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Saturday, December 27, 2014

100 Years Ago - Typhoid Mary

"Typhoid Mary" was the first person in the United States who was identified as an asymptomatic carrier of the pathogen associated with typhoid fever. She never, herself, contracted the disease but carried it.  It is presumed that her unsanitary methods while cooking were the result of her ability to pass on this terrible illness.

Historians believe that she may have infected up to 53 people, three of whom died, while she made her career as a cook. 

Mary Mallon: 9/23/1869 – 11/11/1938

Mary Mallon was born in 1869 in Cookstown, Ireland. Mary traveled from Ireland to America in 1883 at the age of 15. Mary quickly learned that the rate of pay for a cook was much better than working as a domestic servant, so she put her skills to work and was hired by several wealthy families in New York. And where ever Mary went, servants, gardeners, a laundress and family members became sick or died.  She cooked for a Manhattan attorney and left her employment after 7 of the 8 people in that home also became ill.

"In 1906, she was hired as a cook in Oyster Bay, Long Island, and within two weeks ten of eleven family members were hospitalized with typhoid. She changed jobs again, and similar occurrences happened in three more households. She worked as a cook for the family of a wealthy New York banker, Charles Henry Warren. When the Warrens rented a house in Oyster Bay for the summer of 1906, Mallon went along too. From August 27 to September 3, six of the eleven people in the family came down with typhoid fever. 

The disease at that time was "unusual" in Oyster Bay, according to three medical doctors who practiced there. 

Mallon was subsequently hired by other families, and outbreaks followed her."

Mary cooked a little lamb
It's meat was good to swallow
But everywhere that Mary went
Death was sure to follow.
-Denise Goodwin

Mary Mallon was first caught in 1906 when a sanitary engineer was hired to investigate a typhoid outbreak at Oyster Bay, Long Island. Six members of banker Charles Henry Warren’s household had fallen dangerously ill.  Warren hired George Soper to discover the source of the contamination before the highly-contagious and deadly disease spread across the privileged enclave of Oyster Bay.  Oyster Bay was the site of Sagamore Hill, known as “the Summer White House” of President Theodore Roosevelt from 1902-1908.

George Soper
Soper knew he must medically prove that Mary Mallon was a typhoid carrier, but Mary proved to be elusive.  Undeterred, Soper continued to search for her until one day he tracked her down in her latest employer's kitchen.  Soper asked for samples of her blood, urine and feces but Mary retaliated weilding a carving fork and cussing, Soper fled.  He again returned, this time with a doctor from NYC Health Department and Mary reacted in the same manner.

"When a subsequent visit by Soper and a medical colleague only pushed Mallon into another rage, the City Department of Health dispatched Sara Josephine Baker, a female physician who visited with a group of New York City policemen.  
Dr. Sara Josephine Baker

Mallon lunged at the visitors with a long kitchen fork and fled to a nearby shed, where she was arrested and taken to hospital in an ambulance, kicking, screaming, and biting, with Baker sitting on her chest." 

After these events, five police officers chased her over backyard fences to ultimately capture her and bring her to a hospital for testing.  At first she refused to give stool samples, but eventually the physicians were able to obtain some of her feces whereupon they discovered "high levels of Salmonella typhosa bacilli".  She was then held in quarantine (isolation) at the Riverside Hospital grounds, in a cottage, on an island in the East River.”

Quarantine The cottage on North Brother Island in New York's East River where Mary Mallon, better known as Typhoid Mary, was quarantined from 1907 to 1910, and again from 1915 until her death in 1938. -Nova/pbs

Lisa Waller Rogers states that Mr. Soper (a sanitation engineer, whose specialty was the study of typhoid fever) "took his assignment very seriously. He first checked the household plumbing.  He put dye in the toilet to see if it contaminated the drinking water.  It didn’t.   He checked the local shellfish to see if the bay was polluted with sewage.  It wasn’t.   He examined the milk supply in case it was contaminated.  It, too, was free of bacteria.    

