Typhoid Mary Mallon

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Typhoid Mary Mallon

• Kelly Burkholder-Allen
• Paul Rega

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Typhoid Facts

• Typhoid Fever is caused by salmonella typhi
• Characterized by high fever, diarrhea, GI
  irritation, malaise, and headache
• Water and food were the sources of contamination
• In the early 1900s Typhoid Fever had a mortality
  rate of about 10
• Immunization not developed until 1911
• Antibiotics treatment was not available until
  1948, mortality rate remained 10 in developing
  countries
• Todays mortality rate in developing countries is
  approximately 1
• In 1906, there were 3,000 cases in the State of
  NY
• 3 carrier rate was estimated to be the norm
  during Marys time

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Mary Mallon

• Born 9-23-1869 in Cookstown, Ireland
• Emigrated to the US 1884, like many other Irish
  women of her generation
• Worked in a variety of domestic positions prior
  to settling into her career as a cook
• Worked for many wealthy families of Manhattan
• Carried the distinction of being the first
  healthy carrier of Typhoid Fever discovered in
  the US
• Spent 26 years in forced quarantine by the
  Department of Health, City of New York
• Lived in isolation in a cabin on North Brother
  Island, near the Bronx and Rykers Island

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Typhoid Mary

• Known to have infected 47 people (including 3
  deaths)
• Mary Mallons nickname of Typhoid Mary has
  become synonymous with the spread of diseaseit
  became such legend that she was credited with
  having infected hundreds, maybe thousands
• Was forced into quarantined on two separate
  occasions on North Brother Island for a total of
  26 years---without ever having been tried or
  convicted of any crime
• Died11-11-1938

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Marys Story

• Worked as a cook for many affluent families in
  the NYC area during the early 1900s
• In 1906, investment banker, Charles Henry Warren
  and family rented the summer home on Oyster Bay,
  Long Island from George Thompson and his family
• In August, one of Warrens children became ill
  with Typhoid Fever
• Within a short period of time six of the eleven
  household members were ill

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• As Typhoid Fever was a disease common to the
  Oyster Bay crowd, Mr. Thompson hired a
  Sanitarian, George Soper to investigate the cause
  of the outbreak
• Although he initially feared that the soft clams
  were the culprit, that was proven to be incorrect
  as not all of those stricken had eaten them

• After a brief investigation, Soper began to
  suspect the Irish cook as the culprit
• He obtained her employment history (most cooks
  and domestic help at that time registered with a
  handful of agencies) from 1900-1906
• From 7 of her past jobs, 22 had been infected
  with Typhoid Fever and one had died

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• In March of 1907, Mr. Soper arrived at the home
  of Marys employer in Manhattan requesting stool
  and blood samples----Mary waived a meat fork at
  him and denied ever having been ill with Typhoid
• He then unsuccessfully tracked her home and made
  similar requests
• Mary was frequently accused of being the source
  of contact for hundreds of the ill

• After enlisting the support of Dr. Biggs of the
  NYC Department of Health, Dr. Josephine Baker was
  sent to bring Mary Mallon in for testing
• Upon arrival at her employers home, Dr. Baker
  and the police were met by an uncooperative Mary
  who eluded them for 5 hoursfinally being
  apprehended in a closet

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• Mary once again denied having ever been ill with
  Typhoid
• After an uncooperative Mary was forcibly
  restrained, she was transported to Willard Parker
  Hospital for blood and stool testing for typhoid

• Marys stool was positive for salmonella typhi
• Mary was then transferred to North Brother Island
  to Riverside Hospitalwhere she was quarantined
  in a cottage

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Health officials based their power to quarantine
Mary Mallon on sections 1169 and 1170 of the
Greater New York Charter
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According to Section 1169 Board of Health shall
use all reasonable means for ascertaining the
existence and cause of a disease or peril to life
or health and for averting the same throughout
the city
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Section 1170 Said Board may remove or cause to
be removed to (a) proper place to be by it
designated any person sick with any contagious,
pestilential, or infectious disease shall have
exclusive charge and control of hospital for the
treatment of such cases
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• In 1909, Mary unsuccessfully sued the health
  department
• During her two year period of confinement, she
  had120/163 stool samples test positive
• Her own independent laboratory tests were
  however negative
• NO ONE ever attempted to explain to Mary the
  significance of being a carrier, instead they
  offered to remove her gall bladder
• She was unsuccessfully treated with
  Hexamethylenamin, laxatives, Urotropin, and
  brewers yeast
• A post mortem revealed that she shed the
  salmonella typhi bacteria from her gall stones

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• In 1910, a new health commissioner vowed to free
  Mary and assist her with finding suitable
  employment as a domestic
• Mary agreed to the terms of the health
  commissioner and signed an affadavit stating that
  she would no longer seek employment as a cook,
  would register any changes of addresses, and
  would submit to stool testing
• Mary NEVER intended to abide by the agreement,
  she felt fine and was not sick!

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• Mary was demonized by public health and the media
• She was the butt of jokes, cartoons, and
  eventually Typhoid Mary appeared in medical
  dictionaries, as a disease carrier

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• For the next 5 years, Mary worked as a cook in a
  variety of venues
• In 1915, there was a Typhoid Fever outbreak at
  the Sloane Maternity Hospital in Manhattan---25
  ill and 2 dead
• The recently hired cook---Mary Brown was found
  to be the source
• The public was no longer sympathetic to Mary, as
  she was now perceived as being malicious in her
  intent
• Mary was placed back on North Brother Island
  where she remained until her death

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• During her second period of forced quarantine,
  she held a variety of jobs at Riverside Hospital,
  working first as a nurse, an assistant, and
  finally in the laboratory
• Mary sold homemade baked goods to hospital
  employees from her isolated cottage

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Why Mary?

• Tony Labella was also a carrier who is
  responsible for infecting 122 people (including 5
  deaths)
• Other Typhoid Fever carriers broke public health
  agreements to no longer work in the food service
  industry and were not so much as fined, let
  alone CONFINED!
• Much speculation remains regarding the treatment
  that Mary received at the hands of the Department
  of Health City of New York

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• Could we become victims to public health laws
  like Mary?
• Do you know what powers your state and local
  public health departments possess?

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References

• Anthony Bourdain Typhoid Mary An Urban
  Historical. New York Bloomsbury, 2001.
• The following websites
• http//www.history1900s.about.com/library/weekly/9
  9062900a.htm
• http//www.newsday.com/extras/lihistory/7/hs702a.h
  tm
• http//www.snopes.com/medical/disease/typhoid.htm