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20th Century Super-Spreader

13 January

Abandoned building on North Brother Island
An illustration of Mary in The New York American 1909
Mary Mallon in her hospital bed on North Brother Island

The topic this week is Mary Mallon, also known as Typhoid Mary. Joe explains typhoid fever, and Sandra doesn't know what century she's in.

Joe got his information from:

Sandra got her information from:

Audio transcript

Midweek Murders contains graphic and explicit content, listener discretion is advised.

Hello!

I'm not ready!

Absolutely spiffing to hear your voice!

Don't make it weird in the first five seconds.

[Music]

So maybe we should start?

Maybe we should give the listeners a warning that this case is not a murder mystery case like all the others.

Well it's gonna be clear probably from...

I think everybody knows who typhoid Mary is.

I think so too.

But we could say something about it like

hey listeners all of you

interested in potential murder tips skip

this week

skip every week because i always cut it

out so oh god damn it

oh god damn it okay what am i

here for

the jury is still out on that one

i'm just kidding you have a lot to say

about the cases

not always not always but got anything

to contribute joe

no no i think you covered it actually

should we wrap this up

you think that's the case but you talk

for like

60 80 percent of the episodes well then

how much do you cut out jesus

christ

i cut out a lot of you talking

and i'm still 60 me

okay it's wednesday which means that

it's time to talk about

crime i'm your host sandra and i'm your

co-host joe

this week we're going to talk about

typhoid mary

or mary malone as she

is actually named and i got my

information from wikipedia

mary malone and the history of typhoid

fever

from the website where you usually

send me links it's n-c-b-i-n-n-h

gov pnc is that like the medical

articles what is that called ncbi

is the national center for biotechnology

information okay and it forms part of

the united states national library of

medicine

a branch of the national institutes of

health oh

really that is where i got my

uh information some of it an article on

history.com

by christopher klein aina kleiner

an article in the smithsonian magazine

by veronique greenwood

and encyclopedia britannica which i

still can't get over that they spell it

with an

a in the pedia yeah i think that's

probably because a lot of places

don't accept the ae symbol

but yeah also i pronounce it

encyclopedia

but always read it encyclopedia

yeah me too i don't know idea

yeah i don't know how the ae is actually

meant to be pronounced because it's not

included in any english words

so i'm just like encyclopaedia

yeah me too i got my sources from

the wiki wiki and also the

national center for biotechnology

information which is part of the united

states national library

of medicine a branch of the national

institutes of health in the usa

oh my god maybe we're at the same

article

no maybe no

well two of mine were from the ncbi so

it's possible that

one of them was the same probably the

history of

typhoid mary might be the same one but

yeah you know

mary marlon was an irish lady born with

typhoid

in 1869 as her mother had been infected

during her pregnancy

side note this is a theory when mary was

only 15 years old

or thereabouts she moved to america

where she lived with her aunt and uncle

for a while

whilst working as a maid in her 30s

she began working as a cook for a

wealthy man in new york

called charles henry warren

within a week six of the 11 people

living in the warren household had

fallen ill

with typhoid fever and here

surprisingly early in the episode i'm

gonna ask you about typhoid fever

what is it oh good loud i was

i wasn't ready to be involved this early

she's already at the door let me put my

penis away

and get my notes

like a proper lady oh let me just

straighten out my dress and i'll be

right with you

help yourself to the iced tea on the

counter

i will i will i hope it's spiced with

brandy

there's extra sugar in the decanter

so typhoid fever is

a bacterial infection usually spread

by this is pretty gross eating or

drinking

contaminated food or drink and that food

or drink

is contaminated with human feces

for all of those that are not of us in

latin

human feces means

people you get typhoid

from eating or drinking food or drink

with

human in it oh god

so it's most common in what was

formerly known as third world countries

i think they're now known as developing

i thought typhoid fever was like

eradicated

no no no it's not very common

in the developed world oh through

a combination of factors mainly

antibiotic treatment when it was first

established

and health and hygiene practices so

the easiest way to eradicate it is

regular hand washing so the privilege of

running water

not even running water but just the

privilege of

soap oh okay you could still

theoretically get typhoid

from your tap if your water source was

contaminated

if your reservoir was contaminated

then your drinking water would be

contaminated yeah

so it's still possible to get it in

