s a historian of public health, it strikes me that the concept of uncertainty is key to underAstanding pandemics.Much like past pandemics, our current public health crisis, COVID-19, is surrounded by uncertainty. Transmission rates, reinfection probabilities, testing modalities, and—perhaps topping the list right now—the role played by asymptomatic carriers are all shifting scientific questions. And as in the past, scientific uncertainty has led to the questioning of scientific expertise by the broader science-consuming public. It is no surprise, then, that in our own pandemic moment of uncertainty we have turned to past pandemics to help us navigate the present. I have been most interested in seeing the expression “Typhoid Mary” reappear in news headlines, the hashtag #TyphoidMary trend on Twitter. Given that the causative organism for the novel coronavirus can spread through asymptomatic carriers, even if we do not quite yet know the extent, a renewed interest in Typhoid Mary makes sense. The name still provokes stirring images about an inherent dichotomy in modern public health: how governments are at once charged with preserving individual civil liberties and with stopping the spread of infectious disease in the community. Not knowing who is healthy and who is sick is worrying enough; knowing that seemingly healthy individuals can unknowingly spread an infectious disease is quite another matter and has produced palpable anxiety. Judith Walzer Leavitt’s 1996 Typhoid Mary: Captive to the Public’s Health was a milestone scholarly exploration of the most notorious asymptomatic carrier in the past, Mary Mallon. The basic details of Mallon’s life are well known. Born in County Tyrone, Ireland, she immigrated to America in 1883 and became a cook for several prominent New York families. At some point around 1900 Mallon contracted typhoid fever, a foodand water-borne bacterial infection and one of the leading causes of death at the time. A civil engineer, George Soper, independently investigating the cause of a violent outbreak of typhoid in 1907, traced the epidemic back to the cook, Mary Mallon. He implored New York City’s health officer, Hermann Biggs, to apprehend Mallon, obtain stool, urine, and blood samples, and—if they were found positive for typhoid—isolate her. Although Mallon showed no symptoms of the disease, bacteriological tests for Salmonella typhi were positive and Mary was quarantined on North Brother Island for two years. Despite signing a legal affidavit that she would not handle food upon her release, she was discovered—again by Soper—to be the cause of a subsequent outbreak of typhoid at Sloane Maternity Hospital in 1915. Mallon was thereafter demonized by health officials and the media,

中文翻译：

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是公众健康的“威胁”还是烈士？

作为一名公共卫生历史学家，我觉得不确定性的概念是理解流行病的关键。就像过去的流行病一样，我们当前的公共卫生危机 COVID-19 也充满了不确定性。传播率、再感染概率、检测方式，以及——目前可能位居榜首——无症状携带者所扮演的角色都在改变科学问题。和过去一样，科学的不确定性导致了更广泛的科学消费公众对科学专业知识的质疑。因此，在我们自己的不确定性大流行时刻，我们已经转向过去的流行病来帮助我们驾驭现在也就不足为奇了。我最感兴趣的是看到“伤寒玛丽”这个词重新出现在新闻标题中，以及 Twitter 上的 #TyphoidMary 趋势标签。鉴于新型冠状病毒的病原体可以通过无症状携带者传播，即使我们尚不清楚其传播程度，对伤寒玛丽的重新关注是有道理的。这个名字仍然引发了关于现代公共卫生中固有的二分法的激动人心的画面：政府如何同时负责保护个人公民自由和阻止传染病在社区中的传播。不知道谁健康谁生病就够了；知道看似健康的人会在不知不觉中传播传染病是另一回事，并且会产生明显的焦虑。朱迪思·沃尔泽·莱维特 (Judith Walzer Leavitt) 1996 年的伤寒玛丽：公众健康的俘虏是对过去最臭名昭著的无症状携带者玛丽·马伦 (Mary Mallon) 的里程碑式学术探索。马龙生平的基本细节众所周知。她出生于爱尔兰蒂龙郡，1883 年移民美国，成为纽约几个著名家庭的厨师。在 1900 年左右的某个时候，马伦感染了伤寒，这是一种食物和水传播的细菌感染，也是当时的主要死亡原因之一。1907 年，一位土木工程师乔治·索珀独立调查了伤寒暴发的原因，他将这种流行病追溯到厨师玛丽·马伦。他恳求纽约市的卫生官员赫尔曼·比格斯逮捕马伦，获取粪便、尿液和血液样本，如果发现伤寒呈阳性，则将她隔离。尽管马伦没有表现出疾病症状，但伤寒沙门氏菌的细菌检测结果呈阳性，玛丽在北兄弟岛被隔离了两年。