Atlanta tri-weekly journal. [volume] (Atlanta, Ga.) 1920-19??, 1922-10-24
THE TYPHOID PROBLEM
BY H. Addington Bruce

More and more, according to mortality sta
tistics, typhoid fever is becoming problem
of rural districts rather than of city life.
During 1920, the latest year for which 1g-
ures are available the rural death rate from
typhoid in the registration area of the United
States was 90 in loo, 900, while the rate for
the urban population was 5.5.
This would suggest the desirability of an
intensive educational campaign to impress
upon people who live in the country the
dangers lurking in impure drinking water,
and the Importance of safeguarding wells and
springs from contamination. For certainly
the virtual abolition Of typhoid epidemics in
cities has been a direct result Of the securing
of better water. AS noted by Richard Cabot:
"In Philadelphia they cut the mortality of
typhoid to about one-third what it was by
doing nothing in the world but improving
their water supply. In and about Boston
the typhoid mortality has gone rapidly down
since we have had the present water supply"
Also, to be sure recognition of the i'm
portance of obtaining pure milk and of
searching for personal carriers of typhoid
germs has contributed to typhoid reduction
in the cities. There is reason to believe that
in some country districts this last is meas
ure' more urgently needed than even educa-
tion for water protection.
Certainly such was found to be the case in
two Maryland counties made the subject Of
an investigation by workers for the United
States Public Health Service.
The investigation was prompted by the
discovery that for some years typhoid had
been steadily recurring in certain localities
in these counties. Year after year an I'M
usual number of people were reported as be-
ing stricken with typhoid.
Seeking the cause of this endemic condi-
ton, suspicion was naturally directed at first
to the quality of the drinking water. In
only few cases was evidence found of pollu-
i'm Of fhn rrofn INV I0i1 Nor
were there many cases in which pollution Of
the milk supply could reasonably be regarded
as the responsible cause.
On the other hand, it was discovered that
personal contacts with present or past victims
of typhoid seemed to play dominating part
in the causing ofsnew cases. This led to the
making of tests, which revealed the presence
OF not fewer than ten carriers to whom more
than third of the cases of typhoid studied
could be attributed.
It was found, too, that many of the remain
ing cases might we'll have contracted their
typhoid from unrecogniZed carriers. So that,
detailing the findings of this Maryland in
vestigation in Public Health Service re-
port. DR.. R. B. Norment, Jr., comes to this
conclusions:
"It does not seem to be an exaggeration to
state that probably more than 80 per cent of
cases Of endemic rural typhoid fever reported
each year in the counties are traceable to
contact with chronic carriers, and more than
20 per cent to contact with unrecognized
cases.
'It may be that such a conclusion has a
very much wider geographic application. If
this is found to be true the demonstration of
carriers, as well as practical measures for the
prevention of the spread of typhoid by car
r13rs, should receive mora careful 4ons.dera-
ton than has been given in the past"
Obviously an element is hereby introduced
seriously complicating the problem of plotting
out typhoid. Buc in view Of the progress al
ready achieved It will hardly be found to con-
stltute an iasaperable obstacle to further
progress.
Copyright, 1922, by The Associated News
papers.)