SUMMARYWe report a major outbreak of rabies in dogs and other domestic animals that occurred in eastern Bhutan between May 2005 and November 2007. The outbreak peaked in February 2006 and subsided by the end of April 2006 with sporadic cases reported until November 2007. Rabies affected 18 of the 40 sub-districts in the three eastern districts of Bhutan. There were reportedly one human and 256 domestic animal fatalities. The outbreak affected cattle (n=141, 55%), dogs (n=106, 41%), horses (n=7, 3%) and cats (n=2, 1%). Rabies was primarily diagnosed by clinical signs but 36 cases were confirmed by fluorescent antibody test of brain samples. High densities and movements of free-roaming dogs might have been responsible for the rapid spread and persistence of the infection for a longer period than expected in dogs in eastern Bhutan.

In 2010, we investigated anthrax outbreak in Bhutan. A total of 43 domestic animals died, and cutaneous anthrax developed in 9 persons, and 1 died. All affected persons had contact with the carcasses of infected animals. Comprehensive preparedness and response guidelines are needed to increase public awareness of anthrax in Bhutan.

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Highly pathogenic avian influenza A(H5N1), clade 2.3.2.1a, with an H9-like polymerase basic protein 1 gene, isolated in Bhutan in 2012, replicated faster in vitro than its H5N1 parental genotype and was transmitted more efficiently in a chicken model. These properties likely help limit/eradicate outbreaks, combined with strict control measures.

Mountainous regions are affected the most by climate change across the world. The livelihood of highlanders primarily depends on livestock farming and natural resources. In Bhutan, yak farming and sale of Cordyceps sinensis (caterpillar fungus)remain the main source of income for most highlanders. We conducted a study to understand the impact of climate change on the community livelihoods in Bhutan. A cross-sectional survey was conducted and interviewed 132 household heads, two focus group discussions of 20 respondents (10 in each group), and key informant interviews (n = 5) in two highland communities (i.e., Laya and Lunana) of Gasa district in northern Bhutan between August 2019 and February 2020. The study revealed that the caterpillar fungus (78.8%) is the major source of income for highland communities which overtook the yak farming practices since its legalization in 2004. More than 80% of households have abandoned yak farming due to its poor economic return because of the decreased utility of yak for meat purposes and other socio-cultural related practices. The majority of the respondents (91%) expressed concern that climate change is posing a threat to the growth and subsequent harvest of caterpillar fungus. The highland people reported emergence of insects/vectors in their community and mosquitoes were the most frequently reported (85%) insect. A small proportion of respondents (1.5%) were concerned about the grazing habitat of the yaks due to the change in the botanical composition of the rangeland. Given that there is a decrease in caterpillar fungus, which is the main source of income for highland communities, this study calls for a climate-resilient community-based economic opportunity for the sustainable livelihood of highland communities. Furthermore, we recommend a detailed study of the negative impacts due to climate change on freshwater resources, the distribution of vectors and vector-borne diseases, and rangeland ecology in the highland.