The story of Typhoid Mary and COVID-19 are very much related. The well-documented story of Typhoid Mary resonates today during the novel coronavirus pandemic, as she most probably represents the first case of forced isolation to prevent the spread of an infectious disease by a person who is asymptomatic.
Today we worry about the SARS-CoV-2 virus, but viruses are not the only microbes that can spread disease. Bacteria are adept at that as well. Mary Mallon made the most delicious ice cream, but the problem was that it could kill. That is because Mary carried more than the ingredients needed for ice cream! She carried the Salmonella typhi bacterium, the bacterium that causes typhoid fever. And she was well-deserving of the name that was bestowed upon her, “Typhoid Mary.”
Today, typhoid fever is rare in North America thanks to sanitation and the use of antibiotics to prevent its spread, but it still strikes some 12 million people in the developing world every year.
Vaccinations are available and are a must for anyone traveling into areas where the disease is still found. Risk is reduced by drinking only bottled water, eating foods that have been thoroughly cooked and are still hot, and avoiding raw vegetables and fruits that cannot be peeled.
The typhoid bacteria, which live only in humans, can be spread through sewage or through food that has been handled by someone shedding bacteria. A high fever can ensue and even death if antibiotics are not available.
Mary Mallon's story, as mentioned above, is about stopping the spread of a disease by an asymptomatic individual through the forced isolation of that person.
Before widespread water purification, epidemics of typhoid fever were common. But nobody really knew how the disease was transmitted. This was the case until 1906 when ten people in the same household in Long Island, New York, suddenly came down with typhoid fever.
Health authorities sent Dr. George Soper to investigate. Soper had experience with bacteria and knew that Salmonella typhi had been cultured from the stool of typhoid patients as early as 1884. He suspected that the disease could be passed from person to person and asked if there had been any visitors to the house. Yes, he was told, a new Irish cook had recently been hired but was no longer there.
Dr. Soper then traced Mary Mallon through an employment agency and discovered that there had been at least one case of typhoid everywhere she had worked. Finally, he caught up with her in a Park Avenue apartment where the owner’s daughter had already died of typhoid and two servants suffered from it.
When he explained to her that she was spreading disease, Mary attacked him with a cleaver. The police were called and Mary was taken away screaming, kicking, and biting. Health officials found live bacteria in her stool, demonstrating for the first time that typhoid fever could be passed by people who carried the bacteria but were themselves immune to the disease.
Mary was forcibly isolated in Riverside Hospital for three years and was finally released when she agreed to never cook for others and check in every three months. She then disappeared, only to resurface five years later at another New York hospital where she had been hired as a cook! Twenty-five nurses in the hospital were ill with typhoid.
Mary was returned to Riverside Hospital where she was confined for the next twenty-three years, living in a cottage specially built for her. She finally died of a stroke. Her funeral was attended by only nine people because of the fear of catching typhoid fever from Typhoid Mary!
Our forced isolation during this pandemic has been very hard for everyone. But with the slow reopening of the economy, we are now all having to decide how we will continue in a time we call the ‘new normal.’
There is certainly not enough or reliable enough testing and no vaccine yet, as well as not enough evidence about whether or not asymptomatic persons can spread the disease, or exactly how the disease spreads, or how to effectively treat it.
The result is that we must all be very careful to slowly return to life, keep on top of recommendations by the scientific community to protect ourselves and others we come in contact with, and keep a watchful eye for a resurgence of the virus.
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