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Issued September 21, 1912,

U.S. DEPARTMENT. OF AGRICULTURE,

BUREAU OF CHEMISTRY—BULLETIN No. 156.
R. E. DOOLITTLE, Acting Chief of Bureau.

SEWAGE-POLLUTED OYSTERS AS A CAUSE
OF TYPHOID AND OTHER GASTRO-
INTESTINAL DISTURBANCES.

A STUDY OF AN EPIDEMIC AND >
OF CERTAIN INDIVIDUAL CASES.

BY

GEORGE W. STILES, Jr.,
Chief, Bacteriological Laboratory.

WASHINGTON:
GOVERNMENT PRINTING OFFICE,
‘1912.

ORGANIZATION OF BUREAU OF CHEMISTRY.

R. E. Denese Acting Chief of Bureau.
F. L. Dunuap, Associate Chemist.
W. D. Bicetow, Assistant Chief of Bureau.
F. B. Linton, Chief Clerk.
J: G, SHIBLEY, Supervising Clerk, Interstate and Import Records.
GG: SAVAGE, Editor.
A. EK. DRAPER, Inbrarian.
Division of Foods, W. D. BigEeLow, Chief.
. Food Inspection Laboratory, L. M. TOLMAN, Chief.
Food Technology Laboratory, E. * CHACE, Chief, and Assistant Chief of Division.
Oil, Fat, and Wax Laboratory, H. 8. Barry, Chief.
Division of Drugs, EE. KEBLER, Chief.
Drug Inspection Laboratory, G. W. Hoov ER, Chief.
Synthetic Products Laboratory, W. O. Emery, Chief.
Essential Oils Laboratory, E. K. Netson, Chief.
Pharmacological Laboratory, Witu1aM SaLant, Chief.
Chief Food and Drug Inspector, W. G. CAMPBELL.
Miscellaneous Division, J. K. Haywoop, Chief.
Water Laboratory, W. W. SKINNER, Chief.
Cattle-Food and Grain Laboratory, Gr BIDWELL, Acting.
Insecticide and Fungicide Laboratory, G.-C. McDonNeELL, Chief.
Trade Wastes Laboratory, under Chief of Division.
Contracts Laboratory, P. H. WaLKeErR, Chief.
Dairy Laboratory, G. E. Patrick, Chief.
Food Research Laboratory, M. E. PENNINGTON, Chief.
Leather and Paper Laboratory, F. P. Verrcu, Chief.
Microchemical Laboratory, B. J. Howarp, Chief.
Physical Chemistry Laboratory, C. S. Hupson, Chief.
Sugar Laboratory, A. H. Bryan, Chief.
Sections:
Animal Physiological Chemistry, F. C. WEBER, in Charge.
Bacteriological Chemistry, G. W. StTiLEs, in Charge.
Enological. Chemistry, W. aay ALWOOD, in Charge.
Nitrogen, T. C. TrEscor, in Charge.
Plant. Phy siological Chemistry, J. A. LeCuerc, Chief.
Food and Drug Inspection Laboratories:
Boston, B. H. Smiru, Chief.
Buffalo, W. L. Dusors, Chief.
Chicago, A. Ll. Winton, Chief.
Cincinnati, B. R. Harr, Chief.
Denver, R. 8. Hiztner, Chief.
Detroit, H. L. Scuuuz, Chief.
Galveston, G. M. Bartuerr, Acting.
Honolulu, Hawaii, A. W. HANSEN, Acting.
Kansas City, Mo., F. W. LIEPSNER, Chief.
Nashville, R. W. Batcom, Chief.
New Orleans, W. J. McGee, Chief.
_ New York, A. W. OapEn, Acting.
~OQmaha, S. H. Ross, Chief.
Philadelphia, OSs BRINTON, Chief.
Pittsburgh, M. C. ALBRECH, Chief.
Portland, Oreg., A. L. KnisEety, Chief.
St. Louis, D. B. BisBEeex, Chief.
St. Paul, A. 8. MircHe.y, Chief.
San Francisco, R. A. Gouin, Chief.
San Juan, P. R., A. E. Taytor, Acting.
Savannah, W. C. Burnet, Chief.
Seattle, H. M. Loomis, Chief.

Issued September 21, 1912.
Uo Dey aR Eve NT OF AGRICULTURE,

BUREAU OF CHEMISTRY—BULLETIN No. 156.
R. E. DOOLITTLE, Acting Chief of Bureau.

SEWAGE-POLLUTED OYSTERS AS A CAUSE
OF TYPHOID AND OTHER GASTRO-
INTESTINAL DISTURBANCES.

A STUDY OF AN EPIDEMIC AND
OF CERTAIN INDIVIDUAL CASES.

BY

GEORGE W. STILES, Jr.,
Chief, Bacteriological Laboratory.

WASHINGTON:
GOVERNMENT PRINTING OFFICE.
1912,

eee Is Ole IRIN SIC ICAUL,.

UniTED StTaTES DEPARTMENT OF AGRICULTURE,
BuREAU OF CHEMISTRY,
Washington, D. C., March 15, 1912.

Str: The question of the purity of the oyster supplies is one which
has engaged the attention of this bureau for many years, and exten-
sive investigations have been made of native oyster beds, sewage
disposal, and possible contamination of oysters with pathogenic
germs. These studies have been extended to many points along
the coast and in the coastal rivers, including the inlets of Providence
Bay, Long Island Sound, New York Bay, and Chesapeake Bay.
Most valuable information has been obtained relating to the areas
of infection and the results which have been produced by con-
sumption of oysters from infected areas. I beg to offer, therefore,
with a recommendation that it be published as Bulletin 156 of the
Bureau of Chemistry, the first of a series of reports on this question,
embodying the results of actual research in the section of Bacte-
riological Chemistry. The publication of these data will not only
be of interest to the consuming public, but will also be helpful to
the owners of the oyster beds and the authorities controlling them
in securing a speedy betterment of conditions.

Respectfully,
H. W. WILeEy,

: Chief of Bureau.
Hon. JAMEs VYILSON,

Secretary of Agriculture.
5

CONTENTS:

Piece Vann Stikne PIGeMuIC EE eat ieee ey een fol ai let else ceed ole oo
Ince piongolstnenimnVestieattoMersscs tte fn 2. eh ere Nosy teen eck eee ee
Dataxcollecredsbys corespondence: 2 o5 1628's /o.a25 oho 2 oe so bea eee

Distribution of the Minisink
Goshen water supply....-.--
Goshen milk supply......-.--

COSESEe saa A open pee Se ar clnee n eh e

COnSOerAnOMMOl ENOsINeWUIS s- 4305 co ne ee ee ee a
MUNG CROMMMMELON LETS arm cree cee tts ne Seis wire AL Se. eck ae © vite

Cases studied at Rochester, N. Y

PeTGolmasierss Hanquet-sNeWiolre mio N Yen. cess Soke cds ears cts sale ote
Distribution of cases of illness due to eating Rockaway oysters.........-------
EnSanibatyecOonditionyolsamalca, bayentc.assarso ss 65 .4..5.2.-.s2.- 2 eects es

FRE WAOUS IRC POLUS Merete bone ments eeerrravn eee ses Pi? oe OL oes nae eee

Hendrix Street sewer and disposal plambs.- 2.22. 5.2 Sse ol Sees eee
LP LORMUMTONS? CONUS IETHSE ies heel ees Mea Neste 2 eg He
Bacteriological data on water and oysters from Jamaica Bay...............---

Methods of examination.....

Pabulated*datas-s-c.ccse- 25.
Sola tronromoreaisiisas ss: meets te wt Pik Raa A SE UN a ea ate
Bacolandebs Para PlOsusr tyipesucsac2 4. - ces hate. cs pee eee
AEN WOT G GOR AISI Seay tae te oe ea oe Gee me ehleinn,. Saat cera
Eropaplecatise of the eastroenteritis (diarrhea). ...2...0.5-.2.....+-22.5--.422
SULA D IAT. 5 et OSE crete A Ce Ree re aut a re era

— ILLUSTRATIONS:

PLATES.

Plate I. Comparison of oyster shells served at banquet with shells from
Jamaica: Bay 20: $25.42 3. et oe eee ee eee

II. Bird’s-eye view of the five boroughs forming Greater New York, 1904.

III. Fig. 1.—Oyster house of dealer A at Indian Creek, near Canarsie,
Long Island, N. Y. Fig. 2.—Oysters in the cellar under house of

IV. Fig. 1—View of Indian Creek, near Canarsie, Long Island, where
nine oyster dealers float oysters in the cellars of their houses. Fig.
2.—A three-compartment privy located directly over Indian Creek
not far below dealer‘A >. 200 2 Bes ee eee

TEXT FIGURES.

Fig. 1. Arrangement of tables and guests at the Minisink banquet..........--
2. Graphic statement based on total number (155) of guests at Minisink

3. Graphic statement based on 127 guests who ate Jamaica Bay oysters. -
4. Cases of typhoid and enteritis traced back to Rockaway oysters sold

by dealer Asoo.) Soe ere ee
. Map of Jamaica Bay showing principal sewer outlets and oyster beds. -
. Hendrix Street sewage disposal plant, Brooklyn, N. Y.....---...-.-...-
. Average monthly score on shell oysters from different sources......-.--

“IO

Page.

24
32

34

34

SEWAGE-POLLUTED OYSTERS AS A CAUSE OF TYPHOID AND
OTHER GASTROINTESTINAL DISTURBANCES.

INTRODUCTION.

Many years ago attention was called to the fact that infected shell-
fish, when consumed raw, might cause outbreaks of typhoid fever,
cholera, and other intestinal diseases. This fact was especially
noticeable in densely populated European coast towns and cities,
near many of which were located extensive shellfish grounds grossly
contaminated with sewage. In this country the question of shell-
fish pollution has received greater attention since the epidemic of
typhoid fever traced to oysters at Wesleyan University in 1894 and
the Lawrence outbreak in 1905, and particularly since the passage
of the food and drugs act of 1906.

Since the season of 1908 the Bureau of Chemistry has been making
extensive investigations pertaining to the oyster industry, embracing
almost every feature of the problem, beginning with the examination
of oysters, dredged or tonged from their beds, and carried through
the various processes of handling until the oysters are ready for
the consumer. Approximately 2,000 samples have been examined
bacteriologically up to the present time, including oysters and clams,
either shucked or in the shell, and water samples collected from over
the grounds on which the shellfish grew.

This report deals principally with an epidemic of typhoid fever and
other gastrointestinal disturbances following the Minisink banquet,
given on October 5, 1911, at the Music Hall of Goshen, the county
seat of Orange County, New York State. Some individual cases,
especially at Rochester, N. Y., and the conditions surrounding the
smaller banquet of schoolmasters, held at Newburgh, N. Y., are also
reported.

The author wishes to acknowledge, with thanks, valuable services
rendered by Dr. F. F. Russell, of the Army Medical School, Washing-
ton, De C:; Dr Wim. Park, New York City; Prof. H. W. Conn,
Middletown, Conn.; Prof. Frederick P. Gorham, Brown University,
Providence, R. I.; Dr. H. D. Pease, of the Lederle Laboratories,
New York City; Miss Ruth C. Greathouse, of the bacteriological labo-
ratory, Bureau of Chemistry; and the health officers, physicians, and
laymen who contributed valuable information relative to the Minisink
banquet.

5

6 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.
REVIEW OF LITERATURE.

Reviews of foreign and American literature on epidemics of typhoid
fever due to eating raw, infected shellfish have heretofore been pre-
sented by other writers on this subject, and in the present report
only brief mention will be made of the more important and recent
epidemics of this character.

(1) In the outbreak of typhoid fever at Wesleyan University during
1894, Prof. Conn,' of Middletown, Conn., showed that 29 cases, or
25 per cent, of the students who ate raw oysters at their fraternity
banquets contracted the disease within the proper incubation period.
All other articles of food which might play any part in transmitting
the infection were carefully studied and excluded. He summarizes
the chain of evidence as follows:

1. The dates of the cases appearing at Wesleyan, all between October 20 and No-
vember 9, plainly point to a single source of infection to which all of the afflicted
students were exposed at about the same time. This must have occurred a little
more than a week earlier than the appearance of the first case, and the initiation sup
pers perfectly fill the conditions.

2. That these Initiation suppers were the source of infection is rendered certain
from the fact that four of the visitors who attended these banquets, and have had no
further connection with the fraternities, have developed typhoid simultaneously
with the cases in college, and by the further fact that two visiting Yale students who
attended the suppers have similarly suffered from typhoid.

3. The fact that only three out of seven fraternities holding suppers on that even-
ing sufiered from typhoid, pointed to some article of food or drink used at these three
suppers and not used in the other fraternities.

4. The fact that about 25 per cent of the students attending the suppers have
suffered from typhoid, pointed to a universal and very active source of infection,
and not to an incidental one. Whatever article of food contained the infectious
material must have been eaten by nearly everyone present to account for such a
large percentage of cases.

5. Only one article of food or drink was used by the three societies which was
not used equally by the other four fraternities. This article of food was oysters, and
they were eaten raw.

6. These oysters came from a creek, where they had been allowed to fatten for
a day or more, within 300 feet of the outlet of a private sewer, and in such a position
as to make contamination from the sewer a possibility. At the time that the oysters
were there deposited there were two persons in the house supplying the sewer, who
were in the incubation period of typhoid fever, the period during which no atten-
tion would be paid to their excreta.

7. Typhoid germs are not injured by sea water or oyster juices, and if they found
their way into the oyster would certainly have lived long enough to be sent to Mid-
dletown and be served on the tables of the fraternities.

8. Twenty-three cases of typhoid fever followed among the students in attendance
on the suppers at which the oysters were eaten, and 6 cases among persons in attend-
ance and not among the present students at Wesleyan. In all of the cases of un-
doubted typhoid it has been possible to trace either direct or indirect connection
with these oysters. The oysters were also eaten raw by one family 1 in town, and at
least one severe case of typhoid followed.

1Conn, H. W. The outbreak of typhoid fever at Wesleyan University. (Conn. State Board of Health
Report, 1894, pp. 243-264.)

