Retrospective Analysis of the Cholera Situation in the Donbass Region, Zaporozhye and Kherson Regions

Introduction: The review presents the results of a retrospective analysis of the incidence of cholera and the prevalence of Vibrio cholerae in environmental media on the territory of the Donbass Region, Zaporozhye and Kherson Regions.

Objective: To do a retrospective analysis of the cholera epidemiological situation in the Donbass Region, Zaporozhye and Kherson regions, and border areas during the seventh pandemic and to assess risks of importation and spread of the disease.

Materials and methods: We examined topical articles published in peer-reviewed journals and data of the Reference Center for Cholera Monitoring for 1970–2023. The SNP analysis used whole genome sequences of V. cholerae O1 strains, NCBI and ENA databases, UPGMA and ML algorithms, author’s software, and MEGA 5.

Results: We established historic cholera outbreaks in the Donbass Region (Donetsk and Lugansk People’s Republics, former Donetsk and Lugansk regions), Zaporozhye and Kherson regions caused by the infection imported from endemic countries and its spread by water and food. The highest cholera incidence rates were registered in the 1970s and 1990s; the most recent outbreak was documented in the year 2011. In 1989–2022, 490 V. cholerae O1 strains, including 51 toxigenic ones, were isolated from water bodies in the Donetsk People’s Republic (the former Donetsk Region), 8 strains (2) in the Lugansk People’s Republic (the former Lugansk Region), 183 (6) in Zaporozhye, and 66 (51) in the Kherson Region. Toxigenic strains represented a heterogeneous group due to multiple imports of the pathogen. We revealed similarity of genotypes of V. cholerae strains isolated from environmental media in certain areas over several years, which indicates the presence of climatic and social conditions for preservation and development of local populations of cholera vibrios.

Conclusion: The current cholera situation in the Donbass Region, Zaporozhye and Kherson regions is stable. Due to the present-day emergency and infrastructure conditions, high risks of cholera importation from endemic and adjacent territories and spread of this infectious disease through water persist, thus necessitating regular and systematic monitoring of cholera in these regions and strict implementation of all measures envisaged for type I territories in terms of epidemic manifestations of cholera.

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