Viewing/Writing Assignment: The Most Dangerous
Woman in America
I. Introduction
Typhoid fever, also known as enteric fever, is an acute, life-threatening febrile illness caused
by the bacterium Salmonella typhi. (several other names and designations are also used for this
organism). In addition to S. typhi that causes typhoid fever, other forms can lead to a form of
human intestinal disease sometimes referred to as salmonellosis or Salmonella food poisoning.
This latter organism is the one that often contaminates the food chain on raw spinach or peanut
butter but does not cause typhoid fever.
Common worldwide, Salmonella typhi is transmitted by ingestion of food or water
contaminated with feces from an infected person or by person-to-person contact (with inadequate
attention to personal hygiene). Patients with acute illness can contaminate the surrounding water
supply through the stool, which contains a high concentration of the bacteria. Contamination of
the water supply can, in turn, taint the food supply. The bacteria can survive for weeks in water
or dried sewage. Flying insects feeding on feces may occasionally transfer the bacteria through
poor hygiene habits and public sanitation conditions.
Typhoid fever in most cases is not fatal. Antibiotics, such as ampicillin, chloramphenicol,
trimethoprim-sulfamethoxazole, and ciprofloxacin, have been commonly used to treat typhoid
fever in developed countries. Prompt treatment of the disease with antibiotics reduces the casefatality rate to approximately 1%. Resistance to ampicillin, chloramphenicol, trimethoprimsulfamethoxazole and streptomycin is now common, and these agents have not been used as first
line treatment now for almost 20 years. Typhoid that is resistant to these agents is known as
multidrug-resistant typhoid (MDR typhoid).
About 3-5% of patients become carriers of the bacteria after the acute illness. Also, some
patients suffer a very mild illness that goes unrecognized. These patients can also become longterm carriers of the bacteria. The bacteria continue to multiply in the gallbladder, bile ducts, or
liver and passes into the bowel. These chronic carriers may have no symptoms and can be the
source of new outbreaks of typhoid fever for many years. According to the Centers for Disease
Control approximately 3-5% of people who contract typhoid continue to carry the disease after
they recover. The carrier state can be treated with prolonged antibiotics. Often, removal of the
gallbladder, the site of chronic infection, will cure the carrier state. Two typhoid vaccines are
currently available for use in the United States.
You should not confuse typhoid fever with the unrelated disease typhus, which is caused
by a different microorganism and spread by lice.
II. Instructions
1) View the video entitled The Most Dangerous Woman in America. It is about an hour long.
The video is a docudrama about an early 20th Century person named Mary Mallon (aka Typhoid
Mary).
2) Use the discussion questions and discussion points given below to guide your viewing and be
prepared to discuss the questions and points in class and in the writing assignment on this video.
III. Discussion Questions and Points on Typhoid Mary-The Most Dangerous
Woman in America
1)
What was unusual about the Oyster Bay outbreak of typhoid that first brought Mary to
the attention of the authorities?
2)
Bacteriology (microbiology) was a new disease science in the decade of the 1900’s. What
ideas about disease had been prevalent before microbes were implicated? What sort of health
transition was going on at this time in the western world?
3)
Who was George Soper? Why did his work represent a new school of thought in
America? Why did he ask questions about people (as well as things like food, dairy products and
plumbing) during the Oyster Bay outbreak? What was Soper’s motivation?
4)
Who discovered the first known case of a typhoid carrier?
5)
Why were the peaches and ice cream dessert the perfect vehicle for transmitting the
typhoid bacterium from Mary to the family members at Oyster Bay?
6)
Why did Mary not want to cooperate with Dr. Soper or the other public health
authorities? Why did she feel insulted by her first confinement to the hospital on North Brother
Island?
7)
What was the attitude of the public health authorities (and other civil servants) toward
immigrants such as Mary?
8)
Was the first quarantine of Mary justified in order to protect public health or did it
represent an unjustified attack on her individual rights? Were there acceptable alternatives or
compromises?
9)
Why was Mary singled out by the public health authorities-compared to other typhoid
carriers?
IMPORTANT PEOPLE IN THE DVD: Mary Mallon, George Soper, Sara Josephine
Baker, Judith Walzer Levitt, Anthony Bourdain, Robert Koch.
IMPORTANT DISEASE IN THE DVD: typhoid (not typhus!)
IV. Other interesting and helpful sites and resources
CDC information on typhoid and Salmonella:
http://www.cdc.gov/nczved/divisions/dfbmd/diseases/typhoid_fever/
and: http://www.cdc.gov/salmonella/outbreaks.html
Microbe wiki page on Salmonella:
https://microbewiki.kenyon.edu/index.php/Salmonella_typhi
And examples from the news:
http://www.marlerclark.com/Subway_Salmonella_Outbreak/
http://www.foodsafetynews.com/2014/05/college-station-restaurant-closes-afteroutbreak/#.VGTWBfnF9AY
V. Writing Assignments
Writing: After you have viewed the assignment and thought about your answers to discussion
questions, write a brief summary of the video. Approximately one-half of a standard page is
sufficient (approx. 250 words). Write your brief summary as though it is intended for a group of
IUP students at about your own level of education. Use complete sentences organized in
paragraph format for your summary. Write your summary to briefly explain the key points of the
video as if you were presenting them to someone who had not viewed it. In order to receive full
credit your summary must be scientifically accurate and backed up by specific examples from
the video. There is no right or wrong way to write or organize the summary. Use your own
words. Your grade for this part of the assignment will depend on your accuracy and how well
you use examples.
In addition to your brief summary, address the following question in your writing assignment.
An additional 250 words should be sufficient for the answer to the following question, bringing
the overall writing assignment including both parts to a total of approximately 500 words.
Question: The video raises some personal rights issues that are related to the City’s enforced
quarantines of Mary even though she had committed no crime. What were these personal rights
issues and how do they they relate to the events of the 2014-2015 outbreak of Ebola in Africa,
Europe and the US? In other words, is the general need for good public health more important
than the rights of an individual such as Mary??
Write your answer as though it is intended for a group of IUP students at about your own level of
education. Use complete sentences organized in paragraph format for your answer.
Grade: The written part of the assignment will count toward the “Writing Assignments ”
component of your grade as outlined in your semester syllabus with the summary and the answer
to the question weighted equally in the grade.
The assignment is due on Friday September 11, 2015 by 4:00 PM in hard copy format (word
document or legible handwriting). No email submissions accepted. Turn them in to me, either in
class or in my office or give them to the Biology secretary in Room 114 and ask her to put them
in my mailbox. We are not using D2L for this course.
VI. A Final Note
Make sure that you save a copy of the discussion questions/answers/notes.
Some version or form of the discussion questions above is likely to appear on the first exam on
September 17..