Typhoid Questions

1. How and where did Mary Mallon die?

a) of typhoid fever in New York City
b) of consumption (tuberculosis) in debtor’s prison in Ireland
c) of complications following a stroke in New York City
d) of wounds received from an angry mob in a hospital in New York City where doctors refused to treat her, fearing contagion

2. What was Typhoid Mary’s ethnicity

a) English
b) Irish
c) Jewish
d) African-American
e) American born

3. How many people are thought to have died as a result of Typhoid Mary’s activities?

a) 3
b) 16
c) 47
d) 121
e) over 1,000

4. Typhoid fever is caused by

a) a virus
b) a bacterium
c) a parasitic worm
d) the bite of fleas
e) blood-blood contact

5. The causative agent of typhoid fever is a member of the genus

a) Salmonella
b) Vibrio
c) Treponema
d) Mycobacterium
e) Helicobacter

6. Typhoid Mary was actively spreading disease during the years

a) during the American Civil War
b) just before World War I
c) during the height of the Depression
d) just after World War II

7. Two of the great newspaper tycoons at the time of Typhoid Mary were

a) Winchell and Murrow
b) Zengerer and Franklin
c) Eisner and Katzenberg
d) Murdock and Sulzberger
e) Hearst and Pulitzer

8. Who was George Soper?

a) The man with whom Typhoid Mary sometimes lived
b) The judge who refused to release Typhoid Mary from quarantine
c) The health officer who ordered Typhoid Mary’s quarantine (the first time)
d) The civil engineer who tracked Typhoid Mary down
e) The owner of the house on Long Island that was rented by the family that contracted typhoid fever

9. At the end of the nineteenth century, many people still believed in the close connection between miasmas and disease. What is a miasma?

a) a poisonous vapor rising from rotting material and initiating disease in people
b) an imbalance between the body’s four humours
c) a deep sadness characterized by swooning and generally thought to refer to what we now know as “clinical depression”
d) an evil spirit carried on the night wind, especially a northeast wind.
e) a microorganism

10. Who was president of the USA when Typhoid Mary was first discovered and quarantined?

a) James Buchanan
b) Theodore Roosevelt
c) Woodrow Wilson
d) Calvin Coolidge
e) Franklin Roosevelt

11. The probability of death for those who contracted typhoid fever in pre-antibiotic America was about

a) 1%
b) 10%
c) 50%
d) 90%
e) 99.9%

12. The surgical alternative offered to Typhoid Mary was removal of her

a) large intestine and lower bowel
b) small intestine
c) spleen
d) gall bladder
e) liver

13. The whole tragic story of Typhoid Mary took place in

a) Boston
b) New York City
c) Chicago
d) Cleveland
e) San Francisco

14. The germ that causes typhoid fever can enter (and remain) in a carrier state because

a) some people are genetically unable to make the antibody that recognizes it
b) it lodges in tissues that are not supplied with blood or lymph
c) it hides inside cells in special vesicles
d) it is a “slow virus”
e) it can cross the blood-brain barrier

15. We know surprisingly little about the germ that causes typhoid fever because

a) it is hard to grow it in pure culture
b) typhoid fever is not a very prevalent disease any more, hence funding for study is low
c) it can grow only inside of cells (in vesicles)
d) it does not cause typhoid fever in any animal other than humans
e) the disease it causes is over so quickly

16. The recommended medical treatment for the gastroenteritis caused by common Salmonella is

a) antibiotic therapy
b) quarantine until the feces is free of Salmonella for at least three consecutive months
c) removal of the gall bladder or liver
d) laxatives
e) no treatment at all

17. Stomach ulcers are caused most often by

a) Salmonella typhi
b) Salmonella enterica
c) Helicobacter pylori
d) stress and spicy foods
e) environmental carcinogens

18. Which of the following is NOT typical of typhoid fever

a) skin rash on the abdomen and torso
b) fever persisting up to several weeks
c) decreased number of white blood cells
d) persistent cough as the lungs fill with fluid
e) enlarged spleen and distended abdomen

19. In 1925, health department officials thought female carriers of typhoid fever were more dangerous than male carriers because

a) 100% of the known carriers were female
b) women did most of the cooking in families and as servants
c) women had just gained the right to vote
d) women were biologically more susceptible to infections
e) social norms generally required a higher degree of cleanliness for men than for women

20. In the 1909 court hearing, Typhoid Mary’s lawyer tried to have her released by challenging

a) the unfair treatment of Irish-Americans
b) her imprisonment without a trial
c) the credibility of the health department of New York City
d) the definition of healthy carriers as “sick” under the law
e) the prejudicial representation of her story in the tabloid press

21. Four of these names refer to the same person, which one does not fit?

a) Mary Ilverson
b) Mrs. Brown
c) Typhoid Mary
d) Mary Mallon
e) Josephine Baker

22. During Mary Mallon’s lifetime, the number of deaths from typhoid fever (per 100,000 population) declined dramatically. This correlated strongly with

a) the provision of filtered water to cities
b) the discovery and widespread use of antibiotics
c) the discovery of the concept of “healthy carriers”
d) the decline in immigration from Europe and especially Ireland
e) the widespread acceptance of tobacco use by the lower classes

