TORONTO -- The novel coronavirus pandemic may remind us of another deadly infectious disease: typhoid fever.
It has claimed the lives of hundreds of thousands of people and sickened millions more around the world 鈥 and it's almost impossible to talk about typhoid fever without discussing the woman most famously known for spreading it.
Her real name was Mary Mallon, but she is more commonly referred to as 鈥淭yphoid Mary,鈥 the for infecting dozens of people with typhoid fever while she worked as a cook for wealthy families in New York City at the turn of the 20th century. At the time, medical knowledge and understanding of asymptomatic carriers of disease was essentially non-existent, which is part of what made Mallon鈥檚 story all the more intriguing to doctors and public health officials.
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Her story was widely covered in the media, according to Katie Foss, a professor of journalism and media studies at Middle Tennessee State University in the U.S. Foss, who studied Mallon for an upcoming historical book called 鈥淐onstructing the Outbreak: Epidemics in Media & Collective Memory,鈥 says most of the press Mallon got was negative and often one-sided. 鈥淪he was never interviewed in the media, she was never quoted,鈥 Foss told CTVNews.ca in a phone interview from Gatlinburg, Tenn. on May 14.
鈥淲e talk about her, but we don鈥檛 really hear from her. We don鈥檛 give her agency,鈥 Foss added.
WHO WAS MARY MALLON?
To better understand the story behind 鈥楾yphoid Mary,鈥 it helps to understand who Mary Mallon was before she got her famous nickname. Mallon was born in Cookstown, County Tyrone in Northern Ireland, in 1869 and emigrated as a teenager to the U.S., where she was eventually hired as a cook in New York City to prepare meals for some of Manhattan鈥檚 wealthiest families.
Mallon cooked for seven families between 1900 and 1907, unaware that she was a healthy carrier of typhoid fever. No one at the time, including Mallon, really understood that a person showing no signs or symptoms of typhoid, such as fever, cough, fatigue, or diarrhea, could still transmit the disease to others. Her signature dish of peach ice cream, , has also been theorized by experts as the conduit through which Mallon spread the contagious disease.
Judith Walzer Leavitt, an American historian and professor emerita at the University of Wisconsin-Madison who specializes in medical history and women鈥檚 studies, says Mallon鈥檚 story illustrates a unique and unprecedented period in medical history. 鈥淚t鈥檚 a wrenching personal story. She was the first healthy carrier of typhoid fever to be discovered, so people had never seen it before and didn鈥檛 know what to do,鈥 she told CTVNews.ca during a phone interview on Sunday from Madison, Wis. 鈥淚t was completely unheard of. People in the medical community thought, 鈥楬ow could this be?鈥 There were a lot of skeptics,鈥 Leavitt added.
In 1906, a rash of outbreaks erupted in New York and involved the families Mallon worked for. In one particular household, six of the 11 people got sick. That family hired George Soper, a well-known epidemiologist, to find out why. After months of investigation that included following Mallon around for blood, urine and feces samples, Soper concluded that Mallon was the culprit. Some time passed before Soper had Mallon taken into police custody in 1907 and in New York鈥檚 East River, where she was forcibly kept in quarantine for three years.
Mallon hired a lawyer and sued for her release, even requesting a trial to prove her innocence on the accusations made against her. One of the few times the public heard from Mallon directly was in she wrote to her lawyer describing her time in isolation. But a judge found Mallon was still a public threat and ordered her to remain on North Brother Island. She was finally freed in 1910, but on the condition that she stop cooking and stay out of kitchens.
In 1915, Mallon was busted working under a suspected alias in a home kitchen in New York and was once again banished to a life of isolation on North Brother Island, where she remained until her death in November 1938 at the age of 69. In total, Mallon had spent 26 years of her life in quarantine there.
MALIGNED AND MISUNDERSTOOD
Talk of Mallon鈥檚 nickname and reputation as a virus 鈥渟uper-spreader鈥 in light of the COVID-19 pandemic.
Leavitt, who researched and wrote extensively about Mallon in her 1996 book 鈥淭yphoid Mary, Captive to the Public鈥檚 Health,鈥 says she was able to verify and trace 47 typhoid infections and three deaths to Mallon during her career as a cook 鈥 a large number, but not nearly as many as some earlier reports suggest.
When you consider that rocked New York City before this, such as yellow fever, cholera and influenza, the use of the term super-spreader seems to be somewhat excessive. In Leavitt鈥檚 opinion, the epithet is plain wrong. 鈥淚 don鈥檛 think she was a super-spreader. She gave the disease to people she cooked for, in small homes. That鈥檚 not a big number,鈥 she said. According to Dr. Foss, there were an estimated 400 other asymptomatic carriers that were discovered in New York City after Mallon, but much less was said or known about those individuals.
