Contagious Diseases - Human Disease Spreaders-Carriers
( Originally Published 1936 )
We all benefit by the increased protection that has been given the public through the covering and wrapping of food in stores, pasteurization of milk, and so on. This involves the elimination of infected food handlers in places where food is manufactured.
There is, however, another source of infection of food from food handlers which occurs after the manufacture and purchase, and that is infection by cooks and food handlers in the kitchen. No more complete proof of the hazard which these people constitute could be offered than to recall the outbreak of amebic dysentery in Chicago during 1933, most of the cases of which were traced to certain hotels.
In hotels of Chicago, generally, it was found at that time that 3.9 per cent of the employes in hotels and restaurants carried the cause of amebic dysentery on their persons and usually on their hands, and in one hotel it was found that, on the average, about 7 per cent of the employes were carriers.
It is very difficult, as I have said before for boards of health to enforce regulations concerning food handlers of this type. They move around from place to place, and it is difficult to make employers inform the board of health of changes, and a great deal of sentimental obstruction is given to the efforts of the board of health to eliminate the infected carriers. But the possibilities of wide-spread epidemics or disease from this source are so common and so horrible, that the public should demand the enforcement of the regulations to the limit.
HISTORY OF CARRIER CITED
Recently in a popular magazine there was printed the history of the famous Typhoid Mary, who was almost the first person to be proved to be a carrier of typhoid fever. She worked as a cook in many households, and everywhere that Mary went typhoid fever was sure to go. She objected strenuously at first, according to the ac-count, to being prevented from engaging in her ordinary occupation, but finally became reconciled to it and led a happy existence as a lab-oratory assistant. She is, I believe, still alive, although not engaged in any occupation.
She is the most famous, but by no means the only typhoid carrier known. In fact, about one out of every ten persons who ever had typhoid is a carrier (many, as in the case of Typhoid Mary, cannot remember ever to have had typhoid fever, however).
And, according to officials in the U. S. Public Health Service, typhoid epidemics, now that the water supply is so generally under control, are more likely to come from carriers (food handlers) than any other source. An epidemic in Washington a few years ago occurred among the guests at a church supper: the potatoes were "diced" by two women, both of whom carried typhoid germs under their fingernails.
The only sure protection is to be vaccinated against typhoid.
PREVENTION OF TYPHOID FEVER
About 400 persons attended a church supper. Forty-four of these developed typhoid. Four died.
All had eaten potato salad. "The dressing used in this salad was eliminated from suspicion, because it had been boiled. It was evident, then, that the potatoes alone were the vehicle of typhoid transmission.
"In the preparation of the salad, the boiled potatoes while still warm had been peeled and diced by four women. During this peeling and dicing process, hands, soiled with typhoid bacilli, had deposited their germs on the potatoes. The pans containing this food had been covered with towels and set aside until the next day, thus retaining the warmth and providing an excellent culture medium; consequently, contamination was multiplied many times.
"Two of the four women who had peeled the potatoes proved on examination to be typhoid carriers. One of these had a history of typhoid fever twenty-two years previous. In the interim there had been six cases of typhoid in her immediate family. It is interesting to note that an examination of specimens from both carriers in 1927, five years after the outbreak, showed that they still harbored typhoid bacilli."
Typhoid fever is now a carrier disease, says Dr. James G. Cumming, Chief of the Bureau of Preventable Diseases.
Carriers are people who have had typhoid fever and who continuously discharge the germs, and carry them about on their hands. About ten per cent of all people who have typhoid fever become carriers and remain so for life.
What is the answer?
Have yourself vaccinated against typhoid fever. Then no matter what you eat or drink you are in no danger of contracting typhoid fever.
There was a time when typhoid was all around us—in water, in milk. And the toll was frightful. In twenty years the occurrence of typhoid has been reduced 98 per cent. The great danger now is from the carrier. And that is hard for health authorities to control. The safe thing is for everyone to have a preventive vaccination.
A colonel in the Army Medical Corps told me that in the old days whenever he was assigned as medical officer to a regiment in field maneuvers, he wondered whether he would be court martialed when he got back, or not, on account of the number of typhoid cases that would develop. There was no way to keep men from drinking at wells and streams on the line of march. "But," he added "now there is no worry. They can drink what they like. There is no typhoid. There is universal vaccination against typhoid."