Then & Now: Asiatic Cholera & Covid-19

Listening to the news of the coronavirus, it seems timely to look back on another rapidly spreading disease – the pandemic of Asiatic Cholera that reached Hutton Rudby in 1832.  

This was a very frightening pandemic, not because it was terribly contagious – it was noted in 1876 that out of nineteen people drinking from a infected vessel, only five contracted the infection – but because nobody knew how it spread or what caused it and because without treatment it is fatal in half the cases.  Nowadays it is very treatable; the website of Médecins sans frontières explains that it "can be treated simply and successfully by immediately replacing the fluids and salts lost through vomiting and diarrhoea – with prompt rehydration, less than one per cent of cholera patients die."  

The arrival of the cholera in Hutton Rudby was to prove pivotal in the life of the new vicar, the Revd Robert Barlow.  The story of the cholera and Mr Barlow is told in my book Remarkable, but still True: the story of the Revd R J Barlow and Hutton Rudby in the time of the cholera which I posted on this blog in December 2012.

Here are a few excerpts from Chapter 11. 1832: The year of the Cholera to entice readers back to the chapter itself (just click on that hyperlink to get there), with its account of the dilemmas faced by the authorities and the reactions of business interests and ordinary people:

Cholera had always been endemic in pockets of India, but now, perhaps spread by the new conditions of greatly increased trade and British troop movements, it broke out explosively, and soon produced on the minds of the medical attendants the strong conviction that it was a new disease – a most fearful Pestilence.   

It swiftly passed its usual boundaries and spread widely and rapidly along the trade routes of Asia.  An exceptionally severe winter prevented its further spread into Europe, but a second pandemic beginning in Bengal in 1826 spread rapidly across Asia and the middle East. 

By August 1830 it had reached Moscow, and helped by large numbers of refugees from a savage military campaign in Poland, it travelled rapidly along the complex of busy trade routes across Europe.  It carried with it a terrifying reputation, and even though its impact in Britain was far less damaging than had first been feared, it would cause over 31,000 deaths in England, Scotland and Wales in the years 1831 to 1832. 

The British quarantine regulations were developed from those devised to combat plague and yellow fever.

The 31,000 deaths were from a population of 16.54 million (this website explains the figures from the 1831 census).  I think the population of England, Scotland and Wales is now about 65.4m people.

Dr Simpson [who studied the 1832 outbreak] wrote in 1849: 

If quarantine could be strictly enforced, there cannot be the slightest doubt that it would be successful.  The difficulties, however, of enforcing quarantine, between countries where extensive commercial intercourse is constantly going on, would appear to be quite insurmountable.

Internal quarantine was considered:

The Board of Health had considered the possibility of internal quarantine to limit the spread of cholera once it arrived, but it was obviously impracticable.  Given the terrifying nature of the disease reported in Asia and eastern Europe, they recommended local isolation of the first cases and the separation of the sick from the healthy.  This was to be done by a network of local Boards of Health.  The Board envisaged the removal of the sick into cholera hospitals, and thence into convalescent homes, while their contacts would be taken into isolation houses; if all three buildings could be in the same enclosure, this could be conveniently guarded by the local military.  Their homes would be purified with chloride of lime and hot lime wash; the dead would be buried swiftly in ground close to the house for the infected.  Their first circular, published in the press, called for local Boards to be established,

There should be established a local board of health, to consist of the Chief and other Magistrates, the Clergyman of the parish, two or more Physicians or Medical Practitioners, and three or more of the Principal Inhabitants…

The Central Board advised the magistrates to prevent, as far as possible, intercourse with any infected town.  Magistrates and clergy were asked to improve the conditions in which cholera spread:

the poor, ill-fed, and unhealthy part of the population, and especially those who have been addicted to the drinking of spirituous liquors, and indulgence in irregular habits, have been the greatest sufferers from the disease…. 

This circular was published on 20 October 1831 shortly before the news of the first official case of cholera was confirmed in Sunderland in late October. 

Cholera came to Hutton Rudby at nine o'clock in the evening on Tuesday 2 October 1832, when the weaver John Cook came back from Newcastle to his home in the Bay Horse Yard.