An examination of B. W's. feces showed, on July 1, the presence of typhoid bacilli. This would strongly indicate that, he had "walking typhoid " the first two weeks in May. As all the persons in this group drank from the S. well, it is believed that the well was the medium for the transfer of the infection which had its origin in the person of B. W., whose discharges were washed into the well during the heavy rains of the early part of May. The well was abandoned during the first week of June. The last cases had their onset June 13. Careful inquiry of B. W., his employers and his associates in the Wellsville furniture factory does not reveal where he obtained his infection. However, Wellsville has had many cases of typhoid in recent years, many having been traced to carriers through the milk supply. An unrecognized carrier among hist Wellsville associates might explain his infection. An outbreak of this sort is a serious matter. Had B. W's. illness been recognized and proper steps taken to disinfect his discharges, possibly three lives could have been saved as well as twelve other cases of serious illness. A rural survey of these premises would have revealed a most insanitary condition: open privies on a side hill with a dug well so placed that it acted as a catch basin for the washings from the privy and back yard. Very little, however, can be done to remedy these conditions in country districts until the public is educated, and boards of health are thoroughly aroused to the importance of preventive measures. The chart accompanying this report shows in a graphic way. the mode of infection in this outbreak. Upon the reports of health officers and physicians attending typhoid cases" well water" frequently appears as the source of infection. In comparatively few instances, however, is the allegation supported by evidence found upon investigation. In the outbreak described above the evidence is especially conclusive since the source of infection of the well was definitely determined. In this connection, the writer investigated a small outbreak which occurred during the spring and early summer at Menands, an unincorporated village a few miles from Albany on the Troy road. Evidence pointed definitely to infection of several persons through well water, although we were unable to go beyond this |