August 31, 1854: Broad Street Cholera Outbreak, 616 Die in London

A Brief History

On August 31, 1854, a seminal moment in the history of illness and scientific application of anti-disease efforts struck the Broad Street area of Soho, London, England, when a severe cholera outbreak began. Before it was over, 626 people would die of the disease, but scientific study of the outbreak would lead to the saving of millions of lives in the future. (Note: The neighborhood of the outbreak is now known as Carnaby Street.)

Digging Deeper

Small outbreaks of cholera had plagued London in 1854, and on August 31 the Broad Street area was hit. The cholera epidemic in London was considered the worst of its type in history. Luckily for Londoners and humanity, physician John Snow was on hand to study the pattern of illness, and he determined a “focus of infection” on the Broad Street water pump. Snow had suspected the long held belief in “bad air” and “miasma” was just Medieval nonsense, and that cholera may be a water borne illness.

Although the germ theory of illness had not been developed until Louis Pasteur published his theories and findings in 1861, Snow had postulated the cause of cholera was water borne and he set out to test his theory by charting the location of each outbreak and each illness. His investigation revealed the source of the illness to be the Broad Street water pump which seemed to validate his hypothesis. Further evidence that water from this pump was the source of the infection was the finding that workers in the immediate area of the pump had not become ill, and coincidentally had been given beer rations instead of drinking the local water. Snow also discovered the source of the water pumped to Broad Street as coming from a highly polluted sewage laden area of the Thames River, and notably within 3 feet of a leaking cesspool!

The eloquent argument presented by Snow convinced authorities to shut down the Broad Street pump and almost immediately the epidemic slackened considerably. While it is true the epidemic may have been waning anyway, the implication was that Snow was right and civil authorities began to operate on the premise that filthy water was bad for people. It seems so self evident today, but centuries of practice ignoring water quality was no small habit to overcome.

Snow’s work, bolstered by pin maps and support of other researchers convinced the Board of Health to inspect other water sources and ensure none of them were obviously contaminated by raw sewage and cesspools. This action undoubtedly saved many from illness and death until the germ/microbe theory of disease spreading became generally accepted and applied to civil projects. Despite the evidence and the actions of the Board of Health, the official report of the Board was that “miasma” was to blame for the outbreak! It seems old myths die hard, and this report is one more example.

(Note: Cholera is a microbe caused illness of the lower intestine resulting from the Vibrio cholerae bacteria. Its main symptoms are massive amounts of watery diarrhea and cramping, sometimes with vomiting. Death can result from severe dehydration. Different forms of the bacteria cause different levels of illness, and the usual form of infection is caused by drinking contaminated water. Eating raw or undercooked seafood may also cause the disease. Preventative vaccines are available and treatment includes antibiotics and rehydration.)

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