Super Spreader: The Strange Story of Typhoid Mary

Mary Mallon, an unwitting typhoid carrier and unwilling hospital patient, in the early 1900s.
Mary Mallon, an unwitting typhoid carrier and unwilling hospital patient, in the early 1900s.
CBS Sunday Morning, YouTube

In the winter of 1906, Mrs. George Thompson called upon Dr. George Soper, known around New York as an “epidemic fighter,” to investigate the source of a typhoid outbreak that had occurred among renters in her Oyster Bay summer home several months prior.

After finding no issue with the well, the outhouse, the food supplies, or any other part of the property that might have generated germs, Soper considered the possibility that the carrier could have been a healthy person—an idea that wasn’t widely accepted at the time. By process of elimination, he landed on a likely culprit: the cook, a 37-year-old woman named Mary Mallon.

typhoid mary newspaper article from 1909
An article published in The New York American on June 20, 1909.
Lupo, Wikimedia Commons // Public Domain

Mallon, described by the other servants as “not particularly clean,” had arrived at the Thompson home on August 3, 1906. Just weeks later, between August 27 and September 3, six out of the house’s 11 occupants had contracted typhoid fever. Though most of her dishes were hot and prepared at temperatures that would have killed any bacteria, Mallon had served ice cream with fresh peaches one Sunday, which some of the house guests ate with gusto.

Before searching for Mallon herself, Soper followed her trail of employment all the way back to September 1900, unearthing a total of seven households in New York and Maine that had suffered typhoid outbreaks during Mallon’s tenure.

“In nearly every instance, a well-to-do and socially prominent family, soon after moving from the city to the country for the summer, experienced an outbreak of typhoid fever. In no instance had its cause been satisfactorily explained,” Soper recounted in the Bulletin of the New York Academy of Medicine. "The cook always left soon afterward. She had never been suspected."

Soper decided it was time to track Mallon down.

A Mean, Unclean Quarantine Queen

In early 1907, Soper paid Mallon a visit in Manhattan, in an old-fashioned house on Park Avenue and 60th Street where she was working, once again, as a cook.

“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,” Soper wrote.

Mallon seized a carving fork and chased Soper from the premises.

After another unsuccessful attempt to reason with Mallon, Soper asked New York City’s Department of Health to intervene. So Dr. Sara Josephine Baker came calling at the Park Avenue estate, and Mallon made a run for it, evading capture for three hours before police found her in a neighbor’s shed and deposited her into an ambulance.

“The ride down to the hospital was quite a wild one,” Dr. Baker recalled.

Mallon was taken to an isolation ward at Willard Parker Hospital, and doctors tested her feces three times a week between March 20 and November 16, 1907. Salmonella enterica enterica serovar Typhi, the bacterium that causes typhoid, was found in nearly every sample. Soper visited Mallon at the hospital to explain why she had been confined for so long (and also to determine the possibility of securing her release).

“When you go to the toilet, the germs which grow within your body get upon your fingers, and when you handle food in cooking they get on the food. People who eat this food swallow the germs and get sick,” he told her. “If you would wash your hands after leaving the toilet and before cooking, there might be no trouble. You don’t keep your hands clean enough.”

Mallon, frustrated and lonely, wasn’t very receptive to his advice, and refused to give doctors permission to remove her gallbladder, which they suspected was the source of the germs. There’s a good chance that this was true, since recent scientific studies have shown that many asymptomatic typhoid carriers store typhoid bacteria in their gallbladders. When their gallbladders empty bile into their small intestines, some of the bacteria goes with it, and then gets excreted in their stool.

“No knife will be put upon me,” Mallon told the doctors who requested to remove it. “I’ve nothing the matter with my gallbladder.”

typhoid mary cartoon
An illustration of unknown origin showing how Typhoid Mary spread bacteria through food.
National Museum of Health and Medicine, Flickr // CC BY 2.0

Soon after that meeting, Mallon was relocated to a bungalow near Riverside Hospital on New York's North Brother Island. Her quarters, originally built for the superintendent of nurses, were more spacious and more comfortable, but Mallon was still treated like a dangerous outcast, isolated from the rest of the island’s inhabitants.

Two years after her arrest on Park Avenue, Mallon sued the Department of Health, claiming that she had been imprisoned without due process of law—in fact, she hadn’t even been accused of a crime. Dr. William H. Park, the bacteriologist who had tested Mallon’s feces, took the stand to explain how Mallon—though seemingly healthy herself—was an asymptomatic typhoid carrier. Both sides presented compelling arguments, but the court simply didn’t want the responsibility of determining whether Mallon was fit to rejoin society.

They dismissed the case altogether, and a defeated Mallon returned to North Brother Island.

Life As a Culinary Renegade

In February 1910, Riverside Hospital finally decided to release Mallon on the condition that she promise not to work as a cook and “take such hygienic precautions as will protect those with whom she comes in contact, from infection.” She agreed to the terms and left the island.

What she didn’t do was keep her word. For the next five years, Mallon flitted from kitchen to kitchen in the area, introducing herself as “Marie Breshof” or “Mrs. Brown.” She cooked in a restaurant on Broadway, a hotel in Southampton, an inn in Huntington, and a sanatorium in New Jersey. Typhoid followed Mallon wherever she went, but she never stayed in one place long enough to rouse suspicion.

