The uncovered past (and living present) of cholera, at RCPI Heritage Day
In 1832, the sixty-sixth president of RCPI Dr James John Leahy died in Sligo during a cholera epidemic – a public health emergency revisited by RCPI’s Heritage Day, at No. 6 Kildare Street on 15 October.
Ireland during an epidemic of cholera in 1832 – an infectious, and often fatal, bacterial infection – has been eclipsed by the Great Famine of 1845-1852, said Dr Fióna Gallagher (urban historian, Dublin City University).
Dr Gallagher’s interest in the epidemic stemmed from research of her hometown Sligo, which was discovered to have the highest morbidity rate in Ireland during the epidemic. 698 deaths out of a population of 12,000 were recorded by the town’s fever hospital.
Cholera – a waterborne infectious disease – spread through a post-Napoleonic era of economic depression, a period dominated by the campaign for Catholic Emancipation begun by Daniel O’Connell. Small Irish towns, characterised by cabin-built dwellings, extreme poverty and contaminated water supply, experienced the same rate of infection as large English cities, said Dr Gallagher.
Until the 1850s, the widespread medical explanation for cholera was believed to be miasma – a noxious "bad air" that began to pass into accepted common knowledge, as reflected in Victorian literature, according to Prof Geraldine Meaney (professor of cultural theory, University College Dublin).
Using the HathiTrust Digital Library, a large-scale collaborative repository of digital content from research libraries administered by the University of Michigan, Prof Meaney found “miasma” emerging as a popular entry in the mid-19th century.
Prof Meaney mapped how cholera began to take on distinctive characteristics of fiction. The “fog-bred pestilence” that spreads throughout an orphanage in Jane Eyre (1847) was insisted by Charlotte Brontë to be a depicted outbreak of the infectious disease typhus, but Prof Meaney pointed out the “fog-bred” description resembled more the “bad air” of miasma theory. When Irish novelist William Carleton wrote a graveyard scene in his political fiction The Squanders of Castle Squander (1852), a fear of contagion – of joining the undead by being buried alive – seemed to recall anxieties of Ireland’s cholera epidemic.
Prof Meaney also referenced connections made by historian Marion McGarry between stories of the epidemic in 1832 Sligo as told by Bram Stoker’s mother, and the novelist’s fiction Dracula as a kind of expression of the cholera outbreak, through its preoccupation with contagion and the undead.
Miasma theory was widely accepted as the explanation for cholera until English physician Dr John Snow helped make connections with contaminated water during the 1850s. A script-in-hand reading of Miasma, a new play by Colin Murphy, was set during cholera outbreaks in mid-19th century London, and followed Dr Snow’s investigation of the city’s water supply.
The college’s Heritage Day showed that cholera is not an infectious disease confined to the past. “Cholera is still with us,” said Prof Victor Mukonka (former director general, Zambia National Public Health Institute).
Prof Mukonka spoke of public health efforts made in Zambia during a spike in infections in 2024, when the country’s largest sports arena was converted into a cholera treatment centre. “The biggest problem is unplanned settlements with no proper drainage,” he said, sharing photographs of health teams arrived to fishing villages by helicopter, navigating crocodile habitats to treat sick people and install drainage.
Prof Mukonka explained that Zambia joined a global taskforce to end the cholera epidemic by 2030 – a goal reiterated by a World Health Assembly resolution in 2018 calling for all member nations to unite in a coordinated and multisectoral approach.
Zambia National Public Health Institute undertook a review of the country’s progress in 2022, finding increased uptake in pre-emptive vaccines, and effective mapping and targeting of infection hotspots.
Prof Mukonka also spoke of greater coordination between Africa states following recent ebola outbreaks.
“Today our world is one village,” he said.