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The provision of sanitation and the separation of water and sewage functions in developed nations has been the single most important step to improving public health at the population level.
The cholera epidemics in London in 1839 and 1849 together killed over 100,000 people. The cause of the outbreaks was shown to be contamination of the River Thames with human sewage. The microorganism involved was identified in the early 1880’s as being Vibrio cholerae, a bacterium that is excreted in the faeces of humans. Infection resulted from the unintentional ingestion of faeces in the water, the so-called faecal oral route.