5
MYSTERIOUS OUTBREAK
“All the skill of an expert detective is often required . . . to discover the exact manner and the exact route by which typhoid fever was actually conveyed from one person to another.” —William Sedgwick
In the summer of 1906, New York banker Charles Henry Warren rented a spacious country house in Oyster Bay, a village on Long Island. Located in a neighborhood of beautiful homes, the house was surrounded by gardens, lawns, and porches. It was the perfect place for the Warren family to enjoy a relaxing summer away from the city’s stifling heat, humidity, and foul odors.
The rich and powerful were drawn to Oyster Bay, particularly after Theodore Roosevelt became president in 1901. Roosevelt had vacationed in the town when he was a teen in the 1870s. As an adult, he built a house there, which he called Sagamore Hill. The Roosevelt family had made it their home since the mid-1880s, and now it was the summer White House.
But the Warren family’s idyllic summer in famous Oyster Bay took an unexpected and alarming turn. On August 27, a rainy Monday near the end of their stay, the Warrens’ daughter became feverish and weak. A doctor was called immediately, and he broke the bad news: she had typhoid fever. The family was shocked and dismayed, yet more was to come.
Within a week, Mrs. Warren, a second daughter, two maids, and a gardener fell ill. Out of 11 family members and servants staying in the house, 6 developed the awful typhoid symptoms. Two were so sick that they had to be taken to the hospital, though none of the victims died.
Such an outbreak was rare in Oyster Bay. No other cases occurred during the months before and after the Warren household became ill. Typhoid fever seemed to be centered on that single house.
In September, the owners of the house, Mr. and Mrs. George Thompson of New York City, hired inspectors to examine the property and its water supply. The results revealed no definite explanation for the outbreak.
This wasn’t good enough for the Thompsons. Their house was an investment, and they planned to rent it again. With the cloud of typhoid fever hanging over it, the house might as well have a quarantine sign on the front door.
The Thompsons wanted to find out the cause of the outbreak and fix it. That required hiring a first-rate expert, someone with the reputation to assure potential renters that the house posed no danger.
They contacted George Soper.
THE SEARCH FOR ANSWERS
After completing his work in Ithaca in 1903, Soper had continued to build his reputation as “an epidemic fighter.” He investigated typhoid outbreaks throughout the Northeast and advised stricken communities on ways to end their epidemics and prevent new ones. Desperate to solve the mystery of their Oyster Bay house, the Thompsons gladly paid his fee.
Soper’s first step in solving the Thompsons’ problem was to gather as much information as possible. Several weeks had passed since the outbreak, but he was able to review the earlier inspection results. Next, he took the train from Manhattan to Oyster Bay to examine the scene for himself.
When he arrived, he checked the usual causes of typhoid outbreaks, as he had in Ithaca. “The most important question,” Soper later wrote, “was how the first case occurred.”
The Warrens reported that nobody who became ill had been away from the village all summer. Soper interviewed the three doctors who practiced in Oyster Bay. They confirmed that the only cases they had seen were in the Warren household.
Focusing on the house, Soper studied the most common source of typhoid bacteria, the water supply. The drinking water came from a deep well on the property. It was a safe distance from the servants’ outhouse and from two cesspools that collected waste from the family’s indoor toilet. All had been cleaned out in the spring, just a few months before the outbreak. Soper read the water purity reports made by two separate laboratories shortly after the outbreak. The results came back clean with no bacteria.
If the water supply wasn’t the source, maybe typhoid bacteria had been in the household’s food. Soper asked the Warrens about their diet that summer. The family’s milk came from the same dairy used by other residents of Oyster Bay. That eliminated typhoid-contaminated milk, which often caused outbreaks.
Another possibility was that raw foods, such as fruits and vegetables, carried the bacteria. But everyone in the household—those who became sick and those who didn’t—apparently ate the same food. Still, as Soper had seen in other outbreaks, people who were exposed didn’t always develop typhoid. Perhaps they hadn’t ingested enough of the germs, or they had immunity due to a previous attack.
One of the Warrens mentioned how much they all loved clams. At last, Soper thought he might have found the culprit. Shellfish from polluted waters sometimes contained typhoid bacteria.
When he asked more questions, he discovered that no one had eaten clams or other shellfish for six weeks before the disease struck. That was too long to have caused the typhoid fever cases. Soper had to throw out this hypothesis.
A CLUE SURFACES
So far, he couldn’t lay the blame on any of the typical sources of typhoid bacteria. But Soper wasn’t someone who gave up easily.
Keeping in mind typhoid fever’s incubation period, he asked the Warrens: Did anything unusual happen one to three weeks before their daughter—the first victim—became sick? Did anyone in the household have typhoid symptoms earlier in the summer?
No, they answered to both questions.
The Warrens recalled one thing, however. They had changed cooks during the first week of August.
