Dr's Casebook: WWI soldier sheds light on antibiotic resistance

Private Cable's sample is showing us how bugs are continuing to evolve and why we must today limit the use of antibiotics. Photo: adobestock

In Flanders fields the poppies blowBetween the crosses, row on row,That mark our place; and in the skyThe larks, still bravely singing, flyScarce heard amid the guns below.

Dr Keith Souter writes: In Flanders Field, the poem that lies at the heart of the Remembrance Day Poppy Appeal is one of the most famous Great War poems. It was written on the Western Front by a Canadian surgeon and poet, Lieutenant Colonel John Macrae in 1915. The inspiration for it had been the sight of so many poppies that had sprung up amid the bleak, muddy landscape of the Western Front battlefields.

This Remembrance Sunday the poem has a particular poignancy, since the Ukraine War and the Israel-Gaza War are ongoing. There are real concerns about humanitarian crises with the threat of epidemics like dysentery on top of the violence.

It is estimated that 37 million lost their lives during the Great War. Significantly, one third of deaths were from infections or disease. One such victim was Private Ernest Cable serving with the 2nd Battalion of the East Surrey Regiment.

He was sent to hospital in Wimereux, near Boulogne, where he was diagnosed with dysentery. Unfortunately he died from it a few weeks later.

One of his doctors took a bacterial sample from him which was kept for future research. Amazingly, a century later it has been used by scientists in the on-going fight against dysentery and antibiotic resistance.

The dysentery organism, is called Shigella flexneri. Its genome has now been decoded. Private Cable’s sample, which was the first sample to be preserved, shows that the bug had already developed penicillin resistance 13 years before Alexander Fleming famously discovered the antibiotic. It has now been compared with modern isolated samples. This shows that the bug has acquired even more antibiotic resistance in modern times.

This is highly significant, because dysentery still spreads in unsanitary

conditions and in war zones, just as it did in the World War 1 trenches. Thus, Private Cable is still contributing to the fight. His sample is showing us how bugs are continuing to evolve and why we must today limit the use of antibiotics.

We must remember all who have lost their lives as the direct or indirect result of wars.