REVIEW OF LITERATURE. "|

9. The use of oysters from the same locality by the students at Amherst College
produced, or at all events was followed by, an outbreak of typhoid fever among the
students who ate of them.

These facts, taken together, form a chain of evidence practically complete at every
point and leaving no room for doubt. Whatever may be said in regard to oysters
in general, the Wesleyan outbreak of typhoid was caused by a special lot of con-
taminated oysters.

(2) The increased prevalence of typhoid fever in Atlantic City,
N. J, during the summer and autumn of 1902 was traced by Pen_
aineton sail others! to the use of oysters and clams “‘floated”’ in
Penrose Canal, which was highly polluted with sewage. The find-
ings of a committee of five members reporting to the Atlantic City
Academy of Medicine, as to the origin and cause of the infection,
were approved by Dr. A. C. Abbott and Henry Leffmann.

(3) Dr. Bulstrode? during 1902 reported 21 cases of typhoid
fever and 118 cases of gastroenteritis from a total number of 267
guests who had eaten raw oysters at the mayoralty banquets at
Winchester and Southampton, England, on November 10 of that
year. The oysters in question were imported from France and
“laid down,” or floated? for a few days in sewage-polluted ‘‘drink-
ing” grounds at Emsworth. One patient who developed a fatal
case of typhoid ate only one infected oyster, while others ate oy
two or three of these oysters.

(4) During the period from 1894 to 1902, inclusive, Dr. ee
holme,‘ of Brighton, England, investigated 241 cases of typhoid
fever which he ascribed to eating infected shellfish.

(5) During the year 1902, Thresh and Wood® reported in the
county of Essex, England, 4 cases of typhoid fever and 21 cases of
illness due to eating Portuguese oysters sold on August 14 and 21
of that year.

(6) In reporting the typhoid fever cases in New York City for
1904, the health official of that city shows that of the 1,786 cases
reported during 1904 in the Borough of Manhattan data were ob-
tained on 1,322 cases. Of this number, 22 cases, or 1.6 per cent,
were habitual consumers of raw oysters, while 44 cases, or 3.3 per
cent, habitually consumed both raw oysters and raw milk

1 Pennington, B. C., Stewart, W. B., Pollard, W. M., Marvel, P., DeSilver, J. F. Report on typhoid
fever at Atlantic City. (Philadelphia Medical Journal, Nov. 1, 1902, pp. 634-635.)

2 Bulstrode, H. T. Report upon alleged oyster-borne enteric fever and other illness following the mayoral
banquets at Winchester and Southampton, and upon enteric fever occurring simultaneously elsewhere,
and also ascribed to oysters. (Local Government Board, England. 32d Ann. Rept., 1902-3. Suppl.,
App. A, pp. 129-189.)

3 The process of “floating,” “‘drinking,”’ or ‘‘plumping” oysters in the shell consists in placing them
in water containing less salt content than that in which they grew. This practice is treated more fully
on p. 33.

4 Newsholme, A. The spread of enteric fever and other forms of illness by sewage-polluted shellfish.
(Brit. Med. J., Aug. 8, 1903; 2- 295-297.)

5 Thresh, J. C.,and Wood, F. L. Report on an outbreak of typhoid fever and other illnesses due to
oysters. (The Lancet, Dec. 6, 1902, 2: 1567-1569. )

6 New York City Department of Health. Typhoidfever. (Ann. Rept., 1904, 1: 184-188.)

45672°—Bull. 156—12——2

8 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

(7) One of the most recent typhoid epidemics due to infected
shellfish is reported by Soper,’ 1905, at Lawrence, Long Island, N. Y.
His investigations showed that 21 out of 31 cases were traced to
eating oysters and clams which had been floated or grown in polluted
waters in Jamaica Bay, near Inwood, L. I.

Of the oysters examined bacteriologically during November, 1904,
20 per cent showed B. coli in 0.1 ce of shell liquor, and 60 per cent
in 1 ce quantities. According to present methods of scoring oysters
in the shell, they would show only 4 points, yet they were consid-
ered to have come from badly polluted waters.

In reading Soper’s account of this outbreak, there are seen to be
many points In common with the Minisink epidemic to be con-
sidered in this report. The author concludes by saying:

Your board has as much legal right to regulate the purity of shellfish as to regulate
the purity of milk. One is quite as important as the other. It is, in fact, your duty
to exclude from sale, in the village over which you have jurisdiction, all oysters,
clams, and other shellfish which are liable to cause disease.

I positively believe you will find small difficulty in accomplishing this end if
you will act with firmness, moderation, and tact. It is to the interest of honest
oystermen to afford you opportunities for inspecting their methods of cultivating
and handling the shellfish and taking samples of the same for analysis.

In the event of your finding shellfish which are unsuitable for food in your ter-
ritory, you have the-legal right to forbid their sale, and, if necessary, destroy them,
without any compensation to the owners.

Under the circumstances which exist at present, I think you would be justified
in excluding from the village of Lawrence all oysters and other shellfish which have
been taken from Jamaica Bay within the influence of the Arverne sewers or from
the cove at Inwood, which receives the sewage of Far Rockaway.

This warning, given nearly eight years ago by a competent au-
thority, was apparently not heeded; hence the opportunity to study
another epidemic of typhoid fever, the present one at Goshen, due
to eating oysters from the same locality.

(8S) In presenting his thesis on the contamination of oysters,
Fuller? reviewed the literature on this subject, which covered more
than 20 separate outbreaks of typhoid fever due to infected shellfish.

(9) In speaking of the public health of Portsmouth, England, for
1907, when 233 cases of typhoid fever were reported, Dr. Fraser ®
says:

The one article of diet which in this town has a special relationship to typhoid
fever is shellfish, and during last year no fewer than 80 persons, or 34 per cent of the
total number attacked, contracted typhoid from this source * * *.

It seems that the only thing that can be depended upon to stop this loss of life is
legislation making it illegal to collect shellfish from any places certified by local
medical officers to be subject to sewage pollution. Otherwise men are sure to collect

1 Soper, George A. Report of a sporadic outbreak of typhoid fever at Lawrence, N. Y., due to oysters.
(Med. News, Feb. 11, 1905, 86: 241-253.)

2 Fuller, C. A. The distribution of sewage in the waters of Narragansett Bay, with special reference
to the contamination of oyster beds. (In U. S. Bureau of Fisheries Rept., 1904, pp. 189-238.)

3 Fraser, A. Enteric fever and shellfish. (Public Health, London, 1908, 22 (2): 53-d4.)

REVIEW OF LITERATURE. 9

and hawk the fish from such places, and the public purchases them not knowing,
nor apparently caring, what their previous history has been.

(10) On February 5, 1907, M. Netter’ and others, reported to
the Academy of Medicine 33 cases of typhoid fever due to eating
oysters from Cette. The cases were very virulent in character,
7 of the 33 resulting fatally. The illness usually began with diar-
rhea, and in some cases the disease resembled acute tuberculosis.

(11) During the year 1908, Dr. H. D. Pease, then working under
the authority of Dr. Porter ? of the New York State Board of Health,
reviewed the literature on the subject of typhoid transmission from
infected shellfish and made bacteriological and sanitary investiga-
tions pertaining to the oyster industry. He pointed out some of
the unsatisfactory conditions prevailing in that State and called
particular attention to the grossly polluted condition of Jamaica Bay.

(12) One of the most exhaustive reports on the conditions under
which shellfish, other than oysters, are grown, collected, cleansed,
and stored, and the relation of such treatment to the prevalence of
enteric fever and other illness, is submitted by Dr. Bulstrode ?
England. A large number of cases of typhoid fever and other gastro-
intestinal illness are shown to have been due to eating infected
cockles, mussels, and sea food other than oysters.

On page 44 the author summarizes the review of literature in the
following:

The evidence brought forward in this chapter shows—

1. That oysters, mussels, or cockles are at times responsible for isolated cases and
groups of cases of enteric fever, of gastroenteritis, and of mytilotoxin poisoning.

2. That such shellfish have also to be held responsible for extensive outbreaks of
enteric fever and gastroenteritis, and that the amount of mischief in this latter sense
has not hitherto been adequately appreciated.

3. That these shellfish have also been shown to have played and to be still playing
an important part in certain towns in maintenance of enteric-fever prevalence.

4, That for the most part the specific contamination of such shellfish takes place

on the beds or layings, in the storage ponds, or in the process of ‘‘washing,’’ but that
occasionally the shellfish may become infected by the retailer.

On page 127 occur the following conclusions:

The investigation to which the foregoing report relates has brought out shear
the following considerations:

(a) That both enteric fever and gastroenteritis are not infrequently caused by the
consumption of mussels or cockles eaten raw or imperfectly cooked.

(6) That the shellfish here in question are in many instances collected from natural
“*scalps,”’ beds, or layings, which are liable to become specifically polluted by sewage.

1 Netter, M. Epidemic typhoid fever due to oysters. (The Lancet, Feb. 23, 1907, 1- 551.)

2 Porter, Eugene H. Sanitary inspection of shellfish grounds. (New York State Board of Health, 29th
Ann. Rept., 1908, 2. 833-892.)

3 Bulstrode, H. Timbrell. Shellfish other than oysters in relation to disease. (39th Ann. Rept. of the
Local Government Board, 1909-10, Supplement. )

10 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

(c) That even when these shellfish are procured from localities remote from the
risks of pollution they are at times washed, stored, cr laid down in dangerous prox-
imity to sewer or drain outfalls. :

(d) That the shellfish with which this report is concerned may occasionally become
polluted either specifically or otherwise by the treatment to which they are subjected
by the sellers.

(e) That at the present time there is practically no controi, in a sanitary sense,
exercised over places from which these shellfish are collected or wherein they are
laid down, washed or stored.

(f) That large quantities of the shellfish here under consideration are introduced
into England and Wales from Scotland and Ireland and that, therefore, any regula-
tions or restrictions to be effectual should apply to all parts of Great Britain and to
Treland.

(g) That as large quantities of shellfish are introduced into this country from abroad,
notably from Holland, France, and America, any legislation directed to the control
of the home industry must also take account of foreign importations. .

(h) That so long as the state of affairs revealed in this report obtains, both with
regard to home and foreign shellfish, those persons who desire to avoid contraction of
shellfish-borne enteric fever or gastroenteritis should either abstain entirely from such
shellfish as mussels or cockles or consume them only after they have been actually
at the boiling point for at least five minutes.

(13) In Bureau of Chemistry Bulletin No. 136, by the present
writer,! a review of the literature on shellfish contamination is sub-
mitted, together with bacteriological and other data.

THE MINISINK EPIDEMIC.

INCEPTION OF THE INVESTIGATION.

The annual firemen’s parade of Orange County, N. Y., was held
on October 5, 1911. On this occasion fire companies, musicians, and
guests were invited from Tuxedo Park, Middletown, Highland Mills,
Suffern, Port Jervis, Wurtsboro, Nyack, Newburgh, Munroe, and -
New York City, all of whom were present at the banquet given in
honor of the Tuxedo Park Fire Department by the Minismk Hook
and Ladder Co., and served that day at 6 p. m., in the music hall
at Goshen, N. Y.

The following dinners and banquets were served at Goshen on
this day:

(1) Minisink banquet, at Music Hall, about 155 guests present.

(2) Cataract Engine and Hose Co., at the St. Elmo Hotel, about
100 guests present.

(3) Dickman Hose Co., served at M. E. Church, about 125 guests
present.

(4) Goshen Fife and Drum Corps, at the Occidental Hotel, about
50 guests present.

(5) Fire chiefs, engineers, and assistants, at Mrs. Dopp’s, about
30 guests present.

1 Stiles, Geo. W. Shellfish contamination from sewage-polluted waters and from other sources. Apr.
19, 1911.

THE MINISINK EPIDEMIC. 11

Within a short time following this celebration a large number of
illnesses occurred among those who had attended the Minisink ban-
quet. The first ill effects noticed among those attending this par-
ticular banquet were largely diarrheal in character; however, within
10 to 30 days following the banquet 17 well defined cases of typhoid
fever and 83 cases of diarrhea or bowel trouble developed. AIL of
the cases of typhoid and diarrhea were confined to those attending
the one banquet, although it was said by laymen that ‘‘bowel
trouble” was somewhat prevalent in the community during that
time, information which was not confirmed by the local physicians;
perhaps largely because the trouble was said to have been mild in
character and not sufficient to demand the attention of a physician.

On November 17, 1911, there appeared in a number of the New
York newspapers a short account of an epidemic of typhoid and
other illnesses following a banquet given October 5, 1911, at Goshen,
N. Y. These accounts alleged that some of the oysters served on
this occasion were probably the cause of the trouble. The writer’s
attention was first called to these reports on the above date while in
New York City engaged in making a sanitary survey of the oyster
grounds in that vicinity.

Thinking perhaps it would be instructive to obtain a more detailed
account of the epidemic, a visit to Goshen was made that night. A
number of prominent citizens who attended the banquet were inter-
viewed, including the health officer and other local practicing physi-
cians, all of whom gave valuable information and assistance.

After the data obtained had been compiled, certain links of evi-
dence which were essential in order to fully establish the origin of
the epidemic were found to be wanting. On November 28, 1911, a
second trip to Goshen was made and additional evidence obtained;
samples of water were also collected from the well furnishing the
water used for drinking purposes and for washing the oyster shells on
which the oysters were served.

A third visit to Goshen was made on December 15, 1911, as great
difficulty had been experienced in securing positive evidence regarding
the origin and shipment of the oysters said to have been served at
the music hall the night of the banquet. This evidence was not
finally obtained until diligent search revealed the records at the
general office of the Wells-Fargo Co., New York City. During this
time an inspection was made of the source from which the oysters
were shipped, and samples of the shell stock and water were collected
for analysis.

