Microplastics as Potential Drivers of Cholera Persistence and Outbreaks: A Mini Review

Cholera continues to impose a heavy disease burden in regions with limited sanitation, where Vibrio cholerae survives in aquatic systems shaped by climatic and ecological drivers. Recent research suggests that microplastics (MPs), once regarded as inert pollutants, may actively influence the persistence and virulence of this pathogen. This mini-review puts together information that points to MPs as potential drivers of cholera outbreaks. MPs are widespread across rivers, lakes, and wastewater streams, and their textured, hydrophobic surfaces readily attract organic matter and microbes. These features promote the establishment of biofilms in which V. cholerae can persist, protected from environmental stress. Laboratory investigations show that exposure to MPs can alter bacterial behaviour, increasing motility, enhancing adhesion, and stimulating pathways linked to pathogenicity. Field studies further demonstrate that MPs become hotspots for microbial enrichment and rapidly accumulate antimicrobial resistance (AMR) genes, creating mobile reservoirs that facilitate gene exchange. In cholera-endemic regions, this interaction between plastic pollution, pathogen ecology, and antibiotic resistance raises serious concerns for both outbreak dynamics and treatment outcomes. The evidence points to MPs as hidden amplifiers of cholera risk, suggesting the need for integrated strategies that address plastic waste management, strengthen cholera surveillance, and promote antimicrobial stewardship in a One Health framework.