THE EPIDEMIC OF TYPHOID FEVER AT PALO ALTO.
In the spring of 1903, the university community at Palo Alto was startled to find that in about two days upwards of one hundred and thirty students and about a hundred other people—most of them living in the town of Palo Alto, but a considerable number also in fraternity houses on the university campus—were attacked by typhoid fever. The Students' Guild, the cooperative hospital association of Stanford University, immediately' set to work upon the problem of furnishing hospital service, while the department of hygiene of the university and the board of health of the town of Palo Alto devoted themselves to the investigation of possible causes for the outbreak.
The university town, with a population of about four thousand, was entirely new and its health conditions were ordinarily of the very best, there being no slums, cesspools or foulness of the ordinary sort. Every sanitary precaution had been taken in the lodging of students. The water supply was above suspicion, being drawn from deep-driven wells. The whole difficulty was finally traced to a single small daily, the milk of which had been the source of the infection.
A full account of all elements concerned in this case has been published in a pamphlet for free distribution, by Professor J. C. L. Fish, of Stanford University, president of the Board of Health of Palo Alto, together with analyses of reported cases by Dr. C. D. Mosher, and a discussion of the source of infection of the milk supply by Dr. William F. Snow. In view of the lesson to be derived from this case and from the nearly parallel outbreak at Cornell University which preceded it, an account of the method of infection may be found interesting and useful.
The report shows that there were no cases of typhoid fever in Palo Alto, so far as known, between 1894 and 1903. On investigation it was found that the one thing in common which connected the different houses in which cases were reported, was the milk supply. On further investigation it was found that the milk man got a portion of his milk from a Portuguese dairy about five miles from the university on a little brook tributary to Los Trancos Creek. Samples of the water used in washing the cans and cooling the milk were examined by bacteriologists and found to contain large quantities of the bacillus coli communis, the well-known bacillus of typhoid fever.
The investigation of the sources of infection at the Portuguese dairy reads like the plot of a tragedy. The scene is laid in the month of December, 1902, at Stanford University and Palo Alto and the immediate vicinity. The dramatis personæ are taken from homes all over the country. The Serpa house, where the trouble begins, is situated on the banks of the Madera Creek, three miles above Mayfield. A cousin, from San Francisco, comes to visit the Serpas. Soon after his arrival lie complains of feeling ill, and Mrs. Serpa nurses him; she does not consider him sick enough to demand the services of a physician. One week later the relative is better, but Mrs. Serpa is quite sick herself and Serpa calls in a doctor, who pronounces the case one of typhoid fever. A few days more and two of the Serpa children are taken ill with symptoms identical with those of the mother and the cousin. Serpa now becomes thoroughly fright-
