While certain costume dramas would have us believe it would be wonderful to visit Victorian England, to wander the London streets amid barrow boys and horse-drawn carriages, to see Oscar Wilde’s plays performed for the first time, to really rock a decent moustache, not everything was a delight.

Quite apart from the crime and deprivation in London’s slums (across the Atlantic from Copper!), we were still decades away from several huge strides in the understanding of disease and how it is spread. And in the major cities, a lack of what we would now consider to be basic sanitation resulted in several devastating outbreaks of some horrific conditions, of which these are only the top five:

Cholera

It is more shaming to the modern world that cholera can still happen than it would be to criticize the Victorians, simply because they did not have the first clue what caused it. All across the century, all over the world, the disease destroyed whole societies, killing tens of millions of people. They were fairly sure it was something to do with human waste, but a lot of scientists believed it was the smell from the open sewers in Victorian London that was spreading the disease. It took the Englishman John Snow, in 1854, to demonstrate a link between drinking contaminated water and people falling ill, and even then, the idea of microbiology was so new, it took over 30 years for his findings to be widely accepted. 160 years on, this disease should have gone the way of smallpox.

Typhoid

Another disease we should really have seen the back of by now. It’s startling to consider that the public understanding of the need to remain clean, to wash hands after using the toilet and before preparing food, and to sterilize medical equipment, is actually a relatively recent innovation. Before the discovery of microbes and germs, there were so many conflicting theories about diseases and what may have caused them that you could spend your day boiling a black cat in vinegar, to wear as a poultice, only to catch typhoid from a stew prepared by a man with black fingernails, who used water from a well next to a sewer. And if you didn’t know enough to keep yourself clean, you’d end up passing it on too.

Smallpox

It’s easy to treat modern medicine as if it’s a particularly bureaucratic branch of witchcraft, with doctors making confusing claims and counter-claims about how best to treat the human body, and politicians arguing over the best way to pay for treatment. But let’s not forget, we’re only 34 years on from the total eradication of smallpox from the planet. And this is a disease that used to kill 400,000 Europeans a year, and was responsible for a third of all human blindness. This is a human achievement that’s actually better than the moon landings, so the next time you see a doctor, wash your hand, and then shake theirs. And then wash yours again.

Scarlet Fever

And while we’re at it, let’s have a round of applause for Sir Alexander Fleming. Without his discovery and application of penicillin in the development of antibiotics, children would still be dying of scarlet fever, instead of having to suffer a sore throat, diarrhea and a rash, and getting better fairly swiftly. However, this is may not last. In 2011 two people died in Hong Kong after contracting a strain of scarlet fever that has evolved a tolerance to certain antibiotics.

Measles, mumps and rubella

The big three! I’ve lumped these all together because that’s how they sit in the immunization program in the UK. There’s one jab, and it effectively rules out untold human misery, whether that’s for the people who get these horrific illnesses, or the families who have to watch their loved ones suffer (and possibly worse). And if this seems unusually brutal a tone to take for a breezy cross-cultural blog like ours, it’s largely because the take-up rates for the MMR vaccine have dipped over the last 10 years. This is most likely to be because of the intense media storm around Andrew Wakefield’s discredited claim that there’s a link between the jab and the development of autism. As a result of this case, and an unhelpful media debate that gave equal time to heated opinion and scientific research, cases of measles (a spectacularly nasty disease) are now on the rise.

Well done everyone.