Evening star. [volume] (Washington, D.C.) 1854-1972, 1907-07-11

Still more remarkable in the view of those
who favored the construction OIL the $780,
600 filtra ton plant located near the Soldiers
Home, is the fact that the operation OF that
plant has been attended by no appreciable
change in the typhoid situation in the Dis
trict Of Columbia.
Never Isolated From Potomac Water.
The typhoid fever bacillus has never
been isolated from the Potomac river
water the report of these experts de-
clares. I'VE therefore have direct
evidence to prove or disprove that some
of the infection may may not be wa
ter borne. We must, then. satisfy our
selves for the present with certain in
direct evidence bearing upon this i'm
portant question.
Despite the improvement in the water,
due to storage standardization and Ultra
ton, no appreciate change in the ty-
phoid situation is apparent.
"Water-bo epidemics. due to concen-
trated and quickly transferred Infection
may occur at any time of the year, par
ticularly in the spring and late fall. Such
epidemics are generally characterlzed py
sudden onset and sharp decline. Little
is known of the characteristics or ty-
phoid fever outbreaks resulting from wa
ter containing greatly diluted and slowly
transferred infection.
The presence of typhoid bacilli in great
dilution and perhaps attenuation may not
have the power of directly causing tie dis
ease in persons drinking such water. Wa
ter however, containing an occasional ty-
phoid bacillus may infect community in
such a way that large numbers of persons
become bacilus-carriers. With the advent
of the hot weather many such persons may
be stricken with typhoid fever. just as the
depressing influence Of the heat Is known
to determine the onset Of diarrheal disease
and other intestinal infections. In other
words, the presence Of the typhoid bacillus
in the intestinal tract has not always the
power of causing typhoid fever. We must
reckon with our host. The dilute and at
tenuated infection in the water may sow
the seed; for the production of the disease
we must have susceptibility, and this SuS-
ceptib!lity may be largely brought about
by the diminished resistance caused by the
summer heat.
I'VE are totally ignorant of the number
Of bacilli ordinarily necessary to produce
the disease. 1t is reasonable to assume
that water containing the typhoid bacillus
in great dilution may sometimes directly
cause the disease in highly susceptible in
dividuals. On this assumption We would
expect in a community in which the great
majority Of the population drink such wa
ter. the cases to be widely scattered and
very small proportion of the people to have
the disease. Further, we must consider
that the OCCASIONAL and perhaps attenuated
typhoid bacillus in water may increase in
danger and virulence by contamina ting milk
and other beverages or foods that are favor
able media for its rapid growth and multi
plication.
In favor of the view that the Potomac
water plays an important part in the dis
semination of typhoid fever In Washington,
We have the following:
1.-THE uniform distribution of the disease
throughout the city, indicating common
medium, such as water.
1.-The great majority (9S5 per cent? Of the
cases studied gave a history of having
drunk unboiled tap water within thirty days
prior TO the onset of the disease
No Improvement in Situation.
The report states that the Improvement
in the water supply was not followed by
an Improvement in the typhoid fever stua-
ton. IF the water is not a factor in the
spread of the infection, then 1t would ap-
pear" the report says, that some I'M
known agent or agents for the dissemina-
ton of the infection must be peculiarly
active in Washington.
so far as typhoid fever is concerned, 1t
seems that Washington may be classed
with the southern cities, where this disease
IS either unusually prevalent or unusually
virulent, as Indicated by the high death
rates.
After specializing on the various possible
causes of typhoid fever in this city the re-
port continues
Opinion Reserved.
'In view of the foregoing, it is evident
that at the present time it Is not possible
TO present conclusive proof as to the part
played by the Potomac river water In the
spread of typhoid fever in the District of
Columbia. Therefore, the board reserves
final decision on this subject until investi-
cations, now in progress at the hygienic
laboratory, have been completed.
although views may differ concerning
the relative part played by water, milk,
contacts and other factors in the spread of
typhoid fever, there is general agreement
that the successful control Of the disease
lies in destroying the infection as it leaves
the body; that is, We must try to prevent
the infection of our food and drink and
our environment.
Finally, it must be borne in mind that
the typhoid problem in Washington does
not differ radically from that of many
other communities. 1t is part of a world
wide problem. The disease is endemic
throughout the length and breadth of our
large country and prevails to a greater or
less extent In almost every civilized COM
munity. There is a constant interchange
of infection through social and commercial
intercourse. The situation in Washington
has therefore been considered. not only
with regard to local conditions. but also in
reIa ton to studies that have been made
upon the disease in other cities and in
other countries.