A study published in Eurosurveillance has found a link between consumption of contaminated holy water from Ethiopia and recent cases of multidrug-resistant cholera in Germany and the UK. Four patients were infected through imported water, while three had traveled to Ethiopia. Researchers detected the same antimicrobial resistance profile among the bacteria samples obtained from these patients as those recently isolated in England.
The ongoing cholera outbreak in Ethiopia began in 2022, with over 58,000 reported cases and 726 deaths by February 9, 2025. A recent resurgence of the outbreak was reported in the Amhara region, leading to 163 new cases and 3 deaths. One identified contamination source is the Bermel Giorgis holy well, a site of pilgrimage attracting visitors worldwide.
In Germany, three people were initially reported with suspected cholera on February 25, 2025, after consuming water from the holy well while traveling in Ethiopia. Two had traveled to Ethiopia and brought back a small bottle of contaminated water, which they consumed upon their return. The third person received splashes of water to the face and possibly ingested some.
In the UK, four patients were identified with cholera, including two who reported recent travel to Ethiopia. One patient had visited Bermel Giorgis, while another had drank holy water brought back by a fellow traveler who became ill after consuming it in the UK.
Genetic analysis of bacteria samples from the UK cases showed that they belonged to a multidrug-resistant clade of Vibrio cholerae O1 previously linked to outbreaks in Kenya and sub-Saharan Africa. The similarities between these isolates and those isolated in Ethiopia suggested that multidrug-resistant V. cholerae O1 circulating in Africa were transmitted into Europe.
The study highlights the need for improved support for prevention and control of outbreaks in low-income countries, where water, sanitation, and hygiene investments are crucial to controlling outbreaks and epidemics.
Source: https://medicalxpress.com/news/2025-04-patients-multidrug-resistant-cholera-eu.html