New York State Department of Health Files on Milk-Borne Disease Outbreaks

Chronological.

Outbreaks of communicable disease traced to contaminated milk were common when supervision of market milk production was inadequate and the percentage of milk protected by pasteurization was small. This was especially true in the 1920s, when hundreds of outbreaks occurred and thousands of individual cases and hundreds of deaths were reported. Septic throat was a milk-borne disease, as were scarlet fever, typhoid fever, diphtheria, and undulant fever.

A higher incidence of milk-borne disease occurred in small country towns, rural sections, or in communities with numerically small populations. Officers of the Health Department investigated these cases to correctly diagnose and document the cause, extent, and spread of illness in communities, and to locate the milk producer (and the cow which was the source of infection) and the distributor responsible for the tainted milk. The investigations typically included testing infected persons and samples of milk and well water.

The series consists of copies of reports (some draft copies), memoranda, correspondence, laboratory test results, survey data, and news clippings documenting epidemic outbreaks of septic sore throat in parts of Ulster and Greene counties in 1939 and 1942. The outbreaks were caused by use of tainted raw milk, and were investigated and reported by officials of the Health Department, including those in the Bureau of Milk Sanitation.

Two separate outbreaks of septic sore throat (reported as streptococcal pharyngitis) are documented in the series. Key officials in the respective investigations were Dr. Hollis S. Ingraham, health officer for the Kingston district, and Dr. T. Earle McQuade, health officer for Coxsackie. The series contains an isolated memorandum from Environmental Conservation Commissioner Metzler, dated July 1971, which suggests including an account of Dr. Ingraham's activities during the epidemics in a "milk chapter" of a publication to be produced by the Department of Environmental Conservation. The material in this series may have been culled as background for such a work, but it is not known if it was actually used.

The first outbreak documented in this series occurred in May 1939, within two towns; in the Town of Saugerties (Ulster County) at Glasco, Kaatsbaan, Malden, the Village of Saugerties, Veteran, and West Camp; and in the Town of Catskill (Greene County) at Alsen, the Village of Catskill, Cementon, and Leeds. More than 500 cases and three deaths from the disease resulted from use of raw milk from one cow, distributed from one dealer. The distributor was traced, and the cow discovered (by local veterinarian and a Health Department milk sanitarian) and slaughtered.

The second outbreak occurred in April 1942, in Coxsackie (Greene County). It resulted in over 150 cases. The investigation included a survey of infected households and extensive testing of milk samples and water samples (from drilled wells in the community). There is significantly more material on typing of the strains of streptococci from this outbreak because the cow which initially appeared to be the source of infection did not show the expected strain, but another cow that presented no physical signs proved to be the source.

For each outbreak there is a memorandum summarizing the epidemic. This reports the procedure for investigation and control; morbidity by age and gender; clinical manifestations; epidemic chronology and site conditions; mode of spread; and secondary cases. Also included are tables showing cases by gender and age groups; household attack rates by age and gender; complications observed; cases by date of onset; and geographical distribution. For Coxsackie, data from a survey of households was coded and entered onto punch cards for tabulation and reporting. There is a detailed explanation of the coding used as well as correspondence on the tabulations and the problem of follow-up visits and victims who experienced complications.

Other records found in the series include: copy of special directions to epidemiologist or district state health officer investigating milk-borne outbreaks of communicable diseases; memorandums reporting the outbreak to department officials, and from/to doctors who assisted in the investigations; laboratory results of throat cultures ordered by doctors in the areas and reported to the health officers (stating whether hemolytic streptococci were or were not found); laboratory results of milk and water sample testing, including those done by the Health Department's Division of Laboratories and Research, which were also reported to the health officers; correspondence related to testing and test results in typing of strains in the Coxsackie case; copy of press release on the Saugerties epidemic by the Commissioner of Health, Edward S. Godfrey; newspaper clippings on the outbreaks; summary reports by the Bureau of Milk Sanitation of its investigations of the outbreaks; several preliminary draft copies (including one in manuscript) of final reports on the outbreaks; internal memoranda concerning production and submission of the final reports; preliminary drafts of Public Health Council report notes for both outbreaks; correspondence requesting reports on the investigations; and a reprint of a 1940 article authored by Dr. Ingraham, published in the New York State Journal of Medicine, on milk-borne epidemics of scarlet fever and dysentery in Red Creek, Wayne County.

Microfilm is available for use at the New York State Archives or through interlibrary loan.

Folder list is available at the repository.

There are no restrictions regarding access to or use of this material.