Wednesday, February 06, 2008

Who Was Typhoid Mary?

Since I'm studying infectious diseases, salmonella has been on my mind. Specifically, the "First Lady" of Salmonella, Typhoid Mary. Who exactly was Typhoid Mary?
Mary Mallon (September 23, 1869November 11, 1938), also known as Typhoid Mary, was the first person in the United States to be identified as a healthy carrier of typhoid fever. Over the course of her career as a cook, she infected 47 people, three of whom died from the disease. Her fame is in part due to her vehement denial of her own role in causing the disease, together with her refusal to cease working as a cook. She was forcibly quarantined twice by public health authorities and died in quarantine. It was also possible she was born with the disease, as her mother had typhoid fever during her pregnancy.
However, my research also uncovered another Typhoid Mary:
Typhoid Mary (Mary Walker), also known as Typhoid and Bloody Mary, is a fictional mutant character in the Marvel Comics universe, most commonly associated with Daredevil as a supervillainess. She first appeared in Daredevil #254, and was created by Ann Nocenti and John Romita, Jr.

Typhoid Mary is an enemy and former lover of Daredevil with low level psionic powers, including telekinesis. She has been employed by organized crime syndicates as an assassin in the past. She is also truly and gravely mentally ill.
I love how the comic Typhoid Mary does not even come close to sharing the actual disease, which is decidedly much less glamorous. Can you imagine a comic book with the real Typhoid Mary? "Oh no, Superman is ill. All he did was eat at the local cafet... oh no! Typhoid Mary strikes again!"

Anyway, back to the real Typhoid Mary. Salmonella causes enteric fever, which presents with fever (duh), abdominal pain, liver or spleen enlargement and "salmon"/rose colored spots on the abdomen. Salmonella can also cause gastroenteritis, sepsis, and osteomyelitis especially in sickle cell patients. Some individuals enter a carrier state, such as Typhoid Mary:
People catch typhoid fever after ingesting water or food which has been contaminated during handling by a human carrier. The human carrier is usually a healthy person who has survived a previous episode of typhoid fever but in whom the typhoid bacteria have been able to survive without causing further symptoms. Carriers continue to excrete the bacteria in their feces and urine and poor hygiene can lead to its introduction into food and water.
However, it fails to mention how exactly Mary achieved this. Was she a mutant, as the comic book world would like you to believe? Sadly, no. The reality is salmonella can live in the gallbladder for years, and carriers secrete the bacteria in their stool. The best part of the story to me is how Mallon continued to work as a cook even after she was quarantined! She was eventually quarantined again and died in quarantine. You've gotta love the level of denial some people have.

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  1. There's a movie made about this that I watched in nursing school. It does a good job showing her intense denial and the ramifications for that.

    It also does a great job showing the importance of public health and disease control!

  2. Looks like an interesting movie!

    I think it also raises a point that I didn't really discuss in the post. As the comments on IMDB note, Typhoid Mary was the first case of a non-infectious carrier being identified. This presented a legal dilemma as the idea of a 'carrier' was a novel idea at the time. What right did the state have to quarantine her? And for how long?

    I'm not arguing that she should not have been quarantined, but it's clear that there must be some balance between society's well-being and the individual's rights. The issue is especially topical considering the recent case of the lawyer with XDR-TB who traveled from Europe to the U.S.



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