Caregiver Perspective: Avoiding Typhoid Mary
Have you heard of Typhoid Mary?
Mary Mallon or Mary Brown (she used both names) worked as a cook and harbored the typhoid bacteria in her gallbladder. Wherever she worked, the families in those households became sick, and many died, but Mary herself never became ill.
Authorities believed that Mary infected over 50 people with typhoid, several of whom died. They met with her and explained that she probably carried the germ in her gallbladder. When asked to stop working as a cook voluntarily, Mary refused because she did not believe in the germ theory. She asked, “How can I be a carrier if I have never been sick?”
Evidence pointed to Mary
Alas, since circumstantial evidence pointed clearly to Mary as the cause of death in so many cases, authorities took her into custody for a period even though she refused to give stool or urine samples to prove her innocence or guilt.
After months/years in custody, she finally agreed to stop cooking if they would release her. Upon her release, she began work as a laundress, but her income dropped significantly. Within a short time, she moved, changed her name to Mary Brown and resumed her prior career as a cook. The death toll began to rise as well.
With each death, she moved to stay away from the authorities until her death. Upon her death, authorities performed the tests previously requested and denied through finally proving what they suspected all along — Mary Mallon carried the typhoid bacteria in her gallbladder and was the direct link in all the reported deaths.
The moral of this story
Just because you don't believe something is true doesn't mean it isn't.
Mary didn't believe she was a carrier, but she was. She continued to come to work every day exposing others to her germs and making them sick just like people do today who come to work with an active cold or flu symptoms, or fevers, or diarrhea, or nausea and vomiting.
- They come because they need the income.
- They come because they don’t want to get in trouble with their employers for missing a day of work.
- They come because their work ethic tells them that they need to work if they can still stand up.
- They come because being at home is more uncomfortable than being at work.
- They come for any number of personal reasons, exposing the rest of us to their germs.
A sea of carriers of malicious germs
Much of the time when out in public, I feel that I am moving about in a sea of Typhoid Mary’s — carriers of malicious germs, appearing perfectly healthy, totally unaware that they are harboring death-producing organisms, that could jump/run/fly/spring/or swim from their bodies to my own and then from mine to my immunocompromised spouse.
I feel like I need a hazmat suit
After being out in the world touching dirty doorknobs, passing through the spray of sneeze spray and coughed out air filled with germs, picking up any number of items touched by people with any number of still living viruses, bacteria, or fungus, I feel like I’ve walked through a swamp without personal protective equipment. To venture out into this world during the winter, I feel like I need a hazmat suit because it's become a badge of honor in some workplaces to come to work sick. Even in some healthcare facilities, I’ve seen staff walking around wiping their noses on their sleeves when gloved up or sneezing into the crook of their arm just before entering my spouse’s room. I sit waiting for them to sneeze on him and give him their germs.
Sick hospital staff
Have you ever been a patient in a hospital in the winter and noted how many hospital staff came to work sick? I'm sure many get sick from their patients which indicates a need for a refresher for handwashing and using masks, but why don't hospitals promote keeping people out of work if they are sick rather than working sick? I know staffing is an issue. It's hard to maintain staffing levels where they need to be, and that's certainly an issue to consider but here's a suggestion to follow. If you are a patient in a healthcare facility and someone sick comes in to care for you, protect yourself.
- Ask, “Have you washed your hands?” Every person who touches you or your things is supposed to wash their hands before touching you or your stuff.
- If they are visibly sick, you can also ask them to put on a mask. Each patient care area has a supply area that has masks available. Therefore, if someone is coughing or sneezing and enters your room, you can ask them to mask, gown, and glove if you feel they have been contaminating their clothing or might contaminate you. You might get a little pushback on the gown if they are not going to come in contact with your body so don't push too hard on that one unless they are assisting you with a move, but masks are a definite for any time they are in the room.
- If the individual refuses to use a mask or wash their hands/wear gloves for procedures, ask to speak to an administrator or supervisor. Each facility has someone in charge of each shift. Usually, on weekdays it's a manager, and on off shifts, it's a supervisor or administrator type.
Politely educating others to keep our families safe
Look out for yourself and the one for whom you're providing care. Too many people think a cold is no big deal or as long as they can "make it" then they're not hurting anyone else if they come into work or are doing a good thing rather than a bad thing. People don't realize how many others they put at risk when they expose weakened immune systems to germs and it's our place to politely educate and remind to keep our families and loved ones safe.
*Details related to the story of Typhoid Mary are taken from the article "Mary Mallon (1869-1938) and the history of typhoid fever" written by Filio Marineli, Gregory Tsoucalas, Marianna Karamanou, and George Androutsos published in the Annals of Gastroenterology.
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