Introduction
Mary Mallon, famously known as Typhoid Mary, was worked as a cook for eight families in the New York area from 1906 to 1907. These families were affected by malaria, not because of contaminated water, clams, milk, and other direct contacts but because Mary was employed by these families as they cook who had been the silent carrier of this dreadful disease. Mary’s moniker had become a symbol for disease and evil later.
The book namely “Typhoid Mary: Captive to the Public’s Health” was written by Judith Walzer Leavitt in 1996 and was published by Beacon Press located in Boston which vividly illustrates Mary’s ordeal.
A New York-based sanitary engineer named George Soper was first identified that Mary was the cause of the outbreak of malaria in New York is due to his epidemiologic detective work. Strangely, Mallon herself had never suffered from typhoid fever. By contaminating the food that she cooks for others, Mary had spread the disease. Mallon was the first-ever individual who had been labeled as a chronic carrier of the typhoid fever bacillus in the United States.
Leavitt organized her book to illustrate various issues through multiple, varied perspectives like the public health establishment, the media, the law, and Mary herself.
Mary’s ordeal is being considered as historic as she had been denied her liberty for almost 26 years in the guise of interest the public safety. Mary’s episode also teaches us how health officials showed their interest in eliminating the disease out of her rather than educating her ways and means to minimize the transmission by simply cleaning her hands and by not preparing raw food.
Further, she was subject to extreme treatment including quarantine for a long phase of time mainly due to her adamant nature as she was an Irish woman who had a bitter temper, was not a breadwinner, and never accepted that she was a carrier for typhoid disease.
Leavitt’s narration offers an excellent illustration of the importance of history to contemporary public health policy. A real-life scenario like Typhoid Mary will be useful to today’s clinicians, health officials, lawmakers which may offer more vistas on controlling epidemics.
Analysis
Public health issues
Typhoid fever was prevalent in a large number of victims especially among the uneducated and poor and those who live under an atmosphere that encourages infection and lack knowledge about the risk-reducing safety measures. For instance, in 1906 alone, there were about 3470 cases of typhoid were reported in New York City alone and about 640 died of typhoid on that year alone.
When Soper and doctors tried to take her to the hospital for taking a blood test in 1907, she did not cooperate. With the help of police, they successfully removed her to Willard Parker Hospital where feces, urine, and blood were obtained for testing purposes. The stool culture was positive with typhoid bacilli while the urine and blood cultures were negative. As the health officials did not believe that she would behave in the public interest and abide by public health codes, she was kept under custody in the hospital.
Though the hypothesis that an obvious healthy individual could transmit a contagious disease was already under examination in the United States and Europe, Mary’s episode was not only new but also somewhat contentious at that time.
Leavitt believed that an extensive conviction of Mary’s adversaries symbolizes far too minute a historical evaluation. For instance, as Leavitt observes, Mary herself was far from irreproachable as she vehemently turned down the appeals of health officials and resumed cooking.
Typhoid Mary episode also raised modern deliberations of the quarantining of defiant persons affected with tuberculosis or AIDS. Thus, Mary’s episode reminds us how coercive public health initiatives are always abused or an unavoidable evil? However, Leavitt was restrained about quoting direct parallels, informing how the historical model had transformed largely during the 20th century.
As far as public health issue authorities are concerned, the healthy human carrier was not just a passive vector of disease or infection but also acted as a breeding center and warehouse of the particular germs that gave the best narration for the necessity for the maintenance of the infection in the societies.
Mary’s episode illustrated how epidemiological examination functioned as well as why it is so significant. It changed the threat of Mary Mallon, the healthy human carrier into “Typhoid Mary” the icon of epidemiological effectiveness.
The Mary episode illustrated the following significant lessons:
- An individual can be a human transmitter of typhoid.
- Mary posed a peril to the community.
- Her confinement or isolation was validated as it created not only the medical but also the social importance of epidemiology.
- It has demonstrated that cleanliness not only became a solution to communicable disease but also a measure of citizenship.
Healthy carriers of typhoid reined the authority of science to illustrate the medical ramifications of the changing relations, spaces, and interactions attendants on industrialization and urbanization. Mary’s episode also speeded up the invention of preventive medicines for typhoid which was viewed as the cornerstone of public health.
Health officials offered much significance to Mary’s social conditions. The existence of social differences had influenced the health policy implementation. Homeless people or those lacks family did not have physical and social supports to influence health officials that they could care for themselves and not jeopardize the health of others.
Legal Issues
Nearly after 24 months of her captivity in hospital, she filed a suit for her release. She appealed in 1909 which highlighted her predicament to public attention and as the result, she drew out a considerable amount of public compassion. However, the court held that she was a real danger to public health and ordered her to remain in confinement in Riverside hospital in Manhattan. She was finally released in 1910. The conditions of her release stated that she would take up different occupations and report once in a quarter to the laboratory for testing purposes. She was given employment in a laundry by the health commissioner. However, she never respected the conditions of her release and again took up cooking as her profession. Meanwhile, she also disappeared, and only after five years, epidemiologists found her responsible for another typhoid outbreak where she was employed as a cook. This time, she was sent to North Brother Island, New York, and was offered as a hospital laboratory assistant.
