^* For the remainder of the book, the term cholera will refer to the modern definition of the disease unless otherwise specified.

^* Some of the towns mentioned were relocated and exist today at new locations.

^* Lines of dialogue are drawn either from reports of government hearings or from Colin Perkel, Well of Lies (Toronto: McClelland and Stewart, 2002).

^* Since this is likely to be the most controversial of my suggestions, allow me to explain my thinking on POU filters. Properly installed and maintained home filters provide an extra measure of protection, yield water that is superior to tap water, and are often safer than bottled water at one tenth the cost, with far less environmental impact. They can eliminate pathogens that our treatment plants fail to remove and can remove chemical contaminants including the by-products of chlorination that most water supplies leave in the water. They can also protect us against contaminants that enter through flaws in our aging distribution systems. Finally, if terrorists choose to attack our water supplies, home filters add an extra measure of protection.
Although they lack the economies of scale offered by large treatment plants, they allow us to focus the highest level of treatment where it is needed most, the water we drink. Less than one percent of the water that flows into our homes is actually ingested. Treating our public water supplies to the highest level possible just so we can water our lawns, wash our cars, and flush our toilets with pure drinking water is, quite literally, pouring money down the drain. In some small communities it might make sense to have a separate communitywide system for delivering drinking water, but this is not practical for most cities. The universal use of properly chosen POU filters based on either ultrafiltration or reverse osmosis coupled with carbon filtration for a home’s drinking water could all but eliminate the risk of waterborne disease.
Can we justify the cost of putting a water filter into every home? Can we count on people to maintain those systems? In fact, many homes now have water filters, but they are installed in a haphazard way as a function of the household’s income and level of concern about the quality of their municipal drinking water. Furthermore, this has been done independent from the drinking-water utilities. As a consequence, POU filters have never been seen as part of the overall system for providing safe water.
The involvement of utilities in the selection and installation of POU water filters would have several advantages. First, it could ensure a level of uniformity in the quality and efficacy of the systems used by consumers. The utilities could also ensure that water filters are properly maintained. Second, it could be viewed as an integral part of the overall treatment system. Utilities could have confidence that occasional occurrences of accidental, incidental, or intentional contamination would have little if any consequence. Furthermore, chlorination by-products could be more easily controlled without concern that reduced chlorine would cause an outbreak. Third, the involvement of utilities could ensure that high water quality is not limited to those who can afford to install and maintain a system. By leasing or renting the filters to consumers, just as some utilities rent water heaters, utilities could spread out the cost of pure water for the consumer. Utilities have tended to look askance at home water filters as the unnecessary product of public health paranoia. We should remember that every waterborne outbreak described in this book could have been prevented by the universal use of POU water filters.