Current issues and gaps in the implementation of rabies prevention in Ukraine in recent decades
AbstractUkraine remains the only country in Europe where rabies is widespread among animals and humans. Annually there are about 1,600 rabies cases in animals in Ukraine and sporadic cases in humans have been registered despite the conducting of preventive measures. Therefore, the aim of the study was to inspect the failures in rabies prevention, indicate the top reasons for human cases and highlights the risk of animal attacks in view of their species and geographical distribution in Ukraine during 1996–2020. The following archival state materials were used for analysis: from the Ministry of Health of Ukraine and from the annual reports of oblast departments of the State Service of Ukraine for Food Safety and Consumer Protection. In general, more than 84,000 people (187.4 per 100,000 of the population) were affected by bites or harmful contact with animals every year, among them, 2,155 people were victims of rabid animals. Post-exposure prophylaxis (PEP) was prescribed annually, on average, for 21,434 patients (25.5% of all victims). Most people were attacked by cats and dogs that had owners (71.5%). The frequency of the proportion of the risk of attacks by rabid dogs on humans was (1:124), from cats (1:25), wild animals (1:7), and farm animals (1:2), but the largest general proportion of animal attacks on people was from dogs – 838,635 attacks (77.7%). Thus, due to the permanently higher level of contact with people, attacks by dogs remains more dangerous. Geographically attacks on humans by domestic carnivores were observed most commonly in the east part of Ukraine due to the high urbanization of the region and the high density of the human population. A large number of attacks by foxes was observed in the west part of Ukraine due to the larger area of forests and fields. During the last 25 years, there have been 63 human rabies cases. The main sources of rabies were dogs (24 cases) and cats (22 cases). The main causes of development of rabies were: failure to receive the PEP due to the absence of a visit to a hospital after an attack of an animal (n = 38), failures in prescribing PEP (n = 15), failure of PEP (n = 10). In conclusion, the gaps in the control measures against rabies are the lack of agreed coordination of inter-sectoral links, the lack of significant efforts to raise public awareness and the lack of funding for prophylaxis programmes for humans and animals. Our future research will be aimed at modelling the transmission of rabies from the pet population to humans.
Acharya, K. P., Acharya, N., Phuyal, S., Upadhyaya, M., & Lasee, S. (2020). One-health approach: A best possible way to control rabies. One Health, 10, 100161.
Anderson, A., Kotze, J., Shwiff, S. A., Hatch, B., Slootmaker, C., Conan, A., Knobel, D., & Nel, L. H. (2019). A bioeconomic model for the optimization of local canine rabies control. PLoS Neglected Tropical Diseases, 13(5), e0007377.
Antonova, L., Makovska, I., & Krupinina, T. (2021). Istoriya bor'by s beshenstvom v Ukraine so vremen Pastera do nashih dnej [The history of the elimination of rabies in Ukraine from the time of Pasteur to the present day]. Actual Infectiology, 9(1), 1–12 (in Russian).
Baghi, H. B., Alinezhad, F., Kuzmin, I., & Rupprecht, C. E. (2018). A perspective on rabies in the Middle East-beyond neglect. Veterinary Science, 5(3), 67.
Baker, L., Matthiopoulos, J., Müller, T., Freuling, C., & Hampson, K. (2020). Local rabies transmission and regional spatial coupling in European foxes. PLoS One, 15(5), e0220592.
Botvinkin, A., & Kosenko, M. (2004). Rabies in the European parts of Russia, Belarus and Ukraine. In: King, A. A., Fooks, A. R., Aubert, M., & Wandeler, A. I. Historical perspective of rabies in Europe and the Mediterranean Basin. World Organization for Animal Health, Paris. Pp. 47–63.
Brookes, V. J., Dürr, S., & Ward, M. P. (2019). Rabies-induced behavioural changes are key to rabies persistence in dog populations: Investigation using a network-based model. PLoS Neglected Tropical Diseases, 13(9), e0007739.
Calvelage, S., Smreczak, M., Orłowska, A., Freuling, C. M., Müller, T., Fehlner-Gardiner, C., Nadin-Davis, S., Höper, D., & Trębas, P. (2020). Population and variant-based genome analyses ofviruses from vaccine-derived rabies cases demonstrate product specific clusters and unique patterns. Viruses, 12(1), 115.
Chikanya, E., Macherera, M., & Maviza, A. (2021). An assessment of risk factors for contracting rabies among dog bite cases recorded in Ward 30, Murewa district, Zimbabwe. PLoS Neglected Tropical Disiases, 15(3), e0009305.
Cliquet, F., Picard-Meyer, E., & Robardet, E. (2014). Rabies in Europe: What are the risks? Expert Review of Anti-Infective Therapy, 12(8), 905–908.
