Before the significant scientific advances of the 20th century, illness and infection were a scourge. Afflictions that today would be brushed off with a pill and a shrug could quickly become extremely dangerous thanks to the limited understanding of healthcare and hygiene. More serious conditions could be deadly. Diseases that have now been all but eradicated in many areas were still untreatable and claimed lives on a daily basis. Of these, one of the most feared was typhoid.
Typhoid fever is a bacterial infection that has killed thousands throughout history. The disease produces symptoms similar to a bout of extreme food poisoning, with abdominal cramps, nausea, headaches, delirium and extreme temperature changes, that can last for weeks if left untreated. Blood clots form under the skin and internal haemorrhaging affects the intestines. Even today, subjects who go without vaccination or treatment have about a 20 per cent chance of dying from the disease. In the 19th century, this figure was even higher. It’s little wonder that any mention of typhoid was enough to spark fear in communities across the world.
Since typhoid spreads through contact with contaminated faeces and unhygienic environments, it was considered a disease of the underclasses. While wealthy citizens were occasionally affected, it was nowhere near as prevalent in affluent neighbourhoods as it was in the slums of the world’s developing cities. However, in 1900, something strange began to happen to New York City. Rich families in Manhattan and Mamaroneck started to fall ill. A lawyer saw eight of his family succumb to the disease and a servant die. For typhoid to have such a devastating effect on households such as this was almost unheard of. Something sinister was afoot.
By 1906, the curious epidemic had spread further still. Homes in the opulent Oyster Bay area of Long Island were struck down one by one as the disease continued its march through the wealthy citizens of the east coast. There seemed no obvious cause. Despite all precautions, families continued to fall ill. Several more people died and the public became desperate. Clearly, expert opinion was needed to solve this mystery.
In late 1906, Charles Henry Warren, whose entire family were currently suffering from the fever, reached out to typhoid researcher George Soper. It was hoped that Soper could shed some light on the situation and save Warren’s ailing household. After a careful examination of the house, Soper concluded that the outbreak could have come from only one place: the kitchen. It was there that he came face-to-face with Irish immigrant Mary Mallon.
At first, Soper was baffled by Mary. If his scientific training was to be trusted, her food had to be the cause of the outbreak. Yet she seemed perfectly healthy and angrily declared that she had never been ill a day in her life. After Soper requested a sample of her urine and faeces, Mary leapt back in horror and chased the confused scientist out of the house with a meat fork. Despite this hostile reaction, Soper was convinced that he had found the source of the Warrens’ woe. He did some more digging.
To his amazement, he discovered that Mary Mallon had been employed as a cook across the region for the last seven years. When he looked at the families for whom she had worked, he spotted an alarming pattern. At every job Mallon had held, the family had been affected by typhoid. As he looked at each case, it became clear that this wasn’t a coincidence. Soper now had all the proof he needed that Mary Mallon was the cause of disease that was terrorising the region.
When he tried to explain his discovery to Mary, she was having none of it. She pointed to the fact that she was not, nor had ever been, affected by the disease herself, so couldn’t possibly be responsible. After failing to persuade her to undergo testing willingly, Soper took decisive action. He contacted officials from New York’s health department and together, they took Mary into custody.
In order to figure out what was going on, authorities took a less-than-willing Mary to a facility on North Brother Island, a medical internment centre for those suffering from infectious diseases. For three years, she was kept isolated from the rest of society, against her will. Despite the compelling evidence against her, Mary was convinced that she was suffering unjust persecution on account of her immigrant status. Doctors, equally convinced that the disease originated from her gallbladder, attempted to persuade her to get the organ removed. Unsurprisingly, she wasn’t overly enthusiastic.
Eventually, thanks to public pressure and her own vociferous complaints, authorities ruled that infectious disease carriers could not be kept in isolation indefinitely. Eugene H Porter, Commissioner of Health for New York City, agreed to release Mary on one condition: that she never work in a kitchen again. Mary agreed and was allowed to return back to society. Authorities heard nothing from her for several years.
Unfortunately for New York City, Mary still believed that there was nothing wrong with her. After a failed stint as a laundress, a profession that paid significantly less than cooking, she decided to ignore the warnings of health professionals and law enforcement, and seek employment in a kitchen. After changing her name to Mary Brown, she restarted her career as a cook.
As soon as she reentered the profession, typhoid began to once more ravage the upper classes. Wherever she worked, outbreaks occurred and several more deaths were reported. Soper, still suspicious of the bloody-minded Mary, suspected that she was behind this latest epidemic. Unfortunately, she changed job so frequently that it was impossible for him to keep track of her movements.
In 1915, Mary found what would be her final position. She accepted a post at Sloane Hospital for Women, and immediately started another major outbreak. This time, 25 patients and staff contracted the disease and two died. Such was the scale of the tragedy that law enforcement were almost immediately summoned to the scene. As they arrived, Mary was once again apprehended. Despite her protestations, “Typhoid Mary”, as she would forever be known in the press, was returned to her quarantine on North Brother Island, where she would remain for the rest of her life.
For all the havoc she caused, the case of Typhoid Mary is still considered to be a seminal moment in the history of medicine. For the first time, scientists realised that people could be carriers of infectious disease without suffering any adverse effects themselves. This caused a drastic reevaluation of treatment methods and best practice. For his work in hunting down the rampant Mary, Soper was recognised as one of the leading medical minds of his day.
As for Mary, the story was significantly more complicated. While public opinion was with her during her first incarceration on North Brother, the tide turned once she decided to return to the kitchen. Given that long-lasting cases of typhoid have been known to adversely affect mental faculties, some have suggested that she was not deliberately endangering those who she ended up infecting. Others have argued that she knew exactly what she was doing and potentially caused the deaths of more than 50 people through her complicit continuation of employment in the kitchen. Whatever your view of Typhoid Mary, her story remains one food's most fascinating legacies.