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17
One very instructive outbreak occurred in Mitcham,
in which the disease was undoubtedly milk-borne.
Within a very short period 28 cases were notified as
occurring in Mitcham, and it was found that in 22
instances the milk came from one dealer, in nearly all
of the other cases direct contact with infected houses
was traced. On visiting the vendor's farm nothing was
found to be faulty with the cows or with the general
cleanliness, etc.*, of the place, but a child was there
looking ill, and on examination he was found to have some
swelling of the legs and also desquamation of the hands,
feet and body. I was informed that he was under treatment
for Bright's disease, and that he was employed
scouring out the utensils. Undoubtedly he had Scarlet
Fever, and was the cause of the outbreak in the neighbourhood.
On removing this source of infection no
other cases occurred which could be traced directly to
this milk supply. This "missed case" directly and
indirectly was the probable cause of between 40 and 50
cases in Mitcham.
In three instances "return cases" unfortunately
occurred, and in each case it was found that the
patient discharged had contracted a "cold" within a
few days of returning home, and this nasal discharge may
probably have been the source of infection. The practice
at the Isolation Hospital is for no patient to be
discharged until I am satisfied that no infectivity from
the throat, ears, nose, skin, or eyes exists. The following
warning is given to parents and friends on thedischarge
of the patients, but I find that this recommendation
is practically always ignored.