A Forgotten Island & the First “Super-Spreader”
Starting in the 15th century, Venice implemented isolated facilities where victims of bubonic plague were quarantined and cared for to the best of the city’s ability. Many European cities followed the example, creating plague hospitals of their own, both to house ill citizens and quarantine travelers.
In America, citizens have faced many outbreaks of infectious disease—from tuberculosis and smallpox to polio and typhus. Cities and states purchased land and built facilities that acted like those in Medieval Europe, housing and caring for those ill with contagious diseases
New York City houses one of these facilities, now in ruins, on an abandoned island on the East River. Nature is slowly reclaiming the structures that remain, serving as a reminder of a dark time on the East Coast and bringing to memory one of the most famous names in pandemic history.
Island of Isolation
North Brother Island is located between the Bronx and Riker’s Island in the East River of New York City. Its first structure was a lighthouse and connected two-story dwelling, completed in 1869. The island’s location had long been thought ideal for a lighthouse to help guide vessels in a particularly tricky area of the East River. In 1881, North Brother Island was annexed to the city and county of New York to construct “buildings and hospitals for the care and treatment of persons sick with contagious diseases.”
Riverside Hospital was built as a facility for housing and treating individuals with contagious diseases. Patients at the Renwick Institute on Blackwell’s Island (known today as Roosevelt Island), were moved to the new facilities on North Brother Island. It had been opened in 1856 as a smallpox hospital and isolation center.
Renwick. became a nurse dormitory in 1875, at which time the patients at the facil
ity were moved to North Brother Island. After the town of Morrisania (now a neighborhood in the Bronx) reportedly purchased part of the island in 1871, the Sisters of Charity had built a tuberculosis hospital meant for housing TB patients and others with contagious diseases.
That hospital was closed when New York City built the Riverside Hospital for the treatment of infectious diseases. More than a dozen buildings for housing and treating patients dotted the 20-acre island, joined by laboratories and homes/dormitories for doctors, nurses and other staff members.
Mary Mallon
As public health officials did what they could to prevent disease outbreaks and save the lives of infected individuals on North Brother Island, one woman— their worst nightmare, it turned out—was beginning her life in the United States. Mary Mallon left Ireland to settle in America in 1883. She was only a teenager at the time and found work as a domestic servant. By 1900, she was working primarily as a cook for wealthy families in New York City, where she created her signature dish; peach ice cream. She worked for multiple families over the next few years and was working for a family in Long Island when six of the eleven members of the household were stricken with typhoid fever in 1906.
A Deadly Contagion
Typhoid fever is caused by Salmonella typhi bacteria, a relative of the organisms that cause food poisoning, and can be spread through contaminated food or water or other drinks (often milk). Once a person was infected, typhi bacteria attacked the victim’s blood and internal organs. Patients suffered symptoms beginning with abdominal pain, then progressing to fever, headache, chills, diarrhea, fatigue, confusion, body rash and a host of others. In severe cases, complications including intestinal bleeding and/ or holes in the intestine can arise, which are both life-threatening.
As America entered the 20th century, rural residents and arriving immigrants flocked to urban areas undergoing rapid industrialization. In cities like New York, this influx of population led to overcrowding and strained resources. Lack of a clean water supply and waste-disposal systems contributed to multiple outbreaks of infectious diseases, including tuberculosis, cholera and typhoid fever.
In 1900, the incidence of typhoid fever in the US was approximately 100 per 100,000 (CDC), the death rate per 100,00 people approximately 35.8. Though a vaccine had been developed in 1896, those receiving doses were primarily soldiers, who before its creation were more likely to be killed by typhoid than in combat. The general population in the United States still dealt with the disease. Today, there’s only a 1- 4% mortality rate for typhoid victims who quickly receive treatment; however, untreated, 12-30% of victims eventually succumb to complications of the infection.
Super- Spreader
The wealthy family Mary Mallon worked for in 1906 was staying in a rental home at Oyster Bay. After they’d fallen ill with typhoid, the property’s landlord feared that no one else would rent if they didn’t pinpoint the source of the outbreak. To find out, he hired New York City Department of Health Sanitary Engineer George Soper. Soper was a civil engineer by training, but he had become the contact tracer of his time, specializing in the investigation of typhoid outbreaks.
