Forth Horseman of the Apocalypse

The white horse signifies conquest, military misadventure. The red horse stands for war. Black is for famine, persecution and injustice. The pale horse and rider spreads plague and death.

Cholera, albeit a minor plague, not yersinia pestis but can be nearly as bad, given the wasteland of bad water and bad sanitation, which is Baghdad today. Cholera is moving into Baghdad as the doctors and nurses move out. Tired of being ransomed I suppose.

Cholera is a short curved highly motile vibrio that produces a protein enterotoxin. The toxin attacks the mucous membrane of the small intestine causing an out poring of serous body fluid, isotonic salts, in copious volumes of a liter or more an hour. Unbelievable diarrhea in other words, vomiting and rapid dehydration, hemoconcentration, weakness and circulatory failure.

That's bad --- sunken eyes, wrinkled dry skin, kidneys shut down and potassium drops to lethal levels --- without fluid replacement death with in only a few hours. Most cases in non epidemic areas are much milder, but Baghdad is ripe for the worst kind of epidemic with failed sewer and water supplies and rare to intermittent electricity. With poor if any remaining hospital support and a lack of rapid appropriate fluid replacement, the pale rider, the Forth Horseman of the Apocalypse rides predictably and embarrassingly into Iraq. An appropriate allegory, eh? --- circulatory collapse, cyanosis and stupor.