23. In the present day, standard antibiotic therapy

a) is effective against the active form of typhoid fever, but not the carrier state
b) is effective against the carrier state of typhoid fever, but not the active form
c) is effective against both the active form and the carrier state of typhoid fever
d) is effective against neither the active form nor the carrier state of typhoid fever
e) is almost always effective against the active form of typhoid fever, but only very rarely against the carrier state

24. The health department wanted samples to test for the presence of the typhoid fever germ. Which of these did they NOT request

a) feces
b) urine
c) blood
d) sputum


25. Which of these occurred during the years that Mary Mallon was cooking and spreading typhoid fever

a) The Irish potato famine sent another million or more immigrants to the US
b) The English army brutally suppressed the “Easter rebellion” in Ireland, sending another million immigrants to the US
c) Walter Reed “conquered” yellow fever in Cuba and William Gorgas was doing the same in Panama
d) Penicillin was discovered and was slowly gaining acceptance as an effective therapy for the treatment of bacterial diseases
e) John Snow proved that cholera was transmitted by drinking water, thus proving that at least one bacterial disease has a fecal-oral route of transmission

26. Where you be most likely to find bacteria

a. In your urine
b. In your blood
c. In your throat
d. In your liver
e. In your brain

27. If a bacterium divides once every hour, after 8 hours, how many bacteria will there be?

a. 2
b. 8
c. 9
d. 16
e. 256

28. Bacteria have been present on earth for

a. thousands of years
b. hundreds of thousands of years
c. millions of years
d. billions of years
e. hundreds of billions of years

29. What made Mary Mallon so special?

a. She was the first “healthy carrier” of typhoid fever identified in the US
b. She was the first “healthy carrier” of typhoid fever identified in the world
c. She was the first female carrier identified in New York (two males identified before her)
d. She was the first person whose diagnosis of Typhoid Fever was confirmed by a bacteriological test
e. She was one of the very few persons to survive having Typhoid Fever

30. The number of persons thought to have been infected by Mary Mallon was

a. none
b. 3
c. a few dozen
d. a few hundred
e. a few thousand

31. What was Mary Mallon’s profession?

a. Nurse
b. Nanny
c. Cleaning lady
d. Cook
e. Laundress

31. The most common mode of transmission of Typhoid Fever is

a. blood-blood contact
b. dried sputum
c. fecal-oral contamination
d. sexual intercourse
e. insect bites

33. The one man who tried to get Marry Mallon released from North Brother Island in 1909 was

a. Joseph Pulitzer
b. Hermann Biggs
c. George Soper
d. William Randolph Hearst
e. Carlton Gajdusek

34. When Mary Mallon was first approached by someone telling her that she was a carrier of Typhoid Fever and requesting that she submit for testing, she

a. accompanied him willingly to the hospital, but only the first time
b. sat silently and refused to answer his questions
c. contacted her lawyer
d. threw him out of the house
e. fled from the city

35. The lesson of “Typhoid Mary” lives on in a sign we see posed quite frequently, namely:

a. “Employees must wash hands before returning to work”
b. “No oysters in months without an R”
c. “Spitting is prohibited.”
d. “Reg. Pa. Dept. of Agriculture”
e. “Pasteurized”

36. How old was Mary Mallon when she died?

a. in her 20’s
b. in her 30’s
c. in her 40’s
d. in her 60’s
e. in her 80’s

37. Which of these is NOT currently a legal basis for quarantine in the US?

a. Typhoid Fever
b. Tuberculosis
c. Smallpox
d. Mumps

38. Briehof is the name of

a. the chief health officer of the city of New York in 1907
b. a friend of Mary Mallon’s with whom she sometimes lived
c. a man who was also a “healthy carrier” of Typhoid Fever
d. a police official on Papua-New Guinea
e. the German microbiologist who first succeeded in growing the bacterium that causes Typhoid Fever

39. Salmonella typhi evade the body’s defenses because

a. It is not a pathogen and does not need to evade them
b. It is resistant to antibiotics
c. It grows faster than the body’s defenses can counter
d. It prevents the phagocytes from engulfing it
e. It blocks fusion of lytic vesicles with the vacuole containing it

40. The place where S. typhi hides in healthy carriers is most commonly

a. the liver
b. the gall bladder
c. the lungs and throat
d. the fingers
e. the stomach

41. The first efforts at public health involved municipal garbage collection, draining of sewage-contaminated swamps, and primitive sewage treatment facilities. These efforts were spurred by the public’s fear of

a. bacteria
b. floods
c. rats, lice, and mosquitoes
d. evil spirits
e. miasmas

42. The first line of defense of the human body against bacterial infections is

a. The immune response
b. The skin
c. Digestive enzymes
d. Water treatment
e. Antibacterial soaps

43. During the years of Mary Mallon’s first detention on North Brother Island, Ireland

a. underwent a bloody civil war that freed it from English rule
b. underwent a debilitating potato famine that resulted in the emigration of many Irish to the America
c. entered the first World War on the side oft Allied Powers
d. entered the first World War on the side of the Axis Powers
e. remained an unwilling colony of Great Britain

