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Typhoid Mary & COVID-19: A Comparison Abbie Armstrong

In the years of 1906 and 1907, a woman named Mary Mallon caused a typhoid outbreak in New York City. In the year 2020, something similar happened, again with New York City as one of its epicenters. This time it happened on a much larger scale. The disease was called coronavirus (COVID-19), and just as typhoid fever, it was unfamiliar and at times, deadly.

In “Mary Mallon (1869-1938) and the history of typhoid fever” included in the Annals of Gastroenterology, Filio Marineli et al., describes Mary Mallon: “As a healthy carrier of Salmonella typhi her nickname of “Typhoid Mary” had become synonymous with the spread of disease, as many were infected due to her denial of being ill.” Marineli et al. writes that within that year there were over 3,000 cases of typhoid fever. It was decided that the source of infection, Mary herself, needed to be isolated because of the high level of contagion she caused and the lack of immunizations or antibiotics to treat the disease. Typhoid Mary was quite literally forced into quarantine on North Brother Island, and spent a total of 26 years there, during which she tried to sue the health department and was not successful according to Marineli et al. Mary Mallon was what we now call an asymptomatic carrier, and she spread typhoid fever to many people before her death in 1938.

According to the Centers for Disease Control and Prevention (2012), “Epidemic refers to an increase, often sudden, in the number of cases of a disease about what is normally expected in that population in that area. Outbreak carries the same definition of epidemic but is often used for a more limited geographic area.” In this case, New York City was the limited geographic area in which the typhoid outbreak occurred.

This article with an illustration and photograph appeared in The New York American on June 20, 1909, and is included in the New York Public Library’s Digital Collections. It accurately portrays just how frightened people were of typhoid fever during this time. Mary Mallon was a cook for several wealthy New York families. It was determined that the disease was spread through the food she made. In the bottom middle of the page we see a picture of Mary in Riverside Hospital while quarantined on North Brother Island.

The New-York Tribune reported on June 30, 1909, about Mary’s plea to be released from isolation. It states, “The Health Department has kept her on the island because, it says, she is a menace to the community.” Mary claimed that it was not her who infected the typhoid patients and begged for her freedom. She said about life on the island “It’s very lonely over there. I never speak to a soul. Three times a day a fool of a nurse brings my meals on a tray, sets it down at the door and then runs away.” This makes us think about the loss of quality of life for those who spread diseases but are not actually sick. Mary was healthy and could have lived a normal life had it not been for her unusual condition.

On the same day, June 30, 1909, The New York American, also covered Mary’s court appearance. The title, “Why Should I Be Banished Like a Leper?” makes us question whether or not asymptomatic carriers have a duty to their fellow community members to isolate themselves. At what cost? In Typhoid Mary’s case, she never got her full freedom and lived alone for the rest of her life. She also never stopped being a typhoid carrier. Is it always necessary to sacrifice the one at the salvation of the many?

On July 1, 1909, The New York Times included an opinion piece during Mary’s trial in which the writer interjects that she should not be freed and that she needed to stop opposing examination. Mary was very adamant that she was not the one who was giving others typhoid fever and refused to be examined by doctors. She contested this and her isolation many times throughout her life, while those around her believed that her separation must be continued as long as she was contagious to prevent the spread. It leads us to ask, was Mary deserving of this? This article states, “The case of Mary Mallon is extraordinary. Somebody may have blundered diagnosing it. The examination which she is opposing would reveal such a blunder.” Unfortunately, no such mistake had been made.

The New-York Tribune published a full-page article that relays the story of Mary Mallon on July 4, 1909. It starts with the interview of a health department employee where he says that Typhoid Mary was not the only “conveyer” of diseases in NYC. The department knew that many existed, but this particular employee didn’t want to investigate it too closely because of the experience they had had with Mary and all the “trouble” she caused. It also details the findings of Dr. George Soper, the man who discovered that Mary was the source of the outbreak. He spent months investigating the environments surrounding each new typhoid patient and found that the only thing they had in common was each household’s cook, Mary, who strangely enough never contracted the disease though it seemed to follow her. The title of this article is intriguing, “Has New York Many Walking Pesthouses?: Human Beings Who Go About Immune but Spreading Disease Germs.” Here, “pesthouse” refers again to asymptomatic spreaders, though it may not be the most polite way to refer to them.

In response to the above article, Sanitation, as the letter is signed, wrote a letter to the editor in the New-York Tribune on July 29, 1909, suggesting that maybe the only asymptomatic carriers that need to be detained are those who pose a significant amount of danger to the community. The letter specifically mentions cooks, bakers, or anyone who touches food or water consumed by a large number of people. At this time, they knew that typhoid was spread through consumption of contaminated food, so Sanitation’s solution is that those who do not work at positions in which they come in contact food should not have to be quarantined.
“Justice Erlanger in his decision expresses his sympathy with Miss Mallon, but says that the court must protect the community.” This is a quote from the New-York Tribune article published on July 17, 1909, the date of Mary’s court decision. Mary’s writ of habeus corpus for independence had been rejected. When reading the article, one will notice the intense fear that the people surrounding Mary had about letting her go free. So, she continued as a prisoner because it was for the greater good. Mary being stripped of her rights and privileges was simply a necessary sacrifice.

