. Preventive medicine and hygiene. typhoid bacillus is much more widely dis-tributed in man than the cases indicate. Thus, in the District ofColumbia, of 1,000 healthy persons examined during the typhoid seasonof 1908, typhoid bacilli were found in the feces in 3 instances. At leastone and perhaps two of these individuals were regarded as temporarycarriers. In each instance the organisms were found only once. Thepopulation of the District of Columbia in 1908 was 300,000, and at theratio of 1 per 1,000 this would represent about 300 healthy persons inthat community harboring and shedding typhoi
. Preventive medicine and hygiene. typhoid bacillus is much more widely dis-tributed in man than the cases indicate. Thus, in the District ofColumbia, of 1,000 healthy persons examined during the typhoid seasonof 1908, typhoid bacilli were found in the feces in 3 instances. At leastone and perhaps two of these individuals were regarded as temporarycarriers. In each instance the organisms were found only once. Thepopulation of the District of Columbia in 1908 was 300,000, and at theratio of 1 per 1,000 this would represent about 300 healthy persons inthat community harboring and shedding typhoid bacilli for a briefperiod of time during the typhoid season. Modes of Spread.—Typhoid fever is spread either by direct or in-direct contact—indirectly through water, milk, and other foods; throughcontacts; and also flies, fingers, and fomites. Each of these modesof spread needs separate consideration. Water.—Water-borne typhoid is a common occurrence. Not long TYPHOID FEVER: 1902 TO 1916Death Rate per 100,000 of Population. Fig. 12.—Influence of Public Water Supplies on the Typhoid Fever Death Rate.(Diagram prepared by Marshall O. Leighton, U. S. Geological Survey; from figuresfurnished by Dr. Cressy L. Wilbur, Chief Statistician of Vital Statistics, Bureau of theCensus—from Kober.) 96 DISEASES SPEEAD THEOUGH ALVINE DISCHAEGES ago it was regarded as the sole or usual mode of spread; now we knowthat this was a mistake. Most fecal matter ultimately finds its wayto water; most water courses draining inhabited regions are contam-inated with human feces. Surface water is, therefore, apt to containtyphoid bacilli. The fact that there may be no clinical case of typhoidfever in the drainage area is no guarantee that the water may not beinfected—in view of the prevalence of missed cases and bacillus carriers. Fortunately, typhoid bacilli do not grow and multiply in waterunder natural conditions. They usually die in a few days, and rarelypersist longer than 7 days. They suc
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Keywords: ., bookauthorwh, bookcentury1900, bookdecade1910, booksubjecthygiene