Typhoid Fever

Image: Mary Mallon, aka Typhoid Mary, she was active around 40-50 years after the characters portrayed in the Saint Maggie series. But she still has a connection. Read more about her story:
https://www.forbes.com/sites/kionasmith/2017/09/22/who-was-typhoid-mary/#54fb68a51e3e
 
 
I am preparing to write the next novel in the Saint Maggie series and have decided that the main plot will revolve around an outbreak of Typhoid Fever that starts in the dormitory at Josiah Norton’s uniform factory and woolen mill.
 
This disease was prevalent during the Civil War, and especially common in the military. As I noted in a blog post in March, typhoid fever is caused by Salmonella typhi bacteria and is spread through “contaminated food and water or through close contact with someone who's infected. Signs and symptoms usually include a high fever, headache, abdominal pain, and either constipation or diarrhea.” People infected with Salmonella typhi bacteria can pass it on through feces and sometimes in urine. An individual can contract typhoid fever by eating food prepared by an infected person who hasn’t washed their hands after defecating or urinating. Infection also can occur by drinking contaminated water. Without treatment, the disease can be life-threatening.”[1]
 
Before the invention of modern sewage systems, typhoid was common in the United States. Prior to 1920, typhoid fever occurred in 100 out of every 100,000 people.[2]
It wasn’t until the 1880s that scientists realized that bacteria was somehow involved in typhoid fever. A diagnostic test was developed in 1896, followed by a vaccine in 1897, but the perfected vaccine was not developed until 1909.
 
As you can see, in 1864, a vaccine for typhoid fever is 45 years away.
 
Today, during the COVID-19 pandemic, we hear over and over again to wash our hands. The idea of washing one’s hands to protect against infection was nearly unheard of in 1864 and the idea of germs embryonic.
 
In 1846, Ignaz Semmelweis, a Hungarian physician, was appointed as an assistant to Professor Johan Klein at the First Obstetrical Clinic at Vienna General Hospital. In 1847, Klein died after he had been stuck with a scalpel during a postmortem examination. During the post-mortem, Semmelweis noticed that Klein’s body had a pathology similar to that of women who had died of puerperal fever. Upon further investigation, he saw that the rate of death among the patients of student midwives was noticeably lower than that of the patients of medical students, who performed autopsies as well as their maternity work. Semmelweis concluded that the infection was caused by “cadaverous material” and advised all students to wash their hands with a solution of chlorinated lime (calcium hypochlorite).
 
In Walk by Faith, set in 1863, midwife Adela Edler, who is German, instructs her new assistant Lydia Blaine Lape, to wash her hands with the chlorinated lime solution while attending laboring mothers and cites Semmelweis’ work as her reason for requiring hand washing.
 
What Adela does not yet know is that in France, chemist Louis Pasteur is trying to figure out why beverages like milk, whine, and beer go bad, and eventually comes to the realization it was caused by the growth of micro-organisms. In 1865, Pasteur patented a process called pasteurization that stops the growth of the micro-organisms. From there, it was a short hop to proposing that micro-organisms also could infect the bodies of humans and animals and could be stopped, as well.
 
The point is my characters for the most part live in a culture that generally is unaware of germ theory, the power of cleanliness, the proper disposal of human and animal waste, and so on. But lack of knowledge was not located to the mid-1800s.
 
As I pointed out in the March blog, cook Mary Mallon (“Typhoid Mary,” 1869-1938), was an asymptomatic carrier of typhoid fever and in the early 1900s spread the disease to 51 people, three of whom died. Mallon, of course, was the most publicized case of asymptomatic carriers of typhoid fever, but she was not alone in transmitting the typhoid fever through food handling.
 
Now… why would a dormitory at a factory be a breeding ground for typhoid fever? The answer is found in Seeing the Elephant, when Eli Smith takes a tour of Norton Mill #3, located to Blaineton’s south. At one point, Josiah Norton explains that most of his workers live in dormitories since the mill is located some distance from Blaineton. The tour is a real eye-opener for Eli.
 
 
The refectory in the first building smelled of cabbage, slightly rancid meat, and oatmeal and milk that had been left out too long. Eli’s gag instinct wanted to come into play but having experience with the stench of death on the battlefield, he pushed it back down. He was relieved nonetheless when Josiah led him up a set of rickety stairs to the dormitory floor.
 
The sleeping quarters turned out to be a big room with several rows of beds that possessed faded, dirty quilts and pillows. This too smelled, but of human sweat and unwashed clothing. The room was chilly, but that was no surprise since the walls had not been plastered over and there was no sign of a stove or fireplace. In addition, daylight readily peeked through the cracks and holes and the walls. The floorboards also had gaps, one of which was large enough for Eli to see the refectory below. He wondered exactly just what kind of “cosmetic” changes Norton had made.
 

So, two books ago the stage was set for the major outbreak of a disease. How the town of Blaineton and Maggie’s friends and family deal with it will make up the main plot.
 
I’ll be back with another blog on Friday or Saturday.
 
Meanwhile, be patient and kind to one another, and practice love.
 
 
Janet Stafford
 

NOTES

[1] “Typhoid Fever,” Patient Care & Health Information, Diseases & Conditions, Mayo Clinic, 31 July 2018. https://www.mayoclinic.org/diseases-conditions/typhoid-fever/symptoms-causes/syc-20378661
 

[2] http://www.cdc.gov/mmwr/PDF/wk/mm4840.pdf