Between Feb. 25 and March 21, 1942, 59 patients with typhoid were admitted to Provisional Hospital No. 3 in the Territory of Hawaii. All of the patients except 2 were children between the ages of 12 and 16, and all except 2 attended or were employed at the Washington Junior High School. Investigation by the public health authorities disclosed that a healthy intestinal typhoid carrier, employed as a food handler in the school, produced the epidemic by contaminating food eaten by the pupils at one meal. The clinical aspects of this epidemic were described by Hoagland and Fleming.1
All the patients were hospitalized in the same institution and all were under my control. All except 2 were in a similar state of nutrition, and all except 2 were infected by the same strain of Eberthella typhosa. The variables of age, nutrition, climate and strain of infecting organism were absent.
HOAGLAND RJ. SPECIFIC TREATMENT OF TYPHOIDTHE INEFFECTIVENESS OF SULFATHIAZOLE AND IMMUNE SERUM. JAMA. 1943;122(10):653–656. doi:10.1001/jama.1943.02840270011004