Publisher's Synopsis
Excerpt from Transactions of the First Annual Conference of State Sanitary Engineers: Held at Washington, D. C., May 25, 1920
While the circumstantial evidence presented by this chart indicates that this rapid lowering of the typhoid-fever rate in New York State is due primarily to engineering work of supervision of public water supplies, this evidence is quite clearly confirmed by the evi dence furnished by the table (pp. 9 which shows for each of the cities of the State the typhoid-fever rates before and after the intro duction of water purification. You have only to glance down this list to see that in nearly every instance the rates have dropped almost immediately following the introduction of these improvements, and that by no possible coincidence could any other reason than purifi cation or other improvements in these supplies be responsible for the sudden lowering of these typhoid-fever rates.
The in?uence of other possible causes of this rapid decline in the typhoid rate of the State must, of course, not be overlooked; and here statistical and epidemiological records bear out our conclusions. The use of typhoid vaccine has been resorted to to only a very limited extent in the State, and the in?uence Of this factor has been almost negligible. Milk and other food epidemics have been few, and the typhoid rate from this cause has been insignificant in comparison with the total typhoid rate for the State. Typhoid carriers have been apprehended in a number of cases, but the total of their in ?uence has been very small. Secondary infection has been, and will probably continue to be, an important factor, but we must bear in mind that these secondary cases are secondary to primary ones and must be logically classed with them.
Brie?y, our experience in New York State, based on statistical and epidemiological records, has clearly demonstrated that typhoid fever has been, and is still, largely a water-borne disease; and that only through careful supervision Of public water supplies, prompt investigations of outbreaks and the immediate application of reme dial measur'es, while these outbreaks are in their incipient stages, has it been possible to reduce the typhoid rate to almost a negligible figure.
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