By the time he was called, Mary had moved on to another place of employment, cooking for another family somewhere in the area. Soper and other experts from the department investigated the cause/source of the family’s typhoid outbreak. While the others suspected contaminated water was the likely source, Soper was suspicious that the cases originated in contaminated food. That theory first brought him to Mary, since she’d arrived at the home just three weeks before the first person fell ill. He looked into her former places of employment and found a shocking trend: among the families who’d employed Mary, 22 people had been infected with typhoid. Soper had been tracking research in Europe which indicated that the illness might be able to spread through asymptomatic carriers. He suspected Mary Mallon was one of them.
“Typhoid” Mary
Never before had an outbreak been traced back to a single carrier, and no one had ever identified a typhoid carrier who didn’t have symptoms—but Soper was convinced Mary Mallon was his ground zero. And he was right. When he discovered Mary working on Park Avenue, he confronted her with what he’d found and asked for samples to confirm his hypothesis. Mary, then 37 years old, charged at the man with a carving fork. Another public health official was tasked with collecting the samples but Mary chased her away, too. As health officials feared more illness and even death in Mary’s wake, they called on law enforcement to escort Mary to a hospital where she tested positive for Salmonella typhi. At the hospital, the doctors told her of their findings and offered to do the only thing they could to cure her: remove her gallbladder, which was thought at that time to be the source of the bacteria. It was that or quarantine. When she refused an operation, Mary was taken to North Brother Island where she spent her time in a small house on the grounds of Riverside Hospital.
After George Soper presented his findings of Mary Mallon to the public, the New York American dubbed her “Typhoid Mary” in 1909, a name that became famous around the world. She resented the media’s attention and their rep
resentation of her, writing “I have been in fact a peep show for everybody.” In 1909, she sued the city’s Department of Health for “kidnapping” and “imprisoning” her. The case went to the Supreme Court, sparking a debate in the public about state responsibility in public health crises and individual responsibility and autonomy in such situations.
Despite Mary’s argument, the court stated that it would not grant her release from quarantine: “[we] must protect the community against a recurrence of spreading the disease.” The next year, however, Mary caught a break when the city’s new health commissioner allowed her to return to society, with the condition that she never again work as a cook. She agreed and was released from North Brother Island.
Mary did laundry for a while but, underpaid and still not convinced her condition was dangerous to others, she soon moved back into food service under an assumed name. She worked at different facilities until in 1915, when George Soper was investigating the source of another bout of outbreaks. He traced things back to a cook named “Mrs. Brown” (Mary’s pseudonym), who had caused two separate outbreaks, one at a New Jersey sanatorium and another at a Manhattan hospital. Officials identified Mary Mallon, located her and sent her back to North Brother Island. “Typhoid Mary,” as she’d become known, had been directly responsible for at least 51 cases of typhoid and three deaths, and experts know that the real number of cases was probably much higher.
Mary Mallon spent the rest of her life on North Brother Island, a place where many who had contracted contagious diseases were receiving what care there was available. She lived in a small cottage with a dog as a companion.
After her return to the island, Mary began working at the hospital laboratory, where she remained employed until suffering a stroke in 1933. She remained bedridden until she died in 1938.
North Brother: No Stranger to Darkness
The island saw much sickness and tragedy, unrest like Mary’s, and joyous recovery. But the one event that brought unimaginable loss to North Brother Island had nothing to do with infectious diseases, and it occurred even before Mary arrived.
On June 15, 1904, a passenger ferry chartered by the St. Mark’s Evangelical Lutheran Church on the Lower East Side was carrying 1,358 passengers and crew up the East River toward the North Shore of Long Island. Those on board — most of them German-American women and children — were looking forward to a relaxing day on the water, away from the crowded streets of the city. About a half-hour after leaving port, the PS Slocum was in waters off the shores of North Brother Island. It was around that time when a fire ignited on board, spreading rapidly throughout the ship. Passengers panicked, deciding whether to jump into the Hudson (it is likely most of them didn’t know how to swim) or risk burning alive on the ship. In the end, only 321 passengers aboard the PS Slocum survived, 1,358 dying in the tragic accident. Bodies washed ashore for days at North Brother Island, a startling sight even for a place well-acquainted with suffering and death.
New Purpose & Life
After it served as a quarantine facility, North Brother Island was used at different times for housing and drug rehabilitation until its abandonment in 1963. It still holds the decaying remains of the sanatorium pavilion, lighthouse, but is home only to wildlife.
That’s part of where the light comes back into North Brother Island’s story: today, it’s off-limits to locals and visitors (humans, that is), because it’s become a thriving bird sanctuary. Both North Brother and South Brother islands have become part of the Harbor Herons Region, a complex of islands and marshes which provide habitat for shorebirds, including gulls, herons, cormorants and egrets.