a can cover or ladle, and so to the milk.

Diphtheria.

Diphtheria seems to be well established as a disease transmissible by milk, although its occurrence is not so frequent as that of typhoid fever. Not long since, the writer was much interested in an epidemic of this sort described by a physician who was convinced that the bacteria responsible for the mild form of the disease occurred largely in the nose and throat passages. He noted that as the result of these growths a constant exudation from both passages was present, and that a man with this disease, working over the milk, might easily allow the milk to be polluted by this exudate dropping from his nose.

The result was a general distribution of a mild form of diphtheria among those using the milk.

Scarlet fever.

Many examples have also been given of the distribution of scarlet fever through the agency of milk, the specific contagion probably being discharged by the patient from his nostrils, mouth, or from the dry particles of skin so characteristic of this disease. Unfortunately, mild cases of scarlatina are very apt to occur, so mild that a physician is not called in, and the only positive proof of the disease consists in the subsequent "peeling," although the nasal passages may have been alive with germs.