Interesting, thought Soper. He realized that the timing was significant—three weeks before the first person showed symptoms. He asked what they knew about the cook.
Her name was Mary Mallon, the Warrens told him. She was Irish, about forty years old, and an intelligent woman. They had hired her through an employment agency, and she came with fine recommendations. Pleased with the food she prepared, they paid her $45 a month, a good wage for a domestic servant. The family mentioned that Mary had prepared a delicious ice-cream dessert with fresh cut peaches.
She no longer worked for them, though. The cook had left the household a few weeks after their daughter fell ill.
Soper wondered if this woman had been the source of the bacteria. She handled the household’s food every day. Most of it was heated, which killed the bacteria. But she likely touched uncooked foods, too, like fresh cut fruit. If she hadn’t washed her hands after using the toilet, her fingers might have been covered with typhoid germs.
The Warrens said that Mary never became ill, so it didn’t appear that she spread the disease while she was sick. At the very least, thought Soper, the cook might be able to help him figure out the cause of the outbreak.
TRACKING MARY
The Warrens had no idea where Mary Mallon had gone after leaving Oyster Bay. Several weeks had passed. She could be anywhere, even out of the area. Soper had only one lead to go on: the employment agency that had sent her to the Warrens.
When he spoke to the agency’s owner, the man couldn’t guess where Mary Mallon was working now. But he was willing to give Soper a list of her references stretching back several years.
Soper started to work his way down the list of names. At each household, he asked for information about Mallon, including whether anyone had typhoid while she was cooking there.
Mallon’s employers told him that they had been satisfied with her and considered her a competent cook. She seemed to have no problem finding jobs with well-to-do families.
Soper also interviewed housekeepers and other servants. Did they know where he could find her? Few remembered much about Mallon, or they didn’t want to tell him. He suspected they were protecting her. “Servants who had been associated with her never gave any help,” Soper later recalled.
Eventually, he traced her employment history back ten years. In 1897, he learned, a New York City family hired Mallon as their cook. During the summer of 1900, she accompanied them to their vacation home in Mamaroneck, about thirty miles north of Manhattan.
When Soper asked about typhoid fever, the family recalled that a visitor had come to stay at the end of August. Within ten days, the young man developed typhoid. A few days later, Mary Mallon left her job.
Soper picked up her trail again in 1901–02 when, for eleven months, she worked for another family in New York City. A month after Mallon began cooking there, a laundress in the household became so ill with typhoid fever that she had to be hospitalized.
By the summer of 1902, Mallon had moved on again. A lawyer from New York City, J. Coleman Drayton, hired her to travel with his family to their Maine vacation home as the summer cook. The household included 4 family members, 4 servants, and Mallon.
In mid-June, a servant came down with typhoid fever. Before long, 7 of the 9 in the house became sick, as well as a local nurse and servant who came in each day to help.
Mr. Drayton was spared, perhaps because he had immunity after a previous typhoid attack. Mary Mallon didn’t become ill either. She volunteered to help Drayton care for the sick, and he paid her a $50 bonus for her trouble. No other typhoid cases occurred in the Maine community that summer. Tests of the house’s water supply found it safe.
THE TRAIL GETS WARMER
Soper couldn’t pinpoint where Mallon had worked in the months after leaving the Drayton family in 1902. But his search led to another New York City family, the Gilseys, who employed Mallon in 1904.
After she had cooked for the Gilseys for nine months, she went with them to their Sands Point, Long Island, summer home. Within three weeks, 4 people living in the separate servants’ cottage were struck with typhoid fever. One, a laundress, became severely ill, but she survived. None of the victims had worked with Mary Mallon before. An investigation at the time of the outbreak found no contaminated drinking water.
Soper lost the cook’s trail for nearly two years until 1906, when she ended up in Oyster Bay with the Warrens.
After Mallon left there in September 1906, she took a job with the Kesslers in Tuxedo Park, New York, about forty miles north of New York City. Two weeks later, the family’s laundress was taken to the hospital with typhoid. Local health officials reported that there had been no typhoid fever in the town for several years.
Soper was too late to find Mallon with the Kesslers. She had left the job in October, two weeks after the laundress became sick.
After four months, George Soper had uncovered several outbreaks of typhoid fever connected to Mary Mallon. Only a few had been studied at the time they occurred. In most of those, the blame for the outbreak was put on the first victim, who investigators believed caught the disease outside the household. They never figured out where any of these people originally picked up the typhoid bacteria.
Soper wasn’t convinced by this explanation. He had a hunch that Mallon was the key to all these outbreaks.
In early February 1907, he got a tip. After Mallon left Tuxedo Park the previous fall, she had taken a job in New York City. Walter Bowne and his family lived in a brownstone house at 688 Park Avenue in a wealthy neighborhood. Mary Mallon was their new cook.
Soper had finally tracked her down.