Also, on the date her court decision was made, July 17, 1909, the New York Times wrote about the Judge’s decision. “The court therefore, said the Justice did not care to assume the responsibility of releasing her,” said the author. Isn’t it interesting how this Judge clearly sympathized with Mary’s situation, but worried about the backlash he might receive from releasing her maybe even more than he feared her “condition” and typhoid fever itself? Again, we see the same narratives of terror and responsibility to community perpetuated.

On July 26, 1909, in a puzzling piece by the New-York Tribune, the writer directly addresses the conundrum of public rights versus individual rights. “It is unfortunate that, in order to secure the majority in their rights, hardship must sometimes be inflicted on the minority or on an individual” states the author. The majority rights they are referring to are obviously that of health and safety to members of the public to which Mary poses a threat. Even so, they defend Mary and uphold that she still deserves respect despite her circumstances. It also details the difference between isolating a smallpox patient who is clearly ill and isolating a person like Mary who is completely capable of living a full life because she has no symptoms of the sickness inside her. The writer advocates for the best medical care to be given to Mary because she deserves at least that and any attempt to cure her.

Are you confused by this article included in the New-York Tribune on February 21, 1910? There was a short period of time where Mary was released from Brother Island, upon the condition that she not work as a cook. According to Marineli et al., Mary did not keep that promise and “as a cook of Sloane Maternity in Manhattan, she contaminated, in three months, at least 25 people, doctors, nurses and staff. Two of them died.” She was placed back into quarantine five years later and never again escaped.

The New York Times wrote of Mary’s death on November 12, 1938. She died from complications with a stroke that had partially paralyzed her six years previously. Details of the funeral service are included. The article concludes with “Although she fought isolation for many years, she finally adopted a philosophic attitude and tried to make the best of her cloistered existence.”
Released by the New York Times on November 13, 1938, the day after her funeral, this story mentions Mary Mallon’s claim to infamy as “the first known typhoid bacilli carrier in America.”

In the year 2020, 113 years after the typhoid fever outbreak in New York City, a new disease named COVID-19 swept the earth. It was unfamiliar, much like typhoid fever. On March 11, 2020, the World Health Organization (WHO) declared the coronavirus as a pandemic and life changed almost overnight.

This article was published on February 26, 2020, meaning The New York Times caught wind of the coronavirus fairly early on. At this point there were few cases in the United States and people were mostly talking about the city in which it originated: Wuhan, China. Though this article was written before the virus had spread extensively in America, it had been in China long enough for some discoveries to be made about the disease. This news story specifically outlines the finding that some carriers of COVID-19 were asymptomatic. Does this sound familiar at all? We can relate this Typhoid Mary and the many names they called asymptotic carriers in her day including healthy disease spreaders, walking pesthouses, disease conveyors, menaces to public health etc. It it obvious in both cases that there is a large amount of fear surrounding these persons who show no sign of illness, but infect the people around them.

On March 22, 2020, in this report by The New York Times, it is said that New York City had become an epicenter of the coronavirus pandemic. Think back to the typhoid outbreak that Mary started in 1906. Where was the epicenter in that case? New York City. As told by the author of this particular piece, Jesse McKinley, “…more than 15,000 people in New York State have tested positive, with the vast majority in the New York City region. That is about half of the cases in the United States.” If American citizens weren’t frightened up until this point, this was where mindsets started to shift.

Published only 2 days after the previous article, on March 24, 2020 by The New York Times, is a news story that depicts the anxiety the country had begun to develop about this virus. The unknown is often frightening to people, and we knew very little about this virus. What we did know is that it was spreading rapidly in the New York City area, and from looking at patterns from other parts of the world (China, Europe etc) we knew that a 14 day quarantine was necessary for those who showed symptoms. This need to isolate was arguably hard on individual's mental health as they battled to regain their physical health as anxiety and fear levels increased.

A common statistic presented throughout this COVID-19 pandemic involves measuring daily cases and comparing those to past days. On the day this article was published in The New York Times, April 3, 2020, New York City had its highest number of coronavirus deaths ever up until that date. With people dying at such a high rates, resources were dwindling as well as hope.

This piece written on April 13, 2020, found in The New York Times, outlines the negative impact that harboring a great amount of fear and anxiety can have on a person's health. This kind of fear was present in Typhoid Mary's time as well. Many people were terrified of typhoid then, just as they are of the coronavirus now. Obviously a pandemic puts additional stress on the majority of people, so this story recommends cutting back on news consumption, serving those around us, and completing neglected projects as a way to distract and take care of ourselves and others.

