Lady Mary Montagu and the Discovery of the Smallpox Vaccine

Though Edward Jenner is credited with developing the first smallpox vaccine, inoculation had long been practiced in other parts of the world.

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Smallpox had for many years been a scourge in the West, sweeping through the densely populated cities of Europe in periodic epidemics, killing as many as 35% of the people it infected and often leaving the survivors scarred for life. From the wealthiest noble to the humblest peasant, residents of London and Paris lived in abject fear of the next wave of infection. There was no known way to prevent the spread of the disease, and no known cure. But while the populace of the West cowered under smallpox’s shadow, they had no idea that the cultures of China, the Middle East, and Africa had known how to prevent the disease for centuries, and that their method would soon be introduced into England by one very brave and determined woman.

Lady Mary Montagu and the First Inoculations

Lady Mary Wortley Montagu, a member of the British nobility and the wife of an ambassador, was living in Turkey while her husband was posted there. She had firsthand experience with the horrors of smallpox—she had contracted the disease in 1715, and though her prognosis had been grim, she had managed to survive. Before her illness, she had been widely lauded as one of the most beautiful women in Britain; afterward, her face was so misshapen and scarred that she always wore a veil in public. Though she no longer had to fear smallpox for herself, she lived in mortal terror of her two children contracting it. So when she heard the Turks had a method for preventing smallpox, she wanted to hear all about it.

The method had been practiced for centuries, though Westerners knew little to nothing of it. It is possible that inoculation against smallpox was known in India as early as 1000 BC, though the first definitive mention of the treatment was made in 1549, by Chinese author Wan Quan. The inoculation (or variolation, as it was called in the early days) worked on a similar principle to modern vaccines—small particles of diseased matter from an infected person, either in the form of pus or powdered scabs, was blown up the inoculee’s nose or inserted through a tiny cut in the skin. The patient would then develop a mild case of smallpox, after which he or she would be forever immune. There was a small chance the inoculation would be fatal, but it was an infinitesimal risk compared to the mortality rate of full-blown smallpox. Lady Mary, hearing of the method described by doctors Emmanuel Timoni and Jacob Pylarini, became determined to introduce the knowledge to England; to show her commitment to the cause, she vowed to have her own children inoculated.

The Smallpox Vaccine Comes to England

The British public were wary when Lady Mary returned home in 1721 and began making her campaign for variolation. Smallpox was horrible and often fatal; why give yourself a dose of it on purpose? But Lady Mary was relentless, and despite widespread condemnation of her and of Dr. Charles Maitland, who she persuaded to perform the inoculations, she gave the treatment to her children (aged 4 and 5), both of whom survived their ordeals with no lingering effects. Soon others were bringing their children to Lady Mary to have them variolated, and though one or two of the inoculated patients did die of smallpox, on the whole the experiment was a rousing success, so much so that the British Royal Family conceded to having their own children inoculated; still leery of the procedure’s safety, however, they insisted that the inoculations first be performed on six prisoners, who would earn a pardon if they survived. All did, and the royal children were variolated.

Cotton Mather and the American Inoculations

During this time, Lady Mary Montagu had also been corresponding with American minister Cotton Mather, who had noticed that his family’s African slaves seemed immune to smallpox. When Mather asked one of the slaves, Onesimus, about this, the man answered that a similar method of variolation as that practiced in Asia and the Middle East was also common in Africa. Mather convinced Dr. Zabdiel Boylston to inoculate Boylston’s son and two slaves, all of whom recovered, and was instrumental in sowing acceptance for the vaccine in the young United States.

Dr.Edward Jenner Vaccinating Young Boy

Edward Jenner and the Modern Vaccine

Early studies of the use of the cowpox virus to prevent smallpox had been done in 1727 and 1766, but it is British physician Edward Jenner who is generally credited with developing the first smallpox vaccine; the word vaccine was taken from the Latin “vaca,” for cow. The cowpox virus is similar to smallpox, and so conveys immunity to the more deadly disease, but is mainly prevalent in cows and not fatal to humans, making the vaccine much safer. Jenner experimented with his cowpox vaccine in 1796, and presented his findings to the Royal Society, after which he went on to experiment on 23 other people. The vaccine was hugely successful, bringing the death rate from smallpox down to essentially zero.