44. Typhoid Fever is still a “reportable” disease. This means that

a. newspapers are permitted to publish not only its outbreak, but also the names of carriers
b. those diagnosed with Typhoid Fever must report at regular intervals to health officials for testing
c. physicians are required to report all cases to local public health authorities
d. public health officials are required to inform the public of any outbreaks in the region
e. medical journals still accept articles on Typhoid Fever for publication

45. “Typhoid Mary’s” status as a healthy carrier of typhoid fever was established by

a. bacteriological tests performed by the New York City Dept. of Health Laboratories
b. a panel of physicians appointed by the New York City Dept. of Health
c. a panel of physicians appointed by a New York State court
d. a panel of physicians appointed by a federal court
e. perigradular fraglitation of her gall bladder

46. Of the total number of cases of typhoid fever in New York City in 1906-1907, what fraction were thought to have been caused by “Typhoid Mary?”

a. fewer than 1%
b. 12-15%
c. about two thirds
d. 100%
e. all but one case

47. A bacterium is said to be a human pathogen

a. it grows well inside humans
b. it is recognized by the immune response
c. it can grow using blood or plasma as its sole source of food
d. it can be transmitted from one human to another
e. it makes humans sick

48. The reason that Mr. George Thompson hired George Soper was

a. Mr. Thompson had a long-standing interest in Public Health
b. Mr. Thompson needed a physician to treat his family
c. Mr. Thompson needed a political ally in his attempt to become the head of the New York City Board of Health
d. Mr. Thompson wanted to transport bibles and other missionary supplies from Australia to the Fore villages in Papua New Guinea
e. Mr. Thompson wanted to be able to rent out his summer cottage

49. As of 1907 (the time of Typhoid Mary), Public Health Boards

a. had been around since colonial times
b. were still a new concept
c. derived their powers from the “War Powers Act.”
d. were still illegal in most states

50. The woman who came to be known as “Typhoid Mary”

a. could read and write
b. could drive a car
c. was significantly overweight
d. had difficulty speaking English
e. became convinced of her status as a healthy carrier sometime during 1910, the year she was released from her first imprisonment

51. Once a bacterium had been taken up into a phagocyte and enclosed in a vessicle, it is likely that

a. it is then coated with antibodies to target it for destruction
b. it is digested by digestive enzymes poured into the vessicle from a lysozome
c. it fuses with the cell membrane of the phagocyte and kills it
d. it dies because of the high temperature inside the phagocyte
e. it secretes a white substance that we know as “pus.”

52. Which of these was NOT a recommended treatment for healthy carriers of typhoid fever at the time “Typhoid Mary” was first identified?

a. laxatives
b. diuretics
c. vaccinations
d. surgery

53. The most effective way to identify dangerous carriers of typhoid fever was

a. following all reported typhoid fever cases until the stools of the patient were free of typhoid bacilli
b. requiring all food handlers to have a certificate of helath from a private or public physician
c. epidemiological tracking of outbreaks to suspected sources
d. routine testing of the water in all private wells

54. At the time of Typhoid Mary’s capture and transfer to confinement, the news coverage in the major New York newspapers could best be described as

a. independent and authoritative
b. government-controlled
c. erudite and literary
d. tabloid and sensational
e. prudish

55. When did bacteria appear on earth?

a. very soon after humans evolved
b. very soon after warm-blooded animals evolved
c. about the same time as the dinosaurs
d. only after human populations gathered in large groups (i.e. cities)
e. before all other forms of life

56. The belief that “miasmas” were the cause of most disease, especially epidemic disease, led the public to support

a. pasteurization of milk
b. public vaccination programs
c. construction of water filtration plants
d. street cleaning and garbage collection
e. construction of quarantine hospitals

57. The untested legal principle that Mary Mallon’s first court hearing established was that

a. a sick person could be quarantined against her/his will
b. a healthy person could be considered sick if she/he carried typhoid germs
c. women were subject to the quarantine laws, not just men
d. the fifth-amendment protection against self-incrimination was waived in cases of infectious disease

58. An Irish person born and reared in Ireland in the years around 1880-1900 would be most likely to harbor ill will toward

a. the French
b. the Germans
c. the Americans
d. the English
e. the Italians

59. A normal, healthy human being

a. carries no bacteria at all (is sterile from a bacteriological point of view)
b. carries some bacteria, but only non-pathogenic ones
c. carries some bacteria, bot only pathogenic ones
d. carries a mix of pathogenic and non-pathogenic bacteria and would be sicker of they were all removed
e. carries a mix of pathogenic and non-pathogenic bacteria and would be even healthier if they were all removed

60. In the present time, a person would be called a “Typhoid Mary” because

a. he has had typhoid fever
b. he has been persecuted by the authorities unjustly (or to an unreasonable extent)
c. he brings bad luck with him
d. he is a working-class person who stands up for his rights against those who claim to be better educated
e. he is Irish and a member of a labor union

61. Most bacteria

a. cause disease
b. can live in or on humans
c. are too small to be seen without a microscope
d. are multicellular organisms
e. can grow in boiling acid for extended times