This final news story came months after the others on July 22, 2020, and was published in The New York Times. At this point, many Americans had been in isolation for several months and a diagnosed COVID-19 patient had to have tested negative twice to end their quarantine. Testing throughout the country was still unreliable and could take weeks to get results back. So, the CDC came out with a new guideline that if a patient had no symptoms after 10 days, they could stop self-isolating. Compare this to Mary Mallon who was quarantined for most of her life, but never showed symptoms of typhoid fever.

When comparing typhoid fever in the time of Mary Mallon and the current coronavirus pandemic, we see similar themes appear such as fear and anxiety generally, but also surrounding asymptomatic carriers, and the notion that it is your personal responsibility to prevent the spread by isolating yourself. Also, we saw New York City as the epicenter of both diseases. Why? Because there are large groups of people in big cities and spreading of disease is seemingly inevitable. From these two historical events we learn that people haven't changed all that much. We are still afraid of disease and its spread, and we still expect those who contract a disease to isolate themselves until that person is us. At that point, we have two choices. Either to protect those around us and sacrifice our human connection, or see it as an infringement on our rights and go about life as normal. The first choice can lead to increased mental health problems, which I'm sure Mary faced her fair share of, but the second means a potential for putting any person one comes in contact with in harm's way. Ask yourself, which would you choose? Which have you chosen so far in your life? Are you happy with those past decisions? If the answer is no, perhaps some self reflection is required. As we have seen in the year 2020, and I'm sure as the people of New York City saw in the early 1900s, each decision we make has an impact not only on our lives, but on the people we surround ourselves with, loved ones and strangers alike, as well.

Primary Sources:

“‘Typhoid Mary,’” New York Public Library Digital Collections, June 20, 1909. http://digitalcollections.nypl.org/items/85674452-ba9e-6934-e040-e00a180606cf.

“‘Typhoid Mary’ Asks Her Freedom: Woman Isolated on North Brother Island in Court on Habeus Corpus.,” New-York Tribune, June 30, 1909.

“‘Typoid Mary’ Never Ill, Begs Freedom — ‘Why Should I Be Banished Like a Leper?’” New York Public Library Digital Collections, June 30, 1909. http://digitalcollections.nypl.org/items/8566b449-7ac7-ab25-e040-e00a18060bd4.

“Healthy Disease Spreaders.,” The New York Times, July 1, 1909.

“Has New York Many Walking Pesthouses?: Human Beings Who Go About Immune but Spreading Disease Germs.,” New-York Tribune, July 4, 1909.

“Court Fears to Release Germ Laden ‘Patient’ at North Brother.,” New-York Tribune, July 17, 1909.

“‘Typhoid Mary’ Must Stay.: Court Rejects Her Plea to Quit Riverside Hospital.,” The New York Times, July 17, 1909.

“Not a Case for Levity.,” New-York Tribune, July 26, 1909.

Sanitation, “How to Treat ‘Typhoid Carriers’: Why Some May Be More Dangerous to the Public Than Others.,” New-York Tribune, July 29, 1909.

“‘Typhoid Mary’ Gets Liberty.,” New-York Tribune, February 21, 1910.

“‘Typhoid Mary’ Dies of a Stroke at 68: Carrier of Disease, Blamed for 51 Cases and 3 Deaths, but She Was Held Immune,” The New York Times, November 12, 1938.

“Typhoid Mary Buried: Nine Persons Attend Mass for Her at Church in the Bronx,” The New York Times, November 13, 1938.

Roni Caryn Rabin, “They Were Infected With the Coronavirus. They Never Showed Signs.,” The New York Times, February 26, 2020.

Jesse McKinley, “New York City Region Is Now an Epicenter of the Coronavirus Pandemic,” The New York Times, March 22, 2020.

Alan Feuer and Brian M. Rosenthal, “Coronavirus in N.Y.: ‘Astronomical’ Surge Leads to Quarantine Warning,” The New York Times, March 24, 2020.

Alan Feuer, “Coronavirus in N.Y.: Toll Soars to Nearly 3,000 as State Pleads for Aid,” The New York Times, April 3, 2020.

Jane E. Brody, “Managing Coronavirus Fears,” The New York Times, April 13, 2020.

Donald G. McNeil Jr., “Covid-19 Patients No Longer Need Test to End Isolation,” The New York Times, July 22, 2020.

Secondary Sources:

“Principles of Epidemiology.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, May 18, 2012. https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section11.html.

Filio Marineli, Gregory Tsoucalas, Marianna Karamanou, George Androutsos. “Mary Mallon (1869-1938) and the history of typhoid fever,” Annals of Gastroenterology 26, no. 2 (2013): 132-134. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959940/

Created By
Abbie Armstrong
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Created with images by Aaron Burson - "City Dreams" • Markus Spiske - "Cinical thermometer – Coronavirus disease outbreak COVID-19. Made with Canon 5d Mark III and analog vintage lens, Leica APO Macro Elmarit-R 2.8 100mm (Year: 1993)" • CDC - "This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19)." • congerdesign - "coronavirus corona quarantine"