Much has been made during the current Covid-19 outbreak about looking for Patient Zero—the first person to contract the disease and pass it on to others.

More than a hundred years ago, Patient Zero for a Typhoid outbreak in New York state was an Irish cook called Mary Mallon. She became infamous in the media as Typhoid Mary—the symptom-free carrier of the Salmonella typhi bacteria that proved so deadly to her unwitting employers. It eventually led to her exile and incarceration for more than a quarter of a century.

Mary Mallon was born in Cookstown, County Tyrone in Ireland in 1869. She was orphaned as a child and raised by her grandmother, who taught her how to cook using just about any ingredients she had to hand.

In 1883, aged just fourteen, Mary emigrated to America. On Manhattan’s Lower East Side, she found work as a washerwoman, but had ambitions to escape a life of drudgery. She managed this by fabricating references that got her work in the homes of the wealthy. Starting as a scullery maid, she rose to become a cook. Her natural talent kept her in work and saw her rise in prominence.

During the early years of the last century, typhoid fever was seen as a disease that afflicted the poorest neighbourhoods. Fatality rates ran at approximately ten percent. Along with diphtheria, influenza and cholera, typhoid was rife in the slums of the Lower East Side, where the cause was sometimes attributed to the pure stench of rotting animal carcases, sewerage and garbage.

In fact, the bacillus responsible for typhoid fever had been discovered in 1880. Doctors and scientists had already assumed a micro-organism was the source, and had also posited that the spread was due to the consumption of food and water contaminated with the fæces or urine of an existing typhoid patient.

In 1906, Mary Mallon was working as a cook for the Warren family, at the home they were renting for the summer on Long Island. By late August, six of eleven members of the household were ill with typhoid fever. Some reports say Mary herself was also ill, although with a very mild dose. At other times, she is reported as saying she had never suffered from typhoid.

The owner of the house engaged a sanitary engineer, Dr George A. Soper, to try to get to the bottom of the outbreak. Soper had previously been hired by the State of New York to investigate such pockets of disease. Initially, bad shellfish was blamed, but not all those afflicted had eaten this. Soper learned that Mary would often serve ice cream and fresh peaches on a Sunday. It was his opinion that, “no better way could be found for a cook to cleanse her hands of microbes and infect a family.”

As Soper traced other outbreaks among seven well-to-do families, from 1900 to 1906, he discovered that Mary Mallon had been the cook in all the infected households. Her habit of fleeing at the first sign of the illness had further helped it to spread. Soper recorded Mary as the first healthy carrier of typhoid in America.

During 1907, there were roughly 3,000 cases of typhoid fever in New York, for which Mary was largely blamed. Soper called in Dr Biggs of the NY Department of Health and Dr Josephine Baker—an advocate of hygiene and public health—to try to persuade Mary to submit to testing. Her first reaction, when approached, was to chase Soper out of her kitchen with a carving fork. She subsequently evaded capture for five hours.

Eventually, Mary was taken by police and Dr Baker to the Willard Parker Hospital, where her status as a carrier for the bacteria that causes typhoid was confirmed. Then, without any hearing or trial, she was quarantined in a cottage in the grounds of Riverside Hospital on North Brother Island, just off the Bronx.

Mary still had no symptoms of the disease and, it appeared, did not believe she could be a responsible for spreading it. She deeply resented an article in the New York American in 1909, in which the nickname ‘Typhoid Mary’ was coined. “Dr Park has had me illustrated in Chicago. I wonder how the said Dr William H. Park would like to be insulted and put in the Journal and call him or his wife Typhoid William Park.”

The Supreme Court declined to release Mary in 1909, claiming the state’s responsibility in a health crisis. Her lawyer argued that she had been imprisoned without due process. The wording of the Greater New York Charter allowed the board of health to ‘remove or cause to be removed to a proper place…any person sick with any contagious, pestilential, or infectious disease…’ As Mary was not, in fact, showing any signs of sickness, then, legally, the charter did not apply to her.

In February 1910, a new Health Commissioner was appointed. He agreed to release Mary, provided she sign documents that she ‘is prepared to change her occupation (that of cook), and will give assurance by affidavit that she will upon her release take such hygienic precautions as will protect those with whom she comes in contact from infection.’

Unfortunately, no financial compensation was made available to Mary to allow for her years of confinement, nor to make up for the drop in wages from head cook back to the kind of menial laundry work she did as a newly arrived teenage immigrant.

It is hardly surprising, therefore, that by 1914 she was working once again as a cook, this time for the Sloane Maternity Hospital in Manhattan, under the assumed name of Mrs Brown. The following year, they suffered an outbreak of typhoid fever. Two people died.

Although public opinion had been on Mary’s side during her first period of incarceration, the fact she had knowingly gone back to serving food—to pregnant women this time—despite signing a legal document saying she would not do so, was the final straw. She was sent back to her cottage on North Brother Island. There she remained until her death in 1938, following a stroke. There is some controversy over whether a post-mortem examination was carried out or not, but it was claimed that evidence was found of live Salmonella typhi bacteria in her gallbladder, even at age 69.

And her lasting legacy? That sign you see in public restrooms everywhere saying: ‘Employees must wash their hands before returning to work.’

This week’s Word of the Week is ignotism, meaning a mistake made out of ignorance.

See the illustrated version of this blog over on Murder Is Everywhere.