Next, he interviewed the staff.  He found that the family had changed cooks on August 4th, when Warren had hired Mary Mallon.  Shortly after Mary began as cook, Soper was informed, she had served the household a favorite dessert for Sunday dinner: ice cream topped with freshly-cut peaches. 

On August 27, Warren’s daughter, Margaret, fell ill with typhoid fever. Next, Mrs. Warren and two maids became ill, followed by the gardener and another of the Warrens’ daughters.  

Knowing that typhoid typically goes from exposure to outbreak in three weeks’ time, Soper had Clue #1: The epidemic had begun with the arrival of the new cook. If his suspicion was correct, Mary Mallon was a carrier who had passed on the disease when preparing the peaches with unscrubbed hands.  

Unfortunately, when Soper made this astonishing discovery, Mary no longer worked at the Warrens’. Undeterred, Soper set out to find her. Checking with her employment agency, Soper discovered a second and even more astounding truth: 

Typhoid had struck seven of the last eight families Mary had worked for. Mary Mallon was spreading typhoid in her path – and she had to be stopped."    -lisawallerrogers.wordpress.com

Finally, in 1910, after three years in isolation at Riverside Hospital on North Brother Island in New York, Health Commissioner Ernst J. Lederle released Mallon with an understanding and solemn agreement NOT to work as a cook and to remain in touch with the health authorities.

Actual location of North Brother Island

North Brother Island, Library of Congress Photo

Riverside Hospital, North Brother Island, Library of Congress Photo

Not long after her release, Mallon disappeared. Historians have speculated that Mallon was unable to find any work besides her first vocation, and, facing the prospect of total poverty, changed her name and once again became a cook. The trail of typhoid began again, as Mallon again worked briefly at many places and left every time people fell ill.

A 1915 outbreak of typhoid at the Sloane Hospital for Women in New York City proved Mallon's final downfall. Twenty-five nurses and other workers took ill, and epidemiologist Soper was once again called in to determine the source of the infection at an institution that prided itself on its scrupulous attention to cleanliness. Soper learned that workers had nicknamed a cook "Typhoid Mary," and immediately knew he had once again found the elusive Mallon. 

"That she took chances," Soper wrote in The Military Surgeon, "both with the lives of other people and with her own prospect for liberty and that she did this deliberately and in a hospital where the risk of detection and severe punishment were particularly great, argues a mental attitude which is difficult to explain."

Mary Mallon
Tracked to a home on Long Island, Mallon was once again removed to Riverside Hospital on North Brother Island. This time, her prospects for release were slim. "She was now a woman who could not claim innocence," Soper asserted. "She was known willfully and deliberately to have taken desperate chances with human life, and this against the specific instructions of the Health Department. She had been treated fairly; she had been given her liberty and was out on parole. She had abused her privilege; she had broken her parole. She was a dangerous character and must be treated accordingly." -biography.yourdictionary

Most famous picture known of Mary (in the bed closest to you)
Mary was then immediately returned to North Brother Island, where she remained for the rest of her life. She died on November 11, 1938, after living a total of 26 years on the island.  Mary Mallon is thought to have given typhoid to at least 47 people, from which 3 people died.  
1984 Drawing of Mallon

"Mallon spent the rest of her life at Riverside Hospital, more than half her life having been spent confined on the island. After a series of small strokes, she suffered a major stroke in 1932 that left her paralyzed and bedridden until November 11, 1938, when she died. 

The nine mourners at her funeral at St. Luke's Roman Catholic Church in the Bronx were reluctant to be identified but probably included the few friends she had made through her job at the hospital. Mallon was buried at St. Raymond's Cemetery under a headstone that read "Jesus Mercy.""

