June 19 2016 Sunday 01:55 PM
Modified Date 19-Jun-2016

The 19th century sanitary revolution arose from Snow's discovery, reinforced by the work of others: William Farr, physician and vital statistician, the first Compiler of Abstracts in the newly created office of the English Registrar General; the bacteriologists, Louis Pasteur and Robert Koch; the pathologist-sanitarian Rudolph Virchow; the social reformers and early public health specialists, Edwin Chadwick, Lemuel Shattuck, John Simon, soon battalions of others. Human settlements were the seedbed for civilizations, but in the absence of adequate hygiene and sanitation, they were hotbeds of pestilence and disease too. The 19th century cities were dangerous places, rife with disease and premature death. More than a quarter of all babies born alive were dead within a year, half were dead before they were old enough to have children of their own. They died of gastrointestinal and respiratory infections: cholera, typhoid, infant diarrhea, diphtheria, croup, measles, pneumonia, tuberculosis.

Slide author: John Last, Canada


Prior to the 20th century people were exposed to human waste, pollution and many other forms of filth. This chimney sweep shows how poor occupational jobs were, and life in general. Occupational jobs became much cleaner.

The “privy” or Outhouse was the primary place to eliminate human waste. These Outhouses were poorly shield and those using them were typically in contact with human waste. The waste often soiled drinking water producing rapid spread of disease.  As the world improved SES sewer systems  were put in place, reducing the tainting of waste with the drinking supply.  Also with indoor plumbing humans had a much lower contact with waste.




Epidemiologic transition is not something limited to developed countries. Evidence of epidemiologic transition can also be observed in countries like Mexico. The decline in infectious diseases corresponding with a rapid increase in hygiene.

The epidemiologic transition has been clearly noted in most countries in the last century. Here in Mexico, almost all of the infectious diseases were reduced, as this occurred, life expectancy rose, and CHD and CA were unmasked.  This demonstrates the systems of disease on a population basis. 



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