Mary Mallon
Mary Mallon | |
---|---|
![]() Mallon in 1909 | |
Born | Cookstown,County Tyrone,Ireland | September 23, 1869
Died | November 11, 1938 North Brother Island,New York, U.S. | (aged 69)
Resting place | Saint Raymond's Cemetery,The Bronx,New York, U.S. |
Other names |
|
Occupation | Cook |
Known for | Asymptomatic carrieroftyphoid fever |
Mary Mallon(September 23, 1869 – November 11, 1938), commonly known asTyphoid Mary,was anIrish-born Americancook who is believed to have infected between 51 and 122 people withtyphoid fever.The infections caused three confirmed deaths, with unconfirmed estimates of as many as 50. She was the first person in the United States identified as anasymptomatic carrierof the pathogenicbacteriaSalmonella typhi.[1][2]She was forciblyquarantinedtwice by authorities, the second time for the remainder of her life because she persisted in working as a cook and thereby exposed others to the disease. Mallon died after a total of nearly 30 years quarantined.[3][4]Her popular nickname has since become a term for persons who spread disease or other misfortune.
Biography
[edit]Early life
[edit]Mary Mallon was born in 1869 inCookstown,County Tyrone,Ireland.She may have been born with typhoid fever as her mother was infected during pregnancy.[5][6][7]In 1884 at the age of 15, she emigrated from Ireland to the United States.[6][8]She lived with her aunt and uncle for a time and worked as a maid but eventually became a cook for affluent families.[9][10]
Career
[edit]From 1900 to 1907, Mallon worked as a cook in the New York City area for eight families, seven of whom contracted typhoid.[11][12]In 1900, she worked inMamaroneck, New York,where within two weeks of her employment, residents developed typhoid fever. In 1901, she relocated toManhattan,where members of the family for whom she worked developed fevers anddiarrhea.Mallon then went to work for a lawyer and left after seven of the eight people in that household became ill.[13][14]
In June 1904, she was hired by a prosperous lawyer, Henry Gilsey. Soon four of the seven servants were ill. No members of Gilsey's family were infected because they resided separately, and the servants lived in their own house. Immediately after the outbreak began, Mallon left and relocated toTuxedo Park,[15]where she was hired by George Kessler. Two weeks later, the laundry worker in his household was infected and taken toSt. Joseph's Regional Medical Center,where her case of typhoid was the first in a long time. The investigator Dr. R. L. Wilson concluded that the laundry worker had caused the outbreak, but he failed to prove it. The laundry worker died soon afterward.[10]
In August 1906, Mallon began a job inOyster BayonLong Islandwith the family of a wealthy New York banker, Charles Elliot Warren.[16]Mallon went along with the Warrens when they rented a house in Oyster Bay for the summer of 1906. From August 27 to September 3, six of the 11 people in the family came down with typhoid fever. The disease at that time was "unusual" in Oyster Bay, according to three medical doctors who practiced there. The landlord, understanding that it would be difficult to rent a house with the reputation of having typhoid, hired several independent experts to find the source of infection. They took water samples from pipes, faucets, toilets, and the cesspool, all of which were negative for typhoid.[1][17][18] [13]
Investigation
[edit]George Soper,an investigator hired by the Oyster Bay property owner after the outbreak there, had been trying to determine the cause of typhoid outbreaks in affluent families, when it was known that the disease typically occurred in unsanitary conditions. He discovered that a female Irish cook, who fitted the physical description he had been given, was involved in all of the outbreaks. He was unable to locate her because she generally left after an outbreak began, without giving a forwarding address. The Park Avenue outbreak helped to identify Mallon as the source of the infections. Soper learned of the case while it was still active and discovered Mallon was the cook.[13]
Soper first met Mallon in the kitchen of the Bownes' Park Avenue penthouse and accused her of spreading the disease. Though Soper himself recollected his behavior "as diplomatic as possible," he infuriated Mallon and she threatened him with a carving fork.[13][19]When Mallon refused to give samples, Soper decided to compile a five-year history of her employment. He found that, of the eight families that had hired Mallon as a cook, members of seven claimed to have contracted typhoid fever.[20]Then Soper learned where Mallon's boyfriend lived and arranged a new meeting there. He took Dr. Raymond Hoobler in an attempt to persuade Mary to give them samples of urine and stool for analysis. Mallon again refused to cooperate, claiming that typhoid was everywhere and that the outbreaks had happened because of contaminated food and water. At that time, the concept of healthy carriers was unknown even to healthcare workers.[10][21][22]
