The new observation that strains of V. cholerae can be expelled into the environment after being ingested by protozoa, and that these bacteria are then primed for colonization and infection in humans, could help explain why cholera is so persistent in aquatic environments. The disease-causing bacteria are protected in the protozoan gut and ejected into the environment in membrane-bound expelled food vacuoles (EFVs).
Protozoans and pathogens make for an infectious mix
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