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Why is the third cholera pandemic considered the deadliest cholera pandemic?

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A woman in a pink dress receives medical treatment from nurses administering an IV at a crowded hospital in Saint-Marc, Haiti. — cholera A woman with cholera being treated by nurses at St. Nicholas Hospital in Saint-Marc, Haiti, 2010.

The third cholera pandemic (1846–1860) is widely considered the deadliest of the seven global cholera pandemics, resulting in more than one million deaths.1

Erupting in India in 1852 (or 1846, according to some records), the disease spread rapidly across the globe, severely impacting Asia, Europe, North America, and Africa. The pandemic caused widespread devastation, with 1854 often cited as a particularly lethal year; for instance, 23,000 people died in Great Britain alone during that period.23

It was during this pandemic that the English physician John Snow conducted his seminal studies in London, providing the first evidence that cholera was transmitted through contaminated water rather than "miasma" (bad air). Despite this breakthrough in understanding, the disease's rapid global reach and the lack of widespread sanitation infrastructure at the time contributed to its status as the most catastrophic of the cholera outbreaks.4321