Download typhoid assignment for biology class and more Assignments Biology in PDF only on Docsity!
Why was Mary Mallon’s ability to carry and spread typhoid fever without showing symptoms significant? How does this phenomenon affect modern disease outbreaks? Why was Mary Mallon’s ability to carry and spread typhoid fever without showing symptoms significant? How does this phenomenon affect modern disease outbreaks? Mary Mallon’s ability to carry and spread typhoid fever without showing symptoms was significant for several reasons:
1. Revelation of Asymptomatic Carriers Mary Mallon’s case was one of the first documented instances of an asymptomatic carrier of Salmonella typhi , the bacteria that causes typhoid fever. Before her case, it was assumed that only people who were visibly ill could spread infectious diseases. Her ability to carry and transmit the disease without showing symptoms fundamentally changed the understanding of how infectious diseases could spread. It revealed that individuals who seem healthy might still be capable of unknowingly transmitting a disease, which is crucial for disease control. 2. Impact on Disease Control and Public Health Measures At the time of Mary Mallon’s case, there were no antibiotics to treat bacterial infections like typhoid fever. This made controlling outbreaks much harder. Her case underscored the importance of identifying asymptomatic carriers in preventing the spread of disease. It led to the development of new public health practices, such as quarantine and isolation of suspected carriers, even if they weren’t showing symptoms. These strategies became essential tools in managing contagious diseases, especially before the advent of antibiotics. 3. Influence on Hygiene and Sanitation Practices Mary Mallon worked as a cook, and it was through contaminated food and water that she spread the disease. Her case helped emphasize the importance of hygiene and sanitation, particularly in food handling, in preventing the spread of infectious diseases. This understanding led to stricter regulations for food workers and improvements in public health measures, such as better waste disposal, clean water, and food safety practices. How This Phenomenon Affects Modern Disease Outbreaks The concept of asymptomatic carriers continues to be highly relevant in the context of modern disease outbreaks: 1. Asymptomatic Spread in Modern Diseases
The phenomenon of asymptomatic carriers has been crucial in understanding the spread of diseases like COVID-19. During the COVID-19 pandemic, people who were asymptomatic or presymptomatic were able to spread the virus without knowing it. This understanding has shaped how we respond to modern outbreaks by increasing emphasis on testing, contact tracing, and isolation of individuals who may not show symptoms but could still spread the disease.
2. Increased Focus on Preventative Measures In response to diseases with asymptomatic carriers, public health strategies have become more comprehensive. For example, widespread testing for COVID-19 and other infectious diseases, even in the absence of symptoms, has been a critical tool for detecting and isolating individuals who could spread the virus. This has highlighted the need for ongoing surveillance and early intervention during outbreaks. 3. Impact on Quarantine and Isolation Protocols The awareness that asymptomatic individuals can spread diseases has led to the refinement of quarantine and isolation protocols. During outbreaks, even those who do not display symptoms may need to be quarantined to prevent transmission. For example, during the COVID- pandemic, even people who felt fine were often asked to isolate if they had been exposed to someone infected, reflecting the lessons learned from Mary Mallon’s case. 4. Emphasis on Hygiene and Sanitation The importance of hygiene and sanitation remains as relevant as ever in modern outbreaks. Mary's case underlined the role of food safety and clean water in disease transmission. In modern outbreaks, ensuring good hygiene practices, proper sanitation, and the safety of food handling are still key in preventing the spread of many diseases, including those caused by bacteria, viruses, and other pathogens. In summary, Mary Mallon’s case significantly advanced public health understanding by revealing the role of asymptomatic carriers in disease transmission. This lesson continues to shape how we respond to modern disease outbreaks, particularly through increased awareness of asymptomatic spread, enhanced testing, and more stringent public health measures. Mary Mallon's case as a "Typhoid Mary," an asymptomatic carrier of Salmonella typhi, was significant because it highlighted the possibility of disease transmission by seemingly healthy individuals, revolutionizing public health understanding and disease control efforts. This understanding has profound implications for modern disease outbreaks, emphasizing the need for proactive measures to identify and manage asymptomatic carriers. Here's a more detailed explanation: The Significance of Mary Mallon's Case:
After refusing to cooperate, she was forcibly taken by authorities following a dramatic chase and struggle. The correct answer is:
