Floods; A read on estimated One Health implications

What floods bring in Pakistan – 2010, 2013, 2022 and 2025 Facts

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Flood’s Footprints	2010	2013	2022	2025
Human Casualties	1700 plus, 20 million people were affected	500 deaths, 5 million people afflicted	2000 death toll, 33 million affected	Almost ninety-nine districts are afflicted, By September start 800 plus death toll is recorded over 5 weeks (NMDA)
Migration	6 million, mass displaced	Millions were forced moved	8 million displaced	Injured 1100, displacement of 63,000 people, by far
Waterborne Diseases	Cholera, diarrhea, and dysentery, more than 1,000,000 cases	300,000 cases of diarrhea, skin diseases, respiratory infections	Cholera, dysentery, typhoid fever, and hepatitis, 700,000 cases	Confirmation yet to be done; diarrheal outbreaks reported
Mental Health Impact	Post-traumatic stress disorder (PTSD)	Anxiety, depression, and PTSD	Anxiety and PTSD	Will be consistent to prior events
Livestock and loss of crops	2 million + livestock afflicted by drowning, disease, less food and water	1 million animals died by starvation and inadequate veterinary services	FAO reported 70% loss of livestock 1.1 M	Almost 6,180 livestock have been lost, so far
Vector-Borne Diseases	Malaria, dengue fever	Malaria, dengue	Malaria, dengue	Consistent with prior trends, surprisingly tick-borne and mite infections may remain under reported
Zoonotic diseases	Brucellosis, listeriosis	Anthracis, brucellosis and leptospirosis	Rabies, foodborne diseases	Estimates may include prior illness, AMR etc
Animal diseases	~ 30-40% animals in flooded areas showed symptoms of FMD and brucellosis	Reported 40-50% of different veterinary illness cases	Rabies/ leptospirosis, FAO around 30% livestock affected or died from infections	Projections may vary from past trends
Animals at risk 2025	Millions of animals were at risk	Millions of animals were at risk	Millions of animals were risked	Pakistan has 50-53 M cattle, 43M buffalo, 81 M goats, 31.5 M sheep, 1.2 M camels, and almost 1 B poultry birds (PES, 2022-23)
AMR estimates	Increased E. coli and Salmonella MDR (multi-drug resistant) strains, estimated that 40-50% of isolates were from flood-affected regions	Up to 60% of clinical isolates from patients in flood-affected areas with focus on gram-negative bacteria and multidrug-resistant (MDR) tuberculosis	World Health Organization highlighted the growing AMR, with over 60% of urinary tract infections (UTIs) caused by E. coli resistant to first-line antibiotics in affected areas	Cope-up and better response may lead to put a constraint
Mycotoxicosis	Aspergillus and Fusarium species	Aflatoxins and ochratoxins	Pakistan Agricultural Research Council (PARC) estimated around 25-30% stored grain in flood-affected areas was aflatoxin contaminated	Estimated to cause one health implications

Diseases estimated:

Increased zoonotic diseases, food poisonings while standing water creates breeding ground for vectors. Animals at risk accounts for most in Central Punjab which hosts major broiler farms currently stranded by floods. While buffaloes have advantage of being water animal rest every livestock species is at high risk. Mass migration will lead to more human- human or animal-human, wild birds or animals and animal- animal interactions leading to malignant spread of diseases. Also electrocution by electricity or thunder lightning strikes may lead to mortality. AMR Post-Floods is a direct result of unsupervised antibiotic usage in camps and relief treatments. The flooding leads to poor sanitation, further accelerating AMR rates. A significant resistance in E. coli, Salmonella, and Shigella and in animal populations due to self-medication and lack of veterinary control in disaster settings may be recorded.

2025 Flash flood footprints:
Eastern rivers, Ravi, Sutlej and Chenab face exceptionally high flooding, by upstream releases and intense rains affecting 2 million people in Punjab. While 1.6 million people remain at risk in Sindh.
Satellite based evidence as of 29 Aug shows around 1.2 million ha area inundated including 0.8 million ha croplands country wide.
Relief activities, 1,219 relief camps have been established, where 36,550 people are being provided relief, whereas 780,303 people have been rescued in multiple rescue operations.
Conclusion:
Each of these floods caused devastating health outcomes, with long-lasting public and veterinary nature of these disasters, underscores need for ongoing investment in flood management, infrastructure, and public health systems in Pakistan.
The devastating floods in Pakistan in the 21st century, particularly in 2010, 2013, 2022, and now will contribute to spread of emerging and re-emerging infections. Aftermath of such catastrophic events, is a marked increase in incidence of health threats due to environmental changes, lack of access to healthcare, breakdown of sanitation systems and disrupted vaccination programs.

Cites to follow for floods updates and backdates: