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On the Mode of Communication of Cholera

John Snow
TLDR
It would occupy a long time to give an account of the progress of cholera over different parts of the world, with the devastation it has caused in some places, whilst it has passed lightly over others, or left them untouched; and unless this account could be accompanied with a description of the physical condition of the places, and the habits of the people, which I am unable to give, it would be of little use.
Abstract
It would occupy a long time to give an account of the progress of cholera over different parts of the world, with the devastation it has caused in some places, whilst it has passed lightly over others, or left them untouched; and unless this account could be accompanied with a description of the physical condition of the places, and the habits of the people, which I am unable to give, it would be of little use. There are certain circumstances, however, connected with the progress of cholera, which may be stated in a general way. It travels along the great tracks of human intercourse, never going faster than people travel, and generally much more slowly. In extending to a fresh island or continent, it always appears first at a sea-port. It never attacks the crews of ships going from a country free from cholera to one where the disease is prevailing, till they have entered a port, or had intercourse with the shore. Its exact progress from town to town cannot always be traced; but it has never appeared except where there has been ample opportunity for it to be conveyed by human intercourse. There are also innumerable instances which prove the communication of cholera, by individual cases of the disease, in the most convincing manner. Instances such as the following seem free from every source of fallacy. I called lately to inquire respecting the death of Mrs. Gore, the wife of a labourer, from cholera, at New Leigham Road, Streatham. I found that a son of deceased had been living and working at Chelsea. He came home ill with a bowel complaint, of which he died in a day or two. His death took place on August 18th. His mother, who attended on him, was taken ill on the next day, and died the day following (August 20th). There were no other deaths from cholera registered in any of the metropolitan districts, down to the 26th August, within two or three miles of the above place; the nearest being

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Journal ArticleDOI

The mortality rates and the space-time patterns of John Snow’s cholera epidemic map

TL;DR: The high mortality rates identified around the Broad Street pump are consistent with Snow’s theory about cholera being transmitted through contaminated water, and the absence of a clear space-time pattern also indicates the water-bourne, rather than the then popular belief of air bourne, nature of cholERA.
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TL;DR: A combination of interventional approaches targeting various groups with risk-adapted intensities may prove to be the optimal strategy for cholera control.
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