London's first major cholera epidemic struck in 1831 when the disease claimed 6,536 victims. In 1848–49 there was a second outbreak in which 14,137 London residents died, and this was followed by a further outbreak in 1853–54 in which 10,738 died. During the second outbreak, John Snow, a London-based physician, noticed that the rates of death were higher in those areas supplied by the Lambeth and the Southwark and Vauxhall water companies. In 1849 he published a paper, "On the Mode of Communication of Cholera", which posited the theory of the water-borne transmission of disease, rather than the miasma theory; little attention was paid to the paper. Following the third cholera outbreak in 1854, Snow published an update to his treatise, after he focused on the effects in Broad Street, Soho. Snow had removed the handle from the local water pump, thus preventing access to the contaminated water, with a resulting fall in deaths. It was later established that a leaking sewer ran near the well from which the water was drawn.