After all the data had been assembled, the evidence was care-
fully reviewed with four other experts, who were then in Wash-
ington attending the meetings of the American Association for the
Advancement of Science. These were Dr. H. W. Conn, of Connec-

12 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

ticut, who reported the Wesleyan oyster epidemic of 1894; Dr. William
H. Park, of New York City, whose opinions were valued because of
his extensive researches; Prof. Frederick P. Gorham, of Brown Uni-
versity, Providence, R. I., who has for many years been actively
engaged in making examinations of oysters and studying sanitary —
conditions; and Dr. H. D. Pease, now director of the Lederle Labo-
ratories of New York City, who actually did the oyster work for the
New York State board of health reported in 1904, and who has since
that time made extensive examinations of oysters and grounds for
private individuals in that State. Under the direction of Dr. Pease
an independent investigation of the Minisink epidemic was made
subsequent to the writer’s first visit at Goshen on November 17,
1911. His conclusions are in accord with those submitted in hie
report.

After consulting the scientists above mentioned, it was considered
desirable to obtain further information, particularly with reference
to shipments of oysters from the same source to other places. <Ac-
cordingly, on January 18, 1912, the fourth trip was made to Goshen
and neighboring towns, one entire week being given to the collection
of additional data, and on February 7, 1912, the fifth and last trip
was made to Rochester, N. Y., in connection with this epidemic.

In collecting this information more than 200 people, including
health officers, doctors, teachers, and laymen, were interviewed.
Nearly all of these individuals were intelligent, educated men and

women.
DATA COLLECTED BY CORRESPONDENCE.

After the personal visits made to individuals who were in attend-
ance at the Minisink banquet the following letter, accompanied by a
copy of the menu card used on this occasion, was sent to approxi-
mately 170 people. The names and addresses of the people who
were present at this banquet were obtained largely by reference to a
group picture taken during that day. The individuals were identified
from the picture by persons who were well acquainted with them,
but the list was verified during the personal visits and by subsequent

correspondence.
JANUARY 31, 1912.

Str: During the past three months our bacteriological chemist, Dr. George W.
Stiles, has been collecting information relative to the cause of illness following the
Minisink banquet given at Music Hall, Goshen, N. Y., on October 5, 1911.

In order to complete the data obtained by him and to make our records more valuable
we desire to enlist your further cooperation in this matter: Please fill out the inclosed
blank after you have read it carefully, and answer each question to the best of your
knowledge and belief.

This information will be considered strictly confidential and only the facts and not
‘the names will be used for our report.

An addressed return envelope is inclosed which requires no postage.

full
ee H. W. Wiey, Chief.

THE MINISINK EPIDEMIC. 133

Were you at the Minisink banquet? ————.
Mark with an (X) the articles eaten:
MENU.

Oysters on the half shell ( ). Number eaten
Saltines ( ).
Broiled chicken ( ). Mashed white potatoes ( ye
Macaroni and cheese ( )
Tomato salad ( :
Bread ( ). Tea biscuit and gravy ( )s
Pickles ( y; Olives@© 2 Celery? ( ye
Horse radish & la Dickerson ( ye
Currant jelly ( ). Salted nuts ( ).
Ice cream ( ). Number of dishes Assorted cakes ( ).
Coffee ( ). After dinner mints ( ):
Cigars ( ye

Who sat at your right at the table?
Who sat at your left at the table?

Were you sick within one month after the Tene ee ——.
Did you have diarrhea (or bowel trouble)? —
Did you have typhoid fever?
Had you had typhoid fever before October 5, 1911? ———.
When did your first symptoms begin?
How long did your illness last?
Who was the physician attending you?
What is the address of the physician?

Remarks:

Name

Address

From the replies received to the circular letter the following data

were tabulated and figures 1, 2, and 3 constructed, including also
data obtained by personal interviews:

DISTRIBUTION OF THE MINISINK CASES.

Those who attended the Minisink banquet and subsequently
became ill with typhoid fever or gastroenteritis lived at the follow-
ing places:

TYPHOID FEVER.

(SS OE CEE EN Ce aaa te sto Lee Te Retin Ean A ae CN eS ee a Eee 10
SUDO Sins IN CPR Bee co a ec ee, 10 ale Arai eee eee ee MC RE OR 2
ESO GIMEAMOMG KOVEME Ne YCe es ep een ne int me een ee ee oe ee 1
ielncelletaavaaw Nemes eyo ee aN a te Sey ee ec rAd schon ot ey eee 1
IGMP ey, WG as Soe ie kt re ah a ae a 1
SHTRRGIAT. IN WS 2 22s 22 2 ce A te ec a if
Siaiiecc th amie ome Pea ee ee ee aS Lo a ec e see os eee 1

WOM ccc CERES CE DE SEE SE ee ee ee ee eo iy

GASTROENTERITIS (DIARRHEA)

Grostavern, IMs kk GOW 2a ab ele os pn A 48
Abeeteg, Weil i Yo Cas Get Seek eC eee vai
Middletown, N. ee ee ik cole sje ways od ee eee 9
East Hampton, Tous: ligt nal IS, So ns oe Ae eae I a San lee 8 1
Highland Mills, N. me Serene phe eke Sole) Dee 1
IVEOIIEOE, Nene nerae enna eee lo lee coe 1
leqnygine Keron ts oh ah Geaea pire ems oe 2 er i OR er kare NOC me 1
SUNT ST de NCP Se eS ea a if

eR Chiet oe nee en me ere i nS os ee oR ee sca oe 83

14 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID. ©

~\ STAGE. Pe

2 DD 0 D2 N7OSi bp D Dit Vb ep
D... 2 2 DTD eDeD oe! DFO, Oe ab
ee Bee
D DO
De ¢| 22D
D D DO N D DeaD
Carer, DD 21D Died
De -D D:D 2.) T oN
2D Dee Bor De
BF S12. 2 D TD
D2 IT D oe Ss
D D D O 2 0 2
Te Vi DV Oo 2 go
D D D D D D (fe
OnV Oot Ct (go:
2 DI hen 2, Cag TLE 2S
22.0 Viaer@ DoD 2 5
ee Teak Dee S S
N 2 2 2 2 2
Weare le @ a € s §
AE Y-
T= Cases of TyeH01b FEVER-/7 V=CHAIR VACANT- 5
D= 7 277 DIARRHOEA -63 O =A7£.W0 OYSTERS, oT sic 8

N= GUESTS ATE OYSTERS, WoT SICK-4- SS =ATE SEAFORD OYSTERS, NoT S1ICK-Fh
2 =UNDETERIINED.

FRONT.
Fic. 1.—Arrangement of tables and guests at the Minisink banquet.

THE MINISINK EPIDEMIC.

Number of oysters eaten by Minisink quests.

TYPHOID CASES.

Guests. Oysters eaten. | Guests. Oysters eaten.
ag sa Sg PLA, ecie Se eG PA ete eh once asia cu ele ene ae 12
hes a ne a OD ee Se 2 A) See ee ORR MRE Abate y gk is
Na ae CAS iz RAR SAORI a Sie hm ANE ee RS ea ae Ce eR Re ie Ear
1k phage SANISE FE ApS nf eM fe Sete hc a ee OM PeleR ier vac ok un idl os ee
5 vied Cet sy thereee in tes ee, easy oI Ce (0): l| A RR cst tate hts POMP MIMR HR CN ee 2
Tl eeccie sea aan ne ea RCE RENE sy oe Shee

NOT sIcK.! .

SOME HAD
DIARRHEA ,

wy,

4, ORO,
SUVMAAAAAOAA SSSA 0

Vsti itiiissiitha

ALL ATE OYSTERS.

bE ATE

21, ORIB.54YVo,)
HISTORY INCOMPLETE, OYSTER

» BUT FURTHER

LID 2.

Vlg eg yy liga glad

YY D>
Yj ,
OR 3,54 Io, H7,

_

5, 1), ORTOGP%s

| LPRHEA

Fig, 2.—Graphic statement based on total number (155) ot guests at Minisink banquet.

GASTROENTERITIS (DIARRHEA).

Guests. Oysters eaten. | Guests. Oysters eaten.
d Pere See em 1 | REO erie on ee ea ZA TRAD ee ee al ae ee ae eC 6
| RE aioe © a ee 2 ee INSEE Nis (ene ene aha cars PSs ge eee eee 5
Dia a te es eae, re NT oe HS IZA A lees = SAEs negara em BORE ney el Ie 4
ee 5 eS ete eer, ani ee OM Pabopcrie Sie SoS et 2 2 ee ee 3
Doe cle 5 ae Rr ecien Ceeme el Sat OE cee ee ren ye 2 CU et Goel we SN 2
I er eee en oe ee Sa Ty we a 3 10(| SSL a ap ean eS ge Aer AE Nie Af 1

Of the 170 letters sent to guests

there were 107 replies reporting

as follows: Diarrhea, 60; typhoid, 14; miscelianeous, 33; 8 returned

unclaimed, making a total of 115

1 See figure 2, explaining these and 7 other similar

45672°—Bull, 156—12 3

letters accounted for.

One of the

cases. 2 Both had had typhoid fever previously.

15

’

16 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

Minisink guests who had typhoid ate nothing except his plate of 6
oysters. He had previously attended a special dinner at 4 p.m.
with 29 other men and came to the music hall at 6 p. m. to take
part in the program. It is to be noted that he is the only person
among the 30 at the 4 o’clock dinner who was ill afterwards. This

TS |
INCOMPLETE pt 9%}

O a hy K:
its

0

Fic. 3.—Graphic statement based on 127 guests who ate Jamaica Bay oysters.

case is one of the strongest links in the chain of evidence against the
Rockaway oysters served at the Minisink banquet.

Statement concerning 14 of the Minisink typhord cases.

ere of Naer
egin- Ce) :
ning of | oysters Length of illness, ete.
illness. eaten.
1911
Oct 6 | 3 months and 13 days; illness began with diarrhea.
19 4 | 12 weeks; had diarrhea intermittently before typhoid symptoms were in evidence.
22 2 | 8 weeks in bed; no diarrhea soon after banquet. ~
12 4 | Fever lasted 42 days; no diarrhea.
6 6 | Fever lasted about 5 weeks; had diarrhea in beginning.
6 8 | 7 weeks; had diarrhea in beginning.
7 6 | Over 2 months; had diarrhea at first.
19 4 | Eight weeks in bed; disease began with diarrhea.
12 2 | Fever ran 21 days, 2 months sick; had diarrhea.
Nov. 1 4 | Illness lasted 11 weeks; had diarrhea.
Octsw9 5 | Illness lasted 2 months (fever 28 days).
28 3 | In bed 4 weeks; had diarrhea at first for 3 or 4 days.
Nov. 1 3 | Illness lasted 3 months; no diarrhea soon after banquet.
Res lee Died November 17; ate oysters; number not determined.

THE MINISINK EPIDEMIC. aly

A detailed statement was not received from 3 of the 17 cases, but
the information was obtained from personal visits, and all three of
the cases ate oysters. The period of incubation was within the
proper limits, and the cases were diagnosed by competent physicians
as typhoid fever. In most instances Widal’s test was made, with
positive results in each case.

Length of illness due to gastroenteritis (diarrhea).

Number of guests. Weeks.
Hoe sel eS HAY Bion ae Sic ed UN ERIE ome oe e ReS rane a 6
Um Be eo 6 OS ie BSI Sees Ch OE ene OI SE aE at 4
ee PD SNE URE HER ey Ee ac sil sea ee Se Pe Nai aa See sclra e! Scar doa-Sio edie bo G5, alia eho eee 3
Ted ge ek cc Pe Sie eee ig HI A I I a a a A a RR 2,
TT Sk el ee ko ee Be Ta ol SI cl Cee oa eR i
Lo ce eb ee Bh es Bitte ie aise Bete 6 RNS cits aay Belek iL it an Pe an)
Ce ry Sa sof Sy uma A ea AIS nr ia PAT Cicada oS Gig x Soe ae ed cere 4
Bod SBR BORA ES tee ON oie OR Pe AION Tr nn Re ae oR 3
See eRe r ne ad op i ee Ste a eT IS, er aor wer tn Snover cra dy oe aie ois Sia he'd alg a Sie mis Sake 2

One of the guests who ate oysters at the Minisink banquct and
had diarrhea died one week following the banquet. She had
chronic kidney disease and her death was doubtless hastened by
the severe diarrhea. Before the banquet, and for three days after-
wards, she was in her usual health, but with the onset of diarrhea
she rapidly collapsed. Her husband was one of the 17 who had
typhoid fever.

Since the illnesses reported to the health officer and physicians
were wholly confined to the Minisink banquet, no cases having
occurred among the guests at the four other dinners, a study of the
menu served at this banquet was considered one of the first essentials.
However, before going into a detailed consideration of the menu, a
general discussion of Goshen and its surroundings is deemed advisable.

GOSHEN WATER SUPPLY.

When an epidemic of gastrointestinal disease breaks out in any
community, the first thought is to examine the water supply. Goshen
is located about 60 miles from New York City on the Erie Railroad,
and the water for this town of 3,000 or more inhabitants is furnished
by a general impounded lake supply and by numerous private wells.

According to the State board of health reports, the general supply
at times shows some evidence of surface pollution. The source of
this contamination, according to the local health officer, is probably
a barnyard located on the watershed of the reservoir.

All of the water used at the Minisink banquet, both for drinking
purposes and for washing the oyster shells, came from the well near
Music Hall. This well is moderately shallow, with an open top, and
the water is drawn by an endless chain pump. It is located quite

1 Days.

18 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

near the front of a dwelling, but no dangerous source of pollution was
observed. ,

Two samples of water were collected from this well on November
29, 1911, shortly after a rain. The bacteriological examination
showed the presence of gas-forming organisms of the B. coli type in ~
5 ce quantities, but not in 1 cc in either sample.

The water from the well had been continually used, both before
and after the day of the banquet, by a large proportion of the child-
ren attending school nearby and by a number of local residents.
No illness of any description was ever attributed to drinking it, there-
fore the water used at the Minisink banquet could not be held respon-
sible for the epidemic following that occasion.

GOSHEN MILK SUPPLY.

