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" Microbe Carriers^TheNewly Discove
People Who Are Fountains of Germs, Scattering Disease and Death All Their Lives?And the Problem of What to -Do With Them. AVERY worthy member of a California church contributed a huge pan of baked spaghetti to a church snpper, and ninety-three per sons were stricken with typhoid fever. This woman had never had typhoid fever in her- life. Typhoid fferrffe lived in her* bat did not infect her?she was what physicians have lately discovered and now call a "carrier." In Germany, in England and In New York similar wholesale infections have been traced to a "carrier." At this moment the New Yoris Board of Health has made a prisoner for the second time the famous 'Typhoid Mary." Twice has this woman spread a trail of disease and death from her cooking, although "Typhoid Mary** herself has never had typhoid. And there is no known way to find the fountain-head of these deadly germs in Mary and put an end to them. And, beside# "typhoid carriers," there are now known to be scarlet} fever, diphtheria and other carriers. Any worker In a dairy, any cook 07 helper or dishwasher in a hotel or restaurant or steamship or dining can or your own cook may be a carrier. The problem confronting health authorities is a difficult one. Is if possible to examine everybody who has anything to do with cooking? And when a "carrier" is foynd, what then? Should a "carrier" be imprisoned for life, Where he or she cannot menace the health of the community? By SOME ten years ago a new one?If we may use a sporting expression?was put over on the science of preventive medicine. TIiIb was the typhoid earriei^-a person who may or may not have bad typhoid fever; a person, Indeed, apparently In perfect health, -who could harbor the germs of typhoid fever and Infect other people with them. For example: A baker's apprentice?this was in southwest Ger many?died of typhoid fever. Then the doctor set to J&gurlng out how this patient had got his fever. Here we must understand that typhoid la, like cholera and dysentery, an "Ingestion Infection'*?that Is, the only way you can get typhoid Is through having swallowed ~ and drink that has contained the typhoid germs. John B. Huber, A. M., M. D. Though typhoid la a general disease and affeots the whole body, tho main parts affected are the 41s68ttre organs and apparatus, especially the gall bladder and the Intestines, in which the germs multiply and from which the germs called also Che typhoid bacilli are emitted. Wei), on Investigation, it was found that this baker's wife had typhoid some years before, since which Al ness practically every one of that baker's apprentices had come down with "some kind of digestive dis turbance" soon after his apprenticeship began. An examination of the baker's wife?all this was, of course, several years after she had had typhoid?by the health authorities resulted In the discovery that She was a typbdld fever carrier. That is. although healthy, enormous colonies of typhoid bacilli wers constantly developing In her body. The baker's wife, however, would not take the simple precautions the doctors directed. She declared that the apprentices had been taken tU because she fed them with too rich food. It is by such perversity that stupid people claim they have the right and title to be a menace to the reat of the community. It has been well said about euch people that "a rogue is always much easier to deal with than a fool." It was so simple?the advice which this malign woman would not take. Simply to keep her hands clean, and especially before handling food that others would have to eat Soon after her examination a tenant in her house died, also of .typhoid fever, and later another case was attributed to her. Three victims, not counting those apprentices who had suffered from "too high living," and all because this woman refused to keep her hands clean. in another Instance four cases of typhoid were traced to a typhoid carrier who had had the disease forty years before. Think of ltt Forty years before I Then there was the manager of an estate who was found to be a typhoid carrier. This man had suffered from typhoid ten years before. And during those ten years there had been sixteen cases of the disease on or near the estate- It was practically certain this man ager had been the source of those cases. Many milk-borne typhoid cases are due to typhoid bacillus carriers engaged in dairying?people working in that chain which has so many hidden links In its course, from the cow, through the dairy, the milk trains, the city handlers, the domestics, to the con sinner's Upa As for Instance: A number of typhoid eases occurred among employes at a particular dairy and among the consumers of that dairy's milk. Four teen of those people were found to he typhoid carriers. One of them, a woman employe at the dairy, had had typhoid seventeen years before. Here was evidently the origin of the whole trouble. Drs. Bolduan and Noble, of the New York City Health Department, some three years ago discovered a typhoid carrier of forty six years standing to whom a large outbreak In milk borne typhoid fever was traced. Hundreds of like cases have since been found, In both sexes. In many Institutions, in many communities. More Women Than Men Typhoid Carriers More women than men typhoid carriers have been traced. Possibly there sre not reslly more women thus affected. It may be there only appssr to be tnofe, because the chief danger of euch infection lies In handling fobdstuffs, as by cooks and waitfesRee. Be sides. women are more prone to gallstone diseases, and the gall bladder has been found the chief factory of typhoid germ production in the human body, although other parts of the digestive cankl manufacture them. Thus recently a woman typhoid carrier submitted to have her gill bladder operated on, and no typhoid germs were found in that organ, and yet she was a carrier of virulent typhoid germs. The German doo tors, who are permitted by their Government to be much more thorough than we are, found that of 450 female typhoid carrier 314 were hausfrauen (persons who. handle food, cooks, boarding house k'eepers and so on), while fifty-six were domestic seeyants. The classical case is that of the far famed Typhoid Mary, whose case became protolnent several years ago, when she sued the New York City Department of Health, which had her confined for three years on North Brother Island. Her suit was unsuccessful. She was then forty years old. And fhe then deblared she had never K&d typhoid fever or any other dangerous disease. Typhoid Mary's case, the Heatth Department/found, went back to 1906, when there occurred an alarming spread of typhoid at Oyster Bay. Six out of eleven members of a family where Mary was cook had been stricken with this very serious