London School of Hygiene & Tropical Medicine

While working on reconstructing the complex genome of this bacterium, the team from the Wellcome Trust Sanger Institute and the London School of Hygiene & Tropical Medicine also managed to piece together the story of the man who had been infected while fighting in the trenches of the Western Front in 1915. The research is reported in a special World War I edition of The Lancet.

Dysentery is a life-threatening disease that is becoming increasingly hard to treat and continues to spread in unsanitary conditions in today's developing nations and conflict zones.

The sample of Shigella flexneri, which was the first to be submitted to Public Health England's National Collection of Type Cultures, has been genetically decoded for the first time thanks to advances in sequencing technology.

The genetic data revealed the bacterium was resistant to penicillin despite antibiotics not being discovered until 13 years later and showed the researchers how the pathogen had changed in the 100 years since World War I. They hope it may ultimately help in the search for an effective vaccine for Shigella.

Senior author Nick Thomson, Professor of Bacterial Genomics and Evolution at the School and a Principal Scientist at the Sanger Institute, said: "There are two parts to this story: modern genomics has given us the power to untangle fine-scaled relationships between organisms and tell us how they have changed over time; linking this to a soldier who contracted the infection at the very beginning of World War I allowed us to focus on a very real human story that helps us navigate through what was such a monumental and complex period in our history.

"The historical perspectives we gain from samples like this are important because they provide the background information we need to understand infections today."

The human story behind the sample was at the forefront of researchers' minds in this centenary year of World War I and they recognised the opportunity it provided to remember the huge numbers who died of infectious diseases during the conflict. When researchers set out to find the soldier, the sample's strain name, Cable, gave them the clue they needed.

Using Public Health England's records and the National Archives, Dr Alison Mather, a first author from the Sanger Institute, was able to track down the hospital where the sample was probably taken. Trawling through the records of this hospital, a converted hotel in the French coastal town of Wimereux, Dr Mather eventually found an entry for a Private Ernest Cable of the Second Battalion of the East Surrey Regiment; it was the record of his death from dysentery on March 13 1915.

"So many of the samples we work with in bacterial genomics have stories that we'll never know," says Dr Mather. "Finding Ernest and learning his story was a chance to commemorate those who fought in World War I, and to highlight the burden of infectious disease during this time."

In a separate Commentary in the Special Issue, the School's Professor Martin McKee and Professor David Stuckler discuss the expansion of the role of the state in public health as a result of World War I and World War II, ranging from keeping a supply of men at the frontline by improving healthcare to caring for injured veterans.

Video: Interview with Nick Thomson

Video: Sample of an Unknown Soldier (a film by the Sanger Institute)

Publications

• Alison Mather et al. Bacillary dysentery from World War 1 and NCTC1, the first bacterial isolate in the National Collection. The Lancet.
• Kate Baker et al. The extant World War 1 dysentery bacillus NCTC1: a genomic analysis. The Lancet.
• Martin McKee and David Stuckler. The changing role of the British state and its citizens. The Lancet.
• David Wright and Bohumil Drasar. Dysentery in World War 1: Shigella a century on. The Lancet

Image 1: Soldier walk Credit: Genome Research Limited
Image 2: Private Ernest Cable's sample Credit: Genome Research Limited