Mary Mallon

For the fictional character, see Typhoid Mary (comics).

Mary Mallon
Mallon in 1910
Born	(1869-09-23)September 23, 1869 Cookstown, County Tyrone, Ireland (now Northern Ireland)
Died	November 11, 1938(1938-11-11) (aged 69)
Nationality	British subject by birth, subsequently Citizen of the United States by naturalization
Known for	Healthy carrier of typhoid fever

Mary Mallon (September 23, 1869 – November 11, 1938), better known as Typhoid Mary, was the first person in the United States identified as an asymptomatic carrier of the pathogen associated with typhoid fever. She was presumed to have infected some 51 people, three of whom died, over the course of her career as a cook. She was forcibly isolated twice by public health authorities and died after a total of nearly three decades in isolation.

Background

Individuals can develop typhoid fever after ingesting food or water contaminated during handling by a human carrier. The human carrier may be a healthy person who has survived a previous episode of typhoid fever yet who continues to shed the associated bacteria, Salmonella typhi, in feces and urine. Washing hands with soap before touching or preparing food, washing dishes and utensils with soap and water, and only eating cooked food are all ways to reduce the risk of typhoid infection.

Days as a cook

Mary Mallon was born in 1869 in Cookstown, County Tyrone, Ireland (now Northern Ireland) in the United Kingdom. She emigrated to the United States in 1884. From 1900 to 1907 she worked as a cook in the New York City area.

In 1900, Mary worked in Mamaroneck, New York, where, within two weeks of her employment, the residents developed typhoid fever. She moved to Manhattan in 1901, and members of the family for whom she worked developed fevers and diarrhea and the laundress died. Mallon then went to work for a lawyer until seven of the eight household members developed typhoid.

In 1906, she took a position in Oyster Bay, Long Island, where, within two weeks, ten of eleven family members were hospitalized with typhoid. She changed employment again, and similar occurrences happened in three more households.

In Oyster Bay, she worked as a cook for a wealthy New York banker, Charles Henry Warren, and his family. When the Warrens rented a house in Oyster Bay for the summer of 1906, Mallon came along. From August 27 to September 3, six of the eleven people in the house came down with typhoid fever. Typhoid fever in Oyster Bay at that time was "unusual," according to three doctors who practiced medicine there.

Mary was subsequently hired by other families, and outbreaks followed her.

Investigation

In the winter of 1906, one of the families hired typhoid researcher George Soper to investigate. Soper published the results of his investigation in June 15, 1907 in the Journal of the American Medical Association; he believed soft clams might be the source of the outbreak. He then wrote:

"It was found that the family changed cooks on August 4. This was about three weeks before the typhoid epidemic broke out. She remained in the family only a short time, leaving about three weeks after the outbreak occurred. The cook was described as an Irish woman about 40 years of age, tall, heavy, single. She seemed to be in perfect health."

Soper discovered that the common element in the outbreaks was an unmarried, heavyset Irish cook, about forty years old. No one knew her whereabouts. After each case she left and gave no forwarding address. Dr. Soper traced her to an active outbreak in a Park Avenue penthouse—two servants were hospitalized and the daughter of the family died.

When Soper approached Mallon about her possible role spreading typhoid, she adamantly rejected his request for urine and stool samples. Soper left and later published the report in June 1907, in the Journal of the American Medical Association. Since Mary refused to give urine and stool samples, Soper decided to compile a 5 year history of Mary's employment. Soper found that out of eight families that took in Mary as a cook, seven families claimed to have gotten typhoid fever. On his next contact with her, he brought a doctor with him but was turned away again. During a later encounter when Mary was hospitalised, he told her that he would write a book about her and give her all the royalties. She angrily rejected his proposal and locked herself in the bathroom until he left.

First quarantine (1907-1910)

Mary Mallon (foreground) in a hospital bed during her first quarantine.

The New York City Health Department sent Dr. Sara Josephine Baker to talk to Mary, with Baker stating "by that time she was convinced that the law was only persecuting her when she had done nothing wrong." A few days later, Baker arrived at Mary's workplace with several police officers who took her into custody.

Mary got so much attention from the media that in 1908, in the Journal of the American Medical Association she was referred to as "typhoid Mary" and later on in a textbook that defined Typhoid Fever, Mary was referred to as "Typhoid Mary" with the capital "T" in "Typhoid." Under questioning, Mary said she rarely washed her hands when cooking and felt there was no need. Cultures of Mary's urine and stools, taken forcibly with the help of prison matrons, revealed that her gallbladder was teeming with typhoid salmonella. She refused to have her gallbladder extracted or to give up her occupation as cook, maintaining stubbornly that she did not carry any disease.

The New York City health inspector determined her to be a carrier. Under sections 1169 and 1170 of the Greater New York Charter, Mallon was held in isolation for three years at a clinic located on North Brother Island.

