SUPER SPREADERS IN THE TRENCHES

During the latter period of WWI, infection and disease were a universal enemy on both sides of no man’s land. Vaccination and prevention methods became essential for survival, never mind victory, on the frontline

- DR PENNY STARNS

At the turn of the 20th century the basics of epidemiology, vaccine development, infection control and aseptic techniques were incorporated into scientific endeavour and medical practice. However, nobody had yet coined the term ‘superspreader’ or referred to large gatherings as ‘super-spreader’ events. Infection control and quarantine measures relied on observing certain signs and symptoms of illness and isolating sufferers from those who were healthy, and there was no recognition that certain people could be carriers of disease without displaying any of the usual manifestations of infection.

Such asymptomatic carriers were responsible for unknowingly transmitting disease among their families, communities and further afield. The most famous of these super-spreaders was an Irish cook named Mary Mallon, who as a carrier of typhoid (also known as enteric fever), became widely known as Typhoid Mary. Working for wealthy families in an affluent area of New York, Mary’s most popular dish was a serving of peach ice cream, but standards of kitchen hygiene were lax and her signature dessert rapidly spread typhoid wherever she went.

Since the disease was more usually associated with poor sanitation and contaminated water in New York’s deprived areas, doctors began to look for other causes of transmission. One family went a step further and employed a sanitation engineer named George Soper to investigate the issue. Eventually a pattern of infection was established which implicated Mallon. This feisty cook, however, was unconvinced of her super-spreader status.