William Budd

William Budd (born September 14, 1811, North Tawton, Devon, England—died January 9, 1880, Clevedon) was an English physician who identified water as a source of transmission of typhoid fever.

Budd began his medical training as an apprentice to his father, who was a physician. He then trained for four years in Paris with French clinician Pierre-Charles-Alexandre Louis before studying at the University of Edinburgh, where in 1838 he graduated with a medical degree. In 1842 he went to work at St. Peter’s Hospital in Bristol, England, later becoming a physician at the Bristol Royal Infirmary.

In 1853, while still working at Bristol, Budd recorded an outbreak of typhoid fever in the nearby Welsh town of Cowbridge. Local celebrations during that time involved parties on successive nights at a town inn. Eight people who attended the parties subsequently died of typhoid fever. Budd became suspicious about water as a possible source of infection after learning that all eight individuals who became ill had consumed lemonade at the party; the beverage had been made with water from a well located near the septic tank of the inn. He further developed his theory after noting that a person who was recovering from typhoid fever had left the inn before the parties began.

The idea that water served as a source of infection for typhoid fever gained support in 1866, when Budd and a colleague investigated an outbreak involving a group of farm cottages with drains linked to the same stream. An individual who lived in one of the cottages had contracted the disease while traveling. Within several weeks, people in the neighbouring cottages also became ill with typhoid fever. Budd observed that the later infections had all occurred downstream from the first cottage, leading him to conclude that water had been the source of transmission.

In addition to suggesting that typhoid fever was waterborne, Budd argued that the mode of transmission was fecal-oral. He suggested that poor hygiene and unsanitary living conditions contributed to its spread and recommended improved sanitary measures to slow and prevent transmission, including the sanitization of patients’ clothes, the use of disinfectants such as carbolic acid, and the boiling of water. It was thought that the application of such preventive measures helped reduce the spread of cholera in Bristol during that time.

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