Investigation isolated

Mary Mallon (1869-1938) was an Irish immigrant who was the first known healthy carrier of typhoid in the USA. She probably contracted a mild case of typhoid, although she may not have been aware of it, and was never 1______. In this way, she became a carrier, and spread the disease.

Typhoid is an infection of the digestive system caused by a bacterium, Salmonella typhi. Among

other symptoms, it 2______ weakness, high fever, a rash of red spots, chills, sweating, and in serious cases inflammation of the spleen and bones, delirium, and erosion of the intestinal wall leading to haemorrhage. It is 3______ through contaminated food or drinking water.

Mary was the cause of several outbreaks of typhoid in the New York City area between 1900 and 1907. She worked as a cook in a number of different households, and on each occasion, members of the family or other servants 4______ typhoid. 22 people became ill, and one died. At the time, typhoid was a serious problem, especially in cities, and killed around 10% of sufferers.

In the summer of 1906, New York banker Charles Henry Warren hired Mary to be a cook for his family at their rented summer house. When six of the eleven members of the household became ill with typhoid, the owners of the house employed George Soper, a sanitary engineer with experience in typhoid outbreaks, to look for the source. After some months of careful 5_____into Mary's background and her previous jobs, George Soper was certain that she was the cause of the outbreak, and so he asked her for blood, urine, and stool 6______. She did not believe him - in fact, she resisted violently and attacked him with a large fork. At that time, the idea that a person could spread a disease and still remain healthy was not widely known.

Mary resisted two other visits from health officials, shouting and swearing at them and running away. Mary was a strong-minded woman, but it must also have been very frightening for her to be confronted in this way. Eventually the New York City Health Department sent five police officers and an ambulance and 7______ took her to hospital.

The New York City health inspector carried out some tests and 8______that Alary was a

carrier. In 1910 she was transferred to an island near New York City, where she lived in isolation for three years. She was then released but told that she should not work with food again. However, in 1915 she took a job as a cook in a hospital and 9_______ 25 doctors, nurses, and other hospital staff two of them died. Mary was then seized again and kept in 10_______ for 23 years, living alone in a one-room cottage. In December 1932, Mary suffered a massive stroke, which left her paralysed. She died in 1938 of pneumonia. Today 'Typhoid Mary' is a term used to describe a carrier of a dangerous 11________who refuses to take precautions or 12______with the authorities.