developed countries

but with the combination of antibiotics

and

increased public awareness of hygiene

it's a lot less common but in 2015

there were 12.5 million

recorded cases of typhoid fever

and 149 000

deaths so my awareness of this

was nil yeah

yeah i mean i can't comment on that only

you know your awareness of this

yeah yeah no i get it yeah but the usa

records thousands of cases a year but

then you only have to look

at places like the place that hasn't got

fresh water whose name has just

completely evacuated my brain now

flint yes flint so flint would be the

perfect example

of cases in the u.s of typhoid

because they haven't got clean drinking

water yeah

so it would be easy for their water

source to be contaminated

it's a pretty nasty disease so

usually symptoms will occur

after six or seven days of infection in

the first week

you'll suffer from fever malaise

headache cough in the second week

your fever will spike to about 40

degrees

celsius the normal body temperature

is 37 i think or thereabouts

and it's important to know that even a

one

degree shift in body temperature is

enough to start

denaturing your proteins so three

degrees

with this fever can be lethal oh

really yeah a 40 degree fever

can be lethal i've had 40 degrees fever

before

and that's why you're dead now

anywho typhoid so the second week

of symptoms you'll experience

bradycardia which is a decreased heart

rate

delirium and a tender stomach in the

lower quadrant

so the part where you feel your

menstrual

i wouldn't know i don't have a womb okay

you say

okay like this is news to you

well i can't be sure but where's the

fetus gonna gestate

in a box

i'm gonna put it in a shed outside huh

and then the third week the symptoms

start to get

real bad you can experience

intestinal hemorrhage intestinal

perforation which can lead to sepsis

because you've got a bunch of

floating around in your intestines

encephalitis which is inflammation of

your brain

closely linked to meningitis pneumonia

and bronchitis so

pretty brutal so is that what

you had on typhoid fever

i've got a bit more i'm ready the

nomenclature

is quite interesting so the

bacteria that causes typhoid fever

is called salmonella subspecies enterica

sorova typhi which basically means that

it's salmonella typhi but it's the same

species of bacteria that causes some

strains of food poisoning

salmonella so when you get salmonella

food poisoning

you've got lucky because you haven't got

the typhoid version

oh yeah the food poisoning type of

salmonella

can be zoonotic so it can be passed from

animal to human and again is

transferred by fecal matter so

anybody that's got salmonella food

poisoning gross

you've eaten isn't colvid

also us zoonotic yes because it

originated

in bats the interesting thing about

s typhi the bacteria responsible for

typhoid

is that there are no animal carriers

so this particular bacteria

the reservoir host is humans

what yeah it doesn't affect animals

so an animal can be infected with

s-typhy typhoid fever but

they won't pass it on and they won't

exhibit any symptoms of it

the transmission and the reservoir host

is humans oh as we talked about

earlier the best way to control s

typhi is sanitation basically

and the center of disease and infection

control in the us

the cdc has said that something as

simple

as chlorinating water which

every first world country does they

found

that as soon as they started

chlorinating water

the amounts of reported typhoid fevers

dropped

dramatically yeah and it makes sense the

biggest

cause of typhoid fever transmission

is contaminated food or drink if you can

decontaminate that with chlorine

then your transmission rates drop that's

all i have

because the rest is about gall bladder

stuff so we can get onto that later yeah

cool okay so the warren family

hired a sanitary engineer which

sidenote i didn't know was a profession

but i'm glad it is to investigate this

outbreak a man named george

sober see how i read sources that said

he was sopa

oh with a p oh i probably

i mean i did read a source that said he

was sober

but i read two others that said he was

so purr

okay i'm gonna call him george for the

rest of the

so we'll just call him george but it

might be sober or

soper i think i read both and i think

my brain just filtered out the other

ones because the first one i read had

sober and you were like this reflects my

personality

jokes all around therefore

he will be sober so

george published his results the

following year

and although he initially believed

freshwater clams

to have been the source of the spread he

soon realized that some of the infected

had

not eaten the clams he concluded that

mary had exhibited a mild form of

typhoid

and theorized that mary was a healthy

carrier

in quotes of the disease being the first

author to describe this phenomenon

this might take a while phenomenon yes

this is funny because i saw taskmaster

with

and i was like she can't say

phenomenon and then i was like bananaman

are you pulling the same

faces as she did

what are you trying to squeeze out of

poo

christmas strikes again

