Quarantine: An idea whose time may have come again

This historic approach to infection-control may still have a role today, although the human rights implications are troubling.

By Susan J. Landers, AMNews staff. Oct. 18, 2004.

Quietly, the trail of disease stretched from the New York City suburb of Mamaroneck, N.Y., to Manhattan and Long Island's Oyster Bay, leaving suffering in its wake. Twenty-two people had been infected and one person had died from a terrible illness, marked by high fever, swollen lymph nodes and rose-colored spots on the chest and abdomen. It took time, but William H. Park, MD, and S. Josephine Baker, MD, zeroed in on where the illness was coming from -- an Irish-born cook employed by the wealthy families of those who had become ill.

The sickness, of course, was typhoid and the cook was Mary Mallon, who claimed in 1907 never to have had it. Nonetheless, she was found to be a carrier, excreting large numbers of typhoid bacilli. To keep her from infecting anyone else, she was isolated in a hospital for three years before being released with a warning that she must never again be employed in a kitchen.

She didn't listen.

When health department physicians next caught up with her, they hustled her into an ambulance and placed her in isolation for life on North Brother Island in New York's East River. She died there 23 years later of pneumonia.

Typhoid Mary's case spanned the early years of the 20th century and her physicians, even in 1907, wondered whether the health department had the right to deprive her of her liberty.

Today's physicians could find themselves puzzling through scenarios not so far removed, and public health experts urge them to think through such issues as personal liberty versus public health before they surface. Although typhoid has been supplanted by smallpox, severe acute respiratory syndrome and pandemic flu on today's physician watch lists, isolation and quarantine remain methods to be relied upon to keep infectious diseases in check.