2. She was lured out of her home under false pretenses and then detained by the police. Mary Mallon was initially reluctant to cooperate with health authorities. They tricked her into leaving her home by telling her that they needed to examine her health for a potential medical issue, and once she left her residence, she was detained by the authorities. This led to her being quarantined and later forced into isolation due to her status as an asymptomatic carrier of typhoid fever. What was Mary Mallon's significance in public health history? She was a cook who contracted typhoid but recovered and continued working. She was a domestic worker who unknowingly spread typhoid but never showed symptoms herself. She was a nurse who cared for typhoid patients but did not realize she was spreading the disease. She was one of the first people quarantined for typhoid but was later released after proving she was healthy. She was the first known asymptomatic carrier of typhoid fever in North America. The correct answer is: 5. She was the first known asymptomatic carrier of typhoid fever in North America. Mary Mallon is significant in public health history because she was the first person identified as an asymptomatic carrier of Salmonella typhi , the bacteria that causes typhoid fever, in North America. She spread the disease to others without showing any symptoms herself, which led to important changes in how public health authorities approach the identification and isolation of asymptomatic carriers to prevent the spread of infectious diseases.
1906 in this luxurious vacation home in oyster bay long island a young girl margaret warren is gravely ill with typhoid fever she has the best care but without a cure all anyone can do is try to bring down her fever [Music] this is the last thing charles warren banker to the vanderbilts expected when he rented a house for his family in this exclusive seaside resort this was a family that brought servants with them and came to summer out on the island and this individual family no one else in oyster bay but this individual family was struck by typhoid fever and six members of the household came down with the disease typhoid fever is extremely contagious first the youngest daughter became ill then two maids the mother another daughter and finally the gardener how could a disease of the slums strike this wealthy community it wasn't the sort of area that one would expect to see typhoid which was often associated with crowded poor neighborhoods [Music] at the turn of the 20th century the most crowded neighborhood in the world is new york city's lower east side it's even more crowded than calcutta with few connections to city water or sewer the tenements lack even basic sanitation infectious diseases like smallpox diphtheria tuberculosis and typhoid fever kill thousands each year typhoid fever was a fairly common visitor in new york city and in other urban areas especially in the 19th century and in the early part of the 20th century in new york city alone there were about 4 000 new cases of typhoid fever every year the symptoms of typhoid can be severe weeks of fever headache diarrhea delirium one out of 10 dies of the disease when people had typhoid fever in the early 20th century and there were no antibiotics doctors had to just treat the symptoms but the cause of the disease is no longer a mystery thirty years earlier scientist louis pasteur electrified the world by proving that bacteria microbes invisible to the naked eye cause disease typhoid fever comes from salmonella typhi bacteria that grow in the intestinal tract and are shed in the feces [Music] in 1892 new york city set up the country's first bacteriology laboratory devoted to public health the new science the new bacteriology was tremendously exciting this focused on what can we see under the microscope what can we do once we diagnose people with specific diseases what can we do to prevent this from being spread to other people in oyster bay where even president teddy roosevelt summers the threat of a typhoid epidemic is terrifying everybody started looking around for an explanation they started looking for the usual suspects you know let's find that the dirty the poor uh you know maybe some bad dairy the lady on the beach who sells shellfish it's got to be one of them experts are called in to investigate they know typhoid fever is caused by contaminated food or drink they suspect the plumbing in the house and put dye in the toilet to see if it contaminates the drinking water it doesn't they check the local shellfish to see if the bay is polluted with sewage it isn't they examine the milk supply in case it is contaminated it too is free of bacteria [Music] the source of the outbreak remains a mystery though the oyster bay victims recover a cloud of disease hangs over the house
