Budd, William (1811–1880)

Dr. William Budd is considered a pioneer in the development of the germ theory of disease and waterborne transmission. He is best known for identifying water as the source of transmission in typhoid fever.

Budd was born in Devon, England, into a medical family. His father was a physician, and 6 of his 10 brothers studied medicine. After initially completing an apprenticeship with his father, he spent 4 years training in Paris, where he was a student of Pierre Charles Alexandre Louis, who is often referred to as the ‘father of epidemiology.’ In 1841, Budd settled in Bristol, England, where he worked as a physician at St. Peter's Hospital and the Bristol Royal Infirmary. It was during his time in Bristol that Budd developed his theory regarding the transmission of typhoid fever.

In 1853, Budd recorded an outbreak of typhoid fever in the Welsh town of Cowbridge. Local celebrations during this time involved two parties on successive nights at a town inn. Eight of those who attended the parties died of typhoid fever. Budd noticed the close proximity of a local well that was located next to the septic tank of the inn. Given this, he suggested that water may have been the source of the infection. This theory was further developed after [Page 108]noting that a person recovering from typhoid fever had left the inn before the parties began and also that all the eight individuals who became ill had had the same lemonade at the party, made with water from the well.

This theory was later reinforced in 1866 when Budd and a colleague traced a similar outbreak in a group of farm cottages. A father from one of the cottages had become infected with typhoid fever from elsewhere and then returned home to one of the cottages. Several days later, people in the neighboring cottages also became ill with typhoid fever. Budd noted that the drains of the cottages with infected people were linked to the same stream and that those who became infected lived downstream from the original outbreak. Budd concluded that water had been the source of transmission of infection.

In addition to suggesting typhoid was waterborne, Budd also argued that the mode of transmission was fecal-oral. Given this, Budd suggested that poor hygiene and living conditions contributed to its spread and recommended improved sanitary measures, including hand washing and boiling water, to slow and prevent transmission. It was thought that this application of preventive measures helped reduce the spread of cholera in Bristol during this time. In this way, Budd was a great contributor to the public health sanitation movement.

In 1873, Budd's classic paper on typhoid fever, ‘Typhoid Fever: Its Nature, Mode of Spreading, and Prevention,’ was published. Although his primary research focused on typhoid fever, he also suggested, along with Dr. John Snow, that cholera was a waterborne disease. He died in 1880, the same year that the typhoid bacillus, Salmonella typhi, was isolated.