Anthrax outbreak investigation among humans and livestock in Meherpur District of Bangladesh, December 2023: a case study of one health approach
Md Foyjul Islam, Quazi Ahmed Zaki, Fablina Noushin, Jobaida Khanam, Mohammad Rashedul Hassan, Md Omar Qayum, Ahmed Nawsher Alam, Zakir Hossain Habib, M Salim Uzzaman, Mahbubur Rahman, Tahmina Shirin
Corresponding author: Md Foyjul Islam, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh 
Received: 25 Dec 2024 - Accepted: 25 Oct 2025 - Published: 17 Feb 2026
Domain: Epidemiology,Infectious diseases epidemiology,Non-Communicable diseases epidemiology
Keywords: Anthrax outbreak, one health approach, zoonotic disease surveillance
Funding: This work received no specific grant from any funding agency in the public, commercial, or non-profit sectors.
This article is published as part of the supplement Teaching Case Studies in Field Epidemiology and Public Health for the Eastern Mediterranean Region, commissioned by Eastern Mediterranean Public Health Network (EMPHNET).
©Md Foyjul Islam et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Md Foyjul Islam et al. Anthrax outbreak investigation among humans and livestock in Meherpur District of Bangladesh, December 2023: a case study of one health approach. Pan African Medical Journal. 2026;53(1):7. [doi: 10.11604/pamj.supp.2026.53.1.46331]
Available online at: https://www.panafrican-med-journal.com//content/series/53/1/7/full
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Anthrax outbreak investigation among humans and livestock in Meherpur District of Bangladesh, December 2023: a case study of one health approach
Anthrax outbreak investigation among humans and livestock in Meherpur District of Bangladesh, December 2023: a case study of one health approach
Md Foyjul Islam1,&, Quazi Ahmed Zaki1, Fablina Noushin1, Jobaida Khanam2, Mohammad Rashedul Hassan1, Md Omar Qayum1, Ahmed Nawsher Alam1, Zakir Hossain Habib1, M Salim Uzzaman3, Mahbubur Rahman1, Tahmina Shirin1
&Corresponding author
This case study examines an anthrax outbreak in Meherpur District, Bangladesh, that occurred in December 2023, highlighting the application of a One Health approach to investigate the impact on both humans and livestock. The outbreak involved 11 human cases-3 confirmed and 8 probable-linked to direct contact with infected animals. Key findings included a higher incidence among middle-aged females and significant risk factors included handling raw meat and skinning sick animals. The investigation also revealed gaps in public health surveillance, healthcare access, and community awareness. The goal of this case study is to equip trainees with practical skills and comprehensive knowledge for conducting effective outbreak investigations of zoonotic diseases. It focuses on utilizing the One Health approach to analyze data, develop hypotheses, and implement prevention and control strategies. Designed as a training tool for novice field epidemiology students, the case study incorporates group discussions and facilitator-led guidance to reinforce outbreak investigation concepts. Participants will learn to outline outbreak investigation steps, explain the One Health approach, formulate and evaluate hypotheses, interpret epidemiologic data, and propose strategies for preventing and controlling zoonotic diseases. This exercise is intended for Field Epidemiology Training Program (FETP) fellow of frontline, intermediate and advance titer. This also can be used for other public health professional, and who have prior knowledge of disease surveillance and outbreak investigation.
General instructions: this case study should be used as adjunct training material for novice epidemiology trainees to reinforce the concepts taught in prior lectures. The case study is ideally taught by a facilitator in groups of about 20 participants. Participants are to take turns reading the case study, usually a paragraph per student. The facilitator guides the discussion on possible responses to questions. The facilitator may make use of flip charts to illustrate certain points. Additional instructor's notes for facilitation are coupled with each question in the instructor's guide to aid facilitation.
Audience: this case study was developed for novice field epidemiology students and, environmental health officers or laboratory scientists who work in public health-related fields.
Prerequisites: Before using this case study, participants should have received lectures on disease surveillance and outbreak investigation.
Materials needed: internet facilities flip charts, markers, computers with MS Excel
Level of training and associated public health activity: intermediate - Outbreak investigation
Time required: 2-3 hours
Language: English
- Download the case study student guide;
- Request the case study facilitator guide.
The authors declare no competing interests.
We wish to acknowledge the Institute of Epidemiology, Disease Control and Research (IEDCR), Bangladesh, and the Field Epidemiology Training Program (FETP) for their invaluable support and contribution to this case study. Special thanks are extended to Gretchen Cowman, Epidemiologist at the U.S. Centers for Disease Control and Prevention (CDC), for her expert guidance and insights. We also wish to recognize the Eastern Mediterranean Public Health Network (EMPHNET) for their support in developing this case study.
Figure 1: lesion on left arm, forearm and hand of index case at initial presentation
Figure 2: map showing Meherpur district (A), subdisrtrict (B) and Union (C) locations
Figure 3: probable and confirmed human cases of anthrax (n=11), and sudden deaths of cattle (n=5), by date of onset / occurre 03nce, Meherpur District, November-December 2023
Figure 4: map showing location of cutaneous anthrax outbreak in Meherpur District, Bangladesh 2023
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