We have had two indications recently that typhoid fever, for all the vaunted control of the disease which we have claimed, is still alive. The newspapers carried the report of an epidemic in Minneapolis and the U. S. Public Health Service has published a final report of its investigation of the epidemic of typhoid fever that occurred in the Ringling Brothers and Barnum and Bailey’s circus in the summer of 1934.
These evidences of return to the Middle Ages teach us that we can never relax the vigilance which is needed to keep the infectious diseases in subjugation. Boards of health everywhere are constantly working on the control of the water supply and milk supply, and food handlers, yet somehow or other the disease manages to break through the barriers and cause death as well as economic loss.
In the case of the circus, typhoid broke out in Detroit and 68 employees were hospitalized. In the course of time 141 persons were left in hospitals in various cities. Seventy-four of them proved to have typhoid. From the fact that everybody in the circus was infected except train men, porters and elephant men, whose water supply was separate from the rest of the circus, the indications are that the epidemic was water-borne, although in what city enroute or under what circumstances, has not been proved. The epidemic itself certainly teaches us that the only sure way of protection against typhoid is individual inoculation or vaccination by the hypodermic injection of typhoid vaccine.
As an indication of the vigilance with which boards of health work on the problem of water supply, I find in the report of the Indiana Division of Public Health for one month that the Board investigated 32 public water supplies in such cities as Aurora, Elkhart, Fort Wayne, Lafayette Heights, Vincennes, Winslow, etc. It made 999 examinations of drinking water, 93 examinations of bottled water and 49 examinations of swimming water. It made 825 examinations of dairies and 966 examinations of other food stations.
In spite of this staggering amount of work typhoid fever will slip through because none of us have any natural immunity to it. Today the only safe thing to do is to have vaccination of each individual against typhoid. This should be done before the age of 5 years. Parents often balk at the idea of vaccination at early agesvaccination against smallpox and diphtheria as well as typhoid. But this attitude is unwarranted. First, because these diseases strike particularly the young. To make prevention effective, we must begin early. And second because children, as a rule, react less than adults.
This is really true. A one-year-old baby will not have as much trouble with a smallpox vaccination as a man of twenty-five. Just as a baby will not have as rough a trip with measles as an adult.