{"id":462,"date":"2019-05-21T14:26:38","date_gmt":"2019-05-21T18:26:38","guid":{"rendered":"http:\/\/sites.miamioh.edu\/hst-journeys\/?p=462"},"modified":"2020-07-20T16:37:38","modified_gmt":"2020-07-20T20:37:38","slug":"medicine-and-disease-in-history-typhoid-fever","status":"publish","type":"post","link":"https:\/\/sites.miamioh.edu\/hst-journeys\/2019\/05\/medicine-and-disease-in-history-typhoid-fever\/","title":{"rendered":"Medicine and Disease in History: Typhoid Fever"},"content":{"rendered":"\n
\"\"
First Typhoid Fever Inoculations.<\/figcaption><\/figure>\n\n\n\n

By Andreas Van Dijck<\/strong><\/p>\n\n\n\n

Note: Essay 7 in a series, all from Dr. Amanda McVety\u2019s Spring 2019 class on Medicine and Disease in Modern Society <\/p>\n\n\n\n

As one of the City of New York Department of Health\u2019s\ndesignated \u201creportable diseases\u201d in 1940, typhoid fever was viewed as a serious\nhealth hazard by United States health officials, and anyone showing possible\nsymptoms of the disease was required to report those symptoms immediately. An\ninfectious and contagious bacterial disease that spreads via contaminated food\nand water[1]<\/sup><\/a>,\ntyphoid fever caused great suffering to those who contracted it in the 1930s\ndue to the biological and social ramifications of contracting such a disease.\nContracting typhoid fever was an arduous biological and social experience; the\ndisease presented painful physical symptoms, and those who contracted it tended\nto be viewed with suspicion and contempt. In addition, outbreaks of typhoid\nfever disproportionately impacted poor, rural communities across North America,\nwhich exposed the growing economic divide between cities and rural areas. <\/p>\n\n\n\n

            Typhoid\nfever symptoms are painful and physical in nature; those who suffer from the\ndisease come down with a prolonged fever, nausea, headaches, vomiting,\nabdominal pain, rashes, diarrhea, and loss of appetite[2]<\/sup><\/a>. In the 1930s, typhoid fever\nwas sometimes confused with other diseases that caused persistent fevers[3]<\/sup><\/a> such\nas malaria and yellow fever, thus indicating that diagnosing the disease\nsometimes proved difficult. Typhoid fever was still scientifically understood\nto be transmitted by bacteria, Salmonella\n<\/em>Typhi, that can only be carried by humans[4]<\/sup><\/a>. It was also understood that\nthe disease was primarily spread via contaminated water, and when cities such\nas New York City made improvements to their sewage systems and facilitated\neasier access to clean water, instances of typhoid fever decreased\ndramatically; the death rate per 100,00 people due to Typhoid Fever in the\nUnited States dropped from 35.8 in 1900 to 4.9 by 1928[5]<\/sup><\/a>. In addition, several\ntreatments for people affected by typhoid fever existed, including administering\ncalomel, saline draught, and a spoonful of hot water for hydration, with mixed\nresults[6]<\/sup><\/a><\/p>\n\n\n\n

Nonetheless, cases of Typhoid fever\ncontinued to crop up across the country in the 1930s, particularly in rural and\npoor communities; during the 1930s, 65 percent of typhoid outbreaks in the\nUnited States and 77.5 percent of those in Canada occurred in cities with a\npopulation of less than 5,000 people[7]<\/sup><\/a>. Thus, rural residents who\ndid not have ready access to sanitation and clean water most likely to be\naffected by typhoid fever, a fact which also highlights the economic and\ndevelopmental disparities of North America in the 1930s. American cities with\nover one million residents were noted to have nearly eliminated the disease by\n1931 due to being better funded and having modern sewage systems[8]<\/sup><\/a>.\nRural communities did not have the resources, funds, or expertise to update\ntheir sewage systems and curb the spread of typhoid fever. In fact, a 1938\nhealth report estimated that deaths from typhoid fever were 30 to 40 percent\nhigher than reported in Mississippi, a state where only around 30 percent of\nresidents had access to running water in the 1930s and where most residents\nlived in towns of less than 1,000 people[9]<\/sup><\/a>. <\/p>\n\n\n\n