The next general food supply to receive attention was the milk used
in Goshen and at the banquet on October 5. In general, the milk of
Goshen was furnished by four dairymen. According to the health
officer, no case of typhoid fever had occurred on any of the four dairy
farms during the entire season prior to the banquet. In fact, there
had been only five or six cases of typhoid reported in that whole town
and vicinity during the entire summer, and in most instances these
appeared to have been contracted while visiting away from home,
and were in families having no connection with the dairy farms.

The milk and cream used at the Minisink banquet was furnished
from a number of local sources. It was donated in various quantities
by different individuals, and probably represented the entire source
of supply of the four dairymen on that date. Owing to the fact that
the cream and milk was largely used for the coffee and cooking, and
that no cases of illness followed the other dinners, it does not seem
probable that milk played any part whatever in the causation of the
epidemic following the Minisink banquet.

CONSIDERATION OF THE MENU.

A consideration of the menu served at the banquet showed that the
three articles, celery, ice cream, and oysters on the half shell, were
the only food products eaten on this occasion which in any way
could be held accountable for the spread of typhoid. organisms. In
this connection, however, it may be well to mention that the tomato
salad served was made from fresh, whole, ripe, home-grown tomatoes,
which were prepared and handled inacleanly manner. No widespread
epidemic of this character could have resulted from such a product.
Of the 100 guests made ill, 41 did not eat the tomato salad, 7 of the 17
who had typhoid fever, and 34 of the 83 who had diarrhea; so this
article was not the cause of the trouble.

THE MINISINK EPIDEMIC. 19
CELERY.

The celery served at the banquet was grown about 4.5 miles from
Goshen on the same farm and was furnished from the same lot as that
used at the St. Elmo Hotel and the Methodist Church on October 5.
No illness occurred at either of those two places. There were 6 of the
17 typhoid cases and 17 of the 83 diarrhea cases, or 23 of the 100 per-
sons made ill, who did not eat celery, and 11 people who ate celery
and oysters who were not sick; thus celery was not the source of the
difficulty.

ICH CREAM.

The ice cream served was manufactured at a factory located between
Goshen and Middletown, N. Y. From this same lot was also fur-
nished that used at the St. Elmo Hotel and the Methodist Church on
October 5, where no illnesses occurred. There were 9 guests who did
not eat oysters; however, they did eat ice cream, but no illness re-
sulted, while 4 of the typhoid cases, and 7 of the diarrhea cases, or 11
guests did not eat ice cream, but all of them did eat “ Rockaway”’
oysters. This evidence shows that the ice cream was not the cause
of the illnesses following the banquet.

OYSTERS ON THE HALF SHELL.

With two exceptions, all of the people who had typhoid fever or
diarrhea following the Minisink banquet on October 5, 1911, ate raw
oysters served on the half shell. One of the two exceptions was a
lady who had worked hard that day preparing for the banquet and
at night suffered from “‘indigestion,’’ which attacks were not uncom-
mon with her. She did not eat oysters. The other case of illness
began two weeks later, and was called “‘biliousness.”’ It is reason-
able to believe that among 155 people there would be at least one or
two who would have some intestinal derangement following an ordi-
nary banquet, even if no infected food were served.

The oysters for this banquet were furnished by a local retail
merchant, designated dealer C. There were ordered for this occasion
1,000 oysters, to serve 6 oysters per plate for 160 guests, with instruc-
tions that they should be freshly shucked at the store and delivered
to the banquet hall out of the shell. It was intended to place the
shucked oysters on shells before serving, and the shells used were
taken from the same lot of shell stock which was opened at the store
and sold to the banquet. As the oysters were opened, the empty
shells were thrown into an empty oyster barrel, in which container
they reached Music Hall; thus fresh oyster shells were used at the
banquet, and, contrary to unfounded reports, no stale shells were
used on this occasion. The dealer explained that the shells of all
former oysters had been discarded and hauled away by farmers,
who sought them eagerly for poultry food.

20 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

After arriving at the music hall, the oyster shells were carefully
scrubbed at the nearby pump, just described as the source of water
used for this banquet. These shells were cleaned by two men who
used new brushes and the cleansed shells were placed in clean tubs.
The same men who scrubbed the shells had done so on two former
occasions of this character and no epidemics of typhoid followed
those banquets. The previous history of these two individuals is
well known by the health officer, and they never have had typhoid
fever. They are cleanly in their habits, and an examination of their
urine by the Lederle Laboratories gave negative results for typhoid
bacilh. |

This detailed account of these oyster shells is given because a
report was circulated, by some one who had not investigated the
matter, that the oyster shells were responsible for the illnesses fol-
lowing the banquet. The possibility of the oysters becoming con-
taminated from old infected shells was recognized, but careful investi-
gation and consideration of all the facts in the case show no basis
whatever for such a conclusion. The physical characters of these
shells will be described later m connection with the differentiation
of the oysters used at the banquet.

SOURCE OF THE OYSTERS.

At the time of making the first two visits to Goshen the writer was
informed that all oysters sold by dealer C were received from dealer
E of New York City, and accordingly the oysters served at the Mini-
sink banquet were said to have come from the above firm. A visit
to dealer E revealed the fact that one barrel of shell oysters had been
shipped from New York City on October 2, reaching Goshen on the
3d,! or two days before the banquet. The purchase and sale books
of the New York firm showed that these oysters came from the
Great Kulls oyster grounds off the south side of Staten Island, N. Y.
From the past history of these grounds it did not seem probable
that shellfish from this locality would give rise to so many cases of
typhoid fever and diarrhea; thus additional evidence was necessary
to solve the problem as to the origin of the oysters.

At the time of making the third visit to Goshen, a complete list
of all the shipments made by express or freight to dealer C within
one week prior to the banquet was obtained. The Wells, Fargo
Express Co. is the only express company represented at Goshen;
thus a search of this company’s records was sufficient to give complete
information. The list of express articles for this period could not
be identified by dealer C, as his bookkeeping was incomplete; thus
it became necessary to inspect the records of the general office of the

1 Wells, Fargo & Co. express waybill 2, clerk 66, weight 275 pounds, New York, N. Y., Oct. 2, 1911,
1 barrel oysters.

THE MINISINK EPIDEMIC. 21

Wells, Fargo Express Co. at New York City. Here it was ascertained
that dealer C had received oysters from three different shippers
during the week before the banquet, one of which was the shipment
from dealer E sent on October 2, 1911, from New York, leaving the
other two consignments yet to be accounted for.

It was shown by the express records! that one barrel of oysters
in the shell was shipped on October 3, 1911, by dealer B from Fulton
Market, New York City, arriving at Goshen on the 4th; and on
October 4 one 5-gallon tub of opened oysters was shipped from
dealer F,? Seaford, Del., arriving at Goshen on, October 5, 1911, the
day of the banquet. The express records for the Seaford shipment
at the Goshen office were entered as having been received on October
6, but it was explained that the clerk systematically entered the
record on the day following the receipt of the shipments. This
entry caused considerable difficulty in accounting for the presence
of freshly opened bulk oysters in the establishment of dealer C on
the day of the banquet as claimed by him.

On December 12, 1911, the oyster shucking plant of dealer F at
Seaford, Del., was crepacied: samples of water used in washing
oysters were collected, also ovsters taken from the same beds as were
the oysters shipped to dealer C at Goshen, N. Y.

The plant was in a moderately good sanitary condition, perhaps
above the average in cleanliness; and the well water used for washing
oysters did not show B. coli in 5 cc, though they were present in
10 ce quantities.

The oysters came from near the mouth of Nanticoke River, in
Chesapeake Bay, Md., and they scored 14 points, showing a passing
mark. From an inspection point of view, the consumption of these
oysters could not have been held responsible for any serious out-
break of disease.

During the fourth trip to Goshen it was learned that about 4 quarts
of the 5-gallon tub of shucked oysters, received in bulk by dealer C,
were furnished to the Minisnk banquet on account of shortage in
the original delivery; thus complicating the situation as regards the
kind and source of the oysters which appeared responsible for all
the sickness among the Minisink guests.

It was learned that oysters were served at the Occidental Hotel
for 50 of their guests on October 5, 1911, and they were supplied by
dealer C from the same 5-gallon lot of shucked oysters received
from Seaford, Del., from which were furnished the 4 quarts for the
Minisink banquet. No illness followed the dinner at the Occidental;
thus these oysters were considered not to have been the cause of

1 Wells, Fargo & Co. waybill 13, clerk 24, weight 250 pounds, New York, N. Y., Oct. 3, 1911, 1 barrel
oysters.

2 Wells, Fargo & Co. waybill 95, clerk 95, 5 gallons oysters, weight 60 pounds, advanced charges 37 cents,

22 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

any illnesses at the Minisink banquet. This view was sustained by
subsequent investigations. It was shown that the bulk shucked
oysters, or the last delivered, were largely served at the end of one
long table, where no illnesses occurred, with one exception. This
exceptional case was one of the waitresses, seated at the end of the
table marked a—b in the diagram (fig. 1), who ate her dinner after
serving the men, and the plate of oysters served her was brought
by a young man from a portion of the table where the first lot of
shell oysters, which some one else refused to eat, were served. This
waitress developed typhoid fever, representing the only case of ill-
ness at that end of the table, where about 20 guests were served.
In addition to this evidence, a quart or more of the bulk oysters
were left over and taken home by one of the ladies, and were eaten
by a number of persons, none of whom developed any illness whatever.
Considering the source of these opened oysters and the negative
results following their consumption, it is plain that they were not
responsible for the trouble experienced.

Having satisfactorily eliminated the Seaford opened bulk oysters
as a factor in the causation of disease at the Minisink banquet, the
other two shipments of shell oysters, received on October 3 and 4
by dealer C, were considered more in detail. The barrel of 900 shell
oysters was received at Goshen from dealer E on October 3, 1911,
two days before the banquet. As there appeared to be quite a de-
mand for oysters at that time it is probable that these oysters were
quickly consumed. This view is taken because the order for 1,000
oysters could not have been wholly filled from a lot containing 900
oysters at the time of receipt, even though none of the shipment
had been sold during the two days elapsing before the banquet. It
was shown by dealer C that all of the oysters, opened freshly from
their shells in his shop, came from the last shipment he received,
and they had been ordered as “‘special;’’ thus this fact would also
strengthen the position that the oysters from dealer E were not used
on this occasion.

Information subsequently obtained showed that other oysters
taken from Great Kills at the same time as the shipment to Goshen
were sold by dealer E to other retail dealers in different parts of
New York State and no ill effects could be connected with their
consumption. |

When the facts became established that oysters were apparently
responsible for the diseases following the Minisink banquet, all of the
accumulated information pertaining to the quality and the probable
chances of oyster contamination along the entire Atlantic coast
was considered. It had been recognized for some time that Jamaica

cn Note the arrangement of cases in the table diagram. The table to the right, from a to b, was served
with Seaford oysters and the plates marked ‘‘S.”

THE MINISINK EPIDEMIC. 23

Bay was badly polluted, and, in fact, as will be subsequently shown,
many samples of oysters and water had been taken from Jamaica
Bay at the very time the oysters were taken from this place for
shipment to Goshen. These examinations led to a series of seizures
and condemnations of oysters from this bay, the first of which was
made on October 12, 1911."

The first intimation that ‘‘Rockaway”’ or Jamaica Bay oysters
played any part in the problem under solution was on November 29,
1911, the day before Thanksgiving, after searching the records at the
Wells, Fargo & Co. general offices in New York City. It was then
too late in the day to obtain information from dealer B, and it was
not until December 15 that positive information was obtained as to
the source of the ‘‘Rockaway”’ oysters.

Soon after obtaining information relative to the shipment of
oysters to Goshen by dealer B on October 3 from Fulton Market,
New York City, a visit was made to this firm’s establishment. Here
it was ascertained that the oysters in question were ‘‘Rockaways”’
which came from dealer A, located at Indian Creek, near Canarsie,
Long Island. The complete system of bookkeeping followed by
dealer B made it possible to establish this fact beyond any doubt.
The source of the oysters under dispute then lay between the Great
Kills oysters and the Rockaways taken from Jamaica Bay. Having
shown that either the Great Kills oysters or the Rockaways were the
infected oysters, a further study of the physical characteristics of
these two varieties was made.

During the early part of the investigation inquiries were made at
Goshen regarding the color of the oysters served at the Minisink
banquet. The testimony showed that few, if any, ‘‘green”’ oysters
were observed on that occasion. This fact would tend to substantiate
the belief that the oysters were of the Rockaway variety, as it is
commonly known that many of the Great Kills oysters have a decid-
edly green color at certain seasons of the year. Since many people
object to this color these oysters are not so generally sold to be eaten
raw on the half shell. They are more largely used for stews and par-
ticularly for fried oysters in which the color wouid be concealed. On
the other hand ‘‘Rockaway”’ oysters are sold ‘argely for half-shell
purposes, and would generally be ordered for banquets in preference
to the Great Kills oysters.

A close study of Rockaway and Great Kills oyster shells shows
considerable difference in their physical appearance. The Jamaica
Bay or Rockaway shells grow very rapidly, owing to the great food
value of those waters. This fact is recognized by practical oyster-
men and these grounds have been eagerly sought for the rapid
maturing of shell stock. This quick growth causes very long, thin

1U.S. Dept. Agr., Office of the Secretary, Notice of Judgment 1380.

24 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

brittle tips on many of the shells. Those in deeper waters or in the
channels grow less rapidly than those on the flats, or shallow water.
The tips of many Rockaway shells can be easily broken because of
their brittleness and thinness, and many of these shells give evidence
of softening and degeneration. They appear as though some acid
or chemical had acted upon the shell, thus dissolving a portion of
its structure. The practical oysterman realizes the soft character of
the Rockaway oyster shelis, as they are nearly all ‘‘tonged”’ by hand
from their beds instead of using power dredges, such as are operated
in the Great Kills region.

The Great [tills oysters generally grow less rapidly, their shells
are stronger and tougher, the tips are not easily broken by handling,
and they withstand shipping as far as the Pacific coast. These facts
substantiate the belief that Rockaways, and not the Great Kills
oysters, were used at the Minisink banquet.

