Irish cook Mary Mallon (1869-1938) was dubbed "Typhoid Mary" by the media after she infected dozens of people with the dreaded disease.
When Mallon worked as a cook at the turn of the century, typhoid fever was a highly contagious disease and a serious threat to the public health. Mallon was the first identified person who carried and spread the disease without ever exhibiting the symptoms. At least three deaths and 53 cases of typhoid were directly linked to her, with thousands of other probable cases. Because she refused treatment, she spent her final years quarantined as a threat to the public health.
Ordinary Beginnings
Mary Mallon was born September 23, 1869. She claimed to have been born in the United States, but actually was born in Cookstown, County Tyrone, Ireland, to Catherine Igo Mallon and John Mallon, and immigrated from Ireland as a teenager to live in New York with an aunt and uncle. Perhaps destined to lead an ordinary life as a household servant, she instead backed into infamy by way of a suspected childhood case of typhoid that she didn't even remember, and her chosen profession of cook. Little is known about Mallon's life before she caught the attention of sanitary engineer and epidemiologist George A. Soper, who was investigating outbreaks of the disease.
Typhoid fever is relatively rare today, but at the turn of the century, it was a deadly disease that infected as many as 50 per 100,000 people. In New York City in 1906, typhoid struck 3,467 people, killing 639. Because health care was primitive by today's standards, the disease was difficult to treat. Sufferers simply had to endure about a month of symptoms that included a high fever, upset stomach, headache, and red marks on the skin.
Typhoid was thought to be spread through impure water, but at the turn of the century, scientists began to suspect that humans who had lived through typhoid might still harbor the germs that cause it, spreading the disease by contaminating food or household objects.
By talking to her employment agency, Soper pieced together some of Mallon's history. She had worked for several years with a family in Westchester County, New York, disappearing after a guest became ill with typhoid in 1900. Later that same year, she was hired into a family in Manhattan where a fellow worker contracted the disease a few weeks after she arrived, although Mallon was never suspected as a connection. Over the next decade, she worked at eight different households, Soper discovered. Seven of these households experienced typhoid outbreaks. In most cases, as soon as the disease struck, Mallon quit and disappeared.
Tracked Mallon Down
In 1906, Soper was asked to investigate an eruption of typhoid at a summer home in Oyster Bay, Long Island. That summer, six of the eleven members of the household had taken ill three weeks after the arrival of the family's new cook. After searching for sources of contamination like spoiled food or contaminated water, Soper began to suspect a human carrier, and learned that the cook had disappeared. He tracked Mallon through her employment agency, and finally located her in the New York home of her current employer. Soper assumed that Mallon had no idea she was the cause of the repeated outbreaks and would be happy to find out how to guard against future tragedies. "I thought I could count upon her cooperation in clearing up some of the mystery which surrounded her past," Soper wrote in The Military Surgeon, describing how he intended to ask Mallon for samples of her urine and feces for examination. "I hoped that we might work out together the complete history of the case and make suitable plans for the protection of her associates in the future. Science and humanitarian considerations made it necessary to clear up the whole matter."
Apparently, Mallon did not agree. "My interview was short," Soper noted. "It started in the kitchen and ended almost immediately at the basement door. Reason, at least in the forms in which I was acquainted with it, proved unavailing. I never felt more helpless."
Soper planned a raid, enlisting a colleague to help stake out a tenement house where Mallon often visited a male friend. When Soper finally confronted Mallon in hopes of gaining her cooperation, he met with complete denial. "We were unable to make any headway," Soper wrote in The Military Surgeon. "As Mary's attitude toward us at this point could in no sense be interpreted as cordial, we were glad to close the interview and get down to the street. We concluded that it would be hopeless to try again."
Unable to gain Mallon's consent to be examined, Soper turned the case over to the New York City Department of Health, recommending that the department arrest her in order to subject her to a bacteriological examination. In March 1907, the Health Department sent a team, including inspector Dr. S. Josephine Baker, three police officers and several interns, to collect Mallon. When the crew arrived at the house, Mallon herself opened the door, only to slam it again when she realized what was happening. She ran and hid, aided by the other workers in the house, who claimed not to know where she had gone. The officers spent three hours searching the house and the one next door, and were about to give up when one noticed a bit of fabric poking out from an outside closet.
