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Saturday, May 7, 2011

DON'T BE A TYPHOID MARY!

We've all been there, sitting in a public place when someone nearby coughs like the last gasps of a three-pack-a-day smoker. We wonder, is that contagious? Or we come down with a stomach virus after eating at our favorite restaurant. Could the server or cook have been ill? Believing I had allergies and a sinus infection, I just spread my bugs to my family and and elderly friend. Yikes! Surely none of us wants to be a "Typhoid Mary" to others.


scene of Mary's arrest from
the movie "Typhoid Mary"
 What about the real person, though? Mary Mallon was born in Ireland to to a mother who'd had typoid fever while pregnant with Mary. Because Mary was the first healthy carrier of pathogens associated with typhoid fever, she has become infamous and synonymous with those who carelessly spread disease.
Born in 1869 in County Cork, Ireland, Mary immigrated to the United States in 1884. From 1900 to 1907 she worked as a cook in the New York City area.

In 1900, she had been working in a house in Mamaroneck, New York, for under two weeks when 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. She then went to work for a lawyer until seven of the eight household members developed typhoid; Mary spent months helping to care for the people she made sick, but her care further spread the disease through the household. In 1906, she took a position in Oyster Bay, Long Island. Within two weeks, six of eleven family members were hospitalized with typhoid. She changed employment again, and similar occurrences happened in three more households.
 
When typhoid researcher George 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. On his next contact with her, he brought a doctor with him, but was turned away again.
 
Mallon's denials that she was a carrier were based in part on the diagnosis of a reputable chemist who had found her to not harbor the bacteria, so perhaps she is not entirely to blame for her doubts. Moreover, when Soper first told her she was a carrier, the concept of a healthy carrier of a pathogen was not commonly known. Further, class prejudice and prejudice towards the Irish were strong in the period, as was the belief that slum-dwelling immigrants were a major cause of epidemics.


Mary Mallon in hosptial quarantine
During a later encounter in the hospital, Soper told Mary 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.




The New York City Health Department sent Dr. Sara Josephine Baker to talk to Mary, but "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. 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.


It is believed that individuals can develop typhoid fever after ingesting food or water contaminated during handling by a human carrier. The human carrier is usually 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. It takes vigorous scrubbing and thorough disinfection with soap and hot water to remove the bacteria from the hands.


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 of 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.
 
She had been given a job as a laundress, which paid lower wages, however. Mallon adopted the pseudonym Mary Brown, returned to her previous occupation as a cook, and in 1915 was believed to have infected 25 people, resulting in one death, while working as a cook at New York's Sloane Hospital for Women. This time I have no sympathy for her. Knowing she could infect others, she worked in a hospital! Public-health authorities again found and arrested Mallon, and returned 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.



Mary Mallon
On November 11, 1938, aged 69, she died of pneumonia. An autopsy found evidence of live typhoid bacteria in her gallbladder. It is possible that she was born with the infection, as her mother had typhoid fever during her pregnancy. Her body was cremated, and the ashes were buried at Saint Raymond's Cemetery in the Bronx.

1 comment:

Anonymous said...

poor mary