Typhoid Mary

Images:
1) George Soper
https://missoulacurrent.com/art/2020/03/fauci-typhoid-mary/?print=print
2) Dr. Sara Josephine Baker
https://www.britannica.com/biography/Sara-Josephine-Baker
 
 
Before I tell the story of Mary Mallon, aka “Typhoid Mary,” let me explain a bit more about typhoid fever, the disease which she spread.
 
Typhoid fever is caused by bacteria called Salmonella typhi. It is spread through food and water that have been contaminated by feces. What that means is if I am an asymptomatic carrier of typhoid fever and have a bowel movement and neglect to wash my hands thoroughly or don’t wash them at all, and then handle foods while making you dinner – well, you see where this is going. You’re most likely going to get sick.
 
The symptoms of typhoid fever are a fever (obviously, it’s in the name), a poor appetite, headaches, nausea, diarrhea, aches and pains, exhaustion, and sometimes a rose-colored rash. Aside from being ill, the disease may cause serious complications such as intestinal bleeding and perforation which may require surgery. Other, less common but serious, complications are inflammation of heart muscle (and/or the lining of the heart and its valves), inflammation of the pancreas, pneumonia, meningitis, delirium, or kidney or bladder infections (“Typhoid Fever”).
 
Today, we have a vaccine to prevent typhoid fever, as well as a treatment for it should someone get it (antibiotics). But we didn’t have that in the early 1900s.
 
Now here is Mary Mallon’s story.
 
Mary Mallon (1869-1938) was an immigrant from Scotland who arrived in the USA sometime around 1883-1884. In 1906, a New York banker by the name of Charles Henry Warren hired Mallon to work as a cook during the summer at an estate he was renting in Oyster Bay, Long Island. When six out of eleven people at the house suddenly became ill with typhoid fever between August 27 and September 3, the house’s landlord contacted George Soper to locate the source of the outbreak. Soper had trained as a civil engineer and understood sanitation. He also had investigated previous outbreaks of disease for New York State. At the time most cases of typhoid fever occurred among people living in poverty and crowded conditions. Furthermore, in the early 1900s, typhoid fever still had a 10% mortality rate. Why the disease would strike a wealthy family was a real head-scratcher.
 
During the course of his investigation, Soper learned that Mary Mallon was hired as a cook three weeks before the first case of typhoid fever had been diagnosed at the house. At first, Soper thought that perhaps the disease had been transmitted by freshwater clams. However, he soon learned that not all of those who had become ill had eaten the clams. At last, he uncovered the one thing that they all had ingested during the period during which they had been infected: ice cream served with fresh peaches. And Mary Mallon had prepared the dish. It was obvious that Mallon had handled the peaches while cutting them up, and if she had come in contact with typhoid fever, then it was likely that she also had transferred the bacteria from her hands onto the peaches. Those who ate the dessert she prepared then ingested the bacteria.
 
Mallon, of course, had no idea that she was spreading a deadly disease and by then had moved on to work with other well-to-do families in New York. However, Soper was determined track her down. He eventually found her working for a household on Park Avenue. During the interview, Soper explained to Mallon that he believed she was spreading typhoid fever and asked her to give him urine and feces samples so they could be analyzed for the evidence of the disease. Mallon apparently was horrified, as well as frightened by his request. She reportedly ran him off by threatening him with a carving fork.
 
Hoping that a woman to woman talk might soften the request and convince Mallon to surrender the samples, Soper asked fellow physician, Dr. Sara Josephine Baker, to do it in his stead. She did, only to have Mallon chase her away, too.
 
What Soper learned next pushed him to take drastic measures. However, because this piece has turned out to be a long post, we’ll hear the rest of Mallon’s sad story on Friday.
 
 
Until then, stay well, stay connected, stay hopeful.
 
 
Janet R. Stafford
 
 
Resources
 
Filio Marineli, Gregory Tsoucalas, Marianna Karamanou, George Androutsos, “Mary Mallon (1869-1938) and the history of typhoid fever,” History in Gastroenterology, Annals of Gastroenterology (2013) 26, 132-134. The History of Vaccines (from the College of Physicians of Philadelphia)
https://www.historyofvaccines.org/content/articles/typhoid-fever
 
Nina Strochlic, “Typhoid Mary's tragic tale exposed the health impacts of 'super-spreaders',” Coronavirus Coverage, History, National Geographic, 27 March 2020.
https://www.nationalgeographic.com/history/2020/03/typhoid-mary-tragic-tale-exposed-health-impacts-super-spreaders/
 
“Typhoid Fever: Symptoms and Causative Agent,” The History of Vaccines, The College of Physicians of Philadelphia.
https://www.historyofvaccines.org/content/articles/typhoid-fever