Mary Mallon’s Legacy
Miss Mary Mallon had a problem. I’m speaking of a woman immigrated to America from Cookstown, County Tyrone, Ireland in 1883. She was a cook for affluent families in and around the area of New York City.
Miss Mary was employed by several different families until 1907 when it was noticed a family she was employed by developed Typhoid, a particularly virulent and deadly form of bacteria called Salmonella Typhi. From the Centers for Disease Control website we find this statement: “Typhoid fever is a life-threatening illness caused by the bacterium Salmonella Typhi. In the United States, it is estimated that approximately 5,700 cases occur annually. Most cases (up to 75%) are acquired while traveling internationally. Typhoid fever is still common in the developing world, where it affects about 21.5 million persons each year. Typhoid fever can be prevented and can usually be treated with antibiotics. If you are planning to travel outside the United States, you should know about typhoid fever and what steps you can take to protect yourself.”
Now we find a great controversy in the avoidance of Ebola and the possible quarantine necessary after travel to nations noted for the outbreak of this devastating disease.
From the same CDC website we find Ebola described as: “Ebola, previously known as Ebola hemorrhagic fever, is a rare and deadly disease caused by infection with one of the Ebola virus strains. Ebola can cause disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees).
Ebola is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. There are five identified Ebola virus species, four of which are known to cause disease in humans: Ebola virus (Zaire ebolavirus); Sudan virus (Sudan ebolavirus); Taï Forest virus (Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus); and Bundibugyo virus (Bundibugyo ebolavirus). The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates, but not in humans.
Ebola viruses are found in several African countries. Ebola was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks have appeared sporadically in Africa.
The natural reservoir host of Ebola virus remains unknown. However, on the basis of evidence and the nature of similar viruses, researchers believe that the virus is animal-borne and that bats are the most likely reservoir. Four of the five virus strains occur in an animal host native to Africa.”
Under the heading in the CDC website the following is stated: “Because the natural reservoir host of Ebola viruses has not yet been identified, the way in which the virus first appears in a human at the start of an outbreak is unknown. However, scientists believe that the first patient becomes infected through contact with an infected animal, such as a fruit bat or primate (apes and monkeys), which is called a spillover event. Person-to-person transmission follows and can lead to large numbers of affected people. In some past Ebola outbreaks, primates were also affected by Ebola, and multiple spillover events occurred when people touched or ate infected primates.”
It must be remembered this is comparing apples and oranges with this statement concerning Typhoid vs. Ebola and the spread of disease. But there are interesting facts to be noted. Typhoid is a bacterium. Ebola is a virus. Mary Mallon was an immigrant showing no signs of disease through the duration of her life. It was only after being forcibly quarantined to North Brother Island in the East River the contagion was stemmed and people came to understand a person could be asymptomatic (without outward signs of the disease suffered by the host) and, who is a transmitter of the disease. Her incubation period was ongoing, unrepentant and irreducible.
Mary Mallon refused to have her bodily fluids (urine, blood and stool) examined in laboratory. She removed herself from where she worked and went to other employment with other people, as a cook, until formally seized and placed in involuntary quarantine. It was then the fluids were taken for study and Typhoid cells were found in her gall bladder. She was involuntarily quarantined until her death at age 69 in 1938. For all that time she was contagious.
Now we have a major problem. Thomas Eric Duncan, an African native and alien resident in the United States lied about caring for an Ebola infected pregnant woman, while in Africa on a visit (she later died of the disease) when he was first questioned about it. He later admitted to taking care of someone who died in Liberia, but then denied the story to Texas public health officials. Duncan died October 8, but not before infecting two of his nurses at Texas Health Presbyterian (Daily Mail. 10/28/2014)
All of this happened while in hospital quarantine in Texas. Prior to quarantine he moved around the Dallas area and lived with non-infected people who were left with contaminated sheets and bed-clothes after he reported to the hospital actively showing symptoms of the disease.
Now we have a volunteer aid worker returned from treating people in Africa was involuntarily quarantined in New Jersey. Kaci Hickox, who worked with Doctors Without Borders in Sierra Leone, was isolated in a tent at a Newark hospital even after testing negative for the virus.
While I can appreciate the problem of being held captive in any part of New jersey, for any reasons, I also appreciate that as long as there’s 21 day incubation period for this disease and the fact we don’t know for sure it won’t become transmittable by other than open contact with feces, blood, urine or sputum; it’s an acceptable thing to enforce quarantine until we’re sure the person is safe to walk among us.
Typhoid Mary Mallon protested she was well and disease free. She was a person who believed she knew best how she felt. She didn’t believe she could have the disease and not suffer the symptoms. She wasn’t a doctor and knew nothing of biology, immunology, the covert transmission of disease or any of the other medical sciences. And for her ignorance, Mallon is attributed with infecting 47 people with typhoid fever, three of whom died.
People claim there’s no precedent for forcibly and involuntarily quarantining an individual. This is not true. Though the law allowing this prospect seems archaic and too old to accept today, it was in New York City Board of Health Ordinances # 1169 and 1170 said: “The board of health shall use all reasonable means for ascertaining the existence and cause of disease or peril to life or health, and for averting the same, throughout the city. [Section 1169] Said board may remove or cause to be removed to [a] proper place to be by it designated, any person sick with any contagious, pestilential or infectious disease; shall have exclusive charge and control of the hospitals for the treatment of such cases. [Section 1170]6” (www.asdk12.org/staff/sullivan_andy/)
So; we must admit we’re comparing apples and oranges when discussing Ebola and Typhoid. But we’re not ignoring the fact the entire fruit salad shows signs of disintegration and the problems we fear may be delivered through means we (as of now) only treat according to our limited knowledge.
I know it’s hard to be infected with a viral or bacterial disease if you don’t even allow it into your environment. Just thinkin’.
Thanks for listening