The British colonial government took strict measures in order to contain the plague, although this was done too late to prevent the outbreak from spreading in its early stages.

The urban area around the Grand Harbour was isolated from the rest of the island, and settlements with high mortality rates were cordoned off.

[7] The plague arrived in the Maltese Islands by infected crew members on board ships sailing from Alexandria to Malta.

[1] Two other ships which also arrived in Malta from Alexandria on 28 March, the British brigantine Nancy and the Spanish polacca Bella Maria, also had cases of the plague on board.

On 1 April, the ship's captain Antonio Maria Mescara became sick, and a day later so did a servant who had looked after the two infected crew members on board the vessel.

[9] It was initially believed that the disease was contained without coming into contact with the population,[10] but while the San Nicola was in quarantine, some of its guards had stolen linen from its cargo which was infected.

This was stored in a wine shop in Sliema before being sold to Salvatore Borg, a shoemaker, fence and smuggler who lived at 227, Strada San Paolo in Valletta.

[20] The outbreak was particularly severe in Birkirkara, one of the largest settlements outside the harbour area, whose population had increased by about 3000 refugees fleeing the plague from Valletta.

The spread was aggravated since the causes of the disease were unknown at the time, containment measures were not introduced immediately,[1] and some people resisted by refusing to transfer the infected to government-designated depots.

The urban settlements in the harbour area: Valletta and its suburb Floriana, and the Three Cities of Birgu, Cospicua and Senglea were placed under medical observation.

[23] On 17 May, Civil Commissioner Sir Hildebrand Oakes ordered that any suspected case was to be reported to the Board of Health, and anyone concealing the existence of the disease was liable to the death penalty.

[1][24] The sentence was first carried out to Anthony Borg, who had concealed his infection from the authorities, and he was publicly executed by firing squad in Valletta on 17 August.

[5] Throughout the epidemic, the postal service continued to function and it was the only means of communication between individuals in the quarantined cities of the Grand Harbour and the rest of the islands.

[5] Infected people were taken to the Lazzaretto of Manoel Island, a hospital and quarantine facility which had been built to deal with outbreaks of infectious diseases.

By late June 1813, the Lazzaretto had reached its capacity and it became crowded with patients, so no distinction was made between confirmed and suspected cases gathered close together in Fort Manoel.

[1] Huts known as barracche (Maltese: barrakki)[30] were built in various locations, mostly as shelters for people evacuated from their homes or as hospitals.

Others were also built within Valletta and Floriana and at Ta' Xbiex, Fort Manoel, Bighi, Birkirkara, Qormi, Żebbuġ and outside the Cottonera Lines near Birgu.

[27] In 1813, pursuant to the change of Malta's status from a protectorate to a crown colony, and the office of Civil Commissioner was replaced by that of a Governor.

[1] On 10 September, movement from settlements with high mortality rates was restricted, and soldiers surrounded and cordoned off Qormi, Żebbuġ and Birkirkara to prevent any inhabitants from leaving.

[7] On 13 November, Maitland ordered houses and shops in Valletta and Floriana to be purified under the supervision of doctors and the police for a period of 15 days.

Communication with mainland Malta was restricted when the outbreak occurred in Valletta, which initially prevented the disease from reaching Gozo.

Angelo Galea, a Gozitan who was in Qormi at the time out the outbreak, hid a box of clothes (including an għonnella)[34] from the authorities and took them with him when he returned to Gozo in late February 1814.

[1] On 8 March, Maitland cut off all communication between the islands, and the military was sent to cordon off Xagħra to prevent the spread of the plague to the rest of Gozo.

[6] On 12 June, family members of plague victims were taken to Ramla Bay and were told to bathe in the sea three times a day under police supervision.

[7] During the outbreak, some wrote on wooden tablets instead of paper,[39] and in January 1814 the registers of the Monte di Pietà were unbound, disinfected and rebound to ensure that they were not contaminated.

[12] The plague outbreak caused severe economic disruption as trade links and communication were cut off, both internally and with neighbouring countries.

[1] Ties between Malta and Gozo were cut off for a long period of time,[46] although there were instances where limited trade between the islands were allowed.

Other factors such as the Greek War of Independence, growing popularity of Egyptian cotton and the French conquest of Algeria also contributed to the poor state of Malta's economy in the 1820s and 1830s.

[1] These are often examples of folk art which are not necessarily of a high artistic quality, but they have historical significance since they are primary sources which portray life during the course of the epidemic.

[30] A number of accounts of the plague were written, such as G. M. de Piro's Ragguaglio storico della pestilenza che afflisse le isole di Malta e Gozo negli anni 1813 e 1814 which was published in Livorno in 1833.