Friday, February 19, 2021

History of Infectious Diseases (Part 1): "Typhoid" Mary and Polio

Next year I will be teaching a new seminar course titled “The Politics of Pandemics” which will cover the ethical, social and legal implications of trying to mitigate the public health risks posed by the 1400+
infectious organisms that cause disease in humans. 

 The scope of the course will be pretty expansive, covering both historical and contemporary endemics and pandemics ranging from the  bubonic plague, cholera, dysentery, semolina, typhoid fever, the 1918 influenza pandemic, polio, dysentery, Ebola, HIV/AIDS, the 2003 SARS outbreak and culminating with an extensive focus on the COVID-19 pandemic.

 At the moment I am digging deep into research on the infectious diseases that were rampant in the first half of the twentieth century in the United States.  It is proving to be a fascinating (albeit rather depressing) read, and it is amazing how this history is so quickly forgotten.  People living in developed countries often take for granted the extremely low levels of early-life mortality we commonly enjoy now.  But this reality is a true outlier from the circumstances which persisted throughout human history prior to the public health advances of the 20th century. 

I want to share two fascinating stories from this time period here.  The first is the story of “Typhoid Mary”, who was Mary Mallon from Ireland.  Mary emigrated to the US as a teen in 1884.  She worked as a cook and was an asymptomatic healthy carrier of Salmonella typhi.  Mary is often attributed as being the main cause of a typhoid outbreak in New York in the early 1900s. 

The story of how Mary Mallon was identified as the first “super spreader” reads like a detective novel. Immunization against Salmonella typhi was not developed until 1911, and it took over 30 more years for antibiotic treatment to become available.  And poor Mary Mallon spent a total of 26 years in forced quarantine.  More details about her are available here.

The other inspiring, but also tragic, historical example I wish to draw attention to comes from the polio outbreaks in the 1940s.  Polio is a disabling and potentially life threatening infectious disease caused by the virus poliovirus.  It can infect a person’s spinal cord, causing paralysis.  The CDC estimates that, in the early 1950s, before polio vaccines were available, polio outbreaks in the US caused more than 15 000 cases of paralysis each year.  President Franklin D Roosevelt was diagnosed with polio in 1921, at the age of 39. Because of widespread vaccine use, the United States has been polio free since 1979. 

Before vaccines, the “iron lung” was often used to keep patients alive if the virus’s action paralyzed muscle groups in the chest.  Paul Alexander is one the last “iron lung” survivors.  And this video details his journey through life living in the iron lung for nearly 70 years!  

When you consider how prevalent the extrinsic health risks of our environment are, it is amazing that humans have the lengthy life expectancy we enjoy today (over age 72).  The advancements of science and public health are miraculous achievements of human ingenuity, but they are not equally enjoyed by all in the world today.  These are achievements that each new generation must have gratitude for, and a desire to contribute towards to help us further improve the prospects of global health.