Fourteen cases were ultimately discovered. Of these the first, which was unreported and apparently undiagnosed by the attending physician, occurred on a dairy farm supplying milk to one of the two licensed dealers selling Grade C raw milk. This case, with onset in the first week of October, was followed in from seven to ten days by two others upon the same dairy farm, these being unreported and apparently not diagnosed.

The other eleven cases had onsets between October 10 and 20. There were but two factors common to all; water from the public supply and milk from the dealer mentioned above.

While the water supply is known to be open to accidental pollution, water as a source of infection could be practically eliminated from the fact that four unincorporated villages receive water from the same supply, and that in only one-Delmar — had cases occurred.

Certain of the patients had received milk directly from the dealer mentioned. He also furnished milk to the local drug store and the other patients, including a member of the family of the druggist, had received it indirectly from this source in malted milk, "chocolate milk," etc.

On October first the milk dealer discontinued receiving milk from the dairy farm on which the early cases were located, this milk being sent into Albany thereafter until the investigation brought to light the foregoing facts. This no doubt accounts for the abrupt termination of the outbreak.

In July, Dr. B. R. Wakeman, sanitary supervisor, submitted the following interesting report of investigation of a series of 15 cases traced to a carrier, whose previous attack of typhoid had not been reported.

REPORT OF FIFTEEN CASES OF TYPHOID FEVER CONTRACTED FROM A MILD UNREPORTED CASE SHOWING POSITIVE FECES TWO MONTHS AFTER ONSET.

Township of Wellsville, Allegany Co.

The following cases were investigated:

(These three patients taken to hospital June 1 and died

June 10-11.)

V. B, 30 years (boarder).

F. W, 22 years (boarder).

(Both taken to hospital June 1.)

.Onset May 26

.Onset May 27

Onset May 27

. Onset May 27 .Onset May 28

Are related to the O. S's, visited there before and

(Of H street, W, relatives of the O. S's, visited them
and helped care for them until they were taken to
hospital.)

Onset June 13

.Onset June 13

(Son of C. S, lives one-quarter mile north of O. S; called
at the O. S's several times the last of May and the
first of June; did not take a meal at the S's but did
drink from the O. S. well several times.)

W FAMILY.
B. W, 30 years, married one child, L...

Onset June 12

.Onset (?) May 1

(He was indisposed about May 1 and did not work in the
furniture factory for two weeks. Was not confined
to the bed. His physician did not report that he had
typhoid.)

L. W, 7 years.

(Went to B May 30 and was taken sick with typhoid
three days later.)

Mrs. O, 28 years..

(Boards at C. S's, one-quarter mile up the creek from
O. S's. Did washing and housework for B. W.)

.Onset June 3

Onset June 1

On the 26th day of June my attention was called to an outbreak of typhoid in the township of Wellsville and in the village of Wellsville, Allegany county. In company with the health officer of the township we visited the place where we believed the outbreak had its origin.

The O., S., W., and B. families live up a small creek about a half mile north of the Wellsville village limits. These three houses are located on a shelving portion of a shale bank with the creek running down in front of the houses while at the back of each house is a steep hillside, the face of which is not more than

fifteen feet from the rear of the houses. Each house has a privy perched on the side hill a few feet from each house. There are no vaults to these privies and the excrement is easily washed from the bank during a heavy rain.

These three families obtain their water from a dug well in front of the S. house and near the bank of the creek as may be seen in figure No. 1. Figure No. 2 shows these three houses with outbuildings and hillside back of the houses. The house on the left is the O. S. place, the middle one, the home of B. W. and the one at the right is the B. home.

The conditions about these houses are very insanitary. Surface washings from the back yard and privy, especially from the W. property, owing to the lay of the land, can easily reach the S. well. Samples of water from the S. well examined at the laboratories of the State Department of Health, showed gross pollution with large numbers of intestinal bacteria present.

The nearest neighbor to these families lives across the creek and highway about two hundred feet south of the bridge shown in figure No. 1. The members of this family obtain their water from a spring on the east slope and did not come in contact with their neighbors across the way. There was no illness in this family. Other neighbors further down the creek obtain their water from other springs and wells. No illness in these families.

Each of these sixteen persons infected, with the exception of B. W., was very sick. The three members of the O. S. family all died within ten or twelve days after the onset. This would lead one to believe that the infection was obtained fresh and in large quantities. As far as I could learn, none of these persons had come in contact with any person sick with typhoid or with persons who had had typhoid.

As B. W. was the first person in this group to show symptoms of typhoid, it is believed that he was the direct source of the infection. During his brief illness he used the privy daily and no attempt was made to disinfect his discharges, owing to the fact that he was not aware that he had typhoid fever and his physician had not given him any instructions as to the proper disposal of his excreta. During his indisposition he took all of his meals at home and did not come in contact with his neighbors.