# Anthrax in Albania: A Comprehensive Analysis of Epidemiology, Laboratory Diagnosis, and National Control Strategies in Animals

## TL;DR

This paper analyzes anthrax outbreaks in Albania, focusing on their geographic patterns, control measures, and the need for improved One Health strategies to prevent spread between animals and humans.

## Contribution

The study provides a spatiotemporal analysis of anthrax outbreaks in Albania and evaluates the effectiveness of current control strategies using national surveillance data.

## Key findings

- Anthrax outbreaks in Albania are concentrated in southern districts, with human cases aligning with animal outbreaks.
- The number of outbreaks and within-herd cases has decreased due to improved identification and response measures.
- Equine anthrax cases emerged in 2024, while caprine cases remained low, indicating shifting patterns in affected species.

## Abstract

Anthrax, caused by Bacillus anthracis, is a highly infectious disease that poses significant public health and veterinary health challenges. In Albania, it remains one of the leading zoonotic diseases, causing substantial problems in livestock populations. The current surveillance study analyzed national anthrax data from the past five years. It assessed the nationwide spatiotemporal distribution of cases and evaluated the strengths and weaknesses of the existing control program. The study provides detailed insights into ongoing anthrax outbreaks and evaluates laboratory diagnostic capacity and control measures implemented during this period. The results indicate that most cases and outbreaks are concentrated in the southern part of the country. Human cases show a similar geographic pattern, aligning with affected animal areas. Nevertheless, the overall number of outbreaks and within-herd cases has decreased, likely due to more rapid identification and improved response measures. Targeted surveillance of animal outbreaks provides critical insights into disease spread and epidemiological links among affected farms in Albania. Implementing a One Health approach is essential for a deeper understanding of the pathogen’s epidemiology and transmission routes. Such an approach would also enhance the ability to trace infection sources across humans, animals, and the environment.

Anthrax is one of the most significant zoonotic diseases in Albania due to its endemic presence in livestock, the potential for occupational exposure, and human cases. Although the implementation of risk-based livestock immunization, animal movement restrictions, and appropriate carcass disposal, the efficacy of targeted management remains limited in certain outbreaks due to insufficient enforcement of these measures. Their efficacy is specifically diminished by insufficient disinfection, the absence of grazing bans in contaminated pastures, and the absence of designated burial sites for the safe disposal of dead animals. District-level data on animal anthrax control programs were collected and analyzed for the period 2021–2025. In addition, a retrospective analysis of national datasets covering the same period was conducted using data from the national surveillance system, alongside a review of the relevant scientific and grey literature and aggregated program and routine surveillance data. Analysis showed that anthrax affected 149 animals in 97 farms, and the average number of animals per infected farm declined from 1.70 to 1.08, indicating a slight reduction within-farm outbreak. Hotspots for human anthrax were aligned with the animal cases and persisted particularly in the southern districts. The peak of outbreaks was in 2023, primarily driven by cattle (n = 32) and sheep (n = 24). Equine cases appeared only in 2024, with small clusters of 3 cases in both 2024 and 2025. Caprine cases remained consistently low throughout the period. Nevertheless, the number of outbreaks and within-herd cases are decreasing due to more rapid identification and response. Targeted surveillance on animal outbreaks provides critical insights into disease spread and links among affected farms in Albania. Therefore, One Health genomic surveillance and antibiotic susceptibility testing of Bacillus anthracis isolates are essential for understanding its epidemiology, transmission routes, and for tracing the sources of infection across humans, animals, and the environment.