Zoonotic disease outbreaks reported under India's

Background: Timely analysis of zoonotic outbreak surveillance data is critical for assessing the effectiveness of outbreak detection and reporting systems, a priority for global health security. We described the zoonotic disease outbreaks notified under the Integrated Disease Surveillance Program (IDSP) in India between 2018 and 2023 to identify temporal trends and spatial variation. Methods: We conducted a cross-sectional study by reviewing zoonotic disease outbreak line-list data from IDSP weekly outbreak reports and analyzed by year, region, and timeliness of reporting. We conducted a mixed Poisson regression to estimate the change (β coefficient) in outbreaks over the years and visualized maps in R software. Findings: Of the 6948 outbreaks reported in IDSP, 583 (8.3%) were zoonotic, with a median of seven monthly zoonotic outbreaks. Outbreaks significantly increased over the years (β coefficient = 0.07 [0.02-0.12]). Japanese encephalitis accounted for 29.5% of zoonotic outbreaks, followed by leptospirosis (18.7%) and scrub typhus (13.9%). The northeast region contributed 35.8% of zoonotic disease outbreaks, followed by the southern (31.7%) and western regions (15.4%). One-third (34.6%) of outbreaks were reported late, and they declined over the years (52.6% in 2019, 40.9% in 2021, and 5.2% in 2023). The follow-up reports were unavailable for 97.2% of zoonotic outbreaks notified. Interpretation: We documented the regions with high notification of zoonotic disease outbreaks under India's national-level outbreak surveillance system. Critical gaps in weekly outbreak reports were identified, particularly the lack of follow-up documentation. To address these gaps, we recommend strengthening disease-specific surveillance systems in hotspot regions. Funding: The present study is non-funded.