The Ukraine cholera epidemic of 1994 and 1995 was
caused by Vibrio cholerae O1, serotype
Ogawa, biotype El Tor. This epidemic was centred in the area around Respublika
Krim
(Crimea) and Mykolajiv, and spread to include parts of southern Ukraine.
Cases of cholera
occurred between September and November of 1994 and between June and October
of 1995.
The 32 fatalities among 1370 recorded cases (case fatality ratio,
2·3%) occurred throughout the
course of the epidemic. V. cholerae from patients with
cholera produced cholera toxin and
were resistant to multiple antibiotics, though no resistance plasmids were
found. Conjugation
experiments suggested that resistance to multiple antibiotics may be present
on a
self-transmissible genetic element. Environmental sources of
V. cholerae O1 El Tor included
sewage, sea and surface water, and fresh water and marine fish. All but
one of the
environmental V. cholerae isolated during the
epidemic were very similar to selected isolates
from patients at the same time, supporting the role of these environmental
sources in the
spread of disease.