The report by the British Ministry of Defence has suggested Russia is struggling to provide basic public services in occupied territory in eastern Ukraine. It appears access to safe drinking water has been inconsistent, whilst major disruption has occurred to others services such as phone lines and internet supplies.
Captured city Mariupol has worryingly reported its first cases of cholera and remains a major risk for a full outbreak of the water-bound disease.
Ukraine suffered a cholera epidemic in 1995, and has continued to suffer from minor outbreaks of the disease since.
The invasion by Russia added to the inability to provide fresh, clean drinking water and other sanitation services to areas occupied could lead to more cases and a major pandemic.
Medical services are also at a near collapse in major cities such as Mariupol, making the treatment of patients highly impractical.
Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium vibrio cholerae.
The virus remains a global threat to public health and an indicator of inequity and lack of social development.
According to the World Health Organisation (WHO) the “extremely virulent disease” causes watery diarrhoea and dehydration that can lead to death if untreated.
Most of those infected will have no or mild symptoms and can be successfully treated with oral rehydration solution.
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Most people infected with V. cholerae do not develop any symptoms, although the bacteria are present in their faeces for 1-10 days after infection and are shed back into the environment, potentially infecting other people.
Among people who develop symptoms, the majority have mild or moderate symptoms, while a minority develop acute watery diarrhoea with severe dehydration. This can lead to death if left untreated.
An adviser to the occupied port city of Mariupol’s mayor said drinking water had been contaminated by decomposing garbage and corpses, increasing the risk of more infections.
Petro Andryushchenko said on Ukrainian television: “The word ‘cholera’ is not only coming from us now, but inside the city.”
He added city officials had received information that a nearby Russian city across the border was preparing infectious disease units in case of a cholera outbreak that could affect Russian troops in Mariupol.
He continued: “So really, this threat is not only recognised by the World Health Organization and us, but the occupants as well.”
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In a different TV interview Tuesday, Mr Andryushchenko said Russian authorities controlling Mariupol were effectively shutting down the city and introducing a self-imposed quarantine.
“The situation is really quite dangerous,” he said, adding that he hoped the Russians would allow epidemiological experts, whether Ukrainian or international, into the city to help control the situation there.
A report this week suggested the city was “literally drowning in garbage and sewage” as its central water supply and sewage systems were down.
The summer heat has hastened the decomposition of thousands of corpses under the rubble, adding to the problem, it said.
On Friday, the council quoted Mariupol Mayor Vadym Boychenko as saying that tens of thousands of people in the ravaged city could die from dysentery and cholera.
Read more stories like this by following Express.co.uk Defence and Security Correspondent James Lee on Twitter: @JamesLee_DE
During the 19th century, cholera spread across the world from its original reservoir in the Ganges delta in India.
Six subsequent pandemics killed millions of people across all continents.
The current (seventh) pandemic started in South Asia in 1961 and reached Africa in 1971 and the Americas in 1991.
Cholera is now endemic in many countries.