News broke this week that the BBC is producing an upcoming series about Typhoid Mary, one of the most infamous women in history. And the role of Mary will be played by Handmaid's Tale star Elisabeth Moss (she's also an executive producer for the series). So who was Typhoid Mary? It turns out, not only is her story one of scientific discovery, it's also one of the stigma of disease — and the medical establishment's historically less-than-ideal approach to patient care.
Before she was "Typhoid Mary," she was Mary Mallon, born in Ireland in 1869. Mallon immigrated to the US in 1883 and worked as a cook for various families in NYC and Long Island.
However, a pretty odd thing started happening in the households where Mallon worked: People kept getting sick. Between 1900 and 1907, there were 22 typhoid fever cases in households on Long Island and in NYC that would later be traced to Mallon.
Typhoid fever is caused by the Salmonella Typhi bacteria. Today, typhoid fever is most often found among those who have travelled outside the US and eaten contaminated food or water. Typhoid can be fatal, but is usually treated these days with antibiotics and prevented via the typhoid vaccine. But antibiotic treatment wasn't an option until 1948 and typhoid vaccination wasn't common until 1911, well after the initial Mallon-linked cases had popped up.
The really odd thing, though, was that Mallon was never sick herself — or at least, she didn't feel or show any signs of illness. In most people, typhoid causes a high fever, fatigue, stomach pains, and a loss of appetite. But Mallon didn't have any of those symptoms. It took the work of sanitation engineer George Soper to notice the curious pattern. He was investigating an Oyster Bay household in which six out of 11 residents had become sick and, it turned out, Mallon had been working there as a cook.
Initially, Soper suspected that the outbreak was due to contaminated water or freshwater clams, and he started talking to those in the house about their illnesses. Soper began to wonder whether the cook could be the missing link — and when Soper confronted Mallon in 1907 to ask for samples of her blood, urine, and faeces, she threatened him with a knife. Casual.
Eventually, Mallon was forced to give samples to health authorities, and those samples tested positive for typhoid. That, plus Soper's investigations into the other houses Mallon had worked at, pointed to her as the main source of the outbreak (which spread to 3,000 New Yorkers by the end of 1907).
At that point, Mallon became the first asymptomatic typhoid carrier ever identified — and her life took a dramatic turn.
Because she was thought to be spreading danger and potential death pretty much everywhere she went, health department officials forced her into a two-year quarantine, frequent testing, and unsuccessful treatments without ever explaining what it meant to be "a carrier." Instead, they offered to remove her gallbladder. (She turned that one down.)
In 1909, Mallon unsuccessfully tried to sue the health department for her forced quarantine at North Brother Island (which is in the East River, near the Bronx). But in 1910, the department released her on the condition that she never take a job that required her to work with food ever again.
She agreed, and all seemed well — until four years later. At that time, our old friend Soper had been investigating a typhoid outbreak at Sloane Maternity Hospital in NYC. He traced that back to a "Mary Brown" who had been living in Westchester, New York. It turned out that Mary Brown, was, you guessed it, Mary Mallon. And in just three months of working at Sloane, Mallon had infected 25 people with typhoid, two of whom died.
In 1915, Mallon was apprehended and forced back into quarantine on North Brother Island, this time for the rest of her life. While isolated, she became a common figure in newspapers, which referred to her as "Typhoid Mary." She was ridiculed with cartoons and became a symbol of the disease to the public and within the medical community. This is all despite the fact that only three deaths were ever officially traced to Mallon, and other carriers had since been identified and linked to more damage.
Mallon died alone in 1938, after having been paralysed by a stroke six years earlier. Her story remains a cautionary tale — both of the need for adequate public health measures and the callous way the medical establishment often deals with patients. "Mary’s case is a perfect example of how the healthcare system provokes social attitudes towards disease carriers, often associated with prejudice," researchers write in the Annals of Gastroenterology. "The state’s pursuance and Mary’s stubbornness gave her an awkward place in the history of Medicine."