It was the Cholera outbreaks in Soho in 1854, and the work of a London doctor John Snow, that gave impetus to the application of the first Public Health Act. Rapid industrialisation and growth of urban populations, frequently in overcrowded housing lacking sanitary facilities, also saw casualties from Cholera and Yellow Fever reach epidemic proportions. Clean water, sanitation, sewers, the collection of domestic refuse, the provision of public baths and de-lousing facilities were basic measures to control disease, infection and parasite infestation in crowded towns and cities.
Last week I saw a young woman get off a bus in Lewisham in a singlet that exposed the back of arms completely covered in angry red bed-bug bite marks, like a cartoon version of measles. It's not only Cimex lectularius that has gained new life in England; body and head lice, scabies and other parasites are thriving. More dangerously, London has equivalent multi-drug resistant TB infection rates to those in Asian, South American and Russian Federation areas. In Sheffield Hallam, as the Mail reports today, Roma overcrowding has allowed threadworm, hepatitis and rickets to thrive alongside TB, with children exhibiting signs of malnutrition. Those immigrants - several a day - making it through Calais are also walking infection dumps, infested with scabies and other parasites and diseases.
Let's be quite clear. These things thrive alongside poverty, overcrowding and poor sanitary conditions. They are concentrated in immigrant communities not because immigrants are dirty or bad or careless but because of the conditions they live under; if you housed white English families ten to a room with forty sharing a toilet and with no money to maintain clean bedding and towels you would get the same result.
The critical thing is that poor public health affects us all; a solicitor taking the bus because her car is in for a service can pick up head lice, the guy ahead of you on the central line escalator can cough or spit and infect you with TB, and a brush with the M&S fitting room can leave you with scabies. If you live in a big town or city you can't insulate yourself against poor public health - like bees in a hive, there's just too much cross-contact. The only way is draconian public health measures - modern workhouses, disinfestation of public transport, delousing stations, breaking up the slums, compulsory TB testing, school hygiene, fumigation of slum houses and bedding.
Yes, all of this costs money. But without it our urban peoples will become so loaded with disease and parasites that business and the economy will suffer.