'THE conduct of the people of Sunderland was more suitable to the barbarism of the interior of Africa than to a town in a civilised country."

Where Sunderland stumbled in 1831, China is following in 2003. Much to the dismay of diarist Charles Greville, Sunderland tried to deny the existence in its midst of Britain's first outbreak of cholera just as China has been caught trying to deny the scale of the world's first outbreak of Sars. Should Sars arrive in this country, it will be on board a plane; cholera arrived on board a boat. Vessels were toing and froing between the North-East and the Baltic, where cholera had raged since June 1831.

In the October, a couple of keelmen succumbed to suspicious symptoms but it wasn't until 12-year-old Isabella Hazard died on October 17 that it became clear that Sunderland had a problem. Isabella's symptoms were classic cholera - severe diarrhoea, vomiting and cramps - and such was her colour that she became famed posthumously as "the Blue Girl".

On November 1, a couple of local doctors notified the government of an outbreak of "Continental Cholera". The government slapped a 15-day quarantine order on the town, banning shipping movements from Sunderland and Seaham harbours.

The business community, led by Lord Londonderry of Wynyard Hall, was outraged. With winter just around the corner, coal was reaching its highest price of the year. With Middlesbrough springing up just down the coast, Sunderland couldn't afford to be out of action.

Even as a plague pit was being dug at Bishopwearmouth on November 10 the businessmen declared that "Sunderland is now in a more healthy state than has been usual in the autumnal season". On November 11, they said it was a "most malicious falsehood" that there was cholera in the town. On November 12, the doctors recanted. The disease existed, they said, but was not "imported". The government ended the quarantine.

Unchecked, the disease spread like wildfire. By the end of December there had been 534 cases in Sunderland, and 202 deaths. It infected Tyneside, killing 68 people between Christmas and New Year's Day in Gateshead alone, and then spread across the country.

Perhaps, though, Sunderland's behaviour was understandable. There were 17,000 people in the town, 14,000 of whom were officially paupers. They lived in overcrowded, sub-divided slums crammed into airless yards, which they shared with their pigs and the blood-splattered slaughterhouse. Their water supply was a pump, their privies were communal.

Many kept open barrels of their own urine which they sold to dye manufacturers; the grotesque few collected dung, allowed it to mature and then sold it to farmers for fertiliser. In such conditions, there was no way of knowing what contagion was killing people.

There were, though, some positives. The epidemic opened the country's eyes to the squalor in the expanding industrial towns. It forced the country to think about a policy for tackling communicable diseases - and that openness was the best way. More than 150 years later, the Chinese appear not to have listened.