Peter Tyson (PBS) wrote:  "Few instances of the thoughts and handwriting of Mary Mallon, aka "Typhoid Mary," have come down to us. The longest surviving letter, and the one most telling of her plight and state of mind in the height of her quarantine, is a six-page, hand-scrawled diatribe she wrote in late June 1909. By this time, she had been quarantined against her will for over two years on an island in New York City's East River. Below, read the letter and get inside the mind of a woman tragically caught between a rock and a hard place: her discovery and labeling as a healthy carrier of typhoid who by this time had already infected numerous people through her cooking—and the city's obligation to protect the public's health. Reading between the lines, one gets a sense of just how frustrated, upset, and spiteful this 39-year-old Irish immigrant has become at her situation, a situation from which she ultimately never escaped." —Peter Tyson

Note: Mallon's letter (below) was edited for clarity, spelling, and punctuation as well as broken into paragraphs for more manageable reading. -pbs

"George Francis O'Neill

To the Editor of the American

In reply to Dr. Park of the Board of Health I will state that I am not segregated with the typhoid patients. There is nobody on this island that has typhoid. There was never any effort by the Board authority to do anything for me excepting to cast me on the island and keep me a prisoner without being sick nor needing medical treatment. When I first came here they took two blood cultures, and feces went down three times per week, say Monday, Wednesday, and Friday, respectively, until the latter part of June. After that they only got the feces once a week, which was on Wednesday. Now they have given me a record for nearly a year for three times a week.

When I first came here I was so nervous and almost prostrated with grief and trouble. My eyes began to twitch, and the left eyelid became paralyzed and would not move. It remained in that condition for six months. There was an eye specialist [who] visited the island three and four times a week. He was never asked to visit me. I did not even get a cover for my eye. I had to hold my hand on it whilst going about and at night tie a bandage on it.

In December when Dr. Wilson took charge, he came to me and I told him about it. He said that was news to him and that he would send me his electric battery, but he never sent [it]. However, my eye got better thanks to the Almighty God and no thanks in spite of the medical staff. Dr. Wilson ordered me urotropin. I got that on and off for a year. Sometimes they had it, and sometimes they did not. I took the urotropin for about three months all told during the whole year. If I should have continued [it], it would certainly have killed me for it was very severe. Everyone knows who is acquainted in any kind of medicine that it's used for kidney trouble.

When in January [1908] they were about to discharge me, when the resident physician came to me and asked me where was I going when I got out of here, naturally I said to N.Y., so there was a stop put to my getting out of here. Then the supervising nurse told me I was a hopeless case, and if I'd write to Dr. Darlington and tell him I'd go to my sisters in Connecticut. Now I have no sister in that state or any other in the U.S. Then in April a friend of mine went to Dr. Darlington and asked him when I was to get away. He replied "That woman is all right now, and she is a very expensive woman, but I cannot let her go myself. The Board has to sit. Come around Saturday." When he did, Dr. Darlington told this man "I've nothing more to do with this woman. Go to Dr. Studdiford."

He went to that doctor, and he said "I cannot let that woman go, and all the people that she gave the typhoid to and so many deaths occurred in the families she was with." Dr. Studdiford said to this man "Go and ask Mary Mallon and enveigle her to have an operation performed to have her gallbladder removed. I'll have the best surgeon in town to do the cutting." I said "No. No knife will be put on me. I've nothing the matter with my gallbladder." Dr. Wilson asked me the very same question. I also told him no. Then he replied "It might not do you any good." Also the supervising nurse asked me to have an operation performed. I also told her no, and she made the remark "Would it not be better for you to have it done than remain here?" I told her no.

There is a visiting doctor who came here in October. He did take quite an interest in me. He really thought I liked it here, that I did not care for my freedom. He asked me if I'd take some medicine if he brought it to me. I said I would, so he brought me some Anti Autotox and some pills then. Dr. Wilson had already ordered me brewer's yeast. At first I would not take it, for I'm a little afraid of the people, and I have a good right for when I came to the Department they said they were in my [intestinal] tract. Later another said they were in the muscles of my bowels. And latterly they thought of the gallbladder.