the employment agency that placed her with the warrens does not know where she is but directs them to some of her previous employers what he discovers astounds him in 10 years she is known to work for eight families and in six of these typhoid had occurred how is this possible has mary been spreading typhoid bacteria for years without ever appearing to be sick [Music] soper remembers reading a paper written four years earlier by german scientist robert koch coke had found a baker who was not ill but who spread typhoid germs a so-called healthy carrier of disease could this be the case with mary mallon soper had read that literature and thought he was on the cutting edge of you know medical science and history [Music] if soper is right the cook would be the first american identified as a healthy carrier of typhoid fever it would be a major discovery and make his career i think soper is very excited by this possibility he sees that as a scientific puzzle that he is the detective for and he's going to sleuth out and win the prize [Music] to prove his case soper needs specimens from the cook in march 1907 he learns mary is working for a family on park avenue typhoid ii is already in residence a chambermaid has just been taken to the hospital and the family's only child is in critical condition mary helps nurse the girl here you go my daughter all i know is to hold on in there it was at this house that i had my first interview with mary i supposed she would be glad to know the truth i thought i could count on a cooperation soper's account of their meeting is almost theatrical [Music] miss mary mellon i'm mary marlon miss malin my name is dr george soper i have been looking for you for quite a while i was hired to track you down to track me down yes miss malin it appears that you are the unwitting cause of the typhoid fever outbreak at oyster bay last are you mad it is imperative that i get specimens from you of urine feces and blood to confirm my suspicion i've never been sick a day in my life i've never had typhoid miss malin you contain within your body typhoid fever germs when you visit the toilet these germs get on your fingers you then transmit these germs to the food are you suggesting that i don't wash my hands soper claims that the meeting ended badly when mary reached down picked up a meat fork and threatened to uh well stab him with it get out of my kitchen please don't come back keep going i don't want to see you back here again keep going i think that he makes her sound a lot more fearsome than she was simply to explain the fact that you know he well she scared the hell out of him he unleashed a violent temper in her by what he thought was a mild request reasonable request a scientific request and she sees it as the exact opposite of that soper did not mention the families where
i have worked where there was no typhoid he did not see fits to mention the family i always lived within the bronx when i was out of work and where i shared a room with the children without giving them typhoid mary melon had no reason to think that she could have communicated typhoid fever to anybody the concept that if you are sick with a particular disease you can give it to somebody else is fairly new why would you believe all of a sudden a group of scientists telling you that invisible germs that you can't even see that you've never heard of before are causing all these diseases that you've seen for decades and decades [Music] like most people of her time mary mallon does not understand the cause of disease in the 19th century you had this idea about disease that somehow it came from filth and filth was somehow a moral statement about your community so the filthier your community the more subject you were to having what were called miasmas arise [Music] people thought that illness came from mysterious sewer uh sewer gases miasmas you know you know we're not far away from evil spirits [Music] miasmas and the filth that caused them were thought to be concentrated in the tenements overflowing with immigrants [Music] with the population doubling every decade city services were unable to cope [Music] it's a city that's being transversed by 150 to 200 000 horses and of course you know basic public health fact number one is that each horse gives off about 25 pounds of manure a day times 200 000 horses times 365 days in which the manure may or may not be picked up so the city was really filthy uncollected garbage animal carcasses back alley privies clogged sewers and household waste made conditions unbearable cleaning up the city became a moral crusade in 1895 a department of sanitation was created proclaiming cleanliness is next to godliness it recruited an army of street cleaners the white wings there were parades of these guys these guys would march down fifth avenue it's almost like a military exercise at the same time public health is shifting its focus from brooms to bacteriology george soper is part of that change george soper was on the cutting edge of the new science but he's coming from an older field an older field of sanitation that he is in some sense trying to leave behind having mary mallon deemed a typhoid carrier would lead to a new kind of respect and new credibility in the science of bacteriology i discovered that mary was spending the evenings at a rooming house on third avenue below 33rd street with a disreputable looking man named bryhoff who had a room on the top floor and to whom she was taking food he kept his headquarters during the day in a saloon on the corner i got to be well acquainted with him he took me to see the room
