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Typhoid Mary A photo essay by Kelsie Foreman

INTRODUCTION

The typhoid epidemic in New York from 1906-1938 infected and killed hundreds. Though no one is 100 percent sure what caused the outbreak, it's been determined that asymptomatic carriers of the illness, such as Mary Mallon (aka Typhoid Mary) were the primary cause. (Yolanda Smith, “A History of Typhoid Fever In The United States,” Medical News Journal, Last Updated August 2018)

The concept of asymptomatic carriers were rare at the time, but have since made a re-surgence during the COVID-19 pandemic. Let's explore how asymptomatic carriers were painted in the media then and now.

WHAT IS AN EPIDEMIC

Unlike a pandemic, which details an illness spanning across many different countries and can be seen today as we experience COVID-19, an endemic affects only a large group of population in a particular country or region. (Intermountain Healthcare, April 2020)

Mary Mallon was born in Ireland in 1869 and then immigrated to the United States in 1884, where she built a career as a cook for hospitals and wealthy families. However, Mallon was an asymptomatic carrier of typhoid fever, an illness that showed symptoms as vomiting, extreme tiredness, and fever, and due to her asymptomatic condition, ended up spreading the disease to dozens of people through her cooking. She was the first asymptomatic carrier of the illness at the time in the US.

The photo to the left appeared in a 1909 article that named her "Typhoid Mary."

During Mallon's first few years as a cook, several unexplained typhoid outbreaks occurred throughout New York City. In fact, seven of the eight families Mallon worked for contracted typhoid soon after she started. As soon as the families would begin showing symptoms, Mallon would quit and the move on to another family.

When outbreaks like this continued to pop up around the New York area, George Soper, an investigator hired by the city, began to look into the meaning of the outbreaks. When he began investigating a case of typhoid in a wealthy Manhattan family, Soper learned of Mallon and suspected, based on her employment history, that she might be an asymptomatic carrier. Soper confronted her while she was working and accused her of spreading the disease. Mallon, of course was infuriated and threatened Soper with a carving knife; refusing to give samples so that his point could be confirmed.

Soper published his findings in the June 1907 edition of the Journal of the American Medical Association, stating that, "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."

Soper, of course told the New York City health department of his findings, and they arrested Mallon for being a public health threat and took her to a local hospital where she would be forced to give urine and stool samples.

Upon giving samples, it was discovered that massive amounts of the bacteria lived in her intestines and gall bladder. Upon hearing the news, Mallon admitted that she almost never washed her hands after using the bathroom before returning to the kitchen to work.

Upon receiving the results, Mallon would be sentenced to quarantine on North Brother Island where she would be ordered to give samples multiple times a week.

The photo to the right was recovered from Science History Images and was taken of Mallon sometime in 1907 while in her first quarantine on North Brother Island.

During her time on the island, Mallon insisted that she did not have the disease and appealed several times to local governments and even the Supreme Court to be free. However, each of these appeals were denied as the public was terrified of her and the medical community wasn't convinced she could stop infecting others. (“Typhoid Mary Must Stay In Quarantine,” The New York Times, July 7th, 1909)

After two years of isolation in quarantine, and several months of negative samples, The New York Public Health department decided that Mallon could be freed, just so long as she promised to stop working as a cook. And the media knew about it right away, reporting it with a headline "her germs." Which appeared to blame her solely for the outbreak. ("TYPHOID MARY" FREED; Lederle Thinks She's Learned to Keep Her Germs to Herself, The New York Times, February 21st, 1910)

In December 1911, Mallon asked New York City for $50,000 in damages. Not only was Mallon in quarantine for two years, but she was know unable to be a cook and thus earn a living for herself. (“Typhoid Mary Asks $50,000 From City,” The New York Times, December 3rd, 1911). Mallon was not successful and the media at the time crucified her, calling her a "super spreader" a "petri dish of bacteria," and even coining the name "Typhoid Mary," which Mallon referenced in a letter to her lawyer as a name that she absolutely detested.

The first page of Mallon's letter to her lawyer from PBS

The media printed posters about her so others would stay up to date on the news, as seen below, and Mallon's reputation was subsequently ruined. And at the time, Mallon hadn't intentionally done anything wrong, the public just was unsure of asymptomatic carriers--at the time, they were unheard of.

This was a depiction of Mallon, appearing in a poster at the time. From the Library of Congress.

Most media coverage of Mallon painted her as some sort of epic super villiain. However, In 1912, the New York Times printed an editorial on asymptomatic carriers, calling into question their treatment, and whether or not Mallon had ever done anything wrong. (“An Editorial On Typhoid Carriers,” The New York Times, August 15th, 1912).

Several years later, in 1915, Mallon was jobless and decided to go back to work as a cook, using a different name at the Sloane Institution, a local hospital. Of course, in only a few week's time, an outbreak caused by Mallon ravaged the facility, causing an outbreak in 25 doctors and nurses. An article claimed that she had done it on purpose, and referred to her as a "petri dish of bacteria" (“Hospital Epidemic from Typhoid Mary,” The New York Times, March 28th, 1915). A few days later, the Times published another article in which stated that Mallon would be forced to quarantine again, since she broke the rules associated with her release (“Typhoid Mary” Has Reappeared”, The New York Times, April 4th, 1915).

Four years later, in 1919, Soper published another article. This time in the Military Surgeon. His article was more detailed that his previous publish, and discussed the several negative tests that prompted Mallon's release. He too refers to her as a body filled with bacteria and blames her for many of the outbreaks at the time (even though she only officially infected around 51 people). Soper confirmed, at the end of the article that Mallon would be forced to quarantine until her death. (George A. Soper, “Typhoid Mary,” The Military Surgeon, July 1919)

Mary Mallon in her hospital bed at North Brother Island. Photo from here.