An investigation of the kind of oyster shells used at the music hall
led to the discovery that they had been buried the day following the
banquet near music hall beside a telephone pole. About 4 dozen of
the shells were recovered and identified by the man who buried
them. They were brought to the laboratory, washed, and matched
with a similar number of oyster shelis taken by the writer on Decem-
ber 5,1911, from the floating bins of dealer A, at Canarsie, Long Island.
A study of Plate I shows the character of the oyster shells and the
close similarity of those served at the music hall and those obtained
direct from Jamaica Bay.

This evidence seems sufficient to show positively that Great Kills
oysters were not served at the Minisink banquet, which conclusion
was reached after taking into consideration all of these facts and
the analyses subsequently submitted from these two localities.

CASES STUDIED AT ROCHESTER, N. Y.

On October 3, 1911, one barrel of Rockaway oysters from dealer A
was shipped by dealer B to a dealer in Rochester, N. Y., followed by
one barrel on the 11th, two on the 12th, and one on the 14th of Octo-
ber. During the year 1911, 76 cases of typhoid fever were reported
in Rochester;* of this number 48 were reported during the months
of October, November, and December, the latter month having 23
of the 76, or more than 30 per cent of the cases reported for the year.
It is a recognized fact that the typhoid death rate of Rochester is
normally exceedingly low. During the year there had been no
epidemics ascribed to milk infection, and the water had apparently
played little part in the transmission of typhoid bacilli.

When presented with the facts that certain shipments of infected
shellfish had been received during October at Rochester, the health
officer of that city admitted the probability of their being the most

1 Report of the bureau of health of the city of Rochester, December, 1911, p. 3.

PLATE l.

Bul. 156, Bureau of Chemistry, U. S. Dept. of Agriculture.

“AVG VOIVAVE WOYS STISHS HLIM LANONVG LV GSAYSS ST1SHS YALSAO 3O NOSIYVdWOD

SATLSAO AVE VOWEL

LTIONYS TIM ASN LY CINATS SYLLSAO

CASES STUDIED AT ROCHESTER, N. Y. 25

important factor in the greatly increased number of typhoid cases
reported during October, November, and December. There was
obtained from the health office a list of cases reported during these
months in 1911, and January, 1912, and 33 of these cases were per-
sonally investigated. Careful inquiry was made as to the possibility
of contact, the sanitary conditions of premises, the water and milk
used, and whether or not raw oysters were consumed within one month
prior to the illness. The weight of evidence obtained as to the
probable source of infection gave the following results:

OvaterswsOurcenImMdekehimMimle Ges. s osm hee onc oe se loca oe sas oes oe eee 8
TBO INGE S63 beso MEISE cg pres a Gas ick moi am Onn a ge ne 5
TRavira katy coscystaeraes eee dette Seren Set ye, op gee we Sle STA Lie ie tos Less S Ce 8
6 carrey ce teeta ge Na ete Ooch mae Ah gE ail: Sah ee ce ui ase 6
SUH SMTA SH THILO AST (USL) eaten eee AG) Nasty a ee RR, fog er ne eee 4
Maher motrnoehester stil) esse t§ ae a te ee yl ARS tet Mec Re RNs asa il
JN EGU een i a ae Pag fe AES ay Scoala 9h ten aN 1

ATE Tea ae reat etapa te erteete = An roe cyte ene, Mtl 2b dud Suh oesa aval seme 33

According to this table, oysters appeared to be responsible for 13,
or 39.4 per cent, of the 33 cases investigated. Thecases were widely
scattered throughout the city, and in nearly all instances they
appeared among well-to-do families where sanitary conditions were
exceptionally good.

Among the cases reported as eating “Rockaway” oysters, it was
almost impossible to trace the oysters back to the specific dealer from
whom they were obtained; however, all of the firms from whom these
oysters were purchased handled Rockaways almost to the exclusion
of other oysters at the time when they were eaten and when the infec-
tion probably began.

The visit to Rochester was made on January 8 and 9, about four
months after the shipment of oysters in October; thus, owing to tlie
length of time elapsed, it was more difficult to trace the cases directly
to any one of the five shipments made at that time. In most cases
in which oysters appeared responsible for the infection, other members
of the same family were not made ill; however, in nearly every
instance the infected person was the only one who ate the oysters raw.
Those who ate cooked oysters escaped the infection. In fact, it was
generally observed that in most instances oysters were cooked—not
eaten raw, as is the custom in many coast towns located near oyster
grounds. If this is generally true in Rochester, it will explain why
more people did not contract typhoid fever from eating these oysters,
especially the shipment of October 3, 1911, which came from the same
lot served at the Minisink banquet at Goshen, N. Y., on October 5,
1911; had they been eaten raw, the same disastrous results would
doubtless have followed their consumption.

It should be said that a number of the cases reported in Rochester
had been brought from neighboring towns, and some of those inter-

26 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

viewed belonged to this class. As opportunity was not afforded to
visit these towns, no information relative to the source of oysters
eaten was obtained. Data in regard to excessive diarrhea or other
intestinal diseases were nof available, owing to the fact that cases of
this character were not reported to the health office; hence there was
no way of locating persons who may have been afflicted with such
disturbances.

SCHOOLMASTERS’ BANQUET, NEWBURGH, N. Y.

During the Minisink investigation 1t was learned that a shipment of
one-half barrel of shell oysters had been made from dealer A, located
at Indian Creek, by a Fulton Market firm, to Newburgh, N. Y., on
October 12, 1911. These oysters were served at the schoolmasters’
banquet, given at a Newburgh hotel on the following day. There
were present at this banquet about 60 teachers and their guests,
representing some 8 counties of the State. The names and addresses
of the individuals attending this banquet, together with a list of the
articles of food served on this occasion, were obtained.

A circular letter similar in character to that sent the guests of the
Minisink banquet was prepared and sent to each of these 60 indi-
viduals. Of the 57 who replied, 1 stated that he did not attend the
banquet, leaving a total of 56 individuals who were present. The
menu served at this banquet contained oysters on the half shell, soup,
fish, roast chicken, cooked vegetables, salad, ice cream, cake, and
coffee.

These letters showed that 50 of the 56 guests had eaten raw oysters,
and of this number 13, or 23.2 per cent, had gastrointestinal disturb-
ances, in most instances beginning 2 or 3 days later, and somewhat
similar in character to the cases following the Minisink banquet.
Information relative to one positive case of typhoid fever, or 2 per
cent of those eating oysters, was obtained, the illness beginning about
12 days after the banquet. <A personal visit to this individual showed
a clear history of oyster infection. It was the discovery of this case
and a study of his previous history which revealed the fact that he
had attended the Newburgh banquet. No other member of his family
attended this banquet, and no one was ill. In reporting this case of
typhoid fever to the State department of health, the local heaith
officer’s card stated that no oysters had been eaten 20 days prior to
the illness. This is but one of a number of such instances encoun-
tered while making the personal investigations.

The excuse given by another physician for not reporting “‘raw
shellfish”’ as having been eaten within the proper incubation period
was the fact that the patient could not ordinarily afford to buy oysters;
it was self-evident that the card had been filled out in the physician’s
office without even asking the patient what he had eaten. The facts
showed that he had eaten raw oysters at the Minisink banquet. One

ILLNESS DUE TO EATING ROCKAWAY. OYSTERS. 21

very important fact was learned during this house-to-house investi-
gation, and that was the absolute necessity of thoroughness, paying
particular attention to details, and not ignoring information which
would in any way shed light on the problem under consideration.
The average physician does not have time to obtain the proper kind
of a case history, which would, in many instances, give valuable data.

Of the 13 guests who suffered from diarrhea, 6 had previously had
typhoid, also 3 of those who ate oysters and were not sick; thus there
were 9 individuals who were practically immune; however, the one
case of typhoid reported claimed to have had the same disease many
years before.

One man writes:

I beg to say that my wife was also a guest at the hotel, but not at the banquet, and
that she also was troubled for a week afterwards with severe diarrhea. She had eaten
oysters on the half shell.

Another man, who was not sick following this banquet, said:

You will see by the articles crossed on the menu that there was little chance of my
being infected by what Iate. Iam very particular when partaking of food away from
home, hence the lightness of my repast.

You may derive some satisfaction from my statement on learning that I am very
fond of ice cream, and on that night I ate a double portion, so that probably the ill
effects of the banquet came from the oysters or meats and not from the ice cream.

Five men attended from this city and four of them were more or less affected. One
was positively ill for some days with all the symptoms of ptomain poisoning. At our
last banquet on February 9, 1912, at the same place, more or less complaint was heard
of the illness caused by the banquet of three months before, and there was no little
complaint of the quality of the food served this time.

The oysters used at the schoolmasters’ banquet were evidently not
so badly infected as were those used at the Minisink banquet. They
probably came from the water at Indian Creek on October 11, 1911,
or’9 days after those sent to Goshen.

- DISTRIBUTION OF CASES OF ILLNESS DUE TO EATING ROCKAWAY
OYSTERS.

The cases of typhoid fever and gastroenteritis ascribed to eating
‘‘Rockaway’’ oysters, obtained either from dealer A at Indian Creek !
or from other parts of Jamaica Bay, as set forth in this report, are
tabulated as follows:

TYPHOID FEVER.

VEGRIeUnemhynila i Cimepreren. tee nee ate ce a be sages geb oes 17
i Mollavesinging INS Vee a oe Ee Ce ee an 5
MMlevssonmnveraia 10.2 (eae See eo Oe ee Se 2 2
Seni: eh ee EP EECR NA et lk ee Oe ee 1
SCHOO Miiaricts ane ere ene See Le wee dee ence gece 1
FOO kal yate at Nam aera rer er ST. le te ok Ue sk on gees i

TU ot eo os Se 2 oh OL 2 a i a ls on

1 The cases ascribed to Rochester ate ‘‘ Rockaway’ oysters which were not definitely traced to dealer A.
Two of the cases credited to Washington and one to Brooklyn came from a shipper located near dealer A.

28 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

GASTROENTERITIS (DIARRHEA). .
Minisink banquet.: ....s2S. 257 2 See ec ee ee ees 83

schoolmasters’ banquet (including Vhotel cuest)------22-- 2. =e ee it
Washineton, DiC... 5. 20 8 ee ee ee ee Zz
Totals... <.2scs2 5 2k 5 ee 2 eee 99
Total number of cases of typhoid and diarrhea.................---------- 126

In the case at Suffern, N. Y., raw oysters were eaten within the
proper incubation period from the same lot as were shipped to Goshen
on October 3, 1911. As far as could be ascertained all the other
oysters sold from this same shipment were cooked before eating;
however, there were said to have been a number of cases of diarrhea
reported in this town during October, and three or four cases of
typhoid outside of the town concerning which no information was
obtained. Figure 4 sets forth these data in graphic form.

INSANITARY CONDITION OF JAMAICA BAY.
PREVIOUS REPORTS.

Oysters from Jamaica Bay are generally sold under the name
‘‘Rockaways.” This designation appears on the menu cards at
hotels and restaurants where they are served; thus they are known
to the consuming public as ‘“‘Rockaway” oysters. The msanitary
condition of Jamaica Bay and vicinity was fully set forth by Porter *
in 1908; however, no steps appear to have been taken to prevent the
sale of these contaminated oysters, or prevent further pollution of the
waters of this bay. The practice of floating oysters in polluted
waters at Inwood and Indian Creek was also apparently known to
have existed, but no action was taken to stop this dangerous pro-
cedure. In the present report reference is made to the Lawrence
investigations, in which it was shown by Soper in 1904 that 21 out of 31
cases of typhoid fever were traced to oysters floated at Inwood, Long
island. NesY..

In speaking of the floats from which these oysters were taken, that
report says:

That the waters in which these floats were located were badly polluted was amply
demonstrated by the chemical and bacteriological examinations made at a time when
conditions were known to be far better than when the cases of the disease developed.
Samples of oysters were likewise examined bacteriologically, and of them 25 per cent
were shown to contain certain bacteria of the Bacillus coli communis type in one-
tenth of a cubic centimeter of the shell water, and in 60 per cent in 1 cubic centi-
meter of the same.

The sanitary survey showed the discharge of imperfectly treated sewage, from a
population of 15,000, less than half a mile from the oyster floats; in fact, some were
very much nearer. Aside from this pollution, there were many individual sewers,
manure piles, dump heaps, piles of cesspool sludge, which contributed to the pollution
of the water adjacent to the floats.

1 Porter, Eugene H. Sanitary inspection of shellfish grounds. (New York State Board of Health, 29th
Ann. Rept., 1908, 27 833-864.)

INSANITARY CONDITION OF JAMAICA BAY. 29

PTINIS/NA
LANQUET

/7 TYPHOID
83 OIARRHEA

OCT. §

“SCHOOL-
ITASTERS’
BANQUET

1 TYPHO/D

DEALER *
C

GOSHEN, N.Y
eee y/,

DEALER
D

SUFFERN NY]

OCT. 3

DEALER

DEALEP E
B NEW YORK |
NEW YORK CTE
: OCT/2

C/T Y

“OCT. 2
DEALER

/NOIAN CREEX,
CANAASIE, ;
LENS:

Fig. 4.—Cases of typhoid and enteritis traced back to Rockaway oysters sold by dealer A.

30 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID. ‘

Since that report so completely covers the situation under dis-
cussion, the following descriptive data are also submitted:

The Jamaica Bay oyster beds are leased by the State and constitute the largest
oystering district in New York State waters. They are said to yield from 500,000 to
1,000,000 bushels yearly. The principal shipping points from this bay are at Canarsie,
Inwood, and near Flatbush Bay, although large quantities of oysters are taken direct
by schooners to New York markets.

Area of Jamaica Bay inside of Rockaway Point estimated exclusive of marshes to
be 16,690 acres. Mean range of tide 4 feet. Tidal daily volume passing in and out
twice daily is roughly 2,900 million cubic feet.