While outbreaks of typhoid fever\nwere more prevalent in rural towns, the disease still appeared in more affluent\nareas as well, as in the case of \u201cTyphoid Mary\u201d. Mary Mallon was a poor Irish\nimmigrant who worked as a cook for several wealthy New York families in the\nearly 1900s, most of whom contracted typhoid fever while employing Mary. By the\n1930s, it was understood that Mary was a carrier of typhoid fever[10]<\/sup><\/a>;\nshe did not present any symptoms but was still a host to the bacteria causing\nthe disease. As a carrier, Mary could still transmit the disease by handling\nand then serving food or water, which is how most of the families she worked\nfor became ill. After a series of investigations, Mary was apprehended by\nauthorities and forcefully quarantined[11]<\/sup><\/a>. This incident reveals how\ntyphoid fever could still be an isolating social experience even if one was not\nsuffering with the disease\u2019s physical symptoms, and it also highlights how\ntyphoid fever is a uniquely human affliction with human carriers and\ntransmitters; Salmonella<\/em> Typhi cannot\nbe transmitted by animals, which is unlike most other diseases[12]<\/sup><\/a>. In\naddition, the story of Mary Mallone infecting the families she worked for\nspiked prejudice against Irish immigrants, who were seen among some Americans\nas \u201cpotentially dirty and hazardous\u201d[13]<\/sup><\/a>. Because Mary Mallon was\none of the most notorious carriers of typhoid fever, she likely became the\nimage of a carrier in the eyes of the public, and that image was extended to\nIrish immigrants as a whole. As a result, the incidence of typhoid fever and\nthe association of carriers with Mary Mallon further exposed prejudice against\nIrish immigrants, which was already prevalent during this time. <\/p>\n\n\n\n

While typhoid fever was a known entity by the 1930s, and officials knew how to prevent it, the disease\u2019s presence persisted among the poorer parts of society. Considering typhoid fever\u2019s role as a biological and social experience in the 1930s is important because the disease exposed rifts in American society; poor, rural parts of the country were much more likely to experience outbreaks of this disease than bustling metropolitan areas were, which reflected the growing divide between urban and rural prospects in the United States. Indeed, cities benefited more from the \u201croaring 20s\u201d and the technological advancements of the early 20th century than places like rural Mississippi, and thus were able to limit the spread of the disease. The divide between urban and rural areas arguably still exists today in the United States, albeit in a different context, but examining how different parts of the country were impacted by typhoid fever in the 1930s helps expose the origins of that divide. Furthermore, the case of Mary Mallon also shows how the outbreak of typhoid fever was used to justify prejudices against Irish immigrants, revealing how outbreaks of infectious disease can exacerbate existing social tensions and justify biases. While typhoid fever is not a major cause for concern today, the social problems of inequality and anti-immigrant sentiment still exist in the United States. <\/p>\n\n\n\n

Andreas Van Dijck is a Junior Political Science Major and History minor from the Cleveland area.  <\/p>\n\n\n\n

\n\n\n\n

[1]<\/sup><\/a> Center for Disease Control and Prevention,\n\u201cTyphoid Fever\u201d, https:\/\/wwwnc.cdc.gov\/travel\/diseases\/typhoid<\/p>\n\n\n\n

[2]<\/sup><\/a> World Health Organization, \u201cTyphoid\u201d,\nhttps:\/\/www.who.int\/immunization\/diseases\/typhoid\/en\/<\/p>\n\n\n\n

[3]<\/sup><\/a> F.F Russell, \u201cThe Prevention and Treatment of\nTyphoid Fever\u201d, Boston Medical and\nSurgical Journal<\/em> 164, no. 1 (1911), 1 <\/p>\n\n\n\n

[4]<\/sup><\/a> Ibid<\/p>\n\n\n\n

[5]<\/sup><\/a> Abel Wolfman and Arthur E. Gorman,\n\u201cWater-borne Typhoid Fever Still a Menace\u201d, American\nJournal of Public Health <\/em>11, no. 2 (1931), 115<\/p>\n\n\n\n

[6]<\/sup><\/a> James Barr, \u201cAn Address on the Treatment of\nTyphoid Fever\u201d, The Lancet<\/em>, 1900<\/p>\n\n\n\n

[7]<\/sup><\/a> Wolfman and Gorman, \u201cWater-borne Typhoid\nFever Still a Menace\u201d, 119 <\/p>\n\n\n\n

[8]<\/sup><\/a> Ibid, <\/em>120<\/p>\n\n\n\n

[9]<\/sup><\/a> A.L Grey, \u201cThe Probably Typhoid Carrier\nIncidence in Mississippi\u201d, American\nJournal of Public Health <\/em>28, no. 1 (1938), 1415-1416<\/p>\n\n\n\n

[10]<\/sup><\/a> George A. Soper, \u201cThe Curious Career of\nTyphoid Mary\u201d, New York Academy of\nMedicine Bulletin <\/em>698-710, 1939<\/p>\n\n\n\n

[11]<\/sup><\/a> Ibid, <\/em>700<\/p>\n\n\n\n

[12]<\/sup><\/a> Frederick P. Gay, Typhoid Fever Considered as a Problem of Scientific Medicine<\/em>, (New\nYork: Macmillan Co., 1918), 7 <\/p>\n\n\n\n

[13]<\/sup><\/a> Soper, \u201cThe Curious Career of Typhoid Mary\u201d,\n701<\/p>\n","protected":false},"excerpt":{"rendered":"

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