An Epidemic of Scarlet Fever Spread by Ice Cream.*

Ice cream is seldom mentioned in the literature as a vehicle for the transmission of scarlet fever. Typhoid fever outbreaks from this source are not uncommon, but we have been able to find only one scarlet fever epidemic in which ice cream was regarded as a plausible causative agent. This outbreak is mentioned by Chapin (1). It was reported by Buchanan (2), and took place in South Kensington, England, in 1875. Following a large dinner party where the dessert was "frozen pudding" there were fifteen cases of scarlet fever. Buchanan did not seem to be quite certain whether the epidemic should be attributed to this pudding or to the uncooked cream from the same dairy which was served in coffee. An epidemic of scarlet fever occurred in Flint, Michigan, during the latter part of July, and the first ten days of August, 1924. Previous to July 22, the average number of scarlet fever cases reported for the first 29 weeks of 1924 was six per week, and the largest number reported in a single week was fourteen. From July 22-28 inclusive, 41 cases were reported, a number far in excess of the maximum for any other seven-day period in the year. This state of affairs in the middle of the summer, when the incidence of scarlet fever is usually low, demanded investigation, and milk was naturally regarded with suspicion. While making a survey of the dairies and their employees, Mr. Howard R. Estes, Dairy and Food Inspector, Flint Department of Health, learned that an ice cream maker, whom we shall hereafter designate as "Lee," was under quarantine for scarlet fever. Mr. Lee had continued working for three days after onset of the disease, and had made ice cream while he had a sore throat and an eruption. The factory in question was a small one, in which the entire process of ice cream manufacture was carried out by Lee. Inquiry brought out the fact that all of the new scarlet fever cases had eaten ice cream sold by Lee's concern, the " A " Company.