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March 31, 2020

The Terrible Tale of of Mary Mallon, Better Known as ‘Typhoid Mary’, the First Identified Typhoid Carrier in the United States

Mary Mallon, who became known as ‘Typhoid Mary,’ was identified circa 1907 as the controversial “patient zero” in a typhoid fever outbreak in the United States in the early 1900s. Although she never had symptoms, she was forced into quarantine on two occasions, for a total of 26 years.

Mary Mallon (foreground) didn’t show symptoms of typhoid, but spread the disease while working as a cook in the New York City area. She is pictured after having been institutionalized in a hospital on North Brother Island, where she stayed for more than a quarter century. (Bettmann/Getty Images)

Mary Mallon was born on September 23rd, 1869 in Cookstown, Ireland. Little is known about her early life, but she is known to have emigrated to the United States in either 1883 or 1884. Like the majority of Irish immigrants at that time she initially found work as a domestic servant. With time it became apparent that she had a talent for cooking, and around 1900 Mallon started to work as a cook for affluent families in the New York area.

From 1900 to 1907, Mallon worked as a cook in the New York City area for seven families. In 1900, she worked in Mamaroneck, New York, where, within two weeks of her employment, residents developed typhoid fever. In 1901, she moved to Manhattan, where members of the family for whom she worked developed fevers and diarrhea, and the laundress died. Mallon then went to work for a lawyer and left after seven of the eight people in that household became ill.

In August 1906, Mallon took a position in Oyster Bay, Long Island, and within two weeks 10 of the 11 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 11 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.


Investigation

In late 1906, one family hired a typhoid researcher named George Soper to investigate. Soper published the results on June 15, 1907, in the Journal of the American Medical Association. He believed Mallon might have been the source of the outbreak. He wrote:
“It was found that the family changed cooks on August 4. This was about three weeks before the typhoid epidemic broke out. The new cook, Mallon, remained in the family only a short time and left about three weeks after the outbreak occurred. Mallon was described as an Irish woman about 40 years of age, tall, heavy, single. She seemed to be in perfect health.”
Soper discovered that a female Irish cook, who fit the physical description he was given, was involved in all of the outbreaks. He was unable to locate her because she generally left after an outbreak began, without giving a forwarding address. Soper learned of an active outbreak in a penthouse on Park Avenue and discovered Mallon was the cook. Two of the household’s servants were hospitalized, and the daughter of the family died of typhoid.

When Soper approached Mallon about her possible role in spreading typhoid, she adamantly rejected his request for urine and stool samples. Since Mallon refused to give samples, he decided to compile a five-year history of Mallon’s employment. Soper found that of the eight families that hired Mallon as a cook, members of seven claimed to have contracted typhoid fever. On his next visit, he took another doctor with him but again was turned away. During a later encounter when Mallon was herself hospitalized, he told her he would write a book and give her all the royalties. She angrily rejected his proposal and locked herself in the bathroom until he left.


First quarantine (1907–1910)

The New York City Health Inspector determined she was a carrier. Under sections 1169 and 1170 of the Greater New York Charter, Mallon was held in isolation for three years at a clinic located on North Brother Island.

In prison, she was forced to give stool and urine samples. Authorities suggested removing her gallbladder because they believed typhoid bacteria resided there. However, she refused as she did not believe she carried the disease. She was also unwilling to cease working as a cook.

Mallon attracted so much media attention that she was called “Typhoid Mary” in a 1908 issue of the Journal of the American Medical Association. Later, in a textbook that defined typhoid fever, she was again called “Typhoid Mary.”

In a New York American article on 20 June 1910 she was branded ‘Typhoid Mary’ with a capital T and depicted in a sketch, skulls forming in her breath. Mallon did work in other posts, as a laundress, for example, but it was well known that the pay for a cook was far higher, so her return to cooking is understandable.

Eventually, Eugene H. Porter, the New York State Commissioner of Health, decided that disease carriers should no longer be kept in isolation and that Mallon could be freed if she agreed to stop working as a cook and take reasonable steps to prevent transmitting typhoid to others. On February 19, 1910, Mallon agreed that she was “prepared to change her occupation (that of a cook), and would give assurance by affidavit that she would upon her release take such hygienic precautions as would protect those with whom she came in contact, from infection.” She was released from quarantine and returned to the mainland.


Release and second quarantine (1915–1938)

Upon her release, Mallon was given a job as a laundress, which paid less than cooking. After several unsuccessful years of working as a laundress, she changed her name to Mary Brown and returned to her former occupation despite having been explicitly instructed not to. For the next five years, she worked in a number of kitchens; wherever she worked, there were outbreaks of typhoid. However, she changed jobs frequently, and Soper was unable to find her.

Mallon (fourth from right) was quarantined with other inmates for more than a third of her life. It’s likely that Mallon never fully understood how typhoid spread. In two separate outbreaks, she is estimated to have infected 51 people, three of whom died. (Sience History Images/Alamy)

In 1915, Mallon started another major outbreak, this time at Sloane Hospital for Women in New York City. Twenty-five people were infected, and two died. She again left, but the police were able to find and arrest her when she took food to a friend on Long Island. After arresting her, public health authorities returned her to quarantine on North Brother Island on March 27, 1915. She was still unwilling to have her gallbladder removed.

Mallon remained confined for the remainder of her life. She became a minor celebrity and was occasionally interviewed by the media. They were told not to accept even water from her. Later, she was allowed to work as a technician in the island’s laboratory, washing bottles.

Mary Mallon (wearing glasses) photographed with bacteriologist Emma Sherman on North Brother Island in 1931 or 1932, over 15 years after she had been quarantined there permanently.

Mallon spent the rest of her life in quarantine at the Riverside Hospital. Six years before her death, she was paralyzed by a stroke. On November 11, 1938, she died of pneumonia at age 69.

A post-mortem found evidence of live typhoid bacteria in her gallbladder. George Soper wrote however, “There was no autopsy,” a claim cited by other researcher to assert a conspiracy to calm public opinion after her death. Mallon’s body was cremated, and her ashes were buried at Saint Raymond’s Cemetery in the Bronx.

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