The Prevention of Typhoid Fever 
Issued by the Utah State Board of Health. 
Typhoid fever is an infectious or communicable disease 
caused solely by a specific germ called the typhoid bacillus, 
which is passed from the body in the discharges from the 
bowels or bladder. Preventive measures begin with the dis- 
infection of these discharges, and if properly carried out in 
all cases no other measures would be required; but unfortu- 
nately, for various reasons, this result is not attained. Some 
cases are of so mild a type as to escape discovery, the so-called 
walking typhoid being an example. Others have spread the 
infection in the early stages before a diagnosis has been made. 
A third class comprises a small percentage in which the germs 
continue to be present indefinitely in the discharges of a per- 
son having had the disease. These cases are called typhoid 
carriers. The cases, however, which are usually responsible, 
are the ordinary ones in which, through ignorance or indif- 
ference, the proper disinfection of discharges has been neg- 
lected. Every case of typhoid fever results from the failure 
to disinfect discharges from a former case. 
HOW THE GERMS ENTER THE BODY. 
The germs usually gain entrance to the body in water or 
food which has been contaminated. Water becomes contami- 
nated through drainage into wells from infected privy vaults 
or from the surface of the ground where discharges have been 
deposited and washed into streams. A notable example of the 
latter occurred at Plymouth, Pa., where an epidemic of 1,500 
cases was caused by drinking water from a stream on the 
banks of which the discharges from a case of the disease had been deposited the previous season, and were washed into the 
stream by a spring thaw. 
Contaminated milk and raw foods are very often respon- 
sible for the disease, the contamination usually occurring 
through the agency of house flies. 
THE DEADLY FLY. 
This deadly insect, now called the typhoid fly, having 
visited a privy vault which has been the receptacle of undisin- 
fected discharges, may next be found in milk, raw vegetables, 
fruits, or other foods, carrying typhoid germs on its legs and 
in its body. A circular describing measures for the extermi- 
nation of flies will be sent without charge on request to the 
State Board of Health. 
One case of typhoid in the neighborhood of a dairy may 
be the source of an extensive epidemic, as is constantly being 
demonstrated; or an entire neighborhood may be endangered 
by a case in which there is neglect to disinfect discharges be- 
fore depositing them in an open privy vault. In view of the 
foregoing facts the entire chain of preventive measures is ob- 
vious. If faithfully carried out the result would be the com- 
plete eradication of typhoid fever, the most easily preventable 
of all diseases, and the existence of which is a disgrace to any 
community. 
DUTIES OF PHYSICIANS. 
All cases of typhoid fever should be immediately reported 
by the physician in charge as required by law. In cases of 
sickness where typhoid is suspected but the diagnosis is in 
doubt, the physician should instruct the family to observe the 
same precautions as in an unmistakable case of the disease. 
DUTIES OF HEALTH OFFICERS. 
Upon notification, or when he shall otherwise have reason 
to suspect the existence of a case of typhoid, the health officer 
should immediately visit the premises and instruct the attend- 
ants in their duties. He should inspect and cause the disin- 
fection of the privy vault; make careful investigation to dis- cover the source of the disease, especially as to milk and 
water supply, conditions of surrounding premises, etc., and 
cause measures to be taken to prevent further cases from the 
same source; visit the premises frequently to satisfy himself 
that precautionary measures are faithfully and intelligently 
carried out, and strictly enforce the law requiring prompt 
notification by physicians. It should be the object of the 
health officer to surround every typhoid case with so com- 
plete a barrier of prevention that no germs may escape to 
endanger the lives of others. 
DUTIES OF ATTENDANTS. 
All discharges should be carefully disinfected in accord- 
ance with the rules of the State Board of Health as required 
by law. In the absence of a water closet, the disinfected dis- 
charged should be buried, or burned, or if deposited in a vault 
should be thoroughly covered with lime. Flies should be de- 
stroyed and excluded from the sick room; all soiled linen 
should be immediately placed in boiling water or antiseptic 
solution. Dishes used by the patient should be immersed in 
boiling water. The hands of attendants and patients should 
be frequently bathed in an antiseptic solution. Persons selling 
milk should not be permitted to leave milk bottles when de- 
livering milk at premises occupied by a case of typhoid fever. 
GENERAL REGULATIONS. 
An ordinance should be enacted in every county and town 
requiring that all privy vaults shall be so constructed as to 
exclude flies, and that their contents shall be disinfected by 
covering with fresh lime at frequent intervals during the fly 
season. Properly constructed dry earth closets are recom- 
mended to replace privy vaults. Descriptions of model dry 
earth closets w'ill be furnished by the State Board of Health 
on request. The vaults on the premises of dairies should re- 
ceive especial attention, including frequent inspection by 
health officers. Their contents should be thoroughly protected 
from flies and constantly covered with lime. The accumula- tion of manure and garbage, which is the chief breeding place 
lor flies, should be prohibited by law and a constant warfare 
on flies should be maintained. A model ordinance will be fur- 
nished on request by the State Board of Health. 
In localities where a pure water system can be secured, 
it should be installed without delay. In the meantime, where 
the use of well or ditch water is compelled, it should be boiled. 
Camping on streams supplying water for drinking purposes 
should be subject to regulations requiring proper disposal of 
excreta to prevent contamination of the water. 
Privies should under no circumstances be maintained 
within 100 feet of a well. 
Active and efficient health officers should be employed 
and properly remunerated for their services. No better in- 
vestment of public funds can be made. Typhoid fever and 
other preventable diseases are an expensive and unnecessary 
tax upon a community without reference to the suffering and 
death involved. 
DISINFECTANTS. 
The following solutions are recommended for the disin- 
fection of discharges, which should be received in a vessel 
containing a quart of the same, and allowed to remain at least 
an hour before emptying: 
No. 1. Dissolve fresh chloride of lime of the best quality 
in the proportion of six ounces to the gallon; or 
No. 2. Dissolve corrosive sublimate and muriate of am- 
monia in the proportion of two drachms (one-fourth ounce) 
of each to the gallon of water. Dissolve in a wooden or 
earthen vessel. 
No. 3. Carbolic acid in the strength of six ounces to the 
gallon. 
A copy of this circular will be sent without cost to any 
person on request to the State Board of Health. Health of- 
ficers are requested to keep a supply of the circular and to 
place one in every home in which a case of typhoid fever 
exists.