Typhoid Mary
Typhoid Mary, whose real name was Mary Mallon, was an Irish immigrant and cook in New York who became infamous as a healthy carrier of the typhoid bacteria, Salmonella Typhi. Between 1900 and 1906, she was linked to several outbreaks of typhoid fever, leading to the illness of over twenty individuals and resulting in multiple deaths. In 1907, health authorities forcibly quarantined her on North Brother Island after determining she was the source of the outbreaks. Despite her appeals to the New York Supreme Court, she was confined until her death in 1938, with her case highlighting the tension between public health concerns and individual rights. Mallon’s situation was complicated by the prevailing lack of understanding about asymptomatic carriers and sanitation practices, which contributed to her being viewed unfavorably by the public and media. She worked under aliases after her initial release and continued to pose a health risk, leading to a second quarantine. While public health measures have advanced since her time, the story of Typhoid Mary raises important questions about the balance of individual freedoms and societal safety, emphasizing the complexities faced by healthy carriers of infectious diseases.
Typhoid Mary
"Typhoid Mary" was the sobriquet given to Mary Mallon (1869–1938), an Irish immigrant who worked as a cook in New York and died in the sanatorium of North Brother Island in the Bronx, after living almost thirty years in forced isolation. Mallon was found by medical authorities to be a healthy carrier of Salmonella Typhi, the typhoid bacteria, and to have caused at least two serious outbreaks of typhoid fever, which included several deaths. Although Mallon was not the only healthy carrier found at the time to be the source of a typhus outbreak, she became the most notorious. According to scientists, between 1 and 6 percent of people infected with Salmonella Typhi become chronic healthy carriers. Healthy carriers, also known as asymptomatic carriers, are individuals who can spread the disease to others while remaining unaffected themselves. Typhoid fever is no longer a common disease in developed countries.
Brief History
Mary Mallon migrated from Ireland to New York in 1883, and earned her living working as a cook in wealthy private households. From 1900 to 1906, more than twenty people were infected with typhoid fever in New York City. In 1906, the members of a household where Mallon worked fell ill with typhoid. Investigations conducted by the Department of Health, however, first determined the outbreak to be due to contaminated water.
By 1907, however, investigations converged on Mary Mallon as the likely source of typhoid outbreaks in Long Island and New York City. Health authorities eventually found her and forcibly committed her to the North Brother Island sanatorium. Mallon, who had committed no crime, appealed to the New York Supreme Court. Her case was denied, but she was set free in 1910, under the strict condition that she would never work as a cook again and would take all necessary precautions in her daily interactions with people in order not to be a source of contagion.
She soon disappeared from health authorities’ radar. In 1915, she was found to be the source of another typhoid outbreak when several patients in Sloane Maternity Sanatorium fell ill. It was discovered that Mallon had returned to work as a cook, and had worked at health sites under an alias. Upon learning the news, public opinion turned against her. She was apprehended and returned to the North Brother Island isolation center, where she remained until her death in 1938. An autopsy revealed her gallbladder was host to live typhoid cultures. In total, she is believed to have infected about fifty individuals directly, and other cases are indirectly linked to her.
Health officials were never successful in convincing Mary Mallon of the danger that she posed to the public. No government safety net existed at the time, which made Mallon’s economic survival in any other field of work other than as a cook, a struggle. Health authorities, on the other hand, saw no other recourse than to quarantine her, considering her an uncooperative danger to public health. The public considered Mallon a villain.
Overview
Typhoid fever is an infectious intestinal disease, which continues to be a life threatening illness. It is usually disseminated by infected individuals who handle food or fluids without observing proper sanitation, or when water carrying the bacteria contaminates food or drinking water. It is important to note that in the early twentieth century, the importance of disinfecting one’s hands when handling fluids and food was not a widespread notion, causing healthy carriers to be even more dangerous to public health. Symptoms may appear one or two weeks after contagion, making it often difficult to trace the source of infection. Symptoms include nausea, fever, headache, loss of appetite and sometimes, death.
On the face of it, Mary Mallon did behave recklessly. Typhoid fever was a serious health concern during the early twentieth century, causing tens of thousands of deaths each year. On the other hand, the media helped to publicly malign Mary Mallon, sometimes even suggesting she had purposefully infected dozens of people. Her side of the story was never heard.
Mallon tried to fight her case in court and failed. In 1909, already 39 years old and after being quarantined for more than two years, Mary Mallon wrote a letter to the Board of Health, expressing her grief, loneliness, and frustration. She had no other family in the country and no real advocate, either. In fact, it was clear she had become "a peep show," in her own words, a sort of freak show for medical personnel, and she was demonized among the public. She had become afraid of the hospital staff, and the medical personnel seemed to have been unable or unwilling to help her understand her role as a healthy carrier. Apparently healthy and asymptomatic, Mallon had a hard time believing she was a vector for disease. In short, Mary Mallon seems to have been a victim of her circumstances and the prevailing culture.
To put it in perspective with its social and historic context, it is important to understand that other healthy carriers also caused typhoid outbreaks in New York, but did not receive the kind of media attention that Mallon did. The case of William T. Morris and the Ithaca Water Works in 1903 seems even more egregious. Morris, the owner of Ithaca Water Works, disregarded warnings and sanitation regulations. He employed several typhoid carriers to work in the water supply. Estimates find that about one thousand people fell ill and about eighty died from water supply contagion, yet Morris, protected by powerful board trustees and media, never faced public opprobrium for his reckless negligence.
Since Mary Mallon’s time, public policies have been developed that better serve both public health and the rights and needs of individuals suffering from pathologies. The field of public health and individual rights, experts consider, is a work in progress.
Bibliography
Adler, Richard, and Elise Mara. Typhoid Fever: A History. Jefferson: McFarland, 2015. Print.
Dekok, David. Epidemic: A Collision of Power, Privilege and Public Health. Guilford: Lyons, 2011. Print.
Duffy, John. The Sanitarians: A History of American Public Health. Champaigne: U of Illinois P, 1992. Print.
Hays, J. N. The Burdens of Disease: Epidemics and Human Response in Western History. New Brunswick: Rutgers UP, 2010. Print.
Jarrow, Gail. Fatal Fever: Tracking Down Typhoid Mary. Honesdale: Calkins Creek, 2015. Print.
Leavitt, Judith Walzer. Typhoid Mary: Captive to the Public’s Health. Boston: Beacon, 2014. Print.
Marineli, Filio, Gregory Tsoucalas, Marianna Karamou, and George Androutsos. "Mary Mallon (1869–1938) and the History of Typhoid Fever." Annals of Gastroenterology 28.2 (2013): 132–134. Print.
"Typhoid Mary." Encyclopaedia Britannica. Encyclopaedia Britannica Online. 2015. Web. 22 June 2015.