The First-Year Book Program at Georgia State University
The London Cholera outbreak from 1853-54 killed an estimated 31,000 people. This historical narrative explores how the epidemic changed clinical medicine, science, public health infrastructure and the modern world. London physician John Snow believed that contagions spread through contaminated water from the local public water pump. At the time it was believed that disease was spread through vapors, or smells in the air. The dense population of London with its increasing industrialization led to a fast spreading disease that at its height killed 197 residents in 3 days. Urbanization of the city with no proper sewer system led to human excrement flowing into the Thames, the river where the local water companies drew their water.
“Steven Johnson tells the tale with verve, spicing his narrative with scenes of Dickensian squalor and the vibrant street life surrounding that squalor. Readers will recognize a reworking of [Johnson’s] favorite themes: the interface of culture and technology; the phenomenon of emergence (the bottom-up organization of small interconnected elements into more complex systems); and always, like a constant bass line in Johnson's extended riff, the theme of urbanism - the metropolis as a glorious culmination of emergence, technology and culture.”
- San Diego Union-Tribune
“By turns a medical thriller, detective story and paean to city life, Johnson's account of the outbreak and its modern implications is a true page turner.”
- The Washington Post
“Johnson brings to nightmarish, thought-provoking life a world in which a swift but very unpleasant death can be just a glass of water away.”
- Entertainment Weekly (An Entertainment Weekly Best Book of the Year)
“This is more than a great medical detective story. It's the triumph of reason and evidence over superstition and theory, and Johnson tells it in loving detail.”
- Chicago Tribune
“In this tightly written page-turner, Johnson uses his considerable skill to craft a story of suffering, perseverance and redemption that echoes to the present day. Johnson weaves in overlapping ideas about the growth of civilization, the organization of cities, and evolution to thrilling effect. From Snow's discovery of patient zero to Johnson's compelling argument for and celebration of cities, this makes for an illuminating and satisfying read.”
- Publishers Weekly (starred review)
Cholera is a bacterial infection usually found in water or food that has been contaminated by feces containing the bacteria (Vibrio cholerae). Infection can lead to serious symptoms including diarrhea, vomiting, and leg cramps. In severe cases, rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours.
Because the United States has effective water and sewage treatments and sanitation systems, outbreaks are rare. But in less-developed parts of the world, an estimated 3-5 million cases and over 100,000 deaths occur each year.
Sources: MedlinePlus, CDC Image: Vibrio cholerae CDC Nat. Center for Infectious Diseases; Div. of Bacterial and Mycotic Diseases
Epidemic: Affecting or tending to affect a disproportionately large number of individuals within a population, community, or region at the same time.
Epidemiology: A branch of medical science that deals with the incidence, distribution, and control of disease in a population.
Megacity: A thickly populated region centering in a metropolis or embracing several metropolises.
Miasma: A noxious vapor rising from putrescent organic matter, marshland, etc., which pollutes the atmosphere; a cloud of such vapor.
Patient Zero (aka Index Case): Used to refer to the person identified as the first carrier of a communicable disease in an outbreak of related cases.
Public health: The art and science dealing with the protection and improvement of community health by organized community effort and including preventive medicine, hygiene, sanitary issues and social science.
Victorian era: The Victorian era of British history was the period of Queen Victoria's reign from June 20, 1837 until her death on January 22, 1901. The 'Victorian era' describes the age of industrial expansion and economic progress.