Soper published his findings on June 15, 1907, in theJournal of the American Medical Association.[23]He wrote:
It was found that the family changed cooks on August 4. This was about three weeks before the typhoid epidemic broke out. The new cook, Mallon, remained in the family only a short time and left about three weeks after the outbreak occurred. Mallon was described as an Irish woman about 40 years of age, tall, heavy, single. She seemed to be in perfect health.[24]
First quarantine (1907–1910)
[edit]![](https://upload.wikimedia.org/wikipedia/commons/thumb/4/47/Mary_Mallon_in_hospital.jpg/220px-Mary_Mallon_in_hospital.jpg)
Soper notified theNew York City Health Department,whose investigators realized that Mallon was a typhoid carrier. By sections 1169 and 1170 of theGreater New York Charter,Mallon was arrested as a public health threat. She was forced into an ambulance by five policemen and Dr.Sara Josephine Baker,who at some time had to sit on Mallon to restrain her.[21]Mallon was transported to theWillard Parker Hospital,where she was restrained and forced to give samples. For four days, she was not allowed to get up and use the bathroom on her own.[25]The massive numbers of typhoid bacteria that were discovered in her stool samples indicated that the infection source was in hergallbladder.During questioning, Mallon admitted that she almost never washed her hands. This was not unusual at the time; thegerm theory of diseasestill was not fully accepted.[13][26]
On March 19, 1907, Mallon was sentenced to quarantine onNorth Brother Island.While quarantined she gave stool and urine samples three times per week. Authorities suggested removing her gallbladder, but she refused because she claimed she did not believe she carried the disease. At the time, gallbladder removal was dangerous, and people had died from the procedure.[27]Mallon was also unwilling to stop working as a cook, a job that earned more money for her than any other. Having no home of her own, she was always on the verge of poverty.
After the publication of Soper's article in theJournal of the American Medical Association,Mallon attracted extensive media attention and received the nickname "Typhoid Mary."[28]Later, in a textbook that defined typhoid fever, she again was termed "Typhoid Mary."[29]
Soper visited Mallon in quarantine, telling her he would write a book and give her part of the royalties.[30]She angrily rejected his proposal and locked herself in the bathroom until he left.[31]She hated the nickname and wrote in a letter to her lawyer:
I wonder how the saidDr. William H. Parkwould like to be insulted and put in the Journal and call him or his wife Typhoid William Park.[28]
Not all medical experts endorsed the decision to forcibly quarantine Mallon. For example,Milton J. RosenauandCharles V. Chapinboth argued that she just had to be taught to carefully treat her condition and ensure that she would not transmit the typhoid to others. Both considered isolation to be an unnecessary, overly strict punishment.[32]Mallon suffered from a nervous breakdown after her arrest and forcible transportation to the hospital. In 1909 she tried to sue the New York Health Department, but her complaint was denied and the case dismissed by theNew York Supreme Court.[33]In a letter to her lawyer she complained that she was treated like a "guinea pig." She was obliged to give samples for analysis three times a week, but for six months was not allowed to visit an eye doctor, even though her eyelid was paralyzed and she had to bandage it at night. Her medical treatment was hectic: she was givenurotropinin three-month courses for a year, threatening to destroy herkidneys.That was changed to brewer'syeastandhexamethylenetetraminein increasing doses.[34][28][35]She was first told that she had typhoid in her intestinal tract, then in her bowel muscles, then in her gallbladder.[28]
