Sunday, 7 August 2011

Infectious Disease: Typhoid

Typhoid is caused by infection with the bacteria Salmonella Typhi, usually spread via food or water that has been faecally contaminated. In most cases it is an enteric infection causing diarrhoea with a small percentage of sufferers getting an invasive disease ending in septicaemia. A very small percentage (1-3) of people become carriers of the disease and can continuously excrete the bacteria as the bacteria have colonised the gall bladder.

The most famous of these was Mary Mallon, better known today as Typhoid Mary . Mary was a cook who while not ill herself,  was the cause of a number of outbreaks although Mary herself never believed she was the cause. At that time it was not well understood that there could be healthy carriers. 

The Health Department incarcerated her in a cottage near the hospital. She was released after two years after promising not to work as a cook.  For a time Mary complied, working as a laundress and other related occupations but Mary was not able to earn as much doing the other jobs and went back to cooking as a profession. She changed her name and the typhoid cases continued resulting in a number of deaths.  The Health authorities again incarcerated Mary until her death.

Typhoid was fairly common in the early 1900s and before when water supplies were not chlorinated. This was particularly true when the sewage which was also not treated entered the water system and then that water was used for a town supply. An example of this is given below in a quite nice piece of public health investigation.

From Daily News ( London, England ),  Friday, September 24, 1897

Despite the efforts of the sanitary authorities at Maidstone to check the typhoid fever epidemic in the town, the number of notifications of cases has considerably increased this week. On Monday no fewer than 129 were reported, and the total has now reached about 320. The deputy medical  officer has very little doubt as to the cause of the outbreak.

The county town is supplied by the waterworks company with water from three different sources, and on Sunday the springs at East Farleigh, from where a greater bulk  of the supply is obtained, were examined by Mr. ADAMS , in company with the manager to the waterworks company.  In consequence of his investigations, the medical officer had some of these streams cut off, being of the opinion they had been polluted in some way -  perhaps by the large number of hoppers who have recently been in the district. His opinion that it is  Farleigh water supply alone that is polluted is confirmed by the singular fact  that out of 306 cases notified up till Wednesday morning, 295 were in houses supplied with water from Farleigh. This supply has now been cut off entirely, and the company are making a great effort with the sanitary authorities to stop the spread of the disease.  

Newspapers are a great source to find out further information on outbreaks in your area of interest. In Australia, we are very lucky to have Trove  which has an increasing number of digitised papers from 1803 to 1954 from around Australia. It is also a wonderful site for photos, books, articles and so much more. There are 106 000 mentions of typhoid in the newspapers digitised to date. There are also 62 theses where typhoid is mentioned. Theses are a wonderful resource but are often a neglected resource for many family historians. 

New Zealand has Papers Past and we are all eagerly waiting on the release of the United kingdom papers in the joint work between the British Library and FindMyPast. The USA has which is a pay site. 

Many papers have been indexed by family history societies in the area and of course there are many transcriptions on the Web. Google is as always a great way of finding these.
Internet Archive is another great resource for out of copyright books that you can download in a variety of formats including PDF and for your E-Book reader. This contains a book which is a summary of waterborne outbreaks identified in Great Britain and Ireland between 1858 and 1893 and another one on an investigation into a  typhoid outbreak in Ithica, New York in 1903. This one has photos of the area and some interviews with the people. It would be great if your ancestor was named, but even if they are not, if they lived in the area at the time ,this outbreak would have affected them.

As  a public health microbiologist, I still see cases of typhoid today. Usually they are acquired overseas and brought back to Australia although with our global food supply there is always a risk of importation. With modern medical treatment fatalities are rare but this was not the case in the past.

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