Leavitt also illustrated how issues like ethnicity, class, and gender shaped the isolation of Mary for long–term detention even though there existed hundreds of typhoid carriers.
There remain unanswered questions like why the court and the health officials declared Mary as obstinate and thus denied her liberty. This may be mainly due to her perversity or recalcitrance character. Leavitt argued that if Mary had cooperated, she would have secured freedom.
The popularity of Mary grew very fast thanks to the publication of her story in newspapers and the yellow press. Many kinds of hearted were ready to offer their support for legal action as at that time Mary had engaged a lawyer for her case.
It is to be observed that the” New York City Department of Health for typhoid carriers “had the following norm. Typhoid carriers need not be detained in hospitals or other public institutions if they do not prefer the same. Instead, they will be sent back to their home if their residential atmosphere was satisfactory. Thus, people like Mary who do not have a home or family became more susceptible to detention due to the connotation that they could not take care of themselves. Thus, the public health authorities not only found it necessary to explain not just the bacillus transporting character of those deemed jeopardy to the public health but also their social status, even if that social status was irrelevant to elucidating the health perils they caused. (Leavitt, page 158)
Mary was considered to be a source of cause of typhoid in at least 48 cases including 3 deaths.
Issues raised by media
Media played a funny role in Mary’s episode as it had given varied simultaneous narrations of Mary’s quandary. When Mary was detained, the reporters portrayed her as a 200 –pound hefty lady which was contradicted by drawings and photographs of Mary. Media also described Mary as a “human culture tube.” (Leavitt, page 128).
Further, American media had portrayed a common image of Typhoid Mary as a headstrong lady promiscuously spreading out infection. Even children’s jump-rope rhymes have been coined thereby accusing Mary by inquiring “Typhoid Mary, What do you carry? “(Leavitt, page 128).
Mary’s psychological and ethnic issues
Mary was virtually annoyed when she was referred to as “Typhoid Mary” as it blurred her individuality. (Leavitt, page 187). She was also fed up due to her long-period isolation and felt that she had been “shunned like a leper.” (Leavitt, page 162).
As this real episode is written on a small knot, Leavitt could not avoid repetitions and the narration based on identical events and pieces of data, like newspaper accounts and the letter written by Mallon in 1909. Further, Leavitt persuasively demonstrates how each of these events has contributed to historical knowledge about Typhoid Mary and adds that “there is no lone reality about her.” (Leavitt, page 231)
Mary of the view that she never had typhoid and she was hale and healthy and never had typhoid in her life. She accused that the real culprit was the drinking water and hoped to bring more medical evidence in support of her argument. She commented that her doctors had given a clean chit that she never had typhoid germs.
Possibly, if Mary Mallon had a residence to shelter her then health officials might have regarded her as safe and if she had a family that would take care of her, then she might have been released by health officials and by the court despite the truth that she declined to adhere with the health department parameters in this respect. Further, if Mary had been a housewife instead of a domestic caretaker, the health authorities might have found no reason to detain her.
Suppose, if Mary had not been of Irish origin, despite her conventional irritability, she might have been given less coercive retorts to her actions. Further, Mary’s ethnic overtones lurked many remarks about her lack of cooperation and hot temper.
Further, there were some ethnic and some class-related perceptions were obvious in both the public and official thinking about Mary’s situation and they influenced their behavior about her and appear to have influenced the treatment she got from the health department officials.
Conclusion
Mary’s episode obtains its supremacy from its role in illustrating a significant scientific theory namely the prevalence of a healthy human carrier of a contagious disease. The notion of the healthy carrier was footed on the presumptions of the germ theory of disease – the particular microbes created specific diseases –as well as on epidemiological scrutiny. The recognization of such individuals, in turn, corroborated that theory, which was still challenged at the start of the twentieth century and outlined the course of public health policies and medical research.
She was affected by a paralyzing stroke in 1932 and was expired on November 11, 1938. Leavitt concludes that the annals of a character like Typhoid Mary demand “multiple viewpoints … logically located in a specific historical setting. “(Leavitt, page 233).
Leavitt feels that the Typhoid Mary episode is a significant cautionary narration about the attempts to neutralize civil liberties with that of public health of individual patients.
Thus, the Typhoid Mary episode illustrates several lasting lessons like the necessity to shun stigmatizing tags when depicting groups or people who pose peril to public health, the necessity to extend the public health restrictions in an equitable manner, and the significance of employing duress only as a last resort. These lessons are as significant in the epoch of the Ebola virus and AIDS as they were when contagious epidemics like smallpox, typhoid fever, and cholera have occupied the headlines in the American mass media.