Mallon herself claimed never to believe that she was a carrier. With the help of a friend, she sent several samples to an independent New York laboratory. All came back negative for typhoid.[32]On North Brother Island, almost a quarter of her analyses from March 1907 through June 1909 were also negative.[25]After 2 years and 11 months of Mallon's quarantine,Eugene H. Porter,theNew York State Commissioner of Health,decided that disease carriers should no longer be quarantined and that Mallon could be freed if she agreed to stop working as a cook and take reasonable efforts to avoid transmitting typhoid to others. On February 19, 1910, Mallon said she was "prepared to change her occupation (that of a cook), and would give assurance byaffidavitthat she would upon her release take such hygienic precautions as would protect those with whom she came in contact, from infection. "[36]She was released from quarantine and returned to the mainland.[35][37][38]
Release and second quarantine (1915–1938)
[edit]![](https://upload.wikimedia.org/wikipedia/commons/thumb/f/fd/Mallon-Mary_01.jpg/220px-Mallon-Mary_01.jpg)
Upon her release, Mallon was given a job as a laundry worker, which paid less than cooking—$20 per month instead of $50. After a time she wounded her arm and the wound became infected, meaning that she could not work at all for six months.[39]After several unsuccessful years, she started cooking again. She used fake surnames like Breshof or Brown, and accepted jobs as a cook against the explicit instructions of health authorities. No agencies that hired servants for affluent families would offer her employment, so for the next five years, she worked in a number of kitchens in restaurants, hotels, and spa facilities. Almost everywhere she worked, there were outbreaks of typhoid.[36]However, she changed jobs frequently, and Soper was unable to find her.[13]
In 1915, Mallon started working atSloane Hospital for Womenin New York City. Soon 25 people were infected, and two died. The chief obstetrician, Dr. Edward B. Cragin, called Soper and asked him to help in the investigation. Soper identified Mallon from the servants' verbal descriptions and also by her handwriting.[36][39]
Mallon fled again, but the police were able to find and arrest her when she took food to a friend on Long Island.[13][37]Mallon was returned to quarantine onNorth Brother Islandon March 27, 1915.[37][39]
Little is known about her life during the second quarantine. She remained on North Brother for more than 23 years, and the authorities gave her a private one-story cottage. As of 1918, she was allowed to take day trips to the mainland. In 1925, Dr. Alexandra Plavska came to the island for an internship. She organized a laboratory on the second floor of the chapel and offered Mallon a job as a technician. Mallon washed bottles, did recordings, and prepared glasses for pathologists.[40][41]
Media reception
[edit]After Mallon was sent into her initial quarantine, the newspapers changed their opinion of her case. The articles at first mentioned how Dr. Josephine Baker claimed Mallon attacked her and the other doctors with forks, and came at them fighting and swearing.[42]Later the press articles shifted the blame away from being her fault, the claim being that she was unaware she was carrying anything and instead germs that she had no control over were to blame.[42]Despite this shift, she was still popularly understood to have believed that she was contagious.[43]The newspapers also claimed that Mallon was prohibited from using the telephone to contact anybody except the surgeons treating her and her guard. Stories that once celebrated the public health department and legal system eventually became sympathetic to Mallon and the events she supposedly encountered.[42]Public health officials claimed the opposite, that she was treated to their best ability but in return refused to comply with the requests of the health officials.[44]
Death
[edit]Mallon spent the rest of her life in quarantine at Riverside Hospital on North Brother Island. Mallon was quite active until suffering a stroke in 1932; afterwards, she was confined to the hospital.[1]She never completely recovered, and half of her body remained paralyzed.[45]On November 11, 1938, she died ofpneumoniaat age 69.[2]Mallon's body was cremated, and her ashes were buried atSaint Raymond's Cemeteryin the Bronx.[46]Nine people attended the funeral.[47][48]
Some sources claim that a post-mortem autopsy found evidence of live typhoid bacteria in Mallon's gallbladder.[1][13][49]Soper wrote, however, that there was no autopsy, a claim cited by other researchers to assert a conspiracy to calm public opinion after her death.[50][1]
Legacy
[edit]Aftermath
