St Pauls and the plague

I'm coming to the end of my fascinating six months working at the Hospital for Tropical Diseases. Last week in the build-up to Christmas, there was the annual round of Christmas parties, present-giving and HTD Christmas quiz. One interesting fact that stayed with me from the quiz was about the church in Covent Garden: the (less famous) St Pauls church

The beautiful classical portico of the church is one of the designs of the great 17th century architect Inigo Jones (of Welsh family, born in London, trained in Italy), which was achieved in spite of rather than with the support of his sponsors. Jones was commissioned by the Earl of Bedford to build a residential square (now Covent Garden) along the lines of an Italian piazza. The Earl felt obliged to provide a church in the square and he warned Jones that he wanted to economise. He told Jones to simply erect a "barn" and Jones's oft-quoted response was that his lordship would have "the finest barn in Europe". These days, I've heard that the portico is a good spot for meeting pretty Welsh journalists ...

So where does this relate to tropical medicine ? The church was completed in 1633 and consacrated in 1638, and less than 30 years later, in 1665-6 London was to suffer one of the most severe bouts of infectious disease in it's history. St Pauls church served as burial spot for the first "official" case of plague in London in that outbreak: Margaret Ponteous was buried in the churchyard on 12 April 1665. An estimated 100,000 further Londoners fell victim to the "Great Plague", approximately 20% of the population.

The plague raged in London for 18 months, King Charles and his retinue fled the city and most professionals (including doctors) followed suit. In the absence of the interference from ignorant medics, public health measures such as collective disposal of bodies and isolation of cases eventually brought the epidemic under control, and by the time of the Great Fire in September 1666, the plague was already past its peak. Although it was never realised (at the time) that rats and fleas were acting as vectors for the disease, the rebuilding of central London after the Fire included many permanent legislative changes that indirectly limited the rat population: proper sewerage and banning of thatched roofs (a favourite rat habitat!). In 1997, the Globe Theatre needed a special permit for it's roof!

So, Margaret Porteous, RIP in St Pauls Church. Perhaps the severity of the plague outbreaks in London eventually led, via the Broad Street pump and the Dreadnought Unit to the creation of the Hospital for Tropical Diseases and the School of Tropical Medicine?