“As an infectious dose V. Cholerae O1 is estimated to be 105–108 [100,000 to 100 million] Colony-forming units (CFUs) suggest that holy water is contaminated in large amounts, and bacteria remain viable in flight and at ambient temperatures in Europe.
Global Plague
Tests showed that cholera strains brought back by travelers were particularly troublesome. V. Cholerae O1 is associated with other recent outbreaks in East and Middle Africa and is resistant to a variety of antibiotics, namely fluoroquinolone, trimethoprim, chloramphenicol, aminoglycosides, betalactams, macrolides, and sulfonamides. The strain also carried another genetic element (plasmid) that provided a mechanism of resistance to streptomycin and spectinomycin, cephalosporins, macrolides, and sulfonamides.
Oral rehydration is the main treatment for cholera, which causes heavy watery diarrhea and vomiting. Antibiotics may be used to reduce severity. Fortunately, this strain was susceptible to the antibiotic tetracycline, one of the best drugs for cholera. However, there have been reports of other African cholera strains, and have also acquired tetracycline resistance.
Overall, the author writes, “it is rare for an extended cholera outbreak in Africa to cause clusters of infections in Europe.” They ask that travelers be aware of the infectious threat when they eat or drink abroad and not consume holy water. Clinicians should also recognize the possibility of cholera in travelers to Ethiopia.
However, to truly combat the outbreak of cholera, it requires sustained investment in water, sanitation and hygiene (cleaning). Cholera cases have skyrocketed worldwide after the pandemic. According to the World Health Organization.
“Low-income countries continue to need international development support to control outbreaks and outbreaks using effective cleaning, monitoring, communications, diagnosis and delivery of countermeasures programs,” the author of the EuroSurveillance Report wrote.
