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(i) Milk legislation in the United States of America.
4. In the United States legislation relating to milk is confined to states and municipalities, the latter being responsible for the greater part of the effective legislation. As a result, there is a great multiplicity of systems in existence. The federal government, however, undertakes the task of co-ordinating the regulations made by the different municipalities, by means of the promulgation of standards and the dissemination of information, which play such an important part in every field of American administrative activity.
5. The principle of all municipal regulations is the establishment of The defined grades of milk. Of these grades there are a great variety. definition of a grade may extend over any of the following points:-
(1) the health of the cows from which the milk is derived, under which heading it may be required that the cows should have passed a tuberculin test or that they should be subjected to veterinary examination;
(2) the management and sanitary condition of the farms on which the
cows are kept;
(3) the medical examination of employees by whom the milk is handled, whether on the farm or at subsequent stages in its distribution, with a view to establishing their freedom from any infection likely to be conveyed by milk;
(4) the treatment which the milk has, or has not, undergone, including such operations as refrigeration, pasteurisation and bottling, and the state in which it is delivered;
(5) the chemical constitution of the milk;
(6) the bacterial condition of the milk, at different stages of its
distribution.
as
6. Grades are maintained by the municipalities in one of two ways. Under the permit system, each dairy operating in any town must obtain a permit from the municipality to sell milk of any grade, and all milk must be sold under some grade. It is a condition of this permit that the producers and distributors of the milk should submit to the inspection required. Failure to comply with the conditions required for the sale of milk of any a result of chemical or grade, whether revealed by inspection or bacteriological examination of the milk, may be punished by the revocation of the permit. The alternative system of grading is sponsored by the federal government, which has published a milk ordinance constituting a standard Under this ordinance, if it code for adoption by states, counties, or cities. is adopted, the health officer of a city is required to announce from time to time, as the result of the inspection of premises and the examination of milk samples, the grade of milk which is being supplied by all producers and distributors of milk ultimately consumed within the city. All milk must be sold under the name of the grade to which it is assigned. Milk producers or distributors, who, as the result of the inspections and examinations carried out in accordance with the code, are found to have violated the regulations defining the grade of milk which they are selling in any particular, and who do not correct the fault immediately, are obliged to sell their milk under the name of the lower grade to which their methods are appropriate. They are, however, entitled subsequently to apply for a further inspection with a view An to having their supplies of milk reinstated in the higher grade. important section of the ordinance provides that, within twelve months of its coming into force, no milk of the lower grades may be sold, except according to one version of the code, during temporary periods of degrading. In this way the less satisfactory sources of supply are either eliminated or brought up to the required hygienic standard.
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7. In addition to the grades of milk defined by the milk codes of cities and states, there is a further grade, namely, certified milk, which is defined by a private association, the American association of medical milk commissions. "Certified milk" is a trade name, and its use is confined to those producers whose methods comply with the stringent requirements of the association and who are supervised by the local medical milk commission. Certified milk is adopted as a grade both in the milk ordinance published by the federal government and under the regulations of many towns which have not adopted that ordinance.
8. An interesting feature of many of the grading systems in force in the United States is that milk which is subsequently to be pasteurised must be derived from herds which are free from tuberculosis. This argues a lack of faith in the efficacy of commercial pasteurisation as a means for destroying the tubercle bacillus. But the demand for pasteurisation in the United States has arisen more from fear of the dangers of milk-borne epidemics, than from fear of milk-borne tuberculosis. For though milk-borne epidemics do not appear to be relatively much more common there than they are in this country, bovine tuberculosis is very much rarer. The estimated degree of infection of dairy cattle with tuberculosis is to-day no more than 1.4 per cent., compared with 40 per cent. in this country. The prevalence of milk- borne epidemics may be judged from the following table (table 1), in which are given the numbers of such epidemics reported by state and city health officers during the years 1924 to 1930.
TABLE 1.
Milk-borne epidemics reported by state and city health officers of the United States for the years 1924 to 1930, inclusive.
Disease.
Typhoid Paratyphoid A. Paratyphoid B. Diphtheria Septic sore throat
Scarlet fever... Miscellaneous
Total
1924. 1925. 1926. 1927. 1928. 1929. 1930. Total.
34
31
92026040
23
25
27 28
217
0
0
3
5
ROONDO
COOOONG H
11
2
44
44
68 36 41
50
44
8
33
40
21
327
9. Greater emphasis is also placed on the danger of infection with undulant fever from milk than would be justified in Great Britain. About Of 1,300 cases of this disease are reported annually in the United States. these, not more than half are said to be attributable to the consumption of infected milk. Other sources of infection are the consumption of the flesh of infected swine and contact with infected material on the part of those whose occupations expose them to this risk. Even though the incidence of milk-borne undulant fever in the United States appears to be considerably higher than in Great Britain, it is extremely low in comparison with the prevalence of infection in milk. The disparity can be accounted for on one of the following assumptions: first, that infection is only contracted by man from a rare and virulent strain of Brucella abortus; secondly, that man only succumbs to particularly massive infection; and, thirdly, that the great majority of human beings have a high degree of immunity from the disease.
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