A Call To Reinforce One Health Preparedness in Response To the Global Re-emergence of Anthrax

Abstract

In one of the latest documented anthrax clusters globally (May 2025), Thailand faced a significant public health challenge with a cluster of four confirmed cutaneous anthrax cases, including one fatality, in Mukdahan Province [1]. The cases were traced to the slaughter of infected cattle. The index patient initially presented with a skin rash that progressed rapidly to severe systemic symptoms, including convulsions and lymphadenopathy, and died within hours of hospital transfer. The remaining three individuals developed pustular and vesicular lesions and were successfully treated with a combination of levofloxacin and doxycycline. Bacillus anthracis was confirmed in all cases by Reverse Transcription polymerase chain reaction (RT-PCR) (Table 1). This incident marks the first anthrax-related death in Thailand since 1994 and underscores the continued risk of anthrax outbreaks in both endemic and non-endemic settings. As illustrated in (Table 2), globally, anthrax continues to surface in diverse regions. Recent alerts from the World Health Organization (WHO) have reported concurrent outbreaks in the Democratic Republic of Congo (DRC), Uganda, and other countries, all linked to similar ecological and human-animal interfaces. These patterns raise urgent questions: What other zoonotic pathogens are circulating undetected at the periphery of global health systems? And are we equipped to respond when they emerge? This event offers a striking example of the complex interplay between human and animal health. Investigators traced the source to the slaughter of two cattle during a communal merit-making event, a cultural practice that unintentionally facilitates zoonotic transmission. In response, public health authorities screened over 600 individuals, provided post-exposure prophylaxis to at-risk contacts, and launched a livestock vaccination campaign within a five-kilometer radius. These swift actions effectively contained the outbreak, but the incident underscored the critical importance of coordinated surveillance systems, veterinary infrastructure, and culturally informed community engagement.

Keywords: Anthrax, One Health, Zoonotic Diseases, Public Health Preparedness, Bacillus Anthracis