Typhoid Mary

Typhoid Mary

Typhoid Mary Mary Mallon, now known as Typhoid Mary, seemed a healthy woman when a health inspector knocked on her door in 1907, yet she was the cause of several typhoid outbreaks. Since Mary was the first “healthy carrier” of typhoid fever in the United States, she did not understand how someone not sick could spread disease — so she tried to fight back. After a trial and then a short run from health officials, Typhoid Mary was recaptured and forced to live in relative seclusion upon North Brother Island off New York.

You can get typhoid fever if you eat food or drink beverages that have been handled by a person who is shedding typhoid fever bacteria (Salmonella typhi), or if sewage contaminated with typhoid fever bacteria gets into the water you use for drinking or washing food. Therefore, typhoid fever is more common in areas of the world where hand washing is less frequent and where water is likely to be contaminated with sewage. Once Salmonella typhi bacteria are ingested, they multiply and spread into the bloodstream. The body reacts with fever and other symptoms.

Typhoid fever is most often caused by the Salmonella typhi bacteria. Infection of Salmonella typhi leads to the development of typhoid fever. This disease is characterized by the sudden onset of a sustained and systemic fever, severe headache, nausea, and loss of appetite. Other symptoms include constipation or diarrhea, enlargement of the spleen, possible development of meningitis, and/or general depression. Untreated typhoid fever cases result in mortality rates ranging from 12-30% while treated cases allow for 99% survival. S. yphi has a combination of characteristics that make it an effective pathogen. This species contains an endotoxin typical of Gram negative organisms, as well as the Vi antigen which is thought to increase virulence. It also produces and excretes a protein known as “invasin” that allows non-phagocytic cells to take up the bacterium, where it is able to live intracellularly. It is also able to inhibit the oxidative burst of leukocytes, making innate immune response ineffective. Mary carried the disease inside her and she passed on the Typhoid to other people but remained clear of the disease herself.

When she died an autopsy found evidence of live typhoid bacteria in her gallbladder. They think that the bacteria was passed on to her by mother when she was pregnant with Mary, as her mother had Typhoid fever while pregnant. The general route for the Typhoid Bacillus’s entry is through the intestines and into the Enteric portion of the Immune System. It actually grows inside the White Blood Cells. Evidently the bacteria somehow entered and grew in Mary’s system without making her sick.

It never elicited the usual immune reactions so it was never killed by the immune system. As such it was always present in her mouth and throat so she was essentially a walking Petrie Dish. Mary Mallon, known as “Typhoid Mary”, was an asymptomatic carrier of typhoid fever. She worked as a cook for several families in New York City at the beginning of the twentieth century. Several cases of typhoid fever in members of those families were traced to her by the Health Department. It appeared that she “carried” the infectious agent without becoming sick.

There was at the time no way of eradicating the disease, and an attempt was made to restrict her from continuing to work as a cook to avoid spreading it to others. In my opinion, Mary’s treatment was appropriate because Mary had acted as a human carrier of the disease. When she prepared a meal, the germs were washed and rubbed from her fingers into the food. 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. 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.