She may be the most famous medical patient in US history who was never sick. “Typhoid Mary” infected at least 45 people in New York City and killed at least 3, and also touched off a legal battle that still resonates today. Here is her story.
In 1906, a wealthy Wall Street banker named Charles Henry Warren rented a house on the beach at Oyster Bay, Long Island, to take his family for vacation. It was at first a typical family summer outing, with afternoons on the beach and evenings inside at the beach house, where servants waited on them and met their every need.
Then, on August 27, one of Warren’s daughters developed a fever, coughing, stomach pains and headache. She was diagnosed with typhoid fever. For many years, typhoid, which was spread through contaminated food and water, had been a constant presence in American cities, killing thousands of Americans every year, particularly children. In the late 19th century, large cities like New York installed sewer systems, which made conditions more sanitary and sharply cut the number of typhoid cases. So although a case of typhoid in the wealthy area of Oyster Bay was unusual, it was not unexpected.
But then something odd happened. Within a week, Mrs Warren was also sickened with symptoms of typhoid fever. Then two maids who worked in the guest house. Then the gardener, and then another of Warren’s daughters. In all, six of the eleven people in the house were stricken with typhoid fever.
Now, the owner of the beach house, George Thompson, had a problem. It was apparent that the source of the infection was somewhere in the house, and if he did not find it and eliminate it, he would never be able to make a livelihood again by renting out the house. So he hired a private health engineer named George Soper, who had already worked on other typhoid outbreaks. After several months of examining the house for typhoid bacteria, including its water supply and plumbing system, Soper’s suspicions fell on a 35-year old servant who had been hired that summer as the cook–an Irish immigrant named Mary Mallon. Soper noticed that three weeks after the initial cases of typhoid, Mary had left for another job–and the typhoid outbreak at Oyster Bay stopped as soon as she left. With some investigation, Soper checked into Mary Mallon’s past employment record, and found that between 1900 and 1907 she had worked as a cook at 7 different places, and 22 cases of typhoid had appeared in those homes (in one instance, 7 of the 8 people in the house got sick; in another case it was 10 out of 11). One young woman who worked as a laundress in one of the houses died of typhoid.
Since Mary herself had never been sick or exhibited any symptoms of typhoid, Soper suspected that she was a “carrier”, a person who though infected with the bacteria, does not develop the disease but still carries the live pathogen and sheds it into the environment to infect others. To be certain, Soper needed to test samples of Mary’s blood and feces for signs of the bacteria.
Soper managed to track Mary Mallon down, and found her working as a cook in the family home of New Yorker Walter Bower, and visited the house in March 1907. As gently as possible, he told Mary Mallon that he suspected she was a carrier of typhus, and asked if he could obtain a blood and stool sample. Mallon indignantly replied that she was not sick and could not be infecting anyone, and when Soper continued to ask for samples, she grabbed a meat fork from the kitchen counter and threatened to skewer him with it. Soper beat a hasty retreat. Upon learning where Mary lived, Soper tried again, this time accompanied by a local doctor, but Mary once again became enraged, ordered them to leave her house, and shouted expletives at them as they left.
Soper now went to the New York City Health Department, which, after reviewing Soper’s evidence, agreed that a test was needed. A local health inspector was sent to Mary Mallon’s house, and when he was refused entry, he returned with five policemen. Mary stabbed at one of them with a fork and ran off, and was found hiding in her neighbor’s closet and taken into custody.
Against her will, Mary Mallon was taken by ambulance to the Willard Parker Hospital, where, despite continuous protests that she had never been sick and did not have typhoid, blood and stool samples were taken from her. When the tests came back positive for typhoid bacteria, she was taken to a cottage on the grounds of Riverside Hospital, on North Brother Island in the East River, which was converted into an isolation ward for her. She was kept there for the next two years.