That is, until 1915, when Dr. Edward B. Cragin solicited Soper’s help in detecting the cause of a typhoid outbreak at New York’s Sloane Hospital for Women. More than 20 people had fallen ill, and the other servants had taken to calling the cook “Typhoid Mary”—a sobriquet that newspapers had used for Mallon during her solitary confinement.

After Soper positively identified the woman he knew to be Mary Mallon, the hospital alerted the Department of Health, and Mallon was whisked right back to North Brother Island. This time, she didn’t resist.

The Lonely Legacy of America’s Most Famous Asymptomatic Carrier

Mallon lived out her remaining 23 years in the lonely riverbank bungalow, processing tests in the hospital laboratory and making occasional sojourns to Queens to visit a family she was friendly with. According to Soper, “they were not particularly glad to see her.” She suffered a stroke in 1932, and passed away at age 69 on November 11, 1938. Only nine people attended her funeral at St. Luke’s Catholic Church in the Bronx.

In total, Mallon was officially responsible for infecting 53 people with typhoid—three of whom died—though there were likely many more that went unreported. While her commitment to good hygiene may have been lacking, the fact that she was so often treated like a pariah no doubt exacerbated her unwillingness to cooperate with doctors and other health officials. For many, including Mallon herself, it was simply difficult to believe that a perfectly healthy person who had never even been afflicted with a terrifying disease could somehow pass it on to dozens of others.

“It was to be Mary Mallon’s fate to clear away much of the mystery which surrounded the transmission of typhoid fever and to call attention to the fact that it was often persons rather than things who offered the proper explanation when the disease occurred in endemic, sporadic and epidemic form,” Soper wrote.

Mallon, however begrudgingly, charted a new path for scientists studying communicable diseases—and taught the rest of us just how important it is to wash our hands.

Crocs Is Donating More Than 100,000 Pairs of Shoes to Healthcare Workers

Sturdy, comfortable Crocs are a favorite among healthcare professionals.
Sturdy, comfortable Crocs are a favorite among healthcare professionals.
David Silverman/Getty Images

Crocs have long been a favorite among healthcare workers who spend hours on their feet each day—and now, they can get a pair for free.

This week, the company announced that it will give away more than 100,000 pairs of shoes to medical professionals fighting the new coronavirus in the U.S. ClickOrlando reports that workers can submit their requests for Crocs Classic Clogs or Crocs at Work via an online form on the Crocs website, which will open each weekday at 12 p.m. EST and continue accepting orders until it fulfills its daily allotment.

According to a press release, that allotment is a whopping 10,000 pairs of shoes per day. The as-yet-unspecified end date for the program—called “A Free Pair for Healthcare”—depends on inventory levels and the number of requests the company receives. In addition to shipping shoes to individuals, Crocs is also planning to donate up to 100,000 more pairs directly to healthcare organizations. So far, they’ll send shoes to the Dayton Area Hospital Association in Ohio, St. Anthony North Health Campus in Denver, Colorado, the Atlantic Health System in New Jersey, and more.

“These workers have our deepest respect, and we are humbled to be able to answer their call and provide whatever we can to help during this unprecedented time,” Crocs president and CEO Andrew Rees said in the release. “Share the word to all those in healthcare and please be mindful to allow those who need these most to place their requests. This is the least we can do for those working incredibly hard to defeat this virus.”

Healthcare professionals can request their free Crocs here.

[h/t ClickOrlando]

On This Day in 1953, Jonas Salk Announced His Polio Vaccine

Getty Images
Getty Images

On March 26, 1953, Dr. Jonas Salk went on CBS radio to announce his vaccine for poliomyelitis. He had worked for three years to develop the polio vaccine, attacking a disease that killed 3000 Americans in 1952 alone, along with 58,000 newly reported cases. Polio was a scourge, and had been infecting humans around the world for millennia. Salk's vaccine was the first practical way to fight it, and it worked—polio was officially eliminated in the U.S. in 1979.

Salk's method was to kill various strains of the polio virus, then inject them into a patient. The patient's own immune system would then develop antibodies to the dead virus, preventing future infection by live viruses. Salk's first test subjects were patients who had already had polio ... and then himself and his family. His research was funded by grants, which prompted him to give away the vaccine after it was fully tested.

Clinical trials of Salk's vaccine began in 1954. By 1955 the trials proved it was both safe and effective, and mass vaccinations of American schoolchildren followed. The result was an immediate reduction in new cases. Salk became a celebrity because his vaccine saved so many lives so quickly.

Salk's vaccine required a shot. In 1962, Dr. Albert Sabin unveiled an oral vaccine using attenuated (weakened but not killed) polio virus. Sabin's vaccine was hard to test in America in the late 1950s, because so many people had been inoculated using the Salk vaccine. (Sabin did much of his testing in the Soviet Union.) Oral polio vaccine, whether with attenuated or dead virus, is still the preferred method of vaccination today. Polio isn't entirely eradicated around the world, though we're very close.

Here's a vintage newsreel from the mid 1950s telling the story:

For more information on Dr. Jonas Salk and his work, click here.

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