The principal points of pollution are at the four sewage disposal plants at Sheeps-
head Bay, East New York, Jamaica,and Far Rockaway, at the outlet of Paerdegat
and Kings County hospital séwers into Paerdegat Basin, at Bergen Beach, at Canarsie,
and along Rockaway Beach district. In addition to these points, pollution reaches
the bay from various summer cottage colonies, the principal colonies being located
at Plum Beach, at Sand Bay, east of Canarsie, along Mill Creek, at Ramblersville or
Remsen Landing, along Bergen and Cornell creeks, and at the several stations on the
bay of the Rockaway Beach Railroad.

The pollution differs greatly at most points in the summer and winter seasons. The
Sheepshead Bay disposal plant, using the chemical precipitation method, which the
other three plants also use, receives sewage from a normal population of 2,000 in winter
to a summer population of 40,000 to 50,000 on special days. The treatment is prac-
tically ineffective.

Bergen Beach is visited by from 50,000 to 60,000 persons weekly in summer, and the
sewage, from an average of 8,000 persons daily, is discharged into the bay.

Paerdegat Basin receives sewage from a permanent population of over 10,000 per-
sons.

Canarsie is visited by an average of 16,000 persons daily in the summer season,
including 30,000 on Sundays, and practically all the sewage from this population
reaches the bay.

A permanent population of considerably over 50,000 persons contribute sewage to the
New Lots or East New York disposal plant. An average of 10,000,000 gallons of sewage
and storm water per day is pumped at this plant, and in addition a relief by-pass is in
operation from 11 o’clock a. m. until midnight. The plant is so much overtaxed, the
sewage being detained for only 17 to 20 minutes, that the treatment is practically
ineffective.

At Sand Bay, 127 cottages, at Old Mill Creek, 176 cottages, at Ramblersville, 220
cottages,-at Bergen Creek, 50 cottages, at Cornell Creek, 53 cottages, and along the
line of the Rockaway Beach Railroad, over 200 cottages, have privies which discharge
into the water or onto marshes subject to tidal overflow.

The Jamaica disposal plant, effluent from which is discharged into a branch of
Bergen Creek, treats the sewage from about 18,000 persons out of a total population of
25,000 in Jamaica. The plant has ample capacity as a chemical precipitation plant,
although under the best of operating conditions a reduction of organic matter and bac-
teria of about 50 per cent only is possible.

The Far Rockaway disposal plant receives sewage from a normal population of 6,500
and a summer population of 30,000. During the summer season the plant is undoubt-
edly overtaxed.

The Rockaway Beach district varies greatly in population. In the winter season,
from October to June, the population is about 6,000 as based on the registration.
During the summer season the average daily population is from 55,000 to 60,000, and
on a conservative estimate, based on the traffic figures of the railroad and steamboat

INSANITARY CONDITION OF JAMAICA BAY. 31

lines carrying passengers to this district, the population in this district on certain days
may reach as high as 125,000 to 150,000.

Twenty-nine public sewers discharge sewage from this varying population directly
into Jamaica Bay.

By studying the accompanying maps and illustrations (Pl. II and
fig. 5) it will be seen that Jamaica Bay is located dangerously near a
large city and into it many million gallons of sewage empty daily.

In addition to the published report of the New York State Board of
Health for 1908, additional information was obtained from inspection

-PUBLIC SEWER?
DSCHARGES .
000,000 Gall. DAILY

HF

: PAEROEGAT BASIN SEWER \
s__ QISCHARSES
2,000,

Fig. 5.—Map of Jamaica Bay showing principal sewer outlets and oyster beds (shaded areas).

trips made at various intervals during the winter season of 1911-12,
at which time samples of water and oysters were collected for ex-
amination.

HENDRIX STREET SEWER AND DISPOSAL PLANT.

On January 25, 1912, an inspection was made of the Hendrix
Street sewage disposal plant, located at the foot of Hendrix Street,
Brooklyn, N. Y. This plant was said to have been built in 1892-93
for treatment of a maximum capacity of 3,000,000 gallons of sewage
daily. At present they endeavor to treat approximately 10,000,000
gallons daily, while the total outflow of the entire sewer is estimated
at about 18,000,000 gallons under normal dry-weather conditions,
at least one-fourth more during heavy rains, all of which empties into
a flume nearly 1 mile in length which discharges into Jamaica Bay.

There was being used in this plant at the time of inspection about
4,000 pounds of lime to treat 10,000,000 gallons of sewage, or 1

32 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

pound of slacked lime to 2,500 gallons of raw sewage. Four-ounce
samples of sewage, one collected before and one after treatment, were
examined, with the following result:

Examination of sewage samples before and after treatment.

cee. Before After
DIG ROSETTE OES: treatment. | treatment.
Parts per million.
Chemical analyses: !
AMM OMIA «2 2251s Fac eons See eee ee ewe aie ao Se ee oes Se eee ee ee 45.0 50. 0
Nitrogen.as nitrites 255s ae See ee ee So ee eae ee eee een aaa a0 -0
Nitrogen as nitrates.......--- Tenens eh oes cee nc Une see ee eee eee eee -0 -0
Chlorine Soe ye ae oe See en eR a SRO ee eee 60.0 60.0
Organisms per cc.
Bacteriological analyses:
On‘plain agar:at'25° Cs. << 2 asa erat a ee ee eee 7, 100, 000 4,900, 000
On plain agar at 37° C...... Sree wat ene too. s68 Soe Ses eee Se ee ee eee 3, 700, 000 4,000, 000
BECO 5 os onc Sioa se Se ee eee SO eee ape nse i oe oes ee a 10, 000 10, 000

1 Chemical analyses made by W. W. Skinner, Water Laboratory, Miscellaneous Division, who comments
as follows: ‘‘ In the case of sewage, the results of the analysis show this to be probably a raw product, both
before and after treatment. But the examination, so far as made, seems to indicate that the treatment
has little effect upon the character of the material.”” Owing to the small amount of the sample, it was
impossible to make further chemical analyses.

The bacteriological results show that one sample of sewage at the
time of collection contained more bacteria at 25° C. before treatment
than after treatment; however, the sample after treatment with lime
contained a higher total number of organisms at 37°C. The number
of B. coli was unchanged.

The results, both chemically and bacteriologically, would indicate
practically no change resulting from treatment of this sewage at this
disposal plant. It was said that in addition to the lime used there
was also about 50 gallons of crude phenol used per month in washing
down the walls of the sedimentation basins during cleaning.

In the accompanying illustration is shown the disposal plant in the
background, with the flume some 26 feet wide in the foreground.
The flume is reenforced with crossbeams, which cause its peculiar
appearance (see fig. 6).

Besides the Hendrix Street disposal plant, the Jamaica and Far
Rockaway plants are operated in a similar manner; the output,
however, is only a few million gallons daily.

The Paerdegat sewer, having a daily discharge of about 2,000,000
gallons, empties into Jamaica Bay, a short distance to the west of
Indian Creek, where nine oyster dealers, including dealer A, float
their oysters. To the east of the mouth of Indian Creek empty the
18,000,000 gallons of sewage from the Hendrix Street sewer (see fig. 6).

In addition to the effluent from the public trunk sewage systems of
Brooklyn and vicinity, there are numerous small sewers located all

"pO61 ‘MYOA MAN Y3LVaYD ONINYOY SHONOHOG AAI4 SHL JO MSIA ZAQ-S.0NIG

PLATE II.

AYE AFT/MO7
SHL ~

Fa NvRSs NIL
“ONOWH IIE

wr
10 NOR Fre

Bul, 156, Bureau of Chemistry, U. S. Dept. of Agriculture.

FLOATING OYSTERS. 3303

along the south side of Jamaica Bay which empty their contents into
these waters. Aside from these sewers, hundreds of private cottages,
hotels; and summer resorts discharge their sewage directly into the
waters, In some instances almost immediately over the oyster beds,
or near where clams are dug on the flats.

Considered as a whole, Jamaica Bay may be considered as one great
basin into which many millions of gallons of human sewage are con-
stantly flowing, and doubtless myriads of typhoid organisms from
this sewage find their way over a portion of the shellfish grounds
through the medium of polluted water. The bacteriological examina-

Fic. 6.—Hendrix Street sewage disposal plant, Brooklyn, N. Y.

Tn the foreground note the top of the reinforced flume, 26 feet wide, through which more than 18,000,000
gallons of sewage, practically raw, enters Jamaica Bay daily.

tion of all of the water and oyster samples taken from Jamaica Bay
has shown marked evidence of pollution, as set forth in the accom-
panying tables.

FLOATING OYSTERS.

Plates III and IV represent views of the oyster houses occupied by
dealer A and others. The oysters are brought by boat from the
grounds and unloaded through “‘trapdoors” at the sides of the build-
ings, as shown in the illustration, or, in some cases, the boats may
enter the cellars during high tide and there be unloaded. During
low tide this creek is nearly dry, and it is said that fresh-water springs
are located under the houses. By closing the flood gates during ebb
tide, the water under the houses is kept almost free from salt, and the
oysters ‘‘drink”’ under these conditions. The water under the houses

34 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

shown in these plates contains about 1 per cent less salt than that in
Jamaica Bay where the oysters grow; thus they “plump” up by
osmotic action. Upon analysis it was found that this water where
the oysters were stored was badly polluted. In some places
visible masses of human fecal matter were observed in the rear or
at the sides of these buildings, a few feet from the banks of the
stream. Doubtless the oysters were directly polluted by men who
discharged their excretions into these dark cellars. This possibility
was admitted by some of the oystermen at that place.

BACTERIOLOGICAL DATA ON WATER AND OYSTERS FROM
JAMAICA BAY.

METHODS OF EXAMINATION.

Water.—The bacteriological examination of water collected over
oyster beds or from oyster floats was made in the usual manner for
water samples of this character. The method used is fully presented
in Bureau of Chemistry Bulletin 1391 and is based on the report of
the Special Committee on Water Analysis of the American Public
Health Association.

Briefly, the operation consists in the inoculation of lactose peptone
ox-bile media with definite quantities of the water sample, which are
incubated at 37° C. for two or three days, when the presence of
B. coli is determined by subcultures and isolation in pure cultures.
The presence of B. coli in the majority of 1 cc samples is considered as
evidence of serious pollution, particularly when inspection shows
probable contamination from human sources. __

Oysters and other shellfish —Oysters from Jamaica Bay were exam-
ined in the same manner as those from other sources. In general, the
methods outlined by the Committee on Shellfish Examination ? were
followed, as set forth in an article read before the laboratory section
of the American Public Health Association, Milwaukee, September,
1910.3

The samples of oysters were taken for examination either from their
beds by tongs or from floats, and in most instances were shipped to
the Washington laboratory for analysis; some few analyses were
made in the branch laboratory at New York City. Those shipped to
Washington were placed in water-tight cases surrounded by ice, no
water coming in contact with the oysters. Before opening the shells,

1 American Mineral Waters, Skinner, Stiles,and Haywood. Bul. 139, Bureau of Chemistry, June 13,1911.
2Preliminary Report of the Committee on Standard Methods of Shellfish Examination. Reprinted from
the Journal of the American Public Health Association, August, 1911, vol. 1, No. 8.

3Stiles, Geo. W. The bacteriological examination of shucked and Shell oysters. (Journal of the
American Public Health Association, September, 1911, No. 9, pp. 623-631.)

Bul. 156, Bureau of Chemistry, U. S. Dept. of Agriculture. PLATE III.

FiG. 1.—OYSTER HOUSE OF DEALER A AT INDIAN CREEK, NEAR CANARSIE, LONG
ISLAND, N. Y.
Taken January 25, 1912, with the tide rising. Note the closed trapdoors through which oysters

are unloaded from boats. A trapdoor in the floor above permits entrance from the interior
of the building.

FiG. 2.—OYSTERS IN THE CELLAR UNDER HOUSE OF DEALER A.

Picture taken December 15, 1911, at low tide, when only a portion of the shells were under water.

Stier
ye 5

Bul. 156, Bureau of Chemistry, U. S. Dept. of Agriculture. PLATE IV.

Fic. 1.—VIEW OF INDIAN CREEK, NEAR CANARSIE, LONG ISLAND, WHERE NINE OYSTER
DEALERS FLOAT OYSTERS IN THE CELLARS OF THEIR HOUSES.

Arrow points to Dealer A’s house.

Fig. 2.—A THREE-COMPARTMENT PRivy LOCATED DIRECTLY OVER INDIAN CREEK NOT
FAR BELOW DEALER A.

This is one of the immediate and specific sources of pollution in this creek,

BACTERIOLOGICAL DATA. 35

they were well scrubbed, dipped quickly in boiling water, and opened
with sterile instruments, the liquor from each oyster being collected
in a separate sterile petri dish. Quantities of 1 cc, 0.1 cc, and 0.01 cc
of shell liquor were planted in lactose-peptone ox-bile fermentation
tubes, and incubated in the same manner as was observed in making
the water analysis. B. coli were also isolated and studied in pure
culture in the same manner as in the case of water.

The method of scoring oysters was the same for all the samples
herein submitted, and is that recommended and known as ‘The

MONTHLY AVERAGES ON SHELL OYSTERS.

FEBRUARY
NOVEMBER
DECL/IBGBER
SEPTESIELER
OCTOBER
NOVE/IBER

| SANUARY
FEBRUARY

sil

J X\nNorngtQBsy

Fig. 7.—Average monthly score on shell oysters from different sources.

American Public Health Association Method of Scoring Oysters for
B. coli,” summarized as follows:

The presence of B. coli in each oyster of the five examined is to be given the following
values, which represent the reciprocals of the greatest dilutions in which the test for
B. coli is positive:

If present in 1 cc but not in 0.1 cc, the value of 1.

If present in 0.1 cc but not in 0.01 cc, the value of 10.

If present in 0.01 cc but not in 0.001 cc, the value of 100, etc.

The addition of these values for the five oysters would give the total numerical value
for the sample and this figure would be the score for B. coli.

Monthly average scores for oysters from various sources and from Jamaica Bay are
shown on figure 7,

36 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

TABULATED DATA.

Water from Jamaica Bay and tributaries.

[Bacteriological examination of all of the samples collected from this bay-.]

