-
Charles Warren, a wealthy New York Banker, and his family began showing symptoms that physicians diagnosed as typhoid fever while renting a summer beach home. A total of 6 out of 11 in the home became sick. At the time typhoid was fatal in around 10% of cases, however, was usually associated with poorer people living in unsanitary city conditions. To have an outbreak could tarnish a wealthy home's reputation, so the source of the outbreak needed to be determined.
-
A New York City Department of Health sanitary engineer, George Soper, who specialized in typhoid fever epidemics, was hired by the owners of the Oyster Bay rental home to investigate the outbreak. Salmonella typhi, the causative agent of typhoid fever, is transmitted through indirect contact via the fecal-oral route, meaning that a contaminated object or person must perpetuate it. Soper began his investigation by inspecting the house water sources and interviewing the hired summer staff. -
Initially, Soper thought that infected freshwater clams could be the source of the outbreak, but this was dispelled as only a few sick people had eaten clams and no water sources were found to harbor the bacteria.
Instead, his attention quickly turned to Mary Mallon, the cook for the family. He noticed that she had also been employed by other wealthy families who had outbreaks of typhoid, Mary could be directly linked to 22 cases of typhoid fever over the previous 5 years. -
After an outbreak of typhoid occurred, Mary would leave her job and find employment cooking for a new family. This made it hard for Soper to track her down but after learning of an active typhoid outbreak in the Bowen home, he found her working in their kitchen. Soper confronted Mary and accused her of spreading the disease, demanding she gives stool samples to confirm. She refused and chased him out of the kitchen. Soper later tracked Mary to her home, confronting her again to the same results.
-
Soper went on to publish the findings of his investigation and the story of Mary Mallon in the Journal of the American Medical Association. This release led to the case gaining extensive media attention where Mallon was coined as "Typhoid Mary", the phrase went on to be used in medical textbooks about typhoid fever. Soper wanted to capitalize on the attention by publishing a book, he offered Mary some of the royalties but she refused. The book was still published without her consent. -
Concerned that Mary would put more people in danger, Soper notified the NYC Health Department of his findings. It was decided that Mary was a public health threat and was subsequently arrested and forced to give samples for testing.
Mary Mallon was the first asymptomatic carrier of typhoid fever identified, her samples had high bacterial loads but she never showed any signs of illness.
Mary was sentenced to indefinite quarantine on North Brother Island in the spring of 1907. -
During forced quarantine, Mary was continuously tested for the presence of S. typhi and placed on a myriad of medications. Mary never believed that she could be a carrier of the disease, not understanding how not washing her hands was able to pass the bacteria on to others without herself being sick.
The health commissioner decided carriers should not be kept in isolation and Mary was released on the condition she agreed to stop working as a cook and take reasonable hygiene steps. -
Upon release, Mary was given a job as a laundress in NYC, which paid substantially less than her previous employment. After struggling with poverty for a few years she decided to change her surname and fly under the radar to return to jobs as a cook. She worked in many restaurants and hotels, frequently changing jobs to avoid blame when an outbreak of typhoid would occur. Almost everywhere she worked, cases of typhoid would appear, but Mary was unable to be tracked down by health officials.
-
George Soper was contacted by the head obstetrician of Sloane Hospital for Women in NYC to investigate an outbreak of typhoid fever that had infected 25 people and killed two patients. After interviews with the hospital staff, he realized that a new cook they described called Mary Brown was actually Mary Mallon, who had quickly fled after the outbreak. Police were able to track Mary down to Long Island where they arrested her once again. -
Mary was sent back to North Brother Island after her arrest. She remained here in quarantine from the public for more than 23 years. She was given a private cottage in which to live and was permitted to work in a research laboratory as a technician.
She was still required to provide samples for testing, all against her will, which showed that she remained infected for the rest of her life. Mary never believed that she was the cause of the outbreaks and refused to accept her carrier status. -
Mary passed away at age 69 after acquiring pneumonia; she was already in ill health after a stroke left her hospital-bound 6 years earlier. She was never released from her second quarantine as health officials claimed she could not be trusted to take necessary precautions. Mary can be directly attributed to infecting 53 people leading to 5 deaths, as well as causing an unknown number of additional cases indirectly. She passed away never acknowledging her role in the outbreaks of typhoid fever.
-
Mallon was the first individual who was found to be an asymptomatic carrier of the typhoid bacterium, and the health officials had little to no idea of how to deal with someone in her position. However, Mallon’s case helped these officials identify other asymptomatic carriers of many diseases in addition to typhoid fever. By the time she died, New York health officials had identified more than 400 other healthy carriers of Salmonella typhi, but no one else was forcibly confined in quarantine.