yes yes

this sparked a somewhat unhealthy

obsession

in george and healthy see what i did

there

and he started stalking mary tracking

her movements

and the spread of disease

so george had been following the super

spreader around for a while

and had linked 22 outbreaks of typhoid

in new york and long island to mary

although mary herself have proved

elusive

as she had swiftly moved on to another

place of employment

following every outbreak so

what i think happened was that the

household where she worked

had fallen ill and she just moved on to

another household

it seems to be that she worked at

numerous households

but as soon as the investigating

forces got to the household that was

infected she'd already moved on

which in most cases seemed to have been

george himself

but also he was the leading expert

in typhoid outbreaks as i understand it

no yeah he was a specialist in

1907 george approached

mary when she was working as a cook in

the house

on park avenue demanding samples

of her blood feces and urine

george stated of this encounter that

marion promptly seized the carving fork

and advanced in his direction

i don't know when that's amusing i find

it endlessly

humorous because i can just imagine like

this was

in the beginning of the 19th century

wait a minute

is it the 19th century 20th century

darling

ah that's so weird for me it's still

weird

why is it weird you call it the wrong

century okay so you're in the

first year a.d

wait a minute no no listen

you're in 1 a.d this

is the first century

in sweden you can't call it

an other you can you can shut up

yeah 1888 or whatever the year

typhoid mary decided to

spunk all over the chicken is the

19th century after christ

it is not a difficult concept

so 1907 was to 20 years

20th century yes

yes it is it's easy

year 2021 we are in the 21st

century after christ

christ didn't even exist this whole

system is arbitrary

it hasn't even happened yet

it's a fallacy i don't know why you're

stickling over this we should have stuck

to the gregorian calendar

so george then enlisted the help of the

new york

department of health as well as

dr josephine baker who was a famous

doctor at the time

and they went to acquire the samples

from mary alongside

police mary though evaded them

for five hours and was finally caught

because

part of her dress had stuck in the door

of her hiding place

nightmare happens to me all the time

yeah that many layers that is so

20th century

must have been a pain after the stool

sample

tested positive for typhoid the

authorities had her forcibly quarantined

on north brother island an island in the

east river

that housed a hospital that specialized

in

treating spreadable diseases such as

smallpox

and tuberculosis small pox and

tuberculosis

seems such last century but you know

well it literally was

so gonna need five minutes

small box was so last century

yes

yes quite literally it was

okay okay i'm back i'm back you're doing

great

but also it will be a household name

again

seeing as anti-vex is on the race uh

well

yeah in america anyway the island oh my

god

have you seen the island no it's so good

it's like proper like porn for

abandoned places sounds sexy

got a lot of good buildings and a lot of

vegetarian vegetables

veritable vegetables

greenery

there's lots of green the trees oh my

god the trees

love green it gets me right hard it does

there she was housed alone in a small

cottage

although they did give her a fox terrier

to keep her company which i thought was

quite nice

like here's a dog good luck i'd be okay

with that yeah

i'm like oh you you've sended me a

solitary confinement well i've got a dog

okay bye screw you world

i'm fine here with my vegetables and dog

vegetables i think it's funny because

it's like

nowadays when we're all in lockdown and

quarantine

we can appreciate someone giving you a

dog for it

we can appreciate vegetables and dogs

but at the time in the 20th century

hey you got it right they were like oh

my god this is so

unethical but oh my god they abandoned

her with vegetables and dogs

like please i live in a vegan

household

vegetables and dogs that is my life this

is not quarantine

this is life please i live in a

shoe box

in london i haven't been outside for

more than

once a month i have a cat

which is a godsend because i love it so

much

but also it's not that bad

to be honest so george visited

mary on the island telling her that he

was going to write a book

and offering her part of the royalties

she rejected his offer and locked

herself in the bathroom

until he had left which was a bad

decision

so mary however didn't believe that she

was a carrier of the disease

since she had never exhibited any

symptoms and

because she had sent samples away to an

independent laboratory

which had come back negative for typhoid

which as a side note she was required to

leave like

samples i think three times a week

which is more social exposure

than i get but all right and 40

of those test results three times a week

were negative so i'm guessing maybe

it was partly negative because she

wasn't a

symptomatic host now well

