These results demonstrate in a most striking manner the beneficial
effect of chlorination. The general conditions, with the exception of
the raw water supply, were approximately the same in all four districts.
Diagram XIII shows that the raw water supply of District No. 1 was
slightly worse than any of the others, 21.8 per cent of the samples from
District No. 1 containing _B. coli_ in 1 c.cm. as compared with 21.0 per
cent in the most polluted supply of the other districts.
[Illustration: DIAGRAM XIII
B. COLI IN CHICAGO RAW WATER (Young)]
The results obtained at Ottawa are also conclusive. Following two
epidemics of typhoid fever in 1911 and 1912, caused by breaks in the
intake pipe, hypochlorite treatment was commenced and has been in
continuous operation until February, 1917, when chloramine treatment was
substituted. The dosage has been so regulated as to assure a high degree
of purity at all times in the water delivered to the mains and as
evidence of this it might be mentioned that the average _B. coli_ index
(calculated by Phelps' method) for the years 1916 and 1917 was only 0.27
per 100 c.cms. The typhoid rates for the five years preceding the
epidemic years and for a similar subsequent period are given in Diagram
XIV.
[Illustration: DIAGRAM XIV
TYPHOID IN OTTAWA]
The diagram shows that there has been a constant reduction in the city
typhoid rate since the last severe epidemic with the exception of the
year 1915. The high rate of that year was caused by a localised epidemic
started by polluted well water and spread by flies from an unsewered
area. This outbreak was the cause of about seven deaths registered
during that year (population 100,000).
The objection might be raised that if the reduction of the typhoid rate
were due to the water treatment, the decline should have been abrupt and
not a gradual one. It is probable that there has been practically no
water-borne typhoid in the city since chlorination was commenced but
this fact is masked by cases from other sources. During 1911 and 1912
over 3,500 cases of typhoid were reported, of which an appreciable
number would become carriers for various periods of time. As these
carriers decreased the number of cases infected by them would also
decrease and so account for a gradually declining death rate.
It might be further objected that the reduced typhoid rate is due to a
general improvement in the sanitary conditions. If the death rate from
causes other than typhoid can be regarded as a measure of the general
sanitary conditions it is obvious from the data in Table XXXIII that the
improvement in the typhoid rate is immeasurably greater than can be
ascribed to that cause.
TABLE XXXIII.--DEATH RATES IN OTTAWA BEFORE AND AFTER CHLORINATION
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