[edit]Mallon's case became the first in which an asymptomatic carrier was discovered and isolated forcibly. The ethical and legal issues raised by her case are still discussed.[6][51][52]Research has resulted in an estimate that Mallon had contaminated "at least one hundred and twenty two people, including five dead".[1]Other sources attribute at least three deaths to contact with Mallon, but because of health officials' inability to persuade her to cooperate, the exact number is not known. Some have estimated that contact with her may have caused 50 fatalities.[13]
In a 2013 article in theAnnals of Gastroenterology,the authors concluded:
The history of Mary Mallon, declared "unclean" like a leper, may give us some moral lessons on how to protect the ill and how we can be protected from illness[...] By the time she died New York health officials had identified more than 400 other healthy carriers ofSalmonella typhi,but no one else was forcibly confined or victimized as an "unwanted ill".[1]
Two scholarly sources combined to provide this conclusion:
This case highlighted the problematic nature of the subject and the need for an enhanced medical and legal-social treatment model aimed at improving the status of disease carriers and limiting their impact on society.[53]
Other healthy typhoid carriers identified in the first quarter of the 20th century include Tony Labella, an Italian immigrant, presumed to have caused more than 100 cases (with five deaths); anAdirondackguide dubbed "Typhoid John", presumed to have infected 36 people (with two deaths); and Alphonse Cotils, a restaurateur and bakery owner.[54]
Thehealth technologyof the era did not have a completely effective solution: there were not any antibiotics to fight the infection, and gallbladder removal was a dangerous, sometimes fatal operation. Some modern specialists claim that typhoid bacteria can become integrated inmacrophagesand then reside in intestinallymph nodesor thespleen.[55][56]
Ethics
[edit]The ethical question of her arrest and forced quarantine is still being debated. Historians frequently discuss the argument of Mallon knowing that she was infecting her clients with typhoid based on the frequency of the disease being present after her departure. They also cite the argument that antibiotics did not exist at this time and ten percent of those affected by Mallon carrying the infection died.[57]By this argument Mallon could be considered a murderer of those ten percent of people if she knew she was a carrier of the disease, and would be a justification for her arrest.
Others argue that Mallon did not know that she had the bacteria and therefore did not deserve to be arrested when she never committed a crime. At the time, asymptomatic carriers were not understood and Mallon was believed to have said that she did not feel sick, look sick, or have any sort of visible sickness. Although Mallon did not feel ill or look sick, the disease was living dormant in what was assumed to be her gallbladder.[58]
Lessons learned
[edit]![](https://upload.wikimedia.org/wikipedia/commons/thumb/e/e0/Typhoid_Mary_poster_in_B%26W.jpg/220px-Typhoid_Mary_poster_in_B%26W.jpg)
Mallon was the first person found to be an asymptomatic carrier of the typhoid bacterium, and this caused the health officials to have little to no idea of how to deal with her. However, Mallon's case helped these officials identify other people who carried diseases that were dormant in their bodies based on the information they learned from Mallon's case. Mallon's case created controversy concerning personal autonomy and social responsibility. It also was the first case that provided good evidence of the existence of asymptomatic carriers.[44]
In culture
[edit]The phrase "Typhoid Mary"is now a colloquial term for anyone who spreads disease or something else undesirable.[59]
Typhoid Mary Fisk,also known as Bloody Mary and Mutant Zero, is a fictionalsupervillainappearing inAmerican comic bookspublished byMarvel Comics.[60]
Mallon's case inspired the name of the rap music groupHail Mary Mallon.[61]
Mallon was portrayed by Melissa McMeekin in season one of the television seriesThe Knick,[62]in a somewhat fictionalised account of her initial infection of countless wealthy households.
Mallon's butcher knife featured as an artifact in season three of the television seriesWarehouse 13.[63]Associated with Mallon's legacy with disease, the fictional artifact had the ability to transfer illness between individuals holding the knife simultaneously.
See also
[edit]- Superspreader
- Jennie Barmore,Chicago's "Typhoid Jennie"
References
[edit]- ^abcdefgMarineli et al. 2013.