always described herself later as alone in america [Music] she probably put in her time on a laundry seamstress work cleaning hauling coal all the usual lower echelon tasks so it was quite a climb she at some point had had to learn how to cook well how to run a kitchen well and apparently was good at what she did she was hired again and again by very good families cook was the highest rung of the pecking order among servants and she was often not just cook but she was really the kind of manager of the entire enterprise and would have been the most trusted uh member of the staff mary's employers are unaware that their cook may have brought typhoid fever into their home i felt a good deal of responsibility for the case under suitable conditions mary might start a great epidemic but soper alone does not have the authority to force mary to cooperate [Music] typhoid fever smallpox influenza diphtheria tuberculosis [Music] the man leading the charge against these scourges is herman biggs new york city's health commissioner biggs is committed to wiping out disease using science and the tools of public health in this crusade workers have the right to march into tenements to vaccinate people confine the infected to their houses and use force to quarantine those who will not comply on islands in new york harbor this is the power needed to confront mary mallon i laid the facts concerning mary's history before dr hermann biggs with the suggestion that the woman be taken into custody and her specimens examined dr soper asked to have an inspector sent to get specimens from mary i was the inspector assigned the seemingly simple task trained as a physician dr s josephine baker is one of the department of health's roving inspectors you know all the things that people did in the story of mary mellon picking the woman seemed like a really smart sensible human move baker came from a fairly well-off family she was very committed to the poor and to improving the health of the poor however she had nothing kind to say about the people that she worked among and yet there she was committing her life to them the heat the smells the squalor made hell's kitchen something not to be believed its residents were largely irish incredibly shiftless wholly lacking in any ambition and dirty to an unbelievable degree i climbed stair after stare knocked on door after door met drunk after drunk filthy mother after filthy mother and dying baby after dying baby in the home where mary mallon works the daughter dies of typhoid fever [Music] mary must be taken in for testing [Music] i stationed one policeman in the front of the house another on the nearest side street had an ambulance waiting around the corner and with a third policeman at my elbow i knocked at the servant's entrance miss mallon the health department has
sent me to take you with me i'm going nowhere officer mary sees her brandishes a fork again supposedly mary goes on a lamb tries to get away with police searching everywhere [Music] has mary melon come through here [Music] the rest of the servants denied knowing anything about her or where she was even in my distress i liked that loyalty we went through every nook and cranny it was utter defeat then one of the policemen with me caught sight of a tiny scrap of blue calico caught in a door in a back hallway several ash cans were heaped up in front of it mellon out scratching and screaming and yelling no let me go takes the five police officers to get her into the ambulance and josephine baker sits on her in the ambulance the whole way to willard parker hospital where they're going to take her it was like being in a cage with an angry lion mary is taken to willard parker hospital an infectious disease facility for the poor there's a photograph of mary mallon in bed at willard parker hospital and she is in a room with a lot of other people who knows if they have typhoid people or something else or why she's in bed since she's not sick being brought to willard parker was in some sense a statement about mary's worth that she would have understood very clearly she would have said oh my god you know how dare they i mean this is this was a real kind of insult to her i have committed no crime and i am treated like an outcast a criminal it is unjust outrageous uncivilized and it is incredible that in a christian community a defenseless woman can be treated in this manner at new york city's pioneering bacteriology laboratory scientists test mary's specimens using the most advanced tools and techniques [Music] samples are placed in an incubator to see if bacteria grow the results are unambiguous the hospital's laboratory speedily proved that mary was as dangerous as dr soper has suspected her stools were a living culture of typhoid bacilli [Music] george soper knew all along from his work that she could carry typhoid fever this was proof that she did carry typhoid fever [Music] soper has made a major breakthrough in the battle against disease proving that mary harbors the bacteria even though she insists she has never had typhoid fever mary melon did have typhoid fever but she had a very very mild case of the disease and she never knew she had typhoid fever or was that sick at all in fact she probably just thought she had a cold to the flu [Music] in most cases of typhoid fever the body is host to a microbial battle where there is a clear winner if the bacteria win the patient dies if the immune system wins the typhoid bacteria die [Music]