Eventually, the New York State Commissioner of Health, Eugene H. Porter, M.D., decided that disease carriers would no longer be held in isolation. Mallon could be freed if she agreed to abandon working as a cook and to take reasonable steps to prevent transmitting typhoid to others. On February 19, 1910, Mallon agreed that she "[was] prepared to change her occupation (that of a cook), and would give assurance by affidavit that she would upon her release take such hygienic precautions as would protect those with whom she came in contact, from infection". She was released from quarantine and returned to the mainland.

Release and name-change

Upon release, Mallon was given a job as a laundress, which paid lower wages. Mallon changed her name to Mary Brown, and returned to her previous occupation as a cook. For the next five years, she went through a series of kitchens, spreading illness and death, keeping one step ahead of Dr. Soper.

In 1915, a serious epidemic of typhoid erupted among the staff of New York's Sloane Hospital for Women, with twenty five cases and two deaths. City health authorities investigated, learning that a portly Irish-American woman had suddenly disappeared from the kitchen help. The police tracked her to an estate on Long Island.

Second quarantine (1915-1938)

Public-health authorities again found and arrested Mallon, returning her to quarantine on the island on March 27, 1915. Mallon was confined there for the remainder of her life. She became something of a minor celebrity, and was interviewed by journalists, who were forbidden to accept even a glass of water from her. Later, she was allowed to work as a technician in the island's laboratory.

Death

Mallon spent the rest of her life in quarantine. Six years before her death, she was paralyzed by a stroke. On November 11, 1938, aged 69, she died of pneumonia. An autopsy found evidence of live typhoid bacteria in her gallbladder. Her body was cremated, and the ashes were buried at Saint Raymond's Cemetery in the Bronx.

Legacy

A historical poster warning against acting like Typhoid Mary.

Exactly how many people were infected or killed by her is not known. She refused to cooperate with health authorities, withheld information about her past, and used different pseudonyms when she changed cities. Three deaths have been definitely attributed to her, with estimates running as high as 50.

Mallon was the first healthy typhoid carrier to be identified by medical science, and there was no policy providing guidelines for handling the situation. Some difficulties surrounding her case stemmed from Mallon's vehement denial of her possible role, as she refused to acknowledge any connection between her working as a cook and the typhoid cases. Mallon maintained that she was perfectly healthy, had never had typhoid fever, and could not be the source. Public-health authorities determined that permanent quarantine was the only way to prevent Mallon from causing significant future typhoid outbreaks.

Other healthy typhoid carriers identified in the first quarter of the 20th century include Tony Labella, an Italian immigrant, presumed to have caused over 100 cases (with five deaths); an Adirondack guide dubbed Typhoid John, presumed to have infected 36 people (with two deaths); and Alphonse Cotils, a restaurateur and bakery owner.

Today, Typhoid Mary is a generic term for anyone who, knowingly or not, spreads something undesirable.

Further reading

• Bourdain, Anthony. Typhoid Mary: An Urban Historical. New York: Bloomsbury, 2001. Hardcover, 148 pages, ISBN 1-58234-133-8
• Leavitt, Judith Walzer. Typhoid Mary, Captive to the Public's Health. Boston: Beacon Press, 1996. Hardcover, 331 pages, ISBN 0-8070-2102-4
• Baker, Josephine Sarah. Fighting for Life. New York: Macmillan Press, 1939. ISBN 0-405-05945-0 (1974 ed), ISBN 0-88275-611-7 (1980 ed)
• Federspiel, Jürg. The Ballad of Typhoid Mary [translated by Joel Agee]. New York: Ballantine Press, 1985.
• "Typhoid Mary". snopes.com. July 23, 2006.
• "Mary Mallon (Typhoid Mary)". Am J Public Health Nations Health. 29 (1): 66–8. 1939. doi:10.2105/AJPH.January 29, 1966. PMC 1529062. PMID 18014976. {{cite journal}}: Check |doi= value (help); Unknown parameter |month= ignored (help)
• Aronson, S M (1995). "The civil rights of Mary Mallon". Rhode Island medicine. 78 (11): 311–2. PMID 8547719. {{cite journal}}: Cite has empty unknown parameters: |laysource=, |laydate=, and |laysummary= (help); Unknown parameter |month= ignored (help)
• Brooks J (1996). "The sad and tragic life of Typhoid Mary". CMAJ. 154 (6): 915–6. PMC 1487781. PMID 8634973. {{cite journal}}: Unknown parameter |month= ignored (help)
• Finkbeiner, Ann K (1996). "Quite contrary: was "Typhoid Mary" Mallon a symbol of the threats to individual liberty or a necessary sacrifice to public health?". The Sciences. 36 (5): 38–43. PMID 11657398. {{cite journal}}: Cite has empty unknown parameters: |laysource=, |laydate=, and |laysummary= (help)

External links

• A more detailed profile of Typhoid Mary
• PBS NOVA site: "The Most Dangerous Woman in America"
• www.snopes.com about Typhoid Mary
• Photo of Mary Mallon's grave