- ^ab"'Typhoid Mary' Dies Of A Stroke At 68. Carrier of Disease, Blamed for 51 Cases and 3 Deaths, but Immune ".The New York Times.November 12, 1938. Archived fromthe originalon June 5, 2011.RetrievedFebruary 28,2010.
- ^The Gospel of Germs: Men, Women, and the Microbe in American Life,ISBN0674357086
- ^Typhoid Mary: An Urban Historical,ISBN160819518X
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- ^abcWalzer Leavitt 1996,p. 14.
- ^Elsevier 2013,p. 189.
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- ^Elsevier 2013,p. 56.
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- ^Soper 1939,p. 699.
- ^"Dinner With Typhoid Mary"(PDF).FDA.Archived fromthe original(PDF)on December 21, 2019.RetrievedJuly 1,2018.
- ^Soper, George A. (June 15, 1907)."The work of a chronic typhoid germ distributor".J Am Med Assoc.48(24): 2019–2022.doi:10.1001/jama.1907.25220500025002d.Archivedfrom the original on December 21, 2019.RetrievedJuly 5,2019.
- ^Satin, Morton (2007).Death in the Pot.New York: Prometheus Books. p. 169.
- ^abSoper 1939,pp. 704–705.
- ^Rogers 2017,pp. 72–74.
- ^Ochs, Ridgely (2007). "Dinner with Typhoid Mary".Newsday.
- ^"Dinner With Typhoid Mary"(PDF).FDA.Archived fromthe original(PDF)on December 21, 2019.RetrievedJuly 1,2018.
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- ^Walzer Leavitt & Numbers 1997,p. 561.
- ^abAdler & Mara 2016,pp. 143–145.
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- ^abc"Food Science Curriculum"(PDF).Illinois State Board of Education.p. 118. Archived fromthe original(PDF)on December 18, 2010.RetrievedFebruary 9,2011.
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- ^Walzer Leavitt 1996,p. 195.
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- ^abcBenenson, Abram S. (1999)."Review of Typhoid Mary".Journal of Public Health Policy.20(3): 375–379.doi:10.2307/3343413.ISSN0197-5897.JSTOR3343413.S2CID189905236.
- ^Foss, Katherine (April 24, 2020)."#TyphoidMary – now a hashtag – was a maligned immigrant who got a bum rap".The Conversation.
- ^abWald, Priscilla (1997)."Cultures and Carriers:" Typhoid Mary "and the Science of Social Control".Social Text(52/53): 181–214.doi:10.2307/466739.ISSN0164-2472.JSTOR466739.
- ^Campbell Bartoletti 2015,p. 143.
- ^Satin, Morton (December 2, 2009).Death in the Pot: The Impact of Food Poisoning on History.Prometheus Books. p. 174.ISBN978-1-615-92224-6.
- ^"'TYPHOID MARY' DIES OF A STROKE AT 68; Carrier of Disease, Blamed for 51 Cases and 3 Deaths, but She Was Held Immune Services This Morning Epidemic Is Traced ".The New York Times.November 12, 1938.Archivedfrom the original on April 21, 2020.RetrievedMay 14,2020.
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Sources
[edit]- Walzer Leavitt, Judith; Numbers, Ronald L., eds. (1997)."Typhoid Mary Strikes Back".Sickness and Health in America: Readings in the History of Medicine and Public Health.Vol. 3. Wisconsin: The University of Wisconsin Press.ISBN0299153207.
- Adler, Richard; Mara, Elise (2016).Typhoid Fever: A History.McFarland. pp. 137–146.ISBN978-1-476622095.
- Campbell Bartoletti, Susan (2015).Terrible Typhoid Mary: A True Story of the Deadliest Cook in America.Boston: Houghton Mifflin Harcourt. p. 142.ISBN978-0-544-31367-5.
- Carey, Catherine (June 18, 1989). "Mary Mallon's Trail of Typhoid".FDA Consumer.Vol. 23, no. 1. pp. 18–21.
- Walzer Leavitt, Judith (1996).Typhoid Mary: Captive to the Public's Health.Putnam Publishing Group.ISBN978-0807021026.