B. coli
No.| Date present | NaCl. | Location.
es
1908. cc. | Per cent.
i} Apr. i1 a0 @) | Pumpkin patch; water 17 feet deep.
7p Wie | || Seen | gE | pes WP tee ors | Pumpkin paich; waier near surface.
See do ee 120) pele | Surface sample near Canarsie.
Ad do.2 fies oe Bene 2 | Big Channel; 18 feet deep: 13 miles from shore.
Te) (eek t [eee a ae ee eer) Broad Channel; east, below railroad bridge; surface sample.
Go: -sdos=: ahh silt are es -| Broad Channel; 10 feet deep. :
7 fe) Wee Cems 1 OY Ae ee | Yellow Bar; waiter 6 feet deep.
2 Beet eae re yale 2 ae ee ee _ Ruffle Bar; surface sample.
Oy edes = e) Pe. nee | Ruffle Bar; deep sample.

10 j:<- do: SS | Yat a aa | Southeast from Ruffie Bar; water 2 feet deep. 2

idee dos2 2: iE Orne Beaersrge ess | Southeast from Point of Ruffle Bar; water 1 foot deep.

42 '|-=-do-- aL Ole cee 2e ss Brandt Point; water 15 feet deep.

1 [fe oes 1 Te 1 | a eae | Brandt Point; surface sample.

1911
14 | Sept. 28 i eee || 32.81 | Northeast from Hammel, Broad Channel; 12 feet deep; low tide.
| See oyster sample No. 1.

a5 1S do: =e ea 2.81 | Above railroad bridge. Broad Channel; water 12feet deep. Low tide.

LL th ears (ees LO 4 2.85 | Above drawbridge; Broad Channel. Low tide.

cy ers Crea 1.0 2.85 | One mile west of drawbridge: Broad Channel. Low tide.

ibeym Bost! Cease 5.0 2.90 | Off Rockaway Park, 4 milefrom shore. Low fide.

ion Sedo = eee a | 2.89 ) Water 2 feet deep; 100 yards of sma* seweron shore. Low tide.

204) Oct. 12 <a 1.75 | Floating bins, under oyster house, Inwood, LongIsland. Duplicates.

2 dos sh 1.82 Do.

rad ext ene a4 2.56 | Geet storage fioais, outside of oyster house in canal, Inwood, Long

sland. .

Pea 3 Sar é C1 alee 1.0 2.71 | Collected during the afternoon; ebb tide about 2 hours; vicinity of
! | Broad Channel, and Silver Hole, above railroad bridge, over
| oyster grounds.

2A N= 002-2. =} 1.0 212, Do

25) aoedols. 22) 300 2.74 | Do.

re, Os aoe Ce eae 5.0 2.83 Do.

7 fl Fees «Cetin | 1.0 2.68 Do

28 dO | = I 2.70 Do

2915-200. 228 sil 2. 67 Do.

+ (1) ear (ee eee 1004 Pay Do.

ai fy eet Cee cO- 2.68 Do.

= 74 Wie tl eee | -O1 | 2.68 | Sample near Hammel, above railroad bridge.

33 | Dec. 15 | =f .67 Indian Creek, near Canarsie, outside of dealer A’s oyster house.

a7 fees (eae eg | 87 Do.

35 e-d0=-2-= -001 | .92 | Under dealer A’s oyster house where oyster samples Nos. 45 to 50,

| | inclusive, were collected.®

1 Sodium chlorid determinations not made.

2 B. coli determined only in 1 cc or less quantities at that time.
a Sodium chlorid determinations made by L. C. Mitchell, Food Inspection Laboratory, Bureau of

themisiry.

4 B. typhosus isolated from oysters taken this day from these waters. See oysters Nos. 14 io 36, inclusive.

5 Jamaica Bay oysters were taken from this bin under dealer A’s oyster house on Oci. 2, 1911, and
shipped to Goshen, N. Y., on Oct. 3, arriving there Oct. 4, the day before the banquet at Music Hall
on Oct. 5, 1911. It was this lot of oysters which was responsible for 17 cases of typhoid fever, with 1
death, at Goshen, N. Y. The results show that the waters of Jamaica Bay are badly polluted with
sewage.

BACTERIOLOGICAL DATA. Sf

Shell oysters from various sources showing satisfactory bacteriological results.

Gas-producing organ-

Organisms per isms (each score

Cea based on 5 oysters).
No.| Date. Score. Source.
° ° In In
PHO Ce | BIO CR hell ee Oitee. OlOt ec:
1910

1 | Mar. 11} 3,600 500 4 1 0} 5 Lower Providence River.

2| Mar. 25} 3,800 1,800 2 1 0; 3 Great South Bay, Long Island, N. Y.

Sn lpeeOseeee 6, 100 700 2 2 0| 4 Do.

4p leet Oesaac 1,100 230 1 1 0 2 Do.

He ste). 3, 000 1,000 0 0 0; 0 Do.

GuleeeOOseee: 600 230 1 0 Ope Do.

@ |eeedous 500 50 1 1 0; 2 Do.

8 | Mar. 29] 3,800 400 1 0 @ || i Do.

Qe. do... 10, 500 4, 400 2 0 0 2 Do.
10 |...do. 9, 900 200 10 10 (|) © Do.
11 do.. 4, 000 2, 700 2 1 0; 3 Do.
12 do... 10, 000 2,000 1 1 0} 2 Do.
13 | Apr. 9] 5,000 2, 000 4 0 0| 4 Delaware Bay (unfloated).
14 |...do.....| 7,000 1,000 3 0 0; 3 Do.
16 | Nov. 18 | 3,000 3, 000 4 1 0| 5 Great Kills, Staten Island, N. Y.
16 | Dee. 2 | 60,000 2,000 26 21 0) 2.5 Do.
17 | Dee. 10 600 1, 100 4 1 O 4 Do.
18 | Dee. 13 | 13,000 100 + 1 0) 5 Do.
19 | Dee. 14 100,000 6, 000 2 0 Onleee2 Source not determined.
20 |...do.....} 92,000 5, 000 4 1 0) 5 Do.
21 | Dec. 16 | 90,000 700 4 1 O) |) 5 Great Kills, Staten Island, N. Y.
22 do.....| 40,000 3, 000 2 0 OM lee Oyster Bay, Long Island, N. Y.
23 | Dec. 31 150 0 1 0 Mi} 1 Great Kills, Staten Island, N. Y.
24 |...do.....| 2,700 160 5 0 0; 5 Do.

1911
25 | Jan. 6 | 50,000 2,000 4 1 |) & Market oysters; source undetermined.
26 do.....| 13,000 3, 000 1 0 Oneal: Great Kills, Staten Island, N. Y.
27 do 11, 000 300 3 0 Ones Do.
28 do....-| 20,000 3 1 0 0 1 Do.
29 | Jan. 13 | 14,000 2,400 4 0 0} 4 Do.
30 do 4,000 800 5 0 = (> & Do.
31 | Jan. 14 | 20,000 1,000 4 0 0| 4 Patuxent River, Md.
32 do 80, 000 60, 000 3 0 Ones Do.
33 do 60, 000 16, 000 4 0 QO} 4 Do.
34 | Jan. 20 | 50,000 3,000 5 0 0; 5 Norfolk, Va.
35 | Feb. 21 | 11,000 2,000 2 1 0} 3 Patuxent River, Md.
36 do 6, 000 800 2 2 0| 4 Warwick River, Md.
37 | Feb. 27 | 70,000 3,000 1 1 0} 2 Great Kills, Staten Island, N. Y.
38 | Nov. 10 | 44,000 10, 000 4 1 Oi & Norfolk, Va.
39 | Nov. 16 | 8,000 4,000 4 1 Oo 5 Do. :
40 | Nov. 17 | 2,600 400 3 0 Ones “‘Cherrystones,”’ from Virginia.
41 do.....} 1,200 1,100 5 0 0} 5 Do.
42 | Nov. 22] 2,500 1,000 1 0 Oo] 1 Great South Bay, Long Island, N. Y.
43 do 7,000 6, 000 2 2 0} 4 Norfolk, Va.
44 Goyee 8, 000 4, 600 4 1 0} 5 Deo.
45 do 16, 000 8, 000 3 2 OF | ax5 Do.
46 | Nov. 27 |250,000 | 100,000 3 0 Ones New York, N. Y.
47 |...do. 15, 000 2,000 3 il 0} 4 Do. F
48 | Dec. 14 |120,000 20, 000 2 0 Oni: Nanticoke River, Md.
49 | Dec. 4 | 37,000 22, 000 3 2 0} 5 Norfolk, Va. —
50 | Dec. 16 | 10,000 8, 000 4 1 0] 5 Chincoteague, Va. (unfloated).
43.31
1 Out of 4 oysters. 2 Out of 14 oysters. 3 Less than 100. 4 Average score.

NotE.—These oysters were examined according to the recommendations of the Committee on Stand-
ard Methods of Shellfish Examination.

38

Oysters from Jamaica Bay.

SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

— eee

Organisms per cu-

| B. coli determinations (each

| score based on 5 oysters). Total
No. Date. | score
| (points).
| jeeece 0.1 ce. 0.01 ce.
1911
RE es see ke arom nec ee Sept. 28 5 | 5 1 140
TOT NS ed EON ee Sept. 29 5 5 2 230
oi S aoe sn oer coaaaccger sasoceace|(e~4 do.. 5 5 2 230
Borne ems reaerns fee tae seen | coe do.. } | 5) 1 140
NE cease ae aa ree oan Oct. 9 5 5 1 140
(DSU EeSaReavbeeeseeessopesasa oko -do. 5 5 2 230
MESS a waco Rote Es be eee oe do s< 5 | 4 2 140
See eee ae cece emcees Saeed . do. o | 3 1 140
We a a eee Ae ea (ire does 5 + 1 50
DOSE Seer sate. yet sone oe Oct. 10 5 | 5) + 410
1 Ses es ecg re agent amen ge Peer pra Oct. 11 5 5 2 230
2 oes Serene earn Se ee eee les dors s2: 5) 5) 1 140
1S ee es een er gee eee eee Fe dO 5 5 2 230
foe ees ee Se) 5 RC Ee Oct. 12 5 5 3 320
LS A a eee ene eee Rae dor 5 4 2 140
EG Ee a eee As ee SAO (OBESE 3 | 5) 3 320
LY an ROR es RSD oom S| i doz2.= 5 | 5 3 320
Lo Se eS ee es (2S doze" 5 5 4 410
LAE ean es SNE ore 2 eee Rae doz 5 5 3 320
7: ie Sea ea yest Sy ee Se Ee dost=: 5 5 2 230
Dr ee a Nee ee Ee ee ==do= 5) 5) 4 410
7 Rg aN TE ee ee eg do==ze2 5 5 S 410
Deen a Se R SEE SR ee oe Meee dq: 2 5) 5) 0 50
DAE PEL ip eae 23 arrested do. 5 | 4 2 140
7S oA ce rp DO eee Ne dosts.8 5 4 1 50
ZUM oo eee eee See ae eer dO. 25-- 5 5 3 320
74 ES ON ase ae ep ae ee So| RO does 5) 5 4 410
DRI ee te tn ears Co ons do. 5 5 5 500
73 Se NAS ETS Poe ee SP ee be do.. 5 5 5 500
Bee ee a Ce ets are ee =-G022225 a) 5) 3 320
Res eee ete ee Se ee ee doz 5 4 3 230
Bee Ses ee aera ee teres Ba (reese 5 4 t 320
Sc Seba eae rae a arena regi 5.0025 252 5 5 3 320
Gare Same eee aw seme Ae Pee doseeee 5 5 3 320
BON Jason bat cape macs sea Nese snd Os-2e 5 5 4 410
BORE nee ena n ae neta en (aoe a-d02!2] 5 | 5 2 230
SOA Seo ee Ate ones owes Se ae Nov. 20 5 | 3 1 4)
BOD see hia es See eee eee erly ae) 5 3 2 50
OCR a eae ea scene aees ene =2 20022 5 5 1 140
SOU ae Rael Bae ee ene nate Nov. 22 5 5 1 140
OG SNe evar tae este en Ae Be CO Re ra 5 | 4 2 140
DORR se Socere sane see eas bee) ei ou 5 2 230
OY (ede Se Ae a ee aA Nov. 24 on 3 0 32
SO eee ots eS Seep een RG | pee 5 2 0 23
ci a ee St eee ieee es ledote*=s 5 3 0 32
AOR eee sn te eee: Be =200=-2-8 Gy | 5 2 230
ZA TE eae eRe ep epee erate, aoe (od dozz= 5 4 1 50
1 rE ae PR SRR ey ( do. 5 | 1 1 23
AS aioe Aes ci a sre ee dO. 5 | 2 1 32
BAD te Noe eee ea oe BAO tee 5 3 1 41
AE oe ee aa sen eee oe eee Dec. 15 5 2 0 23
cL cee hae feces ee rere el a 5-00-2252 5 3 1 41
Lie wears AR Seca aaa crete aan NIE dois=- 5 4 2 | 140
ZS ees een Maas Ae ese eee lap edore-es 5 + 2 140
AOS Sere ae ees eee esc ee Os seas 5 | 4 0 41
BF os EP a ie eee A Ree) ae doze: 5 | 5 0 50 |
J

bie

centimeter,

plain agar, at—

450, 000
320, 000

700, 000
270, 000

SSS p19 99:0 ww ASS wap Hor o9 o09 b9
SSssssssssssssssssssss

2s
S5

or
me Oo
SOANMNSS
—
ssss
—)

PERS Soon Ss
SS55S8S8

NoTE.—No. 1 collected from Silver Hole, near Broad Channel, Jamaica Bay, N. Y., by Dr. Stiles. Nos.

2, 3, and 4 taken from Fulton Market, New York; said to have been 1 day out of water.
and 9 from dealer, New York City; probably 2 days out of water.

Nos. 5, 6, 7, 8,
No. 10 from market, New York;

unfloated. Nos. 11,12, and 13 from dealer, New York. Nos. 14 to 36, inclusive, from seized lot; all floated
near Inwood. Nos. 37 to 44, inclusive, collected by Inspector Holton from Silver Hole, near Broad

Channel.