is perfectly healthy is sent out there [Music] [Applause] mary is confined to a small cottage on the island she was being cut off from everyone and everything she was familiar with so it was really imprisonment i don't think she would have seen it as anything other than a form of imprisonment when i came here i was so nervous i was almost prostrated with grief and trouble my eyes began to twitch my left eye became paralyzed would not move it remained in this condition for six months not everyone in public health believes mary's quarantine is justified dr milton rossino director of the national hygienic laboratory in washington and other prominent scientists object to her incarceration they understood her dangers they accepted that she was a healthy carrier and yet they said all you have to do is re-train her for another job where she's not cooking and then she won't be a danger to anybody but the department of health is determined not to let mary go instead doctors try to cure her with experimental drugs and procedures i took eurotropin for about three months all told if i should have continued it it would have killed me for it was very severe at first i would not take it for i am a little afraid of these people and i have good right she never listened to reason when they suggested removing her gallbladder the probable focus of infection she was convinced afresh that this was a pretext for killing her mary's doctors have a hunch incorrect as it turns out that removing the gallbladder will cure her they said they'd have the best surgeon in town to do the cutting but i said no no knife will be put on me i have nothing the matter with my gallbladder i think mary mellon may have made a very good choice there if she'd had surgery she probably would have survived but the rates of infection and other problems were higher and there is a chance she might have died from routine gallbladder surgery [Music] mary is kept on north brother island but wages a steady battle she writes letter after letter to biggs soper and baker pleading for her freedom [Music] why should i be banished like a leper and compelled to live in solitary confinement a few years of this life and i will be insane [Music] [Applause] [Music] two years go by mary is even more desperate to regain her freedom will i submit quietly to stay in here a prisoner all my life no as there is a god in heaven i will get justice somehow sometime [Music] in june 1909 mary and the young irish lawyer george o'neill filed suit in the new york supreme court demanding her release her argument was very simple i've never been sick therefore i can't transmit sickness to anybody else and i've never gotten my day in court there has been no due process a few days later publisher william randolph hearst tells mary's story in his new york american [Music] he may even be financing her legal case to sell newspapers this time her identity is revealed but typhoid mary is the name that sticks
[Music] the story includes an article by william park head of the city's bacteriological lab he writes that new screening procedures have uncovered at least 50 healthy carriers of typhoid fever only mary is in quarantine the health department knows and the reason they haven't isolated the other 49 is because walking around the city streets mingling with people in new york was not at all dangerous mary marlon only transmitted typhoid fever when she cooked for people july 1909 mary mannon leaves north brother island for the first time in two years to plead her case before the new york supreme court the department of health defends its position [Music] the health department argued very strongly that there was proof in the laboratory that she was a carrier and therefore dangerous to the public health a menace to the public health and they argued that point alone mary goes into court with some ammunition of her own using her boyfriend breihoff as a courier she has been sending specimens for months to the ferguson laboratory in manhattan the results contradict the health departments the health department report always comes back stating that typhus basili have been fought but my specialist who is the head of his profession reports that he has found none occasionally the specimens of a healthy carrier do not contain bacteria which may explain mary's results in any event the court rules against her historically courts have almost always sided with public health departments be it typhoid fever be it tuberculosis be it other infectious diseases because the fear of the spread of infectious disease is so dramatic i absolutely think that the public health authorities were justified in quarantinia the public has the right to be protected from people who can destroy their lives and end up killing them [Music] we see it today certainly with multi-drug resistance tuberculosis with hiv aids now with sars you see where individuals are being quarantined isolated whose liberty is taken away in the name of protecting the public health well mary mallon gives us an example of that at an extreme level because she was healthy she wasn't even sick [Music] there are two kinds of justice in america and all the water in the ocean wouldn't clear me of this charge in the eyes of the health department they want to make a showing they want to get credit for protecting the rich and i am the victim [Music] several leading public health officials are outraged at mary's continued incarceration charles chapin in rhode island declares it a discredit on public health work in new york the department of health is feeling the pressure there were numerous attempts to find a way to let all involved weasel out there were a number of approaches to marry where don't you want to go stay with your sister in connecticut and she would say but i don't have a sister in connecticut i think the idea there was you know if
