For World Poetry Day, I drafted a poem in celebration of my colleagues who work tirelessly to understand and address the disease burden of cholera, including the “Global Task Force on Cholera Control“, and in honour of the millions who suffer its horrifying effects every year. Remembering that each case depicted on these WHO cholera cases charts is a real person.
Vibrio cholerae
In all those years studying Vibrio cholerae,
Yes, it could have killed me,
But we have containment,
Standard operating procedures,
Biological risk assessments,
Secure infrastructure,
Personal protective equipment.
You, the cause of cholera,
I shake you, view you,
Spread you over nutrient-rich jelly,
Count glossy, colonied domes of you,
I see you swim for your tiny bacterial lives,
Twitching and fast as rockets,
True to your Latin name, ‘Vibrio‘, you ‘quiver’.
We observe your gene regulation loops, this on, that off,
In response to body heat, salt, bile and more,
We see how you’re genetically made-up,
Your ancestors innocuous, seafaring,
But you yourself afflicted, infected,
by a virus carrying cholera toxin,
Add co-regulated appendages, And
you’re all set for sticking and sicking!
But, I have not been
among the million infected,
The thousands slain by your foulness annually,
Swamped in paucity and catastrophe,
When the shit hits their water,
Renders it invisibly non-potable,
Unfit for human consumption,
But all that’s available.
You come hitchhiking, drunk-up,
First they puke up breakfast, lunch and dinner,
Then out flow litres of mucoid liquid,
A fearful torrent of “rice-water” stool, Yet
surprisingly treatable, By
ingestion of unpalatable, But
lifesaving, salty-sweet
re-hydration solution.
I have seen the tiny beasts in the stool,
Witnessed the desperate and emaciated thronging to the cholera hospital,
But I do not know how it feels,
To be kept alive as the scourge rages,
To have your blood acidify,
As your precious seventy percent,
Is lost.
Filippo Pacini first spied, in 1854,
Comma shaped “miriadi di vibrioni”,
Peering down his microscope,
As I have done many a time.
I sat in Soho, where, also in 1854,
right there, John Snow, found
the water pump, the contamination source,
And I read “The Conquest of cholera: America’s greatest scourge”.
But, we have not, in fact,
Conquered cholera,
The scourge is no longer
one of North America,
But remains to fester
In refugee camps, poverty-stricken war zones,
Climate-change-driven “natural” disasters, Where
shattered infrastructure allows foul waters into homes.
Millions caught-up
in a largely forgotten seventh cholera pandemic,
Trillions of microscopic murderers,
Gushing into buckets under hospital beds.
These bacteria somehow unbearably successful,
For reasons that remain elusive, despite
whole genome sequencing
of thousands of their kind.
Why has the seventh pandemic variant swept across the world?
The question fuels global research
and public health efforts.
We learn its inner workings,
How it senses its quorum, hangs on to our guts,
Sticks to its friends, fights its commensal foes,
Swims at just the right time,
Then stops and pumps out its poison.
Do we need to know more to stop it?
Or could we curb it right now,
If there were political will and a bigger vaccine stockpile?
Can we joyfully put ourselves out of a job?
Can the “Global Task Force on Cholera Control”,
Thwart the ultimate diarrhoreal disease,
A killer in less than 24 hours if left untreated?
– by Anne Bishop © 21/3/25
Accounts of rapid cholera deaths
Regarding the long pandemic history of cholera, and the shocking speed with which it can strike people down, here are some historic and current accounts of cholera deaths to put the research, public health work and my poem into context…
Nottingham, UK 1832..
“Mr. John Kale, basket-maker, of South-Street, aged 23 years, and his wife, aged 21 years, died on the 12th of October [1832]. They were both in perfect health when they arose in the morning, but soon after the wife complained of being unwell; not suspecting anything materially amiss, he went on his business to Hucknall, and on returning through Bulwell in the afternoon, was taken ill, and was so bad that he died on the road, and so rapid was the decomposition of the body, that it was obliged to be buried the same evening at Basford. In the meantime, the wife sickened, and died the same night, of Cholera, at South-Street in Nottingham, leaving an orphan, about a year old.”
Page 408 from “Extracts from Henry Field, The date-book of remarkable and memorable events connected with Nottingham and its neighbourhood, from authentic records.” Part 2, 1750-1884. (Nottingham: H. Field, 1884)
East Midlands Collection Not 3.D14 FIE
We now know how to treat cholera victims, so that the death toll is below 1% of cases in most outbreaks, rather than the historic mortality rate of 25-50%. Even so, sometimes it’s too late to save that <1% due to the rapidity and severity of the disease or lack of resources:
Today (21st March 2025) in Nepal
A four-year-old child from ward 1 of Diprung Chuichumma Rural Municipality of Khotang district succumbed to a diarrheal infection on Sunday evening.
Health workers at the district hospital said all their efforts to save the boy were unsuccessful, as he was brought to the hospital only when his condition had deteriorated.
“Family members delayed taking the child to the hospital because another child in the family recovered from diarrhoea at home without medical treatment,”
10th March 2025 in Nigeria
“Chiemela was a graduate of medical laboratory science from Abia State University before his untimely death. He died of cholera infection during the period of his internship programme at the Military Hospital Lagos.
He is was said to have contracted the infectious disease after he drank a tiger nut drink, a locally made non-alcoholic beverage. Many of such drinks sold on the street are not registered with regulatory bodies and often fall short of the required hygienic standards.
Chiemela started stooling and vomiting uncontrollably after drinking the tiger nut and retired to his hostel. His roommates weren’t around at the time to help him get immediate medical care. He was so weak that he couldn’t even pick up his phone to call for help. The cholera infection rendered him helpless till his roommates returned and carried him to the hospital, but unfortunately, Chiemela died.
“I told you that cholera can kill in hours because of its severity,” Ngwogu said as she painfully recalled the death of Chiemela, one of the graduate students assigned to her to supervise last year.“
Dr Anne Bishop 
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