16. The fourth cholera pandemic, 1863-1875
Though by the end of the third cholera pandemic contaminated water had been identified as the manner in which the disease was spread, the disease was far from eliminated. Beginning in 1863 another pandemic, again born along the Ganges, spread around the world. It struck in London in 1866, where it remained localized. British epidemiologist William Farr noted its confinement to London’s overcrowded East End. The East End section of the city’s newly built water treatment and sewage system was incomplete. Contaminated water provided by the East London Water Company was identified as the source of the outbreak.
The fourth cholera pandemic claimed the lives of 165,000 citizens of the Austrian Empire, in part due to the poor sanitation conditions caused by the Austro-Prussian War. The disease spread around the world, carried by infected passengers and crews traveling on ships and trains. Few cities and even fewer small towns had established water treatment systems. Once cholera established itself in a community it thrived, its victims unaware that simply boiling drinking water protected them from the disease. The fourth cholera pandemic killed about 600,000 people, victims of the lack of systems to process human waste and establish clean water.