The Birmingham age-herald., 1916-07-21
TYPHOID OUTBREAK WAS CAUSED BY ICE CREAM OF
 LOCAL MANUFACTURERS

weeks was beyond reasonable doubt
 caused in large part by infection con-
 veyed in ice cream made and sold by one of the manufacturers of ice cream in Birmingham. From a survey of the evidence in respect to sources of ingred- tents and processes of manufacture, it apparently was a matter of chance that infection was extensively spread through the ice cream supply from this source instead of the supply from some other source or sources. The infection in the ice cream may have been introduced at the factory, but the preponderance of evidence is that the infection came in
 the milk or cream from some dairy or
 dairy farm outside Birmingham. As a
 rule, the chances for. the spread of ty-
 phoid infection through milk or milk
 products are greater for milk as such
 than for ice cream. A rigid observance
 of the provisions of ordinance No. 403-C,
 approved July IS, 1916, should insure that the ice cream supply of Birmingham is
 a reasonably safe food for human con-
 sumption, and much safer than is the
 ice cream supply of the average American
 city at the present time Though the predominant factor in the spread of the infection responsible for the excessive number of cases of typhoid fever in the recent outbreak was an ice cream supply local factors other than ice cream also
 were operative in the causation of the
 disease occurring in the period, June l to July 1S Many of these other factors
 are operative to a greater or less extent every summer in Birmingham. The pre- vention of their operation is feasible, and is a matter of vital importance to the city of Birmingham. With the unusually
 large number of foci of infection now
 existing as a result of the outbreak, the af, ,fpr ,oy,f of
 tres in this city is now especially in-
 dicated.
 CONTROL MEASURES "2. Control Measures.-The prompt and vigorous action of the city officials in the inauguration of measures for the con- trol of the recent outbreak of typhoid fever is highly cmmenda able-particularly is this true in view of the financial em- barrassment of the city government at the present time.
 ''S. Publicity.-The publicity recently given through the local press and other
 agencies about the causation of typhoid
 fever in Birmingham has been of an ex- cellent character, and should have g
 marked effect in fostering the develop
 ment of the public sentiment necessary | to the accomplishment of permanent san- itary improvements in a community A. Usual Prevalence of Typhoid Fever. According to the records, typhoid fever is highly prevalent every year in this city Here it is largely a summer disease. With typhoid fever death rate per 100000 population of 40.2 in 1914 and of 33.7 in 1915 Birmingham stands at the
 bottom of the list of American cities with populations ranging from 125,0O0 to 2O0,0 900
 raj ted in order of lowness of typhoid fever death rate. The typhoid fever rate in this city can be reduced to a practically negligible figure by measures like those which have accomplished this in many other cities.
 CAUSES OF TYPHOID
 '5 Causes of Typhoid Fever-Typhoid fever is caused by infection which reaches
 the human body by being swallowed The
 infection has it's origin in the excreta <, (stools and urine) from the bodies of infected persons The infection may be spread by fingers, flies foods, water or anything else contaminated in the slight l est degree with human excreta. Accord l ing to the evidence the greastest single source of typhoid infection perennially | distributed in Birmingham is the open, | insanitary privies of which it is esti-
 mated there are 5000 within the city linn
 it's. The prompt correction of these in-
 sanitary conditions appears to be the
 most important single sanitary measure
 needed in the city of Birmingham.
 RECOMMENDATIONS
 |
 '1. Water.-(O Close all polluted wells and springs within the city-particularly ! those in the public parks-as soon as the , extension of the mains for city water
 makes this feasible-in the meanwhile,
 post warning signs. (b) Official supervis- ] ion of public water supply to insure that | this water will not at any time contain
 more than one colon bacillus to the 50 | c. c. Co The adoption of such engineer ! ing projects as may be necessary to pre- vent at any time the overflow of sew age-laden water into any of the reservoirs I in the public water system.
 "2. Milk and Milk Products.-(a) En- I largement of force of dairy farm inspec-
 tors sufficiently to insure visit to each dairy farm at least once every 30 days | and to insure adequate supervision over
 milk depots (b) Rigidly enforce ordi- l nance requiring every one of the dairy | farms to be provided with a properly in-
 stalled, properly used and properly main tained sanitary privy or sanitary sewer
 age system. Co Thorough measures to
 prevent flies and dirt from gaining access to milk throughout its course from COW ] to consumer. (dD Prohibit the serving of
 dipped milk from delivery wagons. (e) l Tubercular test once each year of dairy herds furnishing milk for city. (f) En- | couragement Of general milk supply. (g)
 Prohibit the sale in the city of any milk l containing at any time more than 300, 900 bacteria to the cubic centimeter, and con- taining after pasteurization more than 5000 bacteria to the cubic centimeter 1 (h) Enactment of an ordinance requiring that all butter sold or offered for sale
 in the citly shall be made from milk
 or cream which has been properly pas- teurized and properly protected after pas teurizaton. (D Rigid enforcement of or dinance No. 403-C passed July IS, 1916
 for the safeguarding of the city's ice cream supply.
 General Foodstuffs.-(a) Enforce
 ment, as rigid as may be feasible, of
 ordinances Nos 341-C and 361-C, for
 the protection of food for human con
 sumption against dangerous contami- nation by flies. dust, fingers or other agents within the city of Birmingham
 and the appointment as soon as practi- cable of a sufficient force of inspec- ! tors to carry out with a reasonable de- gree of adequacy the provisions of these ordinances. The enactment of an l ordinance prohibiting the sale or the offering for sale in the city of Bir- l mingham any green garden truck ob- tained from farms not provided with properly installed. properly used and properly maintained devices (either
 sanitary privies or sanitary sewerage I systems) for the cleanly and safe dis | posal of human excreta.
 GARBAGE
 Stable Manure.-Rigid enforcement of ordinance No 206 to prevent breed- | ing of house-f1ies in stable manure. "Garbage.-(a) Rigid enforcement of ordinances reuuirine the propar ,,sa ~,