disease. Dr. 8oper, for the Health Department, made a very thorough in vestigation, which we cannot detail here, until he focussed his scientific eye on the fact that the family had changed cooks about three weeks before the fever began. Then he investigated Mary Mallon's record, and found that she had been employed In a home where there had been four members of the family and seven servants, and that within a month .of Mary's taking charge of the kitchen four of the servants were 111 with typhoid. In 1903 Mary was blessing, lo the same way, a family of nine at Dark Harbor. Me. Of these nine seven very shortly became typhoid cases. In all, though Dr. Soper traced but fragments of her history during ten veara, he laid at her kitchen door twenty-six typhoid fever cases "Typhoid Mary9 Would Not Listen to Reason **" then, probably still la, a robust woman, weighed 190 pounds and it took five policemen to get her to North Brothers Island. After three years she was released on hef promise that she would not again take a place as a cook. She did not keep the promise, and Is now again under observation after having caused an epidemic In a charitable institution where she had been hired as a cook. The trouble with her was she would not liaten to reason any more than would that baker'a wife. There ere those who say, and with considerable Justice, that she should never have been freed until she was proved to be no longer a menace, no matter how many years that would have taken. "Typhoid Mary" was an Ignorant woman, but there ?re plenty of well educated, highly Intellectual people who, when it comefe down to <lt, have no more sense than she showed. It has been estimated that from 4 per cent up of typhoid fever sufferers continue to shed the typhoid bacilli for indeterminate periods. And there are other* who shed those germs who don't appear to have had this Infection: say they have not had It; certainly have not been abea on that account. First?The doctors make three classes of typhoid carriers. The acute carriers, who have had the dis ease and continue to discharge the germs not longer ' than six weeks after convalescence?that Is. after com plete recovery. Second, the chronic carriers, who may or may not have had'the dlsesae, but who keep on discharging the germs Indefinitely. Those who have not had the dis ease are called the symptomless cases, and they are called lhtermediate carriers, or, as tho German doc tors say?take a long breath here?the Typhusbaall lenswischentraeger. And, third, there are the temporary carriers, who have never had typhoid at all, or who may have, per haps, been "walking cases." but who discharge the germs for a short period, then are free -of them for a time and then again shed them. It has been com puted that something like one in every thousand of us Is a typhoid carrier, whether we have had tho disease or not. Obviously, then, it Is a difficult proposition to pre vent the spread of typhoid fever by the typhoid bacillus carriers. Surgery, as we have seen, does not avail, because other parts of the digestive tract than the gall bladder may contain tho germs, and one cannot have the' whole of bis internal organs removed and live. Investigators with bacterial vaccines have had some fair results, but far from good enough for such means to be successfully or universally applied. There remains then the expedients of segregating the typhoid carrier, as Is done In the case of leprosy? and, Indeed, the carrier is more of a menace than the leper?or, what In effect would be the same thing, to force him into constant cleanliness or to restrict his occupation in such a way as to bring his harm-makirig down to a minimum. This last expedient, as will be seen later, is already in force iq some districts. Against the efficacy of the segregation idea there can be nothing urged. The great obstacle to carrying It out Is. of course, a sentimental one, If we choose to so designate the well nigh universal feeling that causes for isolation of a man from his kind ought not to be lightly multiplied Such segregation Would be for most carriers solitary Imprisonment for life. But It would not be necessary to confine typhoid carriers If they would only understand and ofoserve the sim ple precautions they should take ' qrder that the health and lives Others shall not be endangered them. The activities of typhoid car riers must be so restricted that they shall neither Infect food nor their sur roundings. In essence, all they have to do Is to be careful about their In of by Sclentlflo Served as Thermomete: Bubbling Mi from the Cultures Toi These Microbe Carrier*,' Almost AhvaysPerfectlyHea'lU^r^rbtfDaE^^ "Season" with the Germa of Deadly Bissau Dropping, Indeed, Death Into the Cooking Vessels.1 It Is Then That They Unwittingly cleanliness. They m whenever posslljle In i doctor will give all wash the hands *o tl and'how properly to The chief problem < the 'carriers, so as t This does not necei measles or scarlet t given time?a fortnic^ no longer a menace. Health Departi to Segregate According to a regi ment of Health, any disease germs of fever and other cont to the special rules partment of Health. And anybody can s< this disease carrier bl following Is quoted froi authoritative book. Health"* "The legal t the community as aga Some considerable ques be recognized, howevej is not properly quaraq discharges are permit! tlon (disinfection), an to no consideration if hi receive Infection from 1 carrier to be sterilised As we have seen wltl are three kinds of g chronic and the tempt carriers would be dan p^ullar natural hlstorj ever, we can in genen carriers are people whl 'disease and who dlscha after convalescence; tB harbor and to dlscharfl or years, in fact, indefl rlers are those in goo charge germs for brief, with periods when they And there are "am dyseintery ? dangerous are so likely to spread let fever, diphtheria an< cases, be so mild as t< may not themselves rea school, ride ^n the stred pec ting, at the desk, in keep at t^elr usual wJ handle our food. And ij one of the most dlfflcui Icine. Why do not all those' diseases whose germs tlj tlon no doubt occurred discusJhig typhoid feve takes two people to ma agencies to make an germ; second, the wea that predisposes our org of the germ. If your bi good health you may n< germs In your system. ? germs of which you < I you may carTy these t being run down, succu^ same germs. Your 4>od these germs; your neigh 8inoe the fact of g?r and since it has been sta sciously or unconsclousl many practical difficult! only be detected by p&i Clone. And then, when t the question of control. Fortunately, in most ! ee'eessary. "Sanitary V to say. it Is enough to they are obeying iyati sense and are reasonabl of giving disease to the! keep scrupulously and U os who have the civic an enormous deal by t health authorities.