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Infection and immunity
Infection and immunity

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2.3  Waterborne infection in 19th-century England

Water contaminated with pathogens is still a major source of infection, despite significant improvements in the provision of filtered drinking water and treatment of sewage in many parts of the World. The present truly resembles the past!

Until well into the 19th century, most Londoners obtained their water from the polluted rivers and streams that flowed through the capital. London’s domestic and industrial waste was discharged directly into the rivers or found its way there from over 200 000 cesspits. Several major causes of death in the period were waterborne diarrhoeal diseases and fevers – principally cholera, dysentery and typhoid.

The cartoon shown in Figure 4 was published during a period known popularly as ‘The Great Stink’ when the Houses of Parliament had to be closed for several weeks due to the foul smell from the Thames River. The cartoon is subtitled ‘A Design for a Fresco in the New Houses of Parliament’ because of a rumoured plan to move parliament upstream to Hampton Court in Middlesex and it shows how politically important it had become to deal with the health hazards caused by polluted rivers.

Described image
Figure 4  ‘Father Thames introducing his Offspring to the Fair City of London’, cartoon by Sir John Tenniel, published in Punch magazine, 3 July 1858. The ‘offspring’ are labelled Diphtheria, Scrofula and Cholera (scrofula meant tuberculosis).

The vicious cycle of river pollution and waterborne infection was repeated in other industrial cities of the period, as Frederick Engels (1820–1895), the son of a German textile manufacturer, found when he came to work in his father’s factory in Manchester. His outraged account, written in 1844, of what he saw there gives an unparalleled insight into the causes of infectious diseases at that time:

The manner in which the great multitude of the poor is treated by society today is revolting. They are drawn into large cities where they breathe a poorer atmosphere than in the country; they are relegated to districts which, by reason of the method of construction, are worse ventilated than any others; they are deprived of all means of cleanliness, of water itself, since pipes are laid only when paid for, and the rivers so polluted that they are useless for such purposes; they are obliged to throw all offal and garbage, all dirty water, often all disgusting drainage and excrement into the streets, being without other means of disposing of them; they are thus compelled to infect the region of their own dwellings.

(Engels, F. 1969 [1845])

There are striking similarities between Engels’ description of the conditions of life for the poor of 19th century English cities, and communities who live in shanty settlements, refugee camps and disaster zones in the modern world (Figure 5). In 2012, around 2.5 billion (or 2500 million) people had no access to sanitation and around 750 million had no access to safe drinking water.

Figure 5  The Kibera shanty settlement near Nairobi, Kenya, is home to at least half a million people who have no sanitation and collect all their water from standpipes.

It was well understood by city dwellers in 19th-century England that the water they drank was filthy and a major source of disease (Figure 6).

The caption at the top of this 1828 etching reads: ‘MICROCOSM dedicated to the London Water Companies. Brought forth all monstrous, all prodigious things, hydras and gorgons, and chimeras dire.’ The caption underneath reads: ‘MONSTER SOUP commonly called THAMES WATER, being a correct representation of that precious stuff doled out to us!’

Figure 6  ‘Monster soup’ by William Heath, published in 1828, shows a woman dropping her teacup in horror after seeing a magnified view of a droplet of London water.

As Figure 6 demonstrates, examination of microscopic animal and plant life in water was well established by the early 19th century, but the existence of cells as small as bacteria was not proven until the 1890s, when dyes to stain individual cells and render them visible under new and more powerful microscopes enabled ‘microbes’ to be directly observed.

In the early-to-mid-19th century, the lack of scientific knowledge that bacteria were the root cause of many major diseases of the period did not deter pioneers (like John Snow who you will learn about in the next section) who tackled the death toll from infections, such as cholera, through application of the scientific method.