yeah her first quarantine was two years

wasn't it yeah

yeah so the source that i read she had

163 samples

taken and 120

came back positive yeah all right

typhoid mary

43 of your test samples came back

negative

but 120 came back positive

yeah so maybe hush your typhoid gums

and believe that you might have typhoid

yeah but also

to be fair she did send out samples

via a friend to an independent

laboratory and they told her that

she didn't have typhoid so in the

20th century i'm guessing

she was a skeptic and i kind of

can understand that i'm not saying that

it's

right her negative results could have

also been because of the inaccuracy of

the testing at the time

yeah so after she had been on the island

for circa three years

she was released on the condition that

she would

never work as a cook again

so what did mary do after

some time working as a laundress which

paid less she went right back into being

a professional cook and super spreader

she dipped her fingers in that

contaminated

food oh yeah no she dipped her

contaminated fingers in that food

definitely what i wanted to say

just find it so disturbing that typhoid

is spread by fecal matter

and this is a professional cook although

i read that if it had been boiled

it would have been fine yeah the biggest

contributor to her spread

was her speciality which was ice cream

with peach slices in it which the

peaches

weren't boiled so yeah they were just

spread

cut slices of peach that she got her

shitty fingers all over

and then stuck them in your ice cream

and you were like oh

delicious peach ice cream with oh what's

this brown little speck oh that must be

a lovely chocolate sprinkling oh

delicious

exactly it's how i imagined it when

yeah five years after her release from

the quarantine island

she was found working in a kitchen of

the hospital

where surprise surprise a

typhoid outbreak had started

during these five years she had worked

as a cook for restaurants

hotels and institutions

using fake surnames george

soper or sober we don't know

or maybe we do or maybe i got it wrong

had been hot on her trail but mary

changed jobs frequently and he had been

unable to catch up with her

coincidentally

george's obsession with mary is what led

to her

apprehension as he had been called in to

investigate the outbreak at the hospital

and figured out that mary worked there

from seeing her handwriting

and from hearing the other employees

description

of her which is funny because i don't

think

any of my friends would recognize

my handwriting that's because you've got

a chicken scroll

but george knew her handwriting

so she was apprehended again and sent

back to north brother island to

live in what was more or less isolation

for another

23 years and with more or less i mean

like she was allowed to go

back into new york because north brother

island

as i said is in the east river and it's

not that

far away from the bronx so she was

allowed in

for day visits it was just that she

wasn't allowed to live there because she

couldn't

help being a cook i guess couldn't help

not washing her hands i just mean that

she

wasn't really that isolated because i

mean like

day visits how many days do i spend

outside of my home in this lockdown yeah

but this lockdown is

airborne not fecally transmitted

that's true even though there are many

asymptomatic

carriers of typhoid she was the only one

who had to be forcibly detained because

she refused to stop working as a cook

she might have been the only woman in

history who was repeatedly

told to stay out of the kitchen

at almost the same time there was

another person

also in new york spreading typhoid

oh tony labella i don't know

but they infected more people

and had a higher death rate but because

typhoid mary was the first documented

case of an asymptomatic carrier

she's the one that became famous yeah so

when mary died some sources claimed that

they

found that the salmonella typhi

bacteria was shed from her gal stones

she was offered an operation to remove

her gallbladder

during her first three years of

quarantine

on the quarantine island or north

brother

island but she refused this worth noting

though

is that an operation to remove the

gallbladder

was dangerous and often fatal in the

beginning of the 20th century

there are multiple researchers that

dispute

whether she was ever offered the

gallbladder

removal oh i only read that it was

disputed that they did

an autopsy that is also disputed yeah

yeah there's dispute about whether she

was ever

offered the gallbladder removal okay

so we don't know that but also i think

that it's true

that in those times it was very

dangerous

probably probably would have just cut

her open with

swordfish

there's some organs in there let's just

pull them out all right

so i back up where's my knitting needles

yeah but does it merit any

scientific background that the

gallbladder

could have it's a very

i'm gonna say interesting in the loosest

sense of the term topic so

one of the studies that i read said

that the most common sites for typhoid

infection

are the lower intestine the liver

spleen bone marrow and