In effect, Mary Mallon had been incarcerated in virtual solitary confinement, without any charges or trial and without having committed any crime, and there were serious questions about the legality of her involuntary exile. She kept up a constant barrage of letters to city officials protesting her isolation. “I never had typhoid in my life”, one of her letters thundered, “and have always been healthy. Why should I be banished like a leper and compelled to live in solitary confinement with only a dog for a companion?” Every few days, city health officials tested her feces for typhoid bacteria–they got positive results in 120 of 163 samples. Mary, meanwhile, was sending several of her own stool samples to private doctors at her own expense–and they all came back negative. Mary sued the city in an attempt to gain her freedom, arguing that her de facto incarceration was entirely illegal, that she was not sick, had never been sick, and carried no typhoid germs.
In 1909, a lawyer filed a writ of habeus corpus on Mary’s behalf with the New York Supreme Court. The city argued that, as a carrier of typhoid, Mary Mallon was a danger to the public and had to be confined and isolated as a matter of public health. Mallon, who was quickly dubbed “Typhoid Mary” by the press, argued to the court, “This contention that I am a perpetual menace in the spread of typhoid germs is not true. My own doctors say I have no typhoid germs. I am an innocent human being. I have committed no crime and I am treated like an outcast–a criminal. It is unjust, outrageous, uncivilized. It seems incredible that in a Christian community a defenseless woman can be treated in this manner.” The Court ruled in favor of the city, declared that Mary Mallon presented a public health danger, and ordered her returned to the isolation ward on North Brother Island.
A year later, a new public health commissioner was appointed for New York City, and he was disturbed by the implications of involuntarily locking up a young woman who had committed no crime, in solitary confinement, presumably for the rest of her life. So he arranged to release Mary Mallon, on the condition that she never worked as a cook again. Mary went free on February 19, 1910.
Some historians have concluded that Mary Mallon, who had always insisted that she was not sick and could not infect others, had never really intended to live up to that agreement. Others have noted that she simply had no choice–as an uneducated Irish immigrant woman, her choices of occupation were limited, and the skilled position of “cook” paid far more than any other job she was likely to get. So what happened next was, perhaps, inevitable.
In January 1915, some five years after Mary Mallon left her isolation ward, an outbreak of typhoid fever struck at the Sloane Maternity Hospital in New York City. Twenty-five patients and staff members became sick with typhoid. Two people died. Health investigators looking for the source of infection soon focused on the hospital’s kitchen, where a woman named “Mrs Brown” worked as a cook. “Mrs Brown”, the investigators soon discovered, was actually Mary Mallon.
Once again, she was taken into custody and was returned to her old isolation ward on North Brother Island. Although she still wrote protest letters to everyone she could think of, this time “Typhoid Mary” found no public sympathy–she had known that she was carrying typhoid, had agreed to not work where she would be a health danger to the public, and had done so anyway under a false name. She would now remain exiled on North Brother Island for her remaining 23 years.
After about ten years, Mary was allowed to work in the Riverside Hospital lab, washing glass bottles (which were then sterilized). In December 1932 she suffered a stroke that left her unable to walk, and was confined to a bed in a part of the Children’s Ward (where the patients and staff were all warned not to take anything from her). She finally died in November 1938 at the age of 69. She had spent nearly half of her life in involuntary confinement.
“Typhoid Mary” was not the only carrier to be identified in New York in the first decades of the 20th century: over 1,000 were known. She is not even the only one who defied health official’s orders and continued to work with the public after being ordered not to (and killed someone while doing it). But she is the only one who was forcibly isolated for life. The other identified carriers–many of them businessmen with families–were simply directed to work in areas that did not expose the public to the bacteria.
Several factors made Mary Mallon, and her treatment at the hands of the health authorities, different. She was a woman, she was an immigrant (anti-Irish bigotry was rampant at the time), she was from the lower working class and was uneducated, she was unmarried and had no family, and, perhaps most important, she consistently refused to accept that she was a carrier.
The legal and social issues of Mary Mallon’s case still echo today.