Myanmar earthquake: a One Health approach to address potential infectious threats

On March 28, 2025, a 7.7 magnitude earthquake struck Myanmar, with its epicenter near Mandalay, the country's second-largest city. This earthquake caused widespread devastation, with over 4430 fatalities, 6200 injuries, and 820 people reported missing till now. It was the most powerful earthquake in Myanmar since 1912 and one of the deadliest globally since the 2023 Turkey–Syria earthquakes. Infrastructure, such as houses, mosques, monasteries, and pagodas, was severely damaged by this catastrophe. Road damage and the ongoing conflict have made relief efforts difficult.

Cholera outbreaks have been a major problem for Myanmar, especially in recent years, with 12,000 cases of acute cholera reported nationwide in 2024 [1]. Mandalay was one of the most severely affected areas. The recent 2025 earthquake has put additional strain on Myanmar's healthcare system and raised the possibility of the emergence of cholera and other waterborne diseases. Cholera is one of the serious diseases that can be avoided by vaccination in post-disaster situations, and oral cholera vaccines are significant tools during complex catastrophes, such as earthquakes, for those living in the areas most affected by the earthquake [2], preventing the spread of such diseases. Outreach programs, mobile clinics, and vaccination teams can be employed to overcome obstacles like interrupted communication, transportation, and health services with the help of international organizations, such as WHO and UNICEF. Importantly, preventing cholera will need to be a priority through enhancing water sanitation, hygienic practices, and vaccinations. An example is the neighboring country Nepal, which witnessed a cholera outbreak post-earthquake in 2015. The risk of the emergence and spread of antimicrobial resistance during armed conflicts [3,4] and post-earthquake relief efforts [5] is reported and documented, attributable to early closure of wounds, inadequate or delayed debridement, and wound contamination. Infected wounds, especially with resistant bacteria (Acinetobacter baumannii, Escherichia coli, etc.), could increase the mortality rate [5].

Implementing the One Health concept amid post-disaster situations necessitates many efforts to achieve the desired goal. The 2025 Myanmar earthquake, like any natural disaster, greatly impacts, both directly and indirectly, people, animals, plants, and the environment— the important components of One Health. The risk of disease transmission is increased when earthquakes compel the affected communities to function at minimum levels without access to water, sanitation, or pest control. Prioritizing One Health threats—assessed and evaluated by a multisectoral team belonging to Myanmar's “One Health” initiative—and creating an early response strategy should be the first steps. To identify vaccination priorities, risk assessment is primarily required besides testing capacity, early surveillance capabilities, local awareness communication plans, and environmental assessments. The effective vaccines are crucial for vulnerable populations, such as the elderly and children, and even humanitarian staff [6].

Rabies, AMR, and foodborne diseases are among the One Health priority topics for Myanmar. Rabies remains a significant public health concern in Myanmar, especially in rural areas with limited availability of vaccines and post-exposure prophylaxis (PEP) and a high population of stray animals that have been hampering vaccination efforts. Dog bites are responsible for 96 % of human rabies cases, which indicates a rise in rabies cases. An estimated 600,000 animal bites occur annually in Myanmar, with the majority being dog bites.

In conclusion, the earthquake in March 2025 has had a massive impact on Myanmar's health-care system and the affected population. It can leave a space for infectious diseases to spread, such as cholera and rabies, threatening many people and families and disrupting the community's health. It is essential to prioritize disaster preparedness and response planning, boost financing and resources, and enhance communication to guarantee an efficient response and assistance for people in need. More importantly, the potential Myanmar earthquake consequences, such as rabies and cholera spread, should be urgently addressed through a One Health approach (secure oral cholera and rabies vaccines, adopt trap–neuter–return (TNR) for stray dogs, increase awareness, enhance hygienic conditions, and manage wounds).

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This research did not receive any specific grant from funding agencies in the public, commercial, or non-profit sectors.

Declaration of competing interest

The author declares that he has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Handling Editor: Patricia Schlagenhauf