I have been in fact a peep show for everybody. Even the interns had to come to see me and ask about the facts already known to the whole wide world. The tuberculosis men would say "There she is, the kidnapped woman." Dr. Park has had me illustrated in Chicago. I wonder how the said Dr. William H. Park would like to be insulted and put in the Journal and call him or his wife Typhoid William Park."

PBS.org - "In Her Own Words", 
"The Most Dangerous Woman in America" - NOVA, 2004;
 wikipedia, lisawallerrogers.wordpress; 
“The Deadly Trails of Typhoid Mary,” by Donald G. McNeil, Jr. The New York Times, 4/14/2003; 


Photo: dailymail.co.uk
Photo: smatters.com
Photo: ghosthuntingtheories.com
Photo: kingstonlounge.blogspot
Photo: dailymail.co.uk
Photo: flicker.com
Altar, now in a maintenance building: dailymail.co.uk
Photo: dailymail.co.uk
North Brother Island Quarantine Zone, New York: quarantine zone, leper colony and centre for drug addicts. Just 350 yards from the crowded tenements of the Bronx, North Brother Island was first employed as a quarantine centre in 1885. Closed in 1963, it is now a haunting labyrinth of crumbling ruins. - radiolab.com
Photo: mixedmartialarts.com
Physicians Room - Photo: dailymail.co.uk
Photo: seriouslyforreal.com

The following images are from opactiy.us:

From irishcentral.com - Haunted island where Typhoid Mary was quarantined will open to public -Kayla Hertz @irishcentral, 2014

"The abandoned island has been virtually untouched in a half a century. and is strongly believed to be haunted. There was a morgue on the island for the many patients who didn’t survive, including Typhoid Mary herself. While the modern experience on the island is beautiful to some, like council-member Levine, many others would consider it to be quite eerie.

“To visit there was an experience unlike any other that I’ve had,” he said, adding that it was visually spellbinding. For years, the island has attracted “urban explorers” who enter illegally, and photographers have reveled in the contrast between the decaying man-made structures that have been completely overrun by nature. It has also become a sanctuary for migrating birds.

“I thought it was important to get policy makers onto the island. There’s so much history,” Levine said, “like how we’ve dealt with epidemics,” he added, a topic been on everyone’s minds since the outbreak of Ebola. “The experience of being completely isolated in the forest with these half decayed beautiful buildings as you faintly hear the background sounds of the city – honks from the Bronx, loudspeakers from Rikers [Island].”

Levine said that any plans for the opening island would take into account its importance as a bird sanctuary other environmental needs. Plans would be “respectful of historic nature,” and work with a number of safety concerns.

One idea Levine has is to make the island a “no-touch” and “limited access” environmental education destination, but he is open to other ideas and wants to conduct a study about the island’s potential."

Notable cases

Roger Sherman, one of the Founding Fathers of the United States died of typhoid fever in 1793.

In memory of Leland Stanford, Jr., who died of typhoid in 1884, his parents founded Stanford University.

Gerard Manley Hopkins, English poet, died of typhoid fever in 1889.
Prince Albert
Prince Albert, husband of Queen Victoria, died of typhoid fever at the age of 42.

Major Gonville Bromhead, who fought in the Battle of Rorke's Drift, depicted in the film Zulu, died of typhoid fever in India in 1891.

Dr HJH 'Tup' Scott, captain of the 1886 Australian cricket team that toured England, died of typhoid in 1910.

Wilbur Wright, 1909
Wilbur Wright, the older of the two Wright Brothers, died of typhoid on May 30, 1912.

Edith Claypole, a British scientist, died of typhoid in 1915. She acquired the disease while preparing vaccinations for WWI troops, despite the protection of having been vaccinated herself.

Arnold Bennett, English novelist, died in 1932 of typhoid, two months after drinking a glass of water in a Paris hotel to prove it was safe.

Huang Tzu, Chinese musician, died of typhoid fever in 1938.

Heath Bell
Heath Bell, a relief pitcher for the San Diego Padres acquired typhoid on a 2010 trip to Fiji, but survived.