And Foss also agrees with Leavitt that Mallon was misjudged, believing that the nickname 鈥楾yphoid Mary鈥 strips away all the context of who Mallon actually was, as suggested in on April 24. Foss believes Mallon, as a young, poor and single immigrant, was unfairly characterized as a spreader of disease at a time when little was known or understood about typhoid fever in healthy carriers. And Foss thinks the same can be said about how people today are trying to make sense of the coronavirus. 鈥淚t鈥檚 interesting to see how casually people use Typhoid Mary as a reference [to COVID-19],鈥 Foss said. 鈥淢ost people don鈥檛 understand what an asymptomatic carrier is. People don鈥檛 really understand what it means to feel fine and spread disease at the same time,鈥 she added.
PARALLELS TO TODAY鈥橲 PANDEMIC
For more than a third of her life, Mallon was confined to living in quiet isolation over concerns and fears she would continue infecting people with typhoid fever if she was allowed to live freely. Those same fears resurfaced earlier this year as the coronavirus quickly spread and became a global health pandemic. Governments forced people to quarantine on cruise ships and were ordered to observe strict lockdown measures to help stop the virus.
Foss says the question about whether to sacrifice an individual鈥檚 civil liberties for the safety of a whole society in the early 1900s with Mallon鈥檚 story are resurfacing with the COVID-19 pandemic today. And she believes it鈥檚 important to look to the past to keep the present in perspective. 鈥淎t any moment, this [pandemic] can happen. It鈥檚 arrogant to assume just because we have vaccines and advanced medicine that disease won鈥檛 find a way and we have to be ready,鈥 Foss said. 鈥淲e should also recognize that it鈥檚 selfish to not think about other countries where diseases are still affecting places, like polio and yellow fever,鈥 she added. Foss said the rise of the anti-vaccination movement has played a pivotal role in allowing some of the diseases that were once eradicated to return.
Like Mallon and typhoid fever, Leavitt reiterates that there is still much we don鈥檛 know about , and that what we learn seems to be changing from day to day. 鈥淧eople grasp the concept of asymptomatic carriers, but there is still so much unknown,鈥 she added.
LESSONS TO BE LEARNED
Both Foss and Leavitt agree there is plenty for us to learn from the story of Typhoid Mary when taken into the context of how we navigate pandemics like COVID-19. How media and the public is one of them. How Mallon was blamed for having spread typhoid fever, intentionally or not, and then was given the nickname Typhoid Mary, is another clear example, according to Leavitt. 鈥淪he got the name Typhoid Mary and she felt the sting of it very badly. She was something to be loathed,鈥 Leavitt said.
Society鈥檚 need to find a source of the virus, or to pin blame for its spread, has manifested in the racially-motivated attacks on Chinese people and anti-Asian rhetoric that have since the first case was reported in late December 2019 at a seafood market in Wuhan, China. Leavitt thinks making that association is problematic, and says it doesn鈥檛 help when that kind of messaging is coming from her . 鈥淥ur president called it 鈥榯he China virus鈥,鈥 Leavitt reiterated. 鈥淭he way that the Chinese population is being stigmatized is the same as Mary Mallon.鈥
The importance of clear and honest messaging from governments and public health officials in addressing the coronavirus is another key lesson to be learned from Mallon鈥檚 story, according to Leavitt. 鈥淢ary Mallon understood there were different messages, and she thought she was treated unjustly,鈥 Leavitt said.
As the story of Typhoid Mary serves as a cautionary tale of one person鈥檚 individual rights being infringed upon for the public good, Leavitt thinks the . and in cities around the world in recent weeks means the question of 鈥渇reedom at what cost?鈥 still remains. Quite simply, Leavitt believes that if governments and public health agencies are going to control disease, they鈥檙e going to have to infringe on people鈥檚 rights, in temporary or perhaps, more permanent ways. 鈥淚n Mary鈥檚 case, it was unfair. Her rights were taken away cavalierly,鈥 she said.
While she admits the decision-making political leaders and health officials are tasked with can become harder in the thick of managing a pandemic, she believes their efforts and intentions on protecting people are genuine. Mary Mallon may not have been afforded the opportunity to have it explained to her why she was being vilified, forced to quit her career in cooking, or why she had to be isolated on an island for years at a time. The lesson we can learn today, Leavitt believes, is in having an informed public that is willing to work together to eradicate COVID-19. 鈥淐o-operation is best achieved when you鈥檙e honest and open about what you鈥檙e doing and why you鈥檙e doing it,鈥 she said.
Infographic: Mahima Singh
