Carrier State
Typhoid Mary has become a general term for a person spreading a communicable disease. Typhoid Mary was an actual person, and typhoid carriers are not unusual. Most big cities have typhoid carriers who are registered with the health department, and they are living and working in the community. Because the carrier state cannot be cured with antibiotic treatment, the carriers must live with certain restrictions: they may not work as food handlers or as child care attendants. They can safely work in such establishments at other jobs— for example, as a restaurant accountant. This is an example of the restrictions on personal freedom that a health officer has the legal authority to impose on an individual as a disease control measure.
If a carrier is under orders to restrict activities and does not comply with the orders, the health officer may take stronger actions, including quarantine or incarceration. Typhoid Mary was a threat because she worked as a cook and refused to stop this work. Every time the health department located her, usually through a new outbreak of typhoid, she would move and change her name but not her occupation. She was finally placed under house arrest to keep her from cooking and infecting others. Typhoid Mary infected more than a hundred people, killing several of them, before the more restrictive measures were imposed.
A 1941 case involving a typhoid carrier is a good example of the court’s view of the appropriateness of disease control measures. The case concerned whether the identity of typhoid carriers could be disclosed when necessary to prevent their handling food and thus exposing others to their disease:
The Sanitary Code which has the force of law … requires local health officers to keep the State Department of Health informed of the names, ages and addresses of known or suspected typhoid carriers, to furnish to the State Health Department necessary specimens for laboratory examination in such cases, to inform the carrier and members of his household of the situation and to exercise certain controls over the activities of the carriers, including a prohibition against any handling by the carrier of food which is to be consumed by persons other than members of his own household.… Why should the record of compliance by the County Health Officer with these salutary requirements be kept confidential? Hidden in the files of the health offices, it serves no public purpose except a bare statistical one. Made available to those with a legitimate ground for inquiry, it is effective to check the spread of the dread disease. It would be worse than useless to keep secret an order by a public officer that a certain typhoid carrier must not handle foods which are to be served to the public. [ Thomas v. Morris, 286 N.Y. 266, 269, 36 N.E.2d 141, 142 (N.Y. 1941).]