Nos. 45 to 50, inclusive, from dealer; floated at head of Indian Creek, near Canarsie, L. I.

BACTERIOLOGICAL DATA. 89

ISOLATION OF ORGANISMS.
B. COLI AND B. PARATYPHOSUS TYPES.

During the investigations pertaining to Jamaica Bay in 1908 a num-
ber of organisms were studied from the water and oyster samples col-
lected direct from this bay. The gas-producing organisms were classed
as belonging to the B. coli and B. cloace groups. In reviewing these
records it is observed that some of the atypical types more closely
resemble the paratyphoid type than the B. col or paracolon group.

From the oyster and water samples collected from dealer A on
December 15, 1911, there were a number of JB. coli-like organisms
isolated, and others which resembled the B. paratyphoid group. One
strain agglutinated typhoid immune serum in dilutions of 1:100, but
not in higher dilutions. This serum was active in dilutions of 1:1,000
on typhoid cultures; it was obtained from Maj. F. F. Russell, of the
Army Medical School. 3

In their discussion of the paratyphoid bacillus, Muir and Ritchie ?
show the close similarity existing among various strains of this group.
They say:

With regard to the effects of other sera on the paratyphoid bacillus, it may be said that
usually a typhoid serum will require to be used in greater concentration to clump this
bacillus than is necessary to obtain an effect with the typhoid bacillus itself. * * *
While the paratyphoid bacillus originates a disease resembling typhoid fever, it has
also been found in the stools of typhoid patients, and mixed infections may occur.
Both organisms have been observed together in the stools in typhoid carriers, and pure
paratyphoid carriers are also stated to occur.

Among the 83 cases of gastroenteritis resulting from the Minisink
banquet, a large majority of them exhibited symptoms not unlike a
mild typhoid infection, and in some instances the course of the disease
was from four to six weeks in duration, although in most cases not
longer than one week or 10 days. For the most part, the illness began
in from 24 to 48 hours after the banquet, while in some cases four or
five days or a week elapsed before the first symptoms were noticeable.
The onset of the illness was usually attended by severe abdominal
pains, cramps, profuse diarrhea, loss of appetite, and general gastro-
intestinal disturbances. In some of the more severe cases diarrhea,
loss of weight, gaseous distention, and weakness were prominent
features requiring the services of a physician for a considerable length
of time. None of these cases was reported as typhoid fever, although
many were termed ‘“‘ptomain poisoning” by laymen, and castor oil
was generously used in Goshen following the Minisink banquet.

TYPHOID ORGANISMS.

Among the organisms described in Bureau of Chemistry Bulletin
136, by the author, four strains were obtained which resembled

1 Park, W. H., and Williams, Anna W. A Textbook of Pathogenic Bacteria and Protozoa, 1910, p. 270.
2 Manual of Bacteriology, 1910, p. 382.

40 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

B. typhosus biologically, but did not agglutinate typhoid immune
serum. These cultures were obtained in 1908 from Jamaica Bay
oysters. The description of those organisms is identical in character
to that of a culture isolated from oysters which had been allowed to
‘“‘drink”’ under an oyster house at Inwood, Long Island, on October
12, 1911, in a similar manner as were the oysters floated at Indian
Creek, near Canarsie. The oysters from Inwood were seized and con-
demned by the United States Government."

It will be recalled that the oysters furnished the Minisink banquet
came from the floats on October 2, 1911, or 10 days before the oysters
floated at Inwood, Long Island, from which the above organism was
isolated. |

The cultural. characteristics of the organism isolated from the
oysters floated at Inwood are as follows:

Morphology and staining properties: Gram-negative, actively ‘motile bacilli, rods
usually straight with slightly rounded ends, varying in size from about 0.4 to 0.8 by
1.5 to 4 microns, generally somewhat longer and more slender than Bacillus coli. No
chains, spores, or capsules observed.

Biological characters: Plain agar: Soft, grayish white, moderately abundant growth.
Endo’s medium: Small pearly dewdrop colonies.

Peptonized beef broth: Rendered uniformly turbid with no ring or membrane.

Potato: No visible growth.

Alkaline litmus milk: Unchanged or faintly alkalinized after a slight initial acidity.

Sugar solutions: No gas production in dextrose, lactose, or saccharose.

Nitrate solution: Nitrates absent.

Dunham’s solution: Indol not present.

Gelatin: Not liquefied, more or less circular, flat, whitish growth on surface, filiform
stab.

Agglutination: Positive in 1:1,000 dilutions after five minutes. The typhoid serum
was furnished by Dr. Russell of the Army Medical School.

This organism is considered to be a typical strain of B. typhosus.
To confirm this opinion, cultures were submitted to Dr. F. F. Russell,
of the Army Medical School, and Dr. Wm. H. Park, of the New York
City Department of Health, who agreed with these findings. This
organism was isolated in pure cultures by Ruth C. Greathouse, a
scientific assistant in the Bacteriological Laboratory of the Bureau
of Chemistry, from oysters received on October 19, 1911, or seven
days after the oysters were taken from the water. These oysters
were from the lot seized, were taken from the floats at Inwood, L. L.,
and were in apparently good physical condition. The typhoid cul-
ture, together with 24 other cultures in bouillon 24 hours old, ineclud-
ing members of the B. col, B. paratyphosus, and B. paracoli groups,
were primarily isolated from Endo’s plates made directly from the
oyster liquor without enrichment. The cultures which produced no
gas (15 in number) were incubated in lactose-dextrose litmus agar

1U.S8. Dept. Agr., Office of the Secretary, Notice of Judgment 1380.

BACTERIOLOGICAL DATA. Al

tubes, prepared according to the formula used by Russell.t. Of the
15 cultures thus inoculated, 5 showed reactions corresponding to
Russell’s description of the typhoid organism and were submitted to
the writer for identification. One of these 5 cultures was subsequently
found to be B. typhosus and confirmed as above described. The 4
other cultures were discarded because they were feebly motile; no
attempt was made to rejuvenate or increase their motility.

The organisms described as paratyphoid and paracolon were
classified wholly from their morphological and biological character-
istics on differential media, including their reaction on Russell’s
double sugar litmus agar, dextrose, lactose, and saccharose fermenta-
tion tubes, milk, etc. No agglutination tests were made on these
strains. In addition to these organisms a strain resembling B.
alcaligenes was also recovered and studied in the same manner as
were the others.

After having been out of water for 21 days at 39° F., oysters from
the same lot that contained the typhoid bacilli were examined by
the author. A large number of strains of organisms were isolated
from 24-hour Endo’s plates, prepared directly from the shell liquor
of these oysters, and transferred to Russell’s double sugar agar tubes.
Of the cultures showing reactions for B. typhosus on this medium,
further study was made on differential media and by agglutination
tests.

One strain resembling B. typhosus thus isolated was at first only
moderately motile, but it possessed all the other biological charac-
teristics of typhoid bacilli. Its motility was greatly increased by
growing on gelatin for two generations. The agglutination tests
were made by using one-day gelatin stock cultures grown at room
temperature. These tests were made in dilutions of 1:1,000 macro-
scopically, and confirmed in hanging drop preparations in dilutions

1 Russell, F. F. The Isolation of Typhoid Bacilli from Urine and Feces, with the Description of a New
Double Sugar Tube Medium. (Reprinted from The Journal of Medical Research, vol. 25, No.1.) Enough
5 per cent aqueous solution of litmus is added to plain agar (2 per cent to3 per cent), with a reaction of about
+0.8 per cent to phenolphthalein, to give it a distinct purple violet color, the amount of litmus depending
on color of agar (dark requiring more than the light), and the reaction is then adjusted by addingesodium
hydrate until the mixture is neutral to litmus. Then 1 per cent of lactose and 0.1 per cent of glucose are
added, dissolved ‘in a small amount of hot water, and the medium tubed as for slants. After tubing, pack
slants loosely in basket and sterilize them for 10 minutes on first day and 15 minutes on second day in an
Arnold sterilizer; then slant and store in dark place.

On this double sugar tube the typhoid bacillus gives, after an incubation period of from 8 to 18 hours, an
extremely characteristic appearance; the surface growth is filiform and colorless on a blue background;
the upper part of the tube is unchanged in color, but the lower part, the butt, is a brilliant uniform red.
The entire point of the medium rests upon the difference between the changes produced by the growth of
the typhoid bacillus under aérobic and those produced under the imperfect anaérobic conditions found in
the butt of the tube, where the bacillus obtains its oxygen by breaking down the glucose, with the libera-
tion of considerable acids on the surface, however, in the presence of free oxygen, no acid is formed.

The colon bacillus, which is often slow in producing acid on the Endo plate, shows abundant gas and
acid formation on this medium. The tube is reddened throughout, both above and below, and since the
abundant lactose is attacked equally with the glucose there is exuberant gas formation.

The Bacillus fecaius alcaligenes and other alkali formers leave the medium unchanged or slightly bluer.

49 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

of 1:200 with serum from the same lot previously mentioned, and
used on the culture isolated by Miss Greathouse from oysters exam-
ined on October 19, 1911. It should be said, in connection with the
isolation of these two strains of typhoid organisms, that no other
cultures of typhoid bacilli were being used in the laboratory at that
time. There was a pure culture in stock kept with other organisms
in the ice box, but there was no connection whatever between the
stock cultures and those isolated from the Jamaica Bay oysters.

Inwood is a station located near the eastern end of Jamaica Bay,
while Indian Creek, near Canarsie, is a small stream flowing into the
northwestern portion of the same bay. Both sections are subject to
gross human pollution. The conditions prewailing at the two places
are somewhat similar, and the results obtained from an examination
of the shellfish collected from both are practically the same, being
highly polluted in each instance.

PROBABLE CAUSE OF THE GASTROENTERITIS (DIARRHEA).

From a study of the clinical symptoms, onset of illness, and dura-
tion of the disease, together with the presence of paratyphoid bacilli
in oysters taken from dealer A, the conclusion is reached that the
diarrhea or bowel trouble can probably be ascribed to the presence
of paratyphoid bacilli (said by some authors to be indistinguishable
from or closely allied to the Gaertner bacillus) in the oysters served at
the Minisink banquet. Itisapparent that the disease was due to bacte-
rial infection, arising from the multiplication of the organisms in the
body after ingestion, and not to “‘ptomains,” as suggested by some.

Ptomains are formed most commonly during the decay of animal
matter. They are essentially the decomposed animal tissue, not
excretions of the bacteria, although the bacteria are responsible for
the decomposition. Such decomposition does not occur usually in
the body, even in animal matter taken as food. In abnormal con-
ditions, if food remains in the body until putrefied, ptomains may
be formed in the intestinal contents. When decomposed food con-
taining ptomains is received in the digestive tract, or originally
good food decomposes there, the mucous membrane and blood may
take up ptomains from this decomposed food, which ptomains affect
the tissues like other poisons.

Substances of quite varied chemical constitution are classed under
the head of ptomains solely on account of their origin in proteid
decomposed by bacterial action. Bacterial toxins are to be distin-
guished from ptomains. Toxins are substances which are or have
been a part of the body of the bacteria; some are secretions from the
germ, others are liberated only in case of the death and breaking
down of the germ itself. In this latter class is the toxin of typhoid
fever, which is therefore particularly different in its origin and action

SUMMARY. 43

from ptomains. The toxins are much more poisonous than pto-
mains and each one is produced by a specific germ.

Some cases of sickness due to food have been classed as ptomain
poisoning, when this cause was later discovered to be the ingestion
in the food of a particular bacillus which multiplied in the body and
by its toxin produced intestinal and other disturbances. Such cases
are not ptomain poisoning but may be classed as food poisoning.

SUMMARY.

(1) There is undisputed evidence to show that infected oysters,
clams, mussels, scallops, and other shellfish may cause typhoid fever
and other gastrointestinal disturbances when consumed by suscep-
tible individuals.

(2) The epidemics of typhoid fever, due to ingestion of polluted
sea food, have in most instances been traced to shellfish floated in
polluted water, although there is also evidence that oysters and other
shellfish, grown in polluted waters and directly consumed without
transplanting for a time in pure waters, may be the source of typhoid
infection.

(3) The investigations pertaining to the Minisink banquet, held at
Goshen, N. Y., on October 5, 1911, show conclusively that the
‘““Rockaway’’ oysters served on this occasion were wholly responsi-
ble for the typhoid and gastroenteritis cases following this banquet.

(4) There were 17 well-defined cases of typhoid fever, with one
death, and 83 cases of gastroenteritis (diarrhea) traced directly to
eating “Rockaway” oysters from Jamaica Bay, floated at Indian
Creek, near Canarsie, Long Island, N. Y.

(5) In addition to the typhoid and other intestinal disorders fol-
lowing the consumption of ‘‘ Rockaway” oysters at the Minisink
banquet, there were also 10 other cases of typhoid and 16 of diarrhea
traced to eating “Rockaway” oysters, some of which came from the
same lot furnished for the Minisink banquet.

(6) The bacteriological examination of water and shellfish col-
lected from Jamaica Bay shows that this body of water is dangerously
polluted; the laboratory data are substantiated by. the sanitary
inspection, which shows that millions of gallons of raw sewage dis-
charge daily into this bay, and, in many instances, in close proximity
to or directly over oyster beds.

(7) Typhoid bacilli were isolated in pure culture after 7 and 21
days from oysters which had been floated at Inwood, Long Island,
N. Y., on October 12, 1911, and kept out of water in storage at 39° F.
Organisms of the B. coli and B. paratyphosus groups were also isolated
from oysters floated at Indian Creek, near Canarsie, Long Island.
They were probably the cause of the gastroenteritis cases following
the Minisink banquet.

44 SEWAGE-POLLUTED OYSTERS AS CAUSE OF TYPHOID.

(S) This investigation comprises a complete study of all the fac-
tors which would materially contribute to typhoid infection. Each
item of the menu served at the Minisink banquet was carefully con-
sidered, and the ‘‘Rockaway”’ oysters served were the only articles of
food consumed by all of those who had typhoid or gastroenteritis
following this banquet. : |

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