Asiatic Cholera Pandemic of 1817-23 

Note: This cholera pandemic, occurring during John Snow's early life, did not reach the British isles. 

This was the first great cholera pandemic of the nineteenth century.  It was unprecedented in its fury, affecting almost every country in Asia. While early cases of cholera were reported from Purneah (now Purnia) in Bihar (state in east India) in early 1816, the pandemic is believed to have originated in the town of Jessore (near Calcutta) in August 1817.  A civil surgeon, reporting on the high incidence of a severe gastrointestinal disease among his patients, drew attention to the source of contagion -- contaminated rice.  Amidst attacks of vomiting and diarrhea thousands of people collapsed and died, including hundreds of British soldiers transiting through Bengal.  Cholera then spread rapidly across the country and, in December 1818, arrived in Sri Lanka (Ceylon).

Meanwhile, the infection was transmitted to the Afghan and Nepalese soldiers fighting against British troops along India’s northern borders. Traversing the overland route, cholera arrived in Burma (Myanmar) and Thailand. Almost simultaneously, it was seaborne to Sumatra, Java, the Philippines, China, Japan, and the southeast Asian mainland.

British troops, arriving in Muscat (in Oman) in 1821 to put an end to the slave trade, brought cholera with them. From Muscat, it was carried by the slave traders along the eastern coast of Africa to Zanzibar.  Basra, at the head of the Persian Gulf, was invaded in 1821. Shortly thereafter, it traveled upstream to Baghdad and also infected an invading Persian army. Syria, Anatolia, and the port of Astrakhan in southern Russia were also infected.  An exceptionally severe winter in 1823-24 ensured that cholera did not spread beyond the Caspian Sea into Europe.

The rapidity and virulence with which the disease struck entire populations took everyone by surprise. Subsequently, cholera became endemic in most of the Asian countries and continued to wreak havoc in many parts of Russia. This pandemic marked the first recorded spread of the disease outside India and affected hundreds of thousands of people. Those which followed were more widespread in their impact.