Louisa May Alcott, author of Little Women, acquired typhoid while being a nurse at a hospital in Washington, D.C., but survived.

Gen. Ignacio Zaragoza, general in the Mexican army in charge of the Battle of Puebla on May 5, 1862, died on September 8, 1862, shortly after his victory over the French army, of typhoid fever, at the age of 33.
Abigail Adams
Abigail Adams, wife of Founding Father and President John Adams and mother of the sixth President John Quincy Adams, died of typhoid fever on October 28, 1818, at the age of 73

Baiju Bawra aka (Baijnath Prasad or Baijnath Mishra), the great Indian singer, musician died of typhoid at the age of 71 on the eve of the Indian festival, Basant Panchami in Vikram Samvat 1670 (1613 CE).

Hashimoto Hakaru, discoverer Of Autoimmune Thyroiditis Hashimoto's thyroiditis. Died on January 9, 1934, of typhoid fever.

Mary Mallon, more commonly known as Typhoid Mary, survived a childhood episode in Ireland to become an asymptomatic carrier in the United States.

Edward VII survived.

Joseph Smith
Joseph Smith, founder of the Church of Jesus Christ of Latter-day Saints Latter Day Saint movement, contracted typhoid as a child, survived.

Henry Frederick, Prince of Wales

Princess Victoria of Hesse and by Rhine survived.

Princess Leopoldina
Princess Leopoldina of Brazil, Emperor Pedro II of Brazil's daughter, died of typhoid Fever on 7 February 1871.

Tadeusz Kosciuszko, hero of the American Revolution and Polish patriot leader, died of typhoid Fever in Switzerland, 1817.

Charles Darwin
Charles Darwin, naturalist, during his visit to Chile with HMS Beagle in 1835.

Ignacio Zaragoza, Mexican general and Cinco de Mayo hero. Died of typhoid fever in less than 5 months of his famous victory over the French army in Puebla on September 8, 1862.

Urilla Sutherland Earp, first wife of Marshall Wyatt Earp, probably died of Typhoid Fever in or around 1870 in Lamar Township, Missouri.

Eugenia Tadolini, a celebrated Italian soprano, died of the disease in Paris in 1872.

Leland Stanford Jr. died of typhoid in 1884; his parents founded Stanford University in his memory.

William Wallace Lincoln, third son of Abraham Lincoln, the 16th President of the United States, died February 20, 1862 of typhoid fever.

Mary Todd Lincoln
Mary Todd Lincoln, wife of Abraham Lincoln.

Thoby Stephen, elder brother of novelist Virginia Woolf, died of typhoid fever in 1906 at age 26. The deaths of Woolf's characters, Jacob in Jacob's Room and Percival in The Waves, are based on Thoby's.

Frank McCourt, author of Angela's Ashes. In his memoir, he details nearly dying of the disease in 1940 as a ten-year-old in Limerick, Ireland, and his ensuing 4-month-long hospital stay.

Stephen Douglas, politician and 1860 presidential runner-up.

Dr HJH 'Tup' Scott, captain of the 1886 Australian cricket team that toured England, died of typhoid in 1910.

Arnold Bennett, English novelist, died in 1931 of typhoid, two months after drinking a glass of water in a Paris Hotel to prove it was safe.

Raymond Radiguet, French literary prodigy, died of typhoid at age 20 while on a trip with his mentor, Jean Cocteau.

Keshav Baliram Hedgewar, founder and first Sarsanghchalak of Rashtriya Swayamsevak Sangh, died of typhoid at age 51 on 1940/06/21.

Gerald Manley Hopkins
Gerard Manley Hopkins, Jesuit and poet.

Ralph Rose, three-time Olympic champion and six-time medalist in throwing events, died of typhoid on October 16, 1913 at age 28.
Roger Sherman, a Founding Father of the United States of America.
Georgia O'Keeffe, a famous painter, survived

Ravi Shankar
Ravi Shankar, musician, survived

Tsar Nicholas II of Russia had typhoid in 1900, survived.