nicknamed the cook typhoid mary she called herself mrs brown she was out at the moment but would i recognize her handwriting [Music] he handed me a letter from which i saw it once that it was indeed mary mallon i went up there and went into the kitchen sure enough there was mary earning her living in the hospital kitchen spreading typhoid germs among mothers and babies and doctors and nurses like a destroying angel my sympathy begins to erode a bit for her and i think what is going through her mind how can she go back and start cooking is she either so danced that she didn't get it uh or is she so spiteful that she's gonna show the americans or she's gonna show the employer class that they can't keep her down i don't think she was ever an evil person she didn't intentionally go out to hurt people she just was incapable of understanding that her carrier state was the cause of deaths of people in the illness of people [Music] department of health officers traced mary to a house in queens [Music] she doesn't answer the doorbell so they use a step ladder to get up to the second floor their dogs barking they bring up meat to give to the dogs and quiet them down and they break into the house this time she goes without a struggle i think she understood the jigs up you know this was basically my last shot i'm not getting out of this there is no sympathy now for the woman whose name is synonymous with the disease time that mary malin is quarantined the arguments for doing so have become much more compelling she sort of failed the test of working with the public health officials and she's sent back to the island this time with more justification by the time she hit north brother the second time there was no fight left in her everything that she had was gone one of the women here the second from the left is thought to be mary marlon [Music] adjusting to life on north brother island mary even makes friends with some of the doctors and nurses my father was the medical director of the riverside hospital there and he knew mary mallon very well he was one of the few people that mary got along with he was a first generation irish person i think he could identify maybe more than herman biggs or george soper with what makes an irish immigrant tick three years after her return the department of health occasionally allows mary to take the ferry into new york they would let her leave take day trips to visit friends and she would always return on time i don't think there was anything else for her out there while mary is in quarantine the department of health develops a more flexible approach to healthy carriers food handlers are sometimes retrained or paid to stop working even uncooperative carriers are not punished the way mary mallon is
mary mellen got singled out i think the public health department in the face of her resisting this new authority of science i think god vengeful in their desire to show to teach her a lesson [Music] on the island mary is tested regularly for typhoid she is still a carrier eventually she is given a job as a lab technician at riverside hospital in 1932 her supervisor poses with mary at age
- the photograph that we have of marymount from late in her life shows a woman who's gained weight who has suffered some minor strokes you can see one of her hand is in a fist she does not look very attractive in that picture she doesn't look very happy after 26 years on north brother island mary mallon died in 1938 she was 69 years old she had given 47 people typhoid fever three of them died mary never accepted she was the cause by that time typhoid fever was on the wane the result of better sanitation it would be another 10 years before antibiotics would be used to treat the disease and cure healthy carriers like mary but new and even more deadly diseases continue to arise confronting us with the issues that mary malin first raised a century ago today it might be ebola virus hiv and most recently sars but we always have to as a society be very careful about how we will use public health powers and not trample on the rights of the individuals who are sick though mary malin is long forgotten typhoid mary is not she remains a potent symbol of our fear of disease and of the dilemma over how far we should go to protect ourselves [Music] we now assume that typhoid mary is actually a perpetrator of evil and i think that's uh probably a pretty sad legacy for her i lived a decent and upright life until i was seized locked up and re-christened typhoid mary before god and in the eyes of decent men my name is mary mallon quarantine is as important now as it was in mary mallon's day on nova's website trace the history of quarantine from ancient to modern times including the power states have today to isolate you find it on pbs.org [Music] [Applause] to order this program on vhs or dvd or the book typhoid mary captive to the public's health please call 1-800-255-
