Many people have heard the term Typhoid Mary, and may have even used it to describe someone who makes other people sick.
What few people know is that Typhoid Mary existed. An Irish immigrant working in domestic service, she came up against the newly forged American public health service in a fierce battle for her freedom which lasted more than two decades; one which she ultimately lost.
During the 19th and early 20th century, Typhoid was a much feared bringer of death. No vaccine or consistent treatment existed. Germ theory was only just being popularised by the newly formed Public Health Department in the USA, and the idea that disease could pass invisibly from even healthy-looking people was not yet widely accepted. Typhoid was at that time thought to be caused by dirty living, and was largely associated with the poorer classes, including the large population of Irish immigrants, with less access to sanitation or clean drinking water.
In 1906, Dr George Soper a was hired to investigate the cause of the illness. The Warren family, holidaying in Oyster Bay, Long Island had become ill, though they had had no exposure to a known carrier. After eliminating contamination from food suppliers and sewage leaking into drinking water, Soper looked at the staff. He eliminated the others as being unlikely to touch anything the family might have eaten or drunk, settling on the cook as the possible source of infection. His theory was that she had unwittingly passed the infection to the family through poor hygiene and handling of foods that went to the table uncooked, such as ice-cream.
The cook had by then left her post with the family, with no forwarding address. Soper dug into her history, following her through her previous posts at which someone had become ill or died from Typhoid fever shortly after her arrival. In many cases she had stayed to help treat the sick, much to the relief of the unsuspecting families. Finally, Soper tracked the woman, an Irish immigrant by the name of Mary Mallon, to her new post in a private house in Park Avenue, New York City.
George Soper was not in fact a medical doctor; he was a civil engineer specialising in sanitation. He had set himself the mammoth task of cleaning up the filth and disease he saw in many cities of the day. In Mary Mallon he had found an obsession and his path to fame.
Mary was then a robust woman of thrity-eight . Born in County Tyrone in the middle of the nineteenth century, Mary Mallon was part of a continuing wave of Irish immigration into America. She arrived in the United States in 1884 at the age of fifteen and entered into domestic service.
Soper approached Mary first at the home of her new employers. The interview did not go well. Soper said of it later:
“I had my first talk with Mary in the kitchen of this house. . . . I was as diplomatic as possible, but I had to say I suspected her of making people sick and that I wanted specimens of her urine, feces and blood. It did not take Mary long to react to this suggestion. She seized a carving fork and advanced in my direction. I passed rapidly down the long narrow hall, through the tall iron gate, . . . and so to the sidewalk. I felt rather lucky to escape.”
Soper handed his findings over to the department of health, though he was not pleased by how their meeting had gone.
“I though after I found her all would be easy; shortly I was to be disappointed, for having found Mary I had the greatest difficulty arranging an interview. Finally she agreed to talk with me, and in company with a physician I met her outside the house”.
The Department of Health sent public health official Dr Sara Josephine Baker with two policemen to detain the now extremely guarded Mary. Mary opened the door once again brandishing a carving fork and lunged at Baker, disappearing in the confusion over a fence into a neighbouring property. A thorough search of the house failed to bring her to light until a small piece of cloth was noticed caught on in a cupboard behind some rubbish bins. Mary came out of the cupboard swearing, and was manhandled into an ambulance, a feat which took both policemen to accomplish. Dr Baker sat on her the whole way to the hospital and described the experience as like “being in a cage with an angry lion.”
In custody, Mary admitted to the health authorities that she rarely washed her hands while cooking and saw no need to do so. She had medical samples taken forcibly by the nurses, and refused to admit any wrongdoing even after live Typhoid bacteria was found in her stools. She was removed to North Brother Island and held there in isolation while her situation was investigated. One treatment popular at the time was to remove the gallbladder of a typhoid sufferer, as it was believed that this was the organ which housed the infection. Unsurprisingly, Mary refused this, and all other treatments, maintaining that she was healthy and was being unjustly imprisoned.
Mary Mallon was quarantined at Riverside Hospital on North Brother Island in New York’s East River after being interred there at the orders of the Commissioner for Public Health. The island had been used from 1850 onward to isolate smallpox victims to prevent outbreaks, and later their remit was extended to include other highly contagious diseases. Unlike the other patients, Mary was essentially healthy, but was confined to bed since there was little else to do with her.
Throughout her first period of quarantine, Mary protested her innocence. With the help of her lawyer, Mary created a media storm surrounding what she saw as her wrongful imprisonment. She gave many interviews and wrote many letters, all begging for release and justice, and employed an independent lab to which she sent samples, attempting to prove she was free of typhoid. Finally, in 1910 following a protracted media and legal campaign, the New York Commissioner for Public Health agreed she could be freed if she promised never to work with food again or to cook for any person besides herself. She had been imprisoned now for three years.
After being released from North Brother Island Mallon was given work as a laundress. In terms of society of the time, this would have been a great loss of status and income. She quickly changed her name and disappeared. Dr Soper set out to find her again but only succeeded in tracing her through outbreaks of the disease she was now famous for. He finally traced her to the kitchen at the Sloane Hospital for Women where she worked under the name ‘Mary Brown’. Her employment there resulted in two deaths and more than twenty illnesses.
She was rearrested by the public health authorities and confined again to the island.
Any public sympathy she had previously enjoyed evaporated when it became known she had knowingly caused more deaths. It has even been suggested that her decision to work again with food was a kind of malicious revenge against the Health Department, though no proof for this has ever been produced. She returned to North Brother Island much more sedately, and remained there for twenty-three years.
Mary Mallon died in 1938 of pneumonia following two decades of incarceration on the island. She had worked as a helper in the island’s hospital until a massive stroke caused her to lose mobility down one side of her body. When her autopsy was conducted, Typhoid bacteria were found in her system. Though it is hard to guess how many people she affected, it is guessed that she caused the deaths of more than fifty people.
Typhoid still causes hundreds of thousands of deaths around the world annually. It is prevalent throughout Central Africa and Asia. It is treated with antibiotics and Oral Rehydration Therapy. Two vaccines exist to prevent the disease, but are only considered to be 50-80% effective.
Dr George Soper became managing director of the American Cancer Society. He died in 1948 having spent a lifetime battling infectious disease outbreaks.
North Brother Island was used after World War II to house returned servicemen, and afterwards abandoned until the 1950s when it was reopened as a drug treatment centre. It was forced to close ten years later due to rampant staff corruption and the unorthodox treatments being used. It is now uninhabited and used as a bird sanctuary.
By Kira Carlin