Drozhzhe, Z. (2015). Dynamika poshyrennia skazu v Ukrajini ta Еvropi u 2003–2013 rokakh [Dynamics of the spread of rabies in Ukraine and Europe in 2003– 2013]. Veterinary Biotechnology, 26, 70–76 (in Ukrainian).
Fahrion, A. S., Taylor, L. H., Torres, G., Müller, T., Dürr, S., Knopf, L., de Balogh, K., Nel, L. H., Gordoncillo, M. J., & Abela-Ridder, B. (2017). The road to dog rabies control and elimination – what keeps us from moving faster? Frontiers in Public Health, 5, 103.
Fisher, C., Streicker, D., & Schnell, M. (2018). The spread and evolution of rabies virus: Conquering new frontiers. Nature Reviews Microbiology, 16(4), 241–255.
Fooks, A. R., Cliquet, F., Finke, S., Freuling, C., Hemachudha, T., Mani, R. S., Müller, T., Nadin-Davis, S., Picard-Meyer, E., Wilde, H., & Banyard, A. C. (2017). Rabies. Nature Reviews Disease Primers, 3, 17091.
Franka, R., & Wallace, R. (2018). Rabies diagnosis and surveillance in animals in the era of rabies elimination. Revue Scientifique et Technique de l’OIE, 37(2), 359–370.
Freuling, C., Hampson, K., Selhorst, T., Schröder, R., Meslin, F., Mettenleiter, T., & Müller, T. (2013). The elimination of fox rabies from Europe: Determinants of success and lessons for the future. Philosophical Transactions of the Royal Society: Biological Sciences, 368, 20120142.
Gholami, A., & Alamdary, A. (2020). The world rabies day 2020: Collaborate and vaccinate. Iranian Biomedical Journal, 24(5), 264–268.
Grigoryan, G. V., & Metlin, A. Y. (2016). Global financial crisis as a challenge for prevention of human rabies in the former soviet republics. Austin Virology and Retro Virology, 3(1), 1016.
Hampson, K., Coudeville, L., Lembo, T., Sambo, M., Kieffer, A., Attlan, M., Barrat, J., Blanton, J. D., Briggs, D. J., Cleaveland, S., Costa, P., Freuling, C. M., Hiby, E., Knopf, L., Leanes, F., Meslin, F. X., Metlin, A., Miranda, M. E., Müller, T., & Dushoff, J. (2015). Estimating the global burden of endemic canine rabies. PLoS Neglected Tropical Diseases, 9(5), e0003786.
Klein, A., Fahrion, A., Finke, S., Eyngor, M., Novak, S., Yakobson, B., Ngoepe, E., Phahladira, B., Sabeta, C., De Benedictis, P., Gourlaouen, M., Orciari, L. A., Yager, P. A., Gigante, C. M., Knowles, M. K., Fehlner-Gardiner, C., Servat, A., Cliquet, F., Marston, D., & Freuling, C. M. (2020). Further evidence of inadequate quality in lateral flow devices commercially offered for the diagnosis of rabies. Tropical Medicine and Infectious Disease, 5(1), 13.
Kornienko, L. E., Moroz, O. A., Mezhensky, A. O., Skorokhod, S. V., Datsenko, R. A., Karpulenko, M. S., Polupan, I. M., Dzyuba, Y. M., Nedosekov, V. V., Makovska, I. F., Hibaliuk, Y. O., Sonko, M. P., Tsarenko, T. M., & Pishchanskyi, O. V. (2019). Epizootolohichni ta epidemiolohichni aspekty skazu v Ukraуini za period 1999–2018 rr. [Epizootological and epidemiological aspects for rabies in Ukraine for the period from 1999 to 2018]. Veterinary Science, Technologies of Animal Husbandry and Nature Management, 3, 90–109 (in Ukrainian).
Makovska, І. (2020a). Modelling the spread of rabies in Ukraine. Ukrainian Journal of Veterinary Sciences, 11(3), 33–45.
Makovska, I. (2020b). Novitni pidkhody do analizu epizootychnoi sytuatsii zi skazu v Ukraini [New approaches to the analysis on epizootic situation of rabies in Ukraine]. The Animal Biology, 22(1), 31–35 (in Ukrainian).
Makovska, I., Nedosekov, V., Kornienko, L., Novokhatny, Y., Nebogatkin, I., & Yustyniuk, V. (2020). Retrospective study of rabies epidemiology in Ukraine (1950–2019). Theoretical and Applied Veterinary Medicine, 8(1), 36–49.