Years later, in 1923, another epidemic swept through the Queens neighborhood in New York, raising concerns that other asymptomatic carriers could be existent in the area. (“Typhoid Epidemic In Queens Village,” The New York Times, January 4th, 1923). This was especially concerning because in 1913 (two years before Malloy's final arrest) another asymptomatic person was found in Alcase, France, raising the possibility that these carriers might be everywhere. (“A ‘Typhoid Mary’ Found In Alsace, The New York Times, March 30th, 1913)

Mallon died in 1938 while in quarantine from a stroke. Her funeral wasn't attended by any, and this fact was highlighted repeatedly in an article from the Times. (“Typhoid Mary” Dies of Stroke At 68”, The New York Times, November 12th, 1938)

ASYMPTOMATIC CARRIERS TODAY

The evolution of science in the time since Mallon's time meant that we had a greater idea of what an asymptomatic carrier was when the world was hit by the coronavirus (COVID-19) pandemic. While Mallon was the first ever asymptomatic carrier recorded in the US, evidence from the COVID pandemic paint a picture that displays a MAJORITY of people as asymptomatic carriers.

In fact, an early article published by Vox claimed that as many as 60 percent of people who tested positive for COVID on an airplane appeared to be healthy and felt completely fine. (“How people are spreading Covid-19 without symptoms”, Katherine Courage, Vox, 22 April, 2020). Despite alarming reports such as that, hundreds of people still refuse to quarantine, because they don't believe they could be infected, like Mallon.

Studies reported on by Vox claim that a majority of COVID-positive patients are asymptomatic.

As they did in Mallon's time, the media reported that these asymptomatic people could be "super spreaders," as they called her. (“How Dangerous Are COVID Silent Spreaders?”, Robert Britt, Medium, 27th May, 2020)

However, in contrast to the reports during Mallon's time, the coverage wasn't as harsh and rather focused on the facts--except when large groups of people tested positive at group events, which have been frowned upon since the beginning of the pandemic. And CBS reported, ""This type of blatant disregard for the wellbeing of others is not only extremely disappointing, it will not be tolerated." (“At least 56 people test positive for COVID-19 after "superspreader" wedding and birthday party in New York.” CBS News, 29 October 2020).

Speaking of superspreader events, the White House held an in person event on October 20th, a few days prior, where a handful of people attending an event in close quarters were asymptomatic carriers of the virus. Most were horrified that such an event take place, and that masks were not worn on any of the party-goers. Of course, since it was politicians who were mostly involved, the media reamed them for a few days before focusing on another story. However, if you google "super spreader event" the photo below is the first to pop up, just as Mary Mallon is one of the first hits when you search for typhoid. In both cases, the media had the power to give a literal face to those involved in a health crisis. Image from US News and World Report.

CONCLUSION

Mallon was the first super-spreader in the United States, and the way the media covered her infection can still be seen in the way that super-spreaders are reported on today. Though there is more research on the topic of super spreaders today, it's interesting to see how, despite the research, people still argue that they couldn't be spreading disease because they feel fine. And just as Mallon forgoed the rules and continued working again as a cook, thousands of Americans have forgoed the rules and had these "super spreader parties." History really does repeat itself, and it's unfortunate to see it affect such a large scale of people this time around, whereas before, it was easy to pin down what happened in Mallon's case.

It's also interesting to see how well the media can paint a picture. The media painted Mallon to be an evil villain, when really, she didn't understand the repercussions of her condition (and not many did at the time). And the media paints those who engage in super spreader events today as villains (see the White House scandal and the wedding) imagine if your party became the literal face for "super-spreader event" on Google.

In both cases, it's interesting to hear about people denying science. Mallon denied that she could possibly be an asymptomatic carrier, despite the experts who pleaded with her. And people throughout this pandemic are denying the science behind banning large public gatherings and even wearing masks. Both times, this could be explained by a lack of education on the matter.

BIBLIOGRAPHY

  • “Typhoid Mary Must Stay In Quarantine,” The New York Times, July 7th, 1909
  • "TYPHOID MARY" FREED.; Lederle Thinks She's Learned to Keep Her Germs to Herself, The New York Times, February 21st, 1910
  • “Guide A Walking Typhoid Factory,” The New York Times, December 2nd, 1910
  • “Typhoid Mary Asks $50,000 From City,” The New York Times, December 3rd, 1911
  • “Typhoid Carriers,” The New York Times, August 15th, 1912
  • “An Editorial On Typhoid Carriers,” The New York Times, August 15th, 1912
  • “A ‘Typhoid Mary’ Found In Alsace, The New York Times, March 30th, 1913
  • “Hospital Epidemic from Typhoid Mary,” The New York Times, March 28th, 1915
  • “Typhoid Mary” Has Reappeared”, The New York Times, April 4th, 1915
  • George A. Soper, “Typhoid Mary,” The Military Surgeon, July 1919
  • “Typhoid Epidemic In Queens Village,” The New York Times, January 4th, 1923
  • “Typhoid Mary” Dies of Stroke At 68”, The New York Times, November 12th, 1938
  • Yolanda Smith, “A History of Typhoid Fever In The United States,” Medical News Journal, Last Updated August 2018
  • “What went wrong with the media’s coverage of coronavirus?”, Peter Kafka, Vox, 13th April, 2020
  • “How people are spreading Covid-19 without symptoms”, Katherine Courage, Vox, 22 April, 2020
  • “How Dangerous Are COVID Silent Spreaders?”, Robert Britt, Medium, 27th May, 2020
  • “President Trump Has COVID-19: How the global media responded,” BBC Canada, 2 October, 2020
  • “At least 56 people test positive for COVID-19 after "superspreader" wedding and birthday party in New York.” CBS News, 29 October 2020