the gallbladder in the same

study i think they looked at

a cohort of patients who were classified

as chronic sufferers of typhoid

chronic would have been in the same

category as typhoid mary

in that they had a long-term typhoid

infection

that they weren't symptomatic for and

they found

that 90 of

their chronic typhoid cohort

also had gallstones

they also found that of that ninety

percent

sixty percent were antibiotic resistant

which is more of a modern thing

an analysis of the typhoid

on those patients showed that of

103 patients that had

gallstones five of them tested positive

for typhoid which is around about

five percent which in clinical terms

is a really high percentage oh

which lends to the theory

that gallstones and the gall bladder

can be responsible for harboring

typhoid bacterium of those

five patients that tested positive three

out of four of them had an 80 to

90 percent coverage of their gallstones

with typhoid so almost all of the

gallstone

that was present in their gallbladder

was covered

in typhoid which again leads to

gallstones equals reservoir for typhoid

now if we go back to the original

question which is

does removing the gallbladder remove

the risk of typhoid in modern day

medicine the first line of treatment for

typhoid is antibiotics

if the antibiotics fail to eradicate

the infection in the gallbladder

it can be removed but

typhoid bacteria is not specific

to the gallbladder so if your

antibiotic treatment has not cleared the

infection

in your hepatic system which is

the liver the bile duct and that region

then removing the gall bladder will have

no effect because the bacteria are still

present in your hepatic system so if

mary was offered a gallbladder removal

yeah but her infection had spread

to her liver or her hepatic system then

removing her gallbladder would have had

no effect on

whether she was a carrier or not she

would still harbor that infection

which might have been the case because

seriously she'd been a carrier for a

long time yeah

theoretically they thought that maybe

she had gotten it as a fetus yeah they

thought she got it from

birth even though there's modern

evidence to

show that gallstones and the gallbladder

can be a reservoir in the human body

she had probably progressed past the

point where gallbladder removal

would have been able to relieve her of

her infectivity yeah i don't think

infectivity is a word but i'm going to

go with it

yeah her virility viral

that is all i have okay so even though

there has been ethical issues raised

about mary's case

i don't really feel that bad for her

which is bad i know it's bad but

seeing today's populations

being resistant to wear

masks in public spaces

etc i kind of just feel like

wash your hands in perspective modern

day society

and all of these anti-maskers i was

sharing a bed with ollie earlier

and he's particularly gaseous at the

moment

what did i do put on a mask did you

genuinely

put on a face mask i was like this

stinks

i need some filter i'm gonna put on a

face mask

if i can put on a face mask to avoid my

dog's

farts surely all of these anti-maskers

can just put on a face mask to avoid a

deadly

virus but they don't believe in it

just like mary didn't believe in it but

she was

in a time where that kind of

made sense because she couldn't

believe herself to be a carrier

she was asymptomatic yeah when that was

a new

idea and even though he was the first

author

to describe a healthy carrier

as he put it nowadays that is

not a new idea so i can understand why

my opinions are biased because nowadays

i feel like

everyone should know about it but i also

feel like

that has skewed my perception of

how mary was treated as well because

nowadays i'm like

find them put them in quarantines who

gives a

because they can't understand

basic concepts of spreading

and at her day and age i understand that

it was difficult

because she had never heard of that

before and she had no

education but i also feel like in this

day and age

my patients with people inches

at most that's imperial

i don't know what that means two and a

half

centimeters at most

so mary has been the inspiration for a

comic book character

and has also had a rap group named after

her

and also she had that very famous song

named after her typhoid mary

girl you gotta slow that spreading

down no it was mustang sally

be honest with you bae that was lost on

me

i realized yeah

beautiful rendition but uh wrong

audience

oh you wouldn't know a sad thing i

listened to mustang sally to get it

right

that is quite sad i've been planning

that for two hours

three hours

when i was pooping

this will be hilarious he'll totally get

this

i thought that that was a general

song that the general public would

know about but no well we'll have to

wait and see

okay so that's the case mary malone

time point mary very christmas

y'all

we're done here

thank you so much for listening to

midweek murders

we'll see you next week okay bye bye

bye

Topics
  • Typhoid Mary
  • Mary Mallon
  • typhoid fever
  • salmonella typhi
  • North Brother Island
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