Makovska, I., Nedosekov, V., Polupan, I., & Latmanizova, T. (2018). Analiz trendu poshyrennnia skazu kotiv v Ukrajini [Distribution trend rabies in cats in Ukraine]. Scientific Messenger of LNU of Veterinary Medicine and Biotechnologies, 20(92), 18–23 (in Ukrainian).
Meyerhoff, P., Manekeller, S., Saleh, N., Boesecke, C., Schlabe, S., Wasmuth, J., Bremen, K., Eis-Hübinger, A. M., von Fischer-Treuenfeld, J., Menting, T., Rockstroh, J., & Schwarze-Zander, C. (2021). Rabies post-exposureprophylaxis in Germany – what are the challenges? Epidemiology and Infection, 506, 1–10.
Mogilevsky, B. Y. (1997). Praktycheskaia rabyolohyia [Practical rabiesology]. Naddnipryanochka, Kherson (in Russian).
Müller, T., & Freuling, C. M. (2020). Rabies in terrestrial animals. In: Fooks, A. R., & Jackson, A. C. (Eds.). Rabies. Fourth Edition. Academic Press, Elsevier, Greifswald-Insel Riems. Pp. 195–230.
Picard-Meyer, E., Robardet, E., Moroz, D., Trotsenko, Z., Drozhzhe, Z., Biarnais, M., Solodchuk, V., Smreczak, M., & Cliquet, F. (2012). Molecular epidemiology of rabies in Ukraine. Archives of Virology, 157(9), 1689–1698.
Polupan, I. M., Nedosekov, V. V., Stepanova, T. V., Rudoi, O. V., Parshikova, A. V., & Drozdova, E. I. (2021). Molecular characteristics isolates of rabies virus isolated from humans in Ukraine. IOP Conference Series: Earth and Environmental Science, 677, 042025.
Regea, G. (2017). Review on economic importance’s of rabies in developing countries and its controls. Archives of Preventive Medicine, 2(1), 15–21.
Robardet, E., Bosnjak, D., Englund, L., Demetriou, P., Martin, P., & Cliquet, F. (2019). Zero endemic cases of wildlife rabies (Classical Rabies Virus, RABV) in the European Union by 2020: An achievable goal. Tropical Medicine and Infectious Disease, 4(4), 124.
Roebling, A. D., Johnson, D., Blanton, J. D., Levin, M., Slate, D., Fenwick, G., & Rupprecht, C. E. (2014). Rabies prevention and management of cats in the context of trap-neuter-vaccinate-release programmes. Zoonoses and Public Health, 61(4), 290–296.
Rupprecht, C. E., & Salahuddin, N. (2019). Current status of human rabies prevention: Remaining barriers to global biologics accessibility and disease elimination. Expert Review Vaccines, 18(6), 629–640.
Shwiff, S., Hampson, K., & Anderson, A. (2013). Potential economic benefits of eliminating canine rabies. Antiviral Research, 98(2), 352–356.
Taylor, E., Del Rio Vilas, V., Scott, T., Coetzer, A., Prada, J. M., Alireza, G., Alqadi, N. A., Berry, A., Bazzal, B., Barkia, A., Davlyatov, F., Farahtaj, F., Harabech, K., Imnadze, P., Mahiout, F., Majeed, M. I., Nedosekov, V., Nel, L., Rich, H., & Horton, D. (2021). Rabies in the Middle East, Eastern Europe, Central Asia, North Africa: Building. Journal of Infection and Public Health, in press.
Wallace, R., Undurraga, E., Blanton, J., Cleaton, J., & Franka, R. (2017). Elimination of dog-mediated human rabies deaths by 2030: Needs assessment and alternatives for progress based on dog vaccination. Frontiers in Veterinary Science, 4, 9.
Warembourg, C., Wera, E., Odoch, T., Bulu, P. M., Berger-González, M., Alvarez, D., Abakar, M. F., Maximiano Sousa, F., Cunha Silva, L., Alobo, G., Bal, V. D., López Hernandez, A. L., Madaye, E., Meo, M. S., Naminou, A., Roquel, P., Hartnack, S., & Dürr, S. (2021). Comparative study of free-roaming domestic dog management and roaming behavior across four countries: Chad, Guatemala, Indonesia, and Uganda. Frontiers in Veterinary Science, 8, 617900.
World Health Organization (2018). WHO expert consultation on rabies. WHO Press World Health Organization, Geneva. Pp. 3–15.
Yoder, J., Younce, E., Lankester, F., & Palmer, G. H. (2019). Healthcare demand in response to rabies elimination campaigns in Latin America. PLoS Neglected Tropical Diseases, 13(9), e0007630.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons «Attribution» 4.0 License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.