CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW

FEVER-Continued.

Reports Received from June 30 to July 6, 1923-Continued.

CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW

FEVER-Continued.

Reports Received from June 30 to July 6, 1923-Continued.

PUBLIC HEALTH REPORTS

VOL. 38

JULY 20, 1923

No. 29

Intensive Localized Distribution of the Spore of B. Botulinus and Probable Relation of Preserved Vegetables to Type Demonstrated.

By J. C. GEIGER, Epidemiologist, United States Public Health Service, and HARRIET BENSON, Department of Hygiene and Bacteriology, University of Chicago.

In a report to the Surgeon General,' August, 1921, the writer gave a brief summary of an intensive investigation of outbreaks and distribution of the spore of B. botulinus in a mountain valley, the Yakima Valley, in the State of Washington. A recent investigation, also carried out in the State of Washington, adds further evidence to the localization of distribution of the spore of B. botulinus in a comparatively limited area.

In the southern part of Okanogan County, Wash., situated at an approximate elevation of 2,000 feet and near the Columbia River, there is a ranch of several hundred acres that offers, in the examinations of its soil and preserved food products, the best field evidence to substantiate this interesting epidemiological observation. The following table illustrates this particular point:

TABLE I.-Botulism, H. Ranch, Okanogan County, Wash.

It is stated that several families of Colville Indians working on this ranch died under mysterious circumstarces several years ago. The recent outbreaks have focused attention on these cases, and it is now susJested that they were botulism.

several families of Indians.

Taken from the dining table of a family living on the ranch by the county health officer.

The quality of the beans was tested by feeding them to chickens. The chickens later died with typical symptoms of fowl botulism.

It will be noted that this ranch has had two outbreaks of botulism in human beings, which were undoubtedly botulism and in one of

Annual Report of the Surgeon General of the Public Health Service for the Fiscal Year 1921, p. 17.

which the food involved (home-canned string beans) was proved to contain a toxin (M. L. D. for mice of 1/100,000 of a c. c.) which was neutralized with botulinus antitoxin, type A. The other outbreak was stated to have been due to home-canned beef; but this was not proved by laboratory examination. This is the first outbreak to be recorded in the United States as being caused by this food. An explanation of the high toxicity rate of the foods involved may be found in the distribution of the spores of B. botulinus in the soil of this ranch and in the method of preservation. The cold pack method was used, and it is not unlikely that the temperature at which the processing was done was totally inadequate. It was frankly stated that no attention was paid to either the "fill" or the relation of altitude to the processing temperatures (boiling point).

The bacteriological and toxicological examination of the soil yielded interesting and conflicting data. The garden soil was said to have been moderately manured at irregular intervals. Two samples of garden soil, when tested colorimetrically, showed a reaction of pH 7.1, and a third a reaction of pH 7.3. The reaction of the uncultivated soil, or virgin soil, was pH 6.6. The following table shows briefly the results of the examination of the soil for the spores of B. botulinus, after enrichment in beef-heart media:

TABLE II.-Results of soil examination for B. botulinus, H. Ranch, Okonogan County, Wash.

There are to be noted two things: First, there was a uniformity of results in the various amounts of soil used. This was unexpected, as laboratory data in such experiments usually show variations, which have been explained by assuming that there was an uneven distribution of spores in the specimen; secondly, the same type of toxin was produced-type B.

The demonstration of type A toxin in the foods and type B toxin in the soil demands explanation. These anomalous results were obtained on three different occasions. It seems probable that both organisms are present in the soil, and that the food substances, corn and string beans, are more favorable for the growth of type A organisms and that those of type B are suppressed. This observation may have a bearing on the fact that nearly all human outbreaks of botulism in the United States have been due to type A.