Continued genomic surveillance of Vibrio cholerae O1 isolates from cholera cases in Europe, 2023–2024
Year: 2026
Type: preprint
Abstract: ABSTRACT Background Following the global resurgence of cholera in 2022, 51 cholera cases were reported by European countries. We previously characterised 49 Vibrio cholerae O1 isolates from these cases using whole genome sequencing. In 2023 and 2024, 59 additional cholera cases were reported by 11 European countries. Aim We aimed to confirm that V. cholerae O1 isolates associated with cholera cases reported in Europe in 2023–2024 belonged to the epidemic seventh pandemic El Tor (7PET) lineage rather than to non-epidemic V. cholerae O1 lineages, and to characterise their virulence, antimicrobial resistance (AMR) determinants and phylogenetic relationships. Methods Fifty V. cholerae O1 isolates were available for whole genome sequencing, of which 49 yielded genomes of sufficient quality for analysis. Genomes were analysed together with more than 1,500 publicly available 7PET genomes to place the European isolates into a global phylogenetic context. Results All 49 genomes belonged to the 7PET lineage and Wave 3. Four sub-lineages were identified: BD1.2 (2/49), AFR12 (6/49), AFR13 (8/49) and Pre-AFR15 (33/49). The predominance of Pre-AFR15 confirms its continued contribution to the ongoing global cholera resurgence. In contrast to our 2022 survey, eight highly drug-resistant AFR13 isolates were detected, documenting the international spread of this highly drug-resistant clone resistant to multiple first-line antimicrobial agents. Conclusion Whole genome sequencing should be routinely used by reference laboratories to distinguish epidemic 7PET from non-epidemic V. cholerae O1 lineages and to monitor the emergence and international spread of AMR clones. Continued collaborative genomic surveillance of travel-associated cholera cases can provide early insights into the emergence, international spread and antimicrobial resistance of 7PET sub-lineages.
Authors: Elisabeth Njamkepo, Susann Dupke, Thamida Tauhid, Roger Stephan, Boas van der Putten, Outi Nyholm, Silvia Herrera-León, Richard J. Drew, Martin Cormican, David R. Greig, Borislava Tsafarova, Rosalie Sacheli, Christina Clarke, Ivan N. Ivanov, Claire Jenkins, Maren Lanzl, Inga Fröding, Holger C. Scholz, Caroline Rouard, François-Xavier Weill
Institutions: Institut Pasteur, Université Paris Cité, Robert Koch Institute, Public Health Agency of Sweden, University of Zurich, National Institute for Public Health and the Environment, Finnish Institute for Health and Welfare, Instituto de Salud Carlos III, Centro Nacional de Microbiologia, Rotunda Hospital, Ollscoil na Gaillimhe – University of Galway, UK Health Security Agency, National Center of Infectious and Parasitic Diseases, Centre Hospitalier Universitaire de Liège, University Hospital Galway
Language: English
Subfield: Endocrinology
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W7214214958