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Typhoid Mary Was Not a Super-Spreader (and Super-Spreaders Are Not “Typhoid Marys”)
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Journal Article
Typhoid Mary Was Not a Super-Spreader (and Super-Spreaders Are Not “Typhoid Marys”)
2023
Overview
In discussions about super-spreaders, one figure who features prominently is \"Typhoid Mary\"-the Irish immigrant cook who was an asymptomatic carrier of typhoid bacilli, infected 47 people, and led to at least three deaths in early 20th-century New York State. In the past three years, references to Typhoid Mary, whose real name was Mary Mallon, as the first, most prominent, or prototypical example of a \"super-spreaded' are common in scientific papers, blogs, videos, podcasts, and articles in the popular press (see the Appendix, available as a supplement to the onlineversion of this article at https://ajph.org).Does the historical case of Mary Mallon really qualify her for such a role? The answer obviously depends on how we define super-spreaders. Contemporary applications of the term vary, but most commonly it is used to referto individuals who instigated an \"explosive outbreak\" of simultaneous infections, or to the theoretical discussion of infectiousness heterogeneity in shaping the course of epidemics. Super-spreading, in the sense of actual or potential \"extraordinary\" infectiousness, is described as caused by (1) biological, physiological, or immunological mechanisms or (2) as grounded in social or behavioral dynamics. At first glance, Mary falls into the latter category: she was an asymptomatic carrier of Salmonella typhi who worked as a cook and was characterized by health officials as lacking in personal hygiene. Thus, she had all necessary qualifications to unknowingly and effectively disperse pathogens. Nonetheless, I argue that her story is hardly compatible with our contemporary understanding of super-spreading and that the tendency to associate her with the term is scientifically, historically, and morally precarious.
Publisher
American Public Health Association
Subject
