Seven Sick Patients and an Elusive Suspect: A Medical Whodunit

Albert B. Lowenfels, MD

January 07, 2014

Description of Cases

The index patient was a young man who had enjoyed good health until about 10 days after arriving for a visit with friends who had rented a suburban home for the summer. He became quite ill with fever and gastrointestinal symptoms, but recovered, and there were no other reports of illness in family members or their servants.

Within a few years, 6 members of well-to-do families or their servants were struck with a similar illness. Five of the 7 index patients were young girls, half of whom were servants. One of the 7 patients died, for a case fatality rate of 14%. In addition to the initial 7 index patients, 19 family members became ill with the same disease. All of these patients had similar complaints which included some, but not all, of the following symptoms and signs: elevated temperature to 103°-104° F, malaise, anorexia, abdominal cramps, diarrhea, headache, and neuropsychiatric symptoms. Some of the patients had a rash characterized by flat, rose-colored spots covering the chest and abdomen. The duration of illness was typically about a few weeks.

Eventually a single person was found to be directly responsible for all of the illnesses in these families.

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Famous Persons Who Had Typhoid Fever

Typhoid fever is no longer common, thanks to sewer systems and a regulated water supply, but in the 19th century and even in the first half of the 20th century, it was a frequently occurring illness that attacked all classes of society.

Ten Famous Typhoid Fever Victims

Name	Date	Outcome	Remarks
Franz Schubert	1797	Died	Musician and composer
Abigail Adams	1818	Died	Wife of John Adams, second president of the United States
Jay Gould	1852	Recovered	Financier; "robber baron"
Grover Cleveland	1855	Severely ill at age 18, but recovered	In the 1880s, as Mayor of Buffalo, New York, built a sewer system which drastically reduced the frequency of typhoid fever
William Lincoln	1862	Died	President Abraham Lincoln's third son
Andrew Johnson	1865	Survived	17th US President; contracted typhoid fever before his inauguration as Vice President after Lincoln's assassination
William Taft	1867	Survived	27th US President; had mild case in childhood
Wilbur Wright	1912	Died	Co-inventor of the airplane
Hakaru Hashimoto	1934	Died	Physician who discovered autoimmune thyroiditis
Frank McCourt	1940	Severely ill for 4 months but recovered	Writer, Angela's Ashes

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