- Walzer Leavitt, Judith (1995)."Women and Early Public Health".In Linda K. Kerber; Alice Kessler-Harris; Kathryn Kish Sklar (eds.).U.S. History as Women's History: New Feminist Essays.London: Chapel Hill. p. 156.ISBN0-8078-4495-0.
- Cliff, Andrew; Smallman-Raynor, Matthew (2013).Oxford Textbook of Infectious Disease Control: A Geographical Analysis from Medieval Quarantine to Global Eradication.Oxford University Press. p. 86.ISBN978-0-199-59661-4.
- Soper, George A. (October 1939)."The Curious Career of Typhoid Mary".Bulletin of the New York Academy of Medicine.15(10): 698–712.PMC1911442.PMID19312127.
- Job Readiness for Health Professionals: Soft Skills Strategies for Success.Missouri: Elsevier. 2013. p. 189.ISBN9780323430265.
- Kenny, Kevin (2014).The American Irish: A History.Routledge. p. 187.ISBN978-1-317-88916-8.
- Alexander, Caitlind L. (2004).Typhoid Mary: The Story of Mary Mallon: Educational Version.LearningIsland.com.ISBN9781301357642.
- Marineli, Filio; Tsoucalas, Gregory; Karamanou, Marianna; Androutsos, George (2013)."Mary Mallon (1869–1938) and the history of typhoid fever".Annals of Gastroenterology.26(2): 132–134.PMC3959940.PMID24714738.
- "Typhoid Mary Is Released".The Marion Daily Mirror.Marion. February 21, 1910. p. 2.
- Rogers, Rosemary (July 31, 2017)."Typhoid Mary:How an Irish cook became the most famous symbol of infectious disease".Irish America.New York: Irish America Inc.RetrievedOctober 25,2020.
Further reading
[edit]- Aronson, SM (November 1995). "The civil rights of Mary Mallon".Rhode Island Medicine.78(11): 311–312.PMID8547719.
- Baker, Josephine Sarah(1974) [1939].Fighting for Life.New York:Macmillan Press.ISBN0-405-05945-0.
- Bourdain, Anthony(2001).Typhoid Mary: An Urban Historical(Hardcover ed.). New York: Bloomsbury.ISBN1-58234-133-8.
- Brooks, J (March 15, 1996)."The sad and tragic life of Typhoid Mary".CMAJ.154(6): 915–916.PMC1487781.PMID8634973.
- Federspiel, Jürg.The Ballad of Typhoid Mary(historical noveltranslated by Joel Agee). New York:Ballantine Books,1985.
- 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.doi:10.1002/j.2326-1951.1996.tb03271.x.hdl:10822/896644.PMID11657398.
- Keane, Mary Beth(2013).Fever(Hardcover ed.). New York: Scribner.ISBN978-1451693416.
- Leavitt, Judith Walzer(1996).Typhoid Mary, Captive to the Public's Health(Hardcover ed.). Boston:Beacon Press.ISBN0-8070-2102-4.
- "Mary Mallon (Typhoid Mary)".American Journal of Public Health and the Nation's Health.29(1): 66–68. January 1939.doi:10.2105/ajph.29.1.66.PMC1529062.PMID18014976.
- Mikkelson, Barbara (July 23, 2006)."Typhoid Mary".Snopes.com.
External links
[edit]![](https://upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/30px-Commons-logo.svg.png)
![](https://upload.wikimedia.org/wikipedia/commons/thumb/9/99/Wiktionary-logo-en-v2.svg/40px-Wiktionary-logo-en-v2.svg.png)
- "Typhoid Mary".Snopes.com.September 26, 2002.
- 1869 births
- 1938 deaths
- 19th-century Irish people
- 20th-century Irish people
- Deaths from pneumonia in New York (state)
- American domestic workers
- Index cases
- Irish emigrants to the United States
- People from Cookstown
- People from Oyster Bay (town), New York
- Typhoid fever
- Women and death
- Burials at Saint Raymond's Cemetery (Bronx)