| Tale of 'Typhoid Mary' Relates Early Medical
Woes
By Ed Hatton
[click on
photos to enlarge]
 The
definition of a "Typhoid Mary" is a person who is the source from which
something undesirable spreads. It’s a term we’ve all used or read in a
newspaper or a book. But did you know that "Typhoid Mary" was a real person?
She was Mary Mallon, an Irish woman who worked as a cook in and around
New York City during the early years of the 20th century.
Mallon was the first person in America to be identified as a "healthy
carrier" of typhoid and was dubbed "Typhoid Mary" when the press revealed
that she was responsible for causing several serious outbreaks of typhoid
fever.
Mary Mallon was born in Cookstown, Co. Tyrone, in 1869 and emigrated
to America in 1883 at age 14. By the turn of the century, Mallon had established
herself as a cook, one of the best jobs available to an Irish immigrant
woman at the time. And she wasn't just an ordinary cook; she worked in
the kitchens of some of the most important families in New York City.
Mallon first came to the attention of the health authorities when she
was identified as the probable cause of an outbreak of typhoid fever in
the home of a wealthy banker in Oyster Bay, New York, in 1904. Typhoid
was a serious problem at the turn of the century. Poor sanitation and overcrowding,
particularly in poor or immigrant neighborhoods, often resulted in outbreaks
of uncontrollable infectious diseases.
 Smallpox,
tuberculosis, whooping cough, diphtheria and typhoid were endemic at this
time and caused thousands of deaths every year. In New York City alone,
there were about 4,000 new cases of typhoid annually. Typhoid is a communicable
disease whose symptoms include fever, diarrhea, exhaustion, headache and
intestinal inflammation. It is caused by the bacterium Salmonella typhi,
which is usually transmitted to people by contaminated food or water.
If untreated, typhoid proves fatal in up to 25% of all cases. What was
different about the Oyster Bay outbreak was that it occurred in a high-class
seaside resort that catered to the powerful and wealthy families of New
York City. Typhoid did not typically attack affluent homes or neighborhoods,
so when this unusual outbreak occurred the health authorities were keen
to discover its cause.
A sanitary engineer in the New York City Department of Health, George
Soper, spent months investigating the case. An outbreak of typhoid was
usually traceable to an active case of typhoid, but in this instance no
one could be identified as the source of the infection. Soper, however,
had read an article in a medical journal about a European case where a
healthy person was proven to be a carrier of typhoid. He theorized that
this was another instance of a 'healthy carrier' and concluded that the
family's cook, a 37-year old Irish immigrant, was the source.
Soper identified the cook, who no longer worked for the family, as Mary
Mallon. He tracked her to the next household she worked in, but by the
time he got there she had moved on. He then traced her past employment
history and found that in the previous decade Mallon had worked for eight
families, and typhoid had occurred in six of them. In 1907, Soper finally
traced Mallon to a home on Park Avenue in Manhattan. He apprehended Mallon
and had her committed to Riverside Hospital, the city's largest quarantine
facility, on North Brother Island, off the Bronx, to prevent further outbreaks
of typhoid.
 Mallon
was allowed to live in a cottage on the island, but was not permitted to
leave. In 1909, Mallon and her lawyer filed an appeal to the New York Supreme
Court, asking for her release. At the same time Mallon agreed to be interviewed
by the press. Her story featured prominently in the pages of New York's
sensational press, particularly publisher William Randolph Hearst's New
York American. Instead of treating her case as a miscarriage of justice,
however, the newspapers highlighted the danger that 'Typhoid Mary', as
she was labeled, presented to the public.
Mallon did receive some public sympathy, however, and many pushed for
her release. After all, wasn't she a victim, too? She was an apparently
healthy person who was being confined on an island populated by people
ill with serious, contagious diseases. Not everyone agreed that it was
permissible for the state to protect the health of the public by taking
away the liberty of an individual.
A new health commissioner, Ernst Lederle, was appointed in 1910. Lederle
was more sympathetic to Mallon's plight than the previous commissioner
and released her on the condition that she promise never to work in food
handling or preparation again. Mallon agreed to the terms, and the health
department found her employment as a laundress.
The Department of Health kept track of Mallon for a few years, but it
eventually lost touch with her. Then, in 1915, an outbreak of typhoid fever
at Sloane Maternity Hospital in Manhattan was traced to a cook working
in the facility's kitchen, a woman who called herself "Mrs. Brown." She
turned out to be Mary Mallon. After being released in 1910, Mallon found
that she wasn't able to survive on her salary as a laundress, which was
one of the lowest paying and most unpopular jobs filled by Irish immigrant
women at the time. She had eventually returned to the only profession she
knew: cooking. As a result, 25 doctors, nurses and hospital staff contracted
typhoid; two of them died.
As you would expect, there was no public sympathy for Mallon when she
was re-arrested and returned to North Brother Island. She was forced to
remain there for the rest of her life. Mallon died at age 69 on Nov. 11,
1938, after having spent 26 years on the island.
The story of Mary Mallon - "Typhoid Mary" - is a sad tale of someone
who was in the wrong place at the wrong time. Mallon never accepted the
fact that she was a health risk to the people she served. That is why,
she said, she returned to cooking after she had been released from North
Brother Island in 1910. Despite her lack of ill intention, however, the
fact remains that nearly 50 cases of typhoid and three deaths can be directly
attributable to her. Who knows how many more were infected or died because
of Mary Mallon's actions?
The irony of the story of "Typhoid Mary"' is that once Mallon had been
identified as a "healthy carrier" of typhoid, it didn't take long for scientists
to discover many more carriers. Indeed, by the time of Mallon's release
in 1910 the Department of Health had already identified at least 50 other
"healthy carriers" of typhoid. (It was eventually determined that about
3% of people who survive typhoid end up as "healthy carriers.")
None of these people were ever incarcerated for the public good, despite
the precedent set by the treatment of Mary Mallon. There were efforts made
to require food and restaurant workers in the city to be examined and certified
as typhoid-free, but the administration of such a licensing system was
too onerous to carry out for long, and it was eventually abandoned.
In any case, improvements in sanitation in the city reduced the danger
of typhoid outbreaks steadily over the years. The discovery of antibiotic
treatments for typhoid in the 1940s, after Mallon's death, all but eliminated
it as a serious threat in America and Europe.
Today the trials and tribulations of an unfortunate Irish immigrant
named Mary Mallon have all but been forgotten. All that remains of her
predicament is a phrase in the dictionary: "Typhoid Mary."
 
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