Chronological distribution of cases of typhoid fever in Pana, Illinois, 1916.
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In 1916, a local typhoid epidemic infected 36 residents in Pana, Illinois, resulting in one fatality, highlighting the the Illinois State Water Survey’s (ISWS) longstanding commitment to develop and help maintain clean water and sanitary practices – benefits Illinoisans enjoy to this day as a result of the work of the ISWS.
Typhoid fever is caused by bacteria (Salmonella typhi) that spreads through contaminated food, water, or through close contact with an infected person. Signs and symptoms usually include a high fever, headache, abdominal pain, and constipation or diarrhea.
This wasn't Pana's first encounter with typhoid, either. In 1912, a water plant was not completed properly resulting in only a portion of the town being appropriately sewered. This led to a small outbreak of typhoid fever cases in 1914, and ultimately the construction of a wastewater plant for the town.
City officials initially suspected the source of the outbreak was the public water supply and contacted the ISWS to investigate.
The public water supply was sourced in part from wells northwest of the city and from a reservoir on Beck’s Creek east of the city. Although many wells during this time were not constructed with safeguards to prevent contamination, ISWS determined there was not enough evidence to indicate that the bacteria was being transmitted via the public water supply or through private wells.
During the investigation, ISWS scientists began to inspect Pana’s local dairy industry. Pana was home to four large dairies in the early 1900s in addition to the local small dairy farmers who individually sold milk to their neighbors. Over 90 percent of the infected people reported purchasing their milk from one of the four large dairies, the Pana Ice Cream Company.
While the company’s principal product was ice cream, ice cream production and purchasing records and contact tracing of typhoid cases eliminated the ice cream supply as the cause of the outbreaks. But the company also sold milk. At the time of the outbreak, the company reported purchasing milk from 14 farmers in the area. The first milk received was placed in a can in an icebox and sold to customers during the day. Customers were allowed to bring their own pails and the milk was dipped from the can in the icebox. During an inspection of the plant, ISWS concluded in their report to the Pana city council that the bacteria were being spread from contact with customers’ own milk utensils, infecting the Pana Ice Cream Company’s milk supply and notified the Illinois State Board of Public Health.
The State Board of Health urged city officials to pass a milk ordinance and to institute a water purification plant.