Over the years, Jenner’s work was published around the world, and widespread vaccination became the norm. In the late 1970s, the disease of smallpox was officially eradicated, though two samples of the deadly variola virus that causes it still remain—one at the CDC in Atlanta, Georgia, and one at the State Research Center of Virology and Biotechnology in Koltsovo, Russia. These are kept for research purposes in the event of a new outbreak, due either to natural causes or bioterrorism.

Source:

Carrell, Jennifer (2003). The Speckled Monster: A Historical Tale of Battling Smallpox. The Penguin Group. ISBN: 0452285070.

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Mary Mallon, the Original Typhoid Mary

The Irish cook was responsible for infecting dozens of people in early 20th-century New York City. The original article I wrote can he found here.

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Today, the term “Typhoid Mary” is used to denote someone who deliberately acts as a carrier of disease, or rather is aware that she is a carrier but does nothing to prevent infecting others. Urban legends about such people are quite common, and the phrase has even made the leap to tech jargon, describing a person who unwittingly spreads computer viruses. But the original Typhoid Mary was a real person whose life and death raised still-controversial issues about the trade-off between individual liberty and public health.

Typhoid Mary Arrives in America

Mary Mallon was born in September of 1869 in County Tyrone, Ireland, and in 1884 became one of the millions of Irish immigrants flooding into New York to seek a better life. She discovered she had a natural talent for cooking, and learned the skill to such an extent that she was very rarely out of work over the next several years. Although she was not financially secure by any means, working as a cook in a household was far better paid and more prestigious than other positions like maid or laundress. Mary Mallon even worked for some wealthy families, including that of the Vanderbilt’s banker.

The study of infectious disease was still rather rudimentary in those days, so Mary Mallon was able to work in several households between 1900 and 1907 before anyone began to discern a pattern. But pattern there was: The first house she worked in saw its residents infected with typhoid within two weeks of Mary securing employment there. At the next house, several family members contracted typhoid, and a member of the household staff died of it. All told, Mary Mallon is credited with spreading typhoid to at least 53 people and causing three deaths as she moved from household to household for employment.

Typhoid Spreads

At the time, the concept of a healthy carrier of disease was not widely known, so it’s probable Mary was not spreading the disease on purpose, at least at first. It was likely that Mary had suffered a bout of typhoid when she was younger and had recovered, but retained the bacteria in her body. The bacteria would have been present in her urine and feces, and unless she scrubbed her hands vigorously before touching anything, Mary could have easily spread the disease through her handling of food, or ironically through trying to care for family members who had contracted typhoid.

Scientist and typhoid expert George Soper was the first to see the trail of infection Mary was leaving in her wake, and in 1907 he tracked her down to ask for urine and stool samples to confirm his suspicions. Mary refused, insisting she was healthy and had never had typhoid. Soper’s next attempt was also a failure. Even when he offered Mary royalties if she would let him write a book about her, she furiously turned him away.

Forced Quarantine

Finally, drastic measures were taken. Dr. Sara Josephine Baker of the New York City Health Department went to the house where Mary was working, police officers in tow, and forcibly took Mary into custody, claiming she was a danger to public health. Mary Mallon was taken to a clinic on North Brother Island and quarantined for three years against her will. At the end of this period, she was offered freedom, provided she no longer worked as a cook; unsurprisingly, Mary readily agreed.

Perhaps also unsurprisingly, Mary didn’t stick to the agreement. Clinic authorities secured her a job as a laundress, but the wages were significantly less than what she was used to, so using the pseudonym Mary Brown, Mallon got work as a cook again, going on to infect 25 people with typhoid. She was taken into custody again in 1915, and stayed in quarantine until she died of pneumonia in 1938. A post-mortem examination indeed found typhoid bacteria in her gall bladder. Though other “healthy carriers” were identified later, Mary Mallon was the first and most famous “Typhoid Mary,” a symbol of the constant struggle between an individual’s personal freedoms and the health of the community at large.

Sources:

Brunvand, Jan Harold. Curses, Broiled Again!: The Hottest Urban Legends Going. New York: Norton, 1990. Print.

Stradling, Jan. Bad Girls: The Most Powerful, Shocking, Amazing, Thrilling and Dangerous Women of All Time. New York: Metro, 2008. Print.