Evening star. [volume] (Washington, D.C.) 1854-1972, 1909-10-20
CAUSES OF TYPHOID
Contact and Milk Infection to
Be Guarded Against.
REPORT OF COMMISSION
Result of Three Years Study by
Marine Hospital Experts.
CLOSER INSPECTION IS NEEDED
Vigorous Campaign Against Fever
as a contagious Disease" Rec
commended to Eliminate
Its Spread.

I'VE believe that i'm order to cause
further and a marked reduction in the
prevalence of typhoid fever in Washing
ton it will be necessary to carry out
measures to prevent the conveyance OF
infection by milk and by personal contact.
Our studies indicate that If the market
milk supplied the city were pasteurized
under official supervision and an efficient
campaign made to diminish contact in
fection there would result very great
diminution in the amount of typhoid fever
in the District of Columbia
Such are the conclusions of the eX-
perts of the public health and marine
hospital service as just reported to the
District Commissioners, after an investi
cation of three years into the causes of
the prevalence of typhoid fever in the
National Capital and the steps necessary
to prevent it. The Investigations and the
report were made by NJ. J. Rosenau, di-
rector of the hygenic laboratory: l.. l..
Lumsden, passed assistant SUI lgeon, and
Joseph H. kastle, chief OF the division Of
chemistry.
In addition to the archaeological data
collected from personal visits to every
(May 1 to November ID. we made during
that season archaeological examinations
of the raw and filtered Potomac river
water, also numerous examinations of the
tap water. the applied water. etc.
Selected Section Studied.
AT the suggestion of Prof. Sedgwick,
made at the meeting of the advisory
board of the hysienic laboratory, We made
a study of the problem in a selected dis
trict, comprising thrty-two city blocks
and containing $500 persons. This study
was made by Passed Assistant Surgeon
Norman Roberts. We found no cases Ok
clinical typhoid fever among theSe people
which had not been diagnosed as such anu
| reported to the health officer. A specla
| search was also made for bacillus carriers
in this area.
Upon our request DR.. l.. o. Howard.
chief of the bureau Of entomology, De
partment of Agriculture. made study OF
lily abundance in relation to the prev
aience of typhoid fever in the District Of
Columbia. But little connection between
the germ of typhoid fever and the f1y a.
its dlsseminator could be made out.
The prevalence of typhoid fever in
the District of Columbia showed but
slight differences between the two years
1861 and 1898. Our studies showed that
about 10 per cent of the cases during the
typhoid season of these two years were
definitely attributable to Importation. con-
tact with previous cases In the febrile
stage of the disease, and to infected milk
The evidence strongly suggests that more
cases were due to personal contact and
to infected milk than were traceable tc
these factors.
In it's conclusions, the committee de-
cares that typhoid fever is peculiar to
the city of W aShlngtOn, and that Its re-
duction depends on steps To insure safe
milk supply and to prevent the spread OF
the disease by personal contact.
Summary of Conclusions.
The conclusions are:
'Race-During the warm season the dis
ease prevails proportionately among
white and colored. In the cold weather,
however, the disease prevails proportion
ately more heavily among the whites
''SeX-The disease is somewhat more
prevalent among males, especially among
those between the ages OF II and 81.
.Age.-The disease in 1905 again was
eSpec ially prevalent among children, sug-
gestlng that milk and contact are re-
sponSlDle for more cases than can be
definitely traced to these factors.
"Endemicity.-Them majority OF cases oc-
cur among persons who have not been
absent from Washington within the thir-
ty days previous to onset of illness, and
moreover, among those who have lived in
Washington all their lives. showing that
Washington is d true endemic center.
Seasonal Prevalance.-In 1906 and 1905
| the typhoid season and the summer sea-
son were both early. In 1907 there were
cool spring and late summer, also a
belated typhoid curve, showing striking
ly the correlation between the begin
ming of summer weather and the increas
ed prevalence of the disease. In 1907 anG
1908 the high typhoid fever continued un-
til the cessation of warm weather; H.
13O6, however. there was very marked
decline in the typhoid fever rate eight
weeks before the marked decline in the
warm weather. indicating that in this
year some factor or factors independent
of warm weather per Sc operated to :
relatively greater extent than In 1907 ana
l.us.
Geographical Distribution.-During the
three years there has been a general anu
fairly uniform distribution of cases
throughout the city.
Not Due to Poor Sanitation.
SANITARY Conditions.-The majority Oh
the cases occur among persons VINO h'e
in houses of good or fairly good sanitary
condition. In 1907 and 1908 the proportion
of cases among persons living under the
host sanitary conditions was much smaller
than in 1906
Sewerage System.-There is little diff
farence in the prevalence of the disease
in the severed and in the non-seWered
districts There has been no eSpeclal
grouping of cases, nor an excessive pre-
valence of the disease in the sections OF
the city in which a number OF privies re-
main
"Flies-In a well severed city, as WASH
ington now is, flies would not be expected
to play much of a part; and the lack or
correlation between the seasonable curve
of fly abundance and that of typhoid fever
seems to corroborate this view.
..Servants.-The majority of the cases
occur in households without servants
There is no evidence to support the sup
psition that day servants frequently con-
vey infection to the households OF their
employers.
Imported Cases.-With the decreased
prevalence of the disease in 1907 and 1908.
the relative percentages of imported cases
have increased. but the actual number
has remained practically the same during
the three years
"Contact-Our studies again show that
contact is one of the major factors In
the spread of the disease.
Milk, Shellfish and Water.
"Milk.-About 10 per cent of the cases
in 1905 as in 1906 and 1907. were definite
ly attributed to infected milk. In the