The risks of cholera importation and the forecasting system in epidemiological surveillance in the Russian Federation

Background:The risks of cholera importation into Russia are determined by the intensity of the epidemic process in endemic countries of Southeast Asia, the Eastern Mediterranean, and Africa. The assessment of risk factors for cholera importation and spread forms the basis of the risk-oriented methodology in proactive epidemiological surveillance, which ensures timely forecasting of the epidemiological situation, preparedness, and rapid response in case of its deterioration, as well as the prevention of severe consequences. Aim:To assess the effectiveness of proactive epidemiological surveillance of cholera in Russia in 2023–2024. Materials and methods:a risk-oriented approach was employed, based on the systematic collection of official data on global cholera incidence from sources such as the Weekly Epidemiological Record (WHO), official and regional WHO websites, internet resources including ProMED-mail post, ECDC, and other platforms. The study adhered to regulatory documents issued by the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing for 2023–2024 and utilized operational epidemiological analysis data from the Reference Center for Cholera Monitoring in Russia. Whole-genome sequencing (WGS) and genome assembly were conducted on the MiSeq (Illumina) platform, and genetic determinants were identified in WGS data using BioEdit 7.2.5 and BLASTN 2.2.29. Statistical data processing was performed using the StatSoft STATISTICA 6.1.478 Russian software. Results:A comprehensive analysis of global cholera incidence data was conducted, providing a realistic forecast of the risks of cholera importation into Russia in 2023. The epidemic preparedness of Rospotrebnadzor and the Ministry of Health of Russia was assessed, followed by a prompt response to two imported cholera cases detected in Tambov region and Moscow in 2023, both originating from India. Timely identification of these cases, including genomic and phylogenetic characterization of the pathogens, was achieved. Infection foci were localized and eliminated, preventing further spread. Cholera monitoring in Russia continued throughout 2024, with preventive measures implemented to minimize the risks of cholera importation and spread. Conclusions:The analysis of the 2023–2024 monitoring results demonstrated the effectiveness of the proactive epidemiological surveillance system, which relies on early identification of cholera importation risks and their precursors, forecasting, rapid response to potential complications in epidemiological situation, and control of objects and factors contributing to infection spread. The epidemiological stability regarding cholera in Russia was ensured.