Analysis of Peculiarities of Epidemiological Situation on Cholera in the World and in the Russian Federation in 2024 and Forecast of its Development in 2025

Анализ особенностей эпидемиологической ситуации по холере в мире и в Российской Федерации в 2024 году и прогноз на 2025 год
E. V. Monakhova, V. D. Kruglikov, E. A. Menshikova, М. И. Ежова, А С Водопьянов, N. E. Gaevskaya, Е. А. Москвитина, В. В. Агафонова, I. V. Savina, О. А. Подойницына, N. A. Selyanskaya, O. V. Duvanova, E. S. Shipko, A. V. Evteev, V. S. Kaz’mina, P. V. Bodraya, E. N. Sokirkina
2025-04-04

Vibrio cholerae O1 El Torantibiotic-resistant Vibrio choleraecholera epidemiological surveillanceenvironmental waterborne Vibrio monitoringnon-toxigenic V. cholerae O1 and O139
The aim of the work was to analyze the peculiarities of the cholera epidemiological situation in the world and in Russia in 2024; forecast for 2025. The results of proactive epidemiological surveillance showed a continued upward trend in cholera morbidity in the world despite of the decrease in this indicator in 2024 (762 830 cases in 42 countries) as compared to 2023 (816 235 in 47 countries). A special feature was the import of a polyantibiotic-resistant Vibrio cholerae O1 El Tor strain from Tanzania to Island Mayotte. Active labor migration to the Russian Federation (RF) from countries with unfavorable cholera situation was noted (11 686 foreigners, 88.17 % – from India). No cholera patients (vibrio carriers) were identified in RF. The features of epidemiological situation have been established: two toxigenic V. cholerae O1 strains similar to the one isolated in 2023, and one toxigenic strain of NAG, documented in RF for the first time, were detected in surface water bodies. It has been determined that the non-toxigenic V. cholerae O1 strain, which caused a case of acute intestinal infection, and waterborne O1 strains circulating in Russia belong to the same clone. For the first time, the non-toxigenic V. cholerae O139 strain was isolated from a patient with acute intestinal infection. An increase in the number of non-toxigenic O1 strains isolated from water bodies was noted (335 in 2024, 52 in 2023), mainly due to the clonal complex (250 strains, Krasnodar Territory) spread through karst waters. Diseases caused by non-toxigenic NAG vibrios V. parahaemolyticus and V. fluvialis , were detected. The forecast for 2025 covers the risks of cholera importation, including cases caused by antibiotic-resistant strains; increase in labor migration from countries with an unfavorable cholera situation; the likelihood of detecting toxigenic O1 and nonO1/nonO139 strains in the environment, an increase in the number of acute intestinal infections caused by non-toxigenic cholera and other pathogenic vibrios; possible detection of extra-intestinal infections, an increase in the number of non-toxigenic V. cholerae O1 in environmental objects. It is advisable to start monitoring studies earlier (April) and finish them later (October) in RF in 2025 in type I territories classed according to epidemic manifestations of cholera.
1
A polyantibiotic-resistant Vibrio cholerae O1 El Tor strain was imported from Tanzania to Mayotte, indicating risk of antibiotic-resistant strain spread.
2
Environmental surveillance in Russia detected two toxigenic V. cholerae O1 strains similar to 2023 isolates and, for the first time, a toxigenic NAG strain in surface waters.
3
For the first time in Russia, a non-toxigenic V. cholerae O139 strain was isolated from a patient; infections by non-toxigenic NAG vibrios V. parahaemolyticus and V. fluvialis were also detected.
4
Forecast for 2025 predicts risks: importation of (including antibiotic-resistant) cholera strains, increased labor-migration-related importation, detection of toxigenic O1 and nonO1/nonO139 strains in environment, more acute intestinal and possible extra-intestinal infections, and increased environmental non-toxigenic V. cholerae O1.
5
Global cholera cases decreased from 816,235 (47 countries) in 2023 to 762,830 (42 countries) in 2024 despite a continued upward trend overall.
6
No human cholera cases or carriers were detected in the Russian Federation in 2024, but 11,686 foreign labor migrants arrived, 88.17% from India, increasing importation risk.
7
Non-toxigenic V. cholerae O1 strains causing human infection and waterborne O1 strains in Russia belong to the same clone; non-toxigenic O1 isolations from water rose to 335 in 2024 (from 52 in 2023), largely from a Krasnodar Territory clonal complex (250 strains) spreading via karst waters.
8
Recommendation: extend Russian environmental monitoring of cholera in type I territories to start in April and continue through October in 2025.

Epidemiological situation of cholera (world and Russian Federation in 2024) and related Vibrio isolates in environmental and clinical sources

Characteristics, trends, sources and risks of cholera transmission including incidence trends, importation (including antibiotic-resistant strains), detection of toxigenic and non-toxigenic V. cholerae (O1, O139, NAG) in water and patients, clonal relationships, and forecasted development in 2025 with surveillance timing recommendations

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2025-04-04
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Authors
E. V. Monakhova
V. D. Kruglikov
E. A. Menshikova
М. И. Ежова
А С Водопьянов
N. E. Gaevskaya
Е. А. Москвитина
В. В. Агафонова
I. V. Savina
О. А. Подойницына
N. A. Selyanskaya
O. V. Duvanova
E. S. Shipko
A. V. Evteev
V. S. Kaz’mina
P. V. Bodraya
E. N. Sokirkina
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