Trapped, Mallon was still unwilling to relent. "She fought and struggled and cursed," Baker recalled, reported John Steele Gordon in American Heritage. "I told the policemen to pick her up and put her in the ambulance. This we did, and the ride down to the hospital was quite a wild one." Baker, whose own father died of typhoid fever, described having to sit on Mallon the entire way to the hospital.
At the hospital, Soper made a third and final attempt to reason with Mallon. He visited Mallon in her room in the detention area, hoping to persuade her to give a medical history. Once again, Soper was met with frustration. "This interview was shorter than the other two," he wrote in The Military Surgeon. "Without uttering a word Mary retreated with dignity to the toilet, leaving me standing alone in the room."
Confirmation and Controversy
Just as Soper had suspected, even though Mallon appeared to be perfectly healthy, her stools contained a pure culture of the bacteria that causes typhoid fever. Finally, Soper's theory was proven. Mallon had acted as a human carrier of the disease, perhaps as a result of a childhood case of typhoid that she didn't even recall. "The implication was plain," Soper wrote. "The cook was virtually a living culture tube in which the germs of typhoid multiplied and from which they escaped in the movements from her bowels. When she prepared a meal, the germs were washed and rubbed from her fingers into the food. No housekeeper ever gave me to understand that Mary was a particularly clean cook."
Even though Mallon remained a threat to public health because she still harbored the disease and because she refused to accept that she was a carrier, some people felt Mallon was being imprisoned unfairly. Her case was argued unsuccessfully before the state supreme court, which found that the Health Department had good cause to keep Mallon in custody, although the judge expressed sympathy for Mallon's situation. Finally, in 1910, after three years in isolation at Riverside Hospital on North Brother Island in New York, Health Commissioner Ernst J. Lederle released Mallon upon her agreement to avoid employment as a cook and to keep in close contact with health authorities.
Not long after her release, Mallon disappeared. Historians have speculated that Mallon was unable to find any work besides her first vocation, and, facing the prospect of total poverty, changed her name and once again became a cook. The trail of typhoid began again, as Mallon again worked briefly at many places and left every time people fell ill.
Rediscovery
A 1915 outbreak of typhoid at the Sloane Hospital for Women in New York City proved Mallon's final downfall. Twenty-five nurses and other workers took ill, and epidemiologist Soper was once again called in to determine the source of the infection at an institution that prided itself on its scrupulous attention to cleanliness. Soper learned that workers had nicknamed a cook "Typhoid Mary," and immediately knew he had once again found the elusive Mallon. "That she took chances," Soper wrote in The Military Surgeon, "both with the lives of other people and with her own prospect for liberty and that she did this deliberately and in a hospital where the risk of detection and severe punishment were particularly great, argues a mental attitude which is difficult to explain."
Tracked to a home on Long Island, Mallon was once again removed to Riverside Hospital on North Brother Island. This time, her prospects for release were slim. "She was now a woman who could not claim innocence," Soper asserted. "She was known willfully and deliberately to have taken desperate chances with human life, and this against the specific instructions of the Health Department. She had been treated fairly; she had been given her liberty and was out on parole. She had abused her privilege; she had broken her parole. She was a dangerous character and must be treated accordingly."
Over the years, Mallon seemed to have come to a sort of peace with her situation. She lived in nearly total isolation for many years in a one-room cottage with only a dog for company. Eventually she was allowed to work in the hospital laboratory and earned small tastes of freedom. She ventured off the island for short unsupervised trips into the city, where she would visit friends and shop for special foods. Predictably, she cooked and ate alone.
Following her second capture, Mallon spent the rest of her life at Riverside Hospital, more than half her life having been spent confined on the island. After a series of small strokes, she suffered a major stroke in 1932 that left her paralyzed and bedridden until November 11, 1938, when she died. The nine mourners at her funeral at St. Luke's Roman Catholic Church in the Bronx were reluctant to be identified but probably included the few friends she had made through her job at the hospital. Mallon was buried at St. Raymond's Cemetery under a headstone that read "Jesus Mercy."
Books
Leavitt, Judith Walzer, Typhoid Mary: Captive to the Public's Health, Beacon Press, 1996.
Periodicals
American Heritage, May-June 1994, p. 118.
FDA Consumer, June 1989, p. 18.
The Military Surgeon, July 1919.
Resident and Staff Physician, May 1987.
