1. Epidemiology of Rabies in Southeast Europe
Nicholas Johnson
Rabies and Wildlife Zoonoses Group
WHO Collaborating Centre for the Characterization of Rabies and Rabies-Related Viruses

2. Introduction
Rabies is endemic within many countries of south east Europe
The fox is the principal reservoir species but dog rabies cases still reported
Few epidemiological studies reported from the region
Identify factors that contribute to epidemiology
Lack of knowledge hampers vaccination programmes

3. Southeast Europe (the Balkans)

4. The Balkan Peninsular Poland Russia Czech Republic Ukraine Slovakia
Austria
Hungary
Slovenia
Romania
Croatia
Bosnia and
Herzegovina
Serbia
Bulgaria
Mac
Albania
Greece
Turkey

5. Cohort Details Country (Cases 2005) Fox Dog Jackal Human Other
Not recorded
[Total]
Bosnia-Herzegovina (36) 10 3 4 17
Bulgaria (8) 5 2 1 12
Georgia
Serbia & Montenegro (101)
Hungary (9)
Poland (138)
Romania (530) 9
Russia (3087)
Slovak Republic (50)
Turkey (193) 7 21 75

6. Isolate details Code No. Country Region Species Year Genbank Accession
Number 5
Bulgaria
Lovech
Fox
2003
DQ300293
1279
Romania
Iolomita ? -
RV1124
Turkey
Manisa
2000
AY091610

7. Region of the Genome N P M G L 327 nucleotides
TTATCGTGGATCAATATGAGTACAAGTACCCTGCCATCAAAGATTTGAAAAAGCCCTGTATAACTCTAGGAAAGGCTCCC
GATTTAAATAAAGCATACAAGTCAGTTTTATCATGCATGAGCGCCGCCAAACTTGATCCTGACGATGTATGTTCCTATTT
GGCGGCGGCAATGCAGTTTTTTGAGGGGACATGTCCGGAAGACTGGACCAGCTATGGAATCGTGATTGCACGAAAAGGAG
ATAAGATCACCCCAGGTTCTCTGGTGGAGATAAAACGTACTGATGTAGAAGGGAATTGGGCTCTGACAGGAGGCATGGAA
CTGACAAGAGACCCCAC

8. Phylogenetic analysis of RABV sequences from Southeastern Europe
Bulgaria
SAD B19
Eastern Turkey
Pasteur
Romania
Western Turkey
Romania / Russia
Bosnia-Herzegovina

9. Phylogenetic tree of Eastern European Isolates
Central Romania
Wave 1: Western Turkey
Western Turkey
Bosnia-Herzegovina
Outgroup
Bulgaria *
Eastern Romania / Russia
0.01 substitutions / site *
Bootstrap values > 700

10. Romania
Romania / Russia
Romania / Poland

11. Bulgaria Targovishte Dobrich Lovech Montana Pleven Lovech
Former Yugoslavia
Vidin
Montana

12. Bosnia-Herzegovina
Bosnia-Herzegovina
Hungary

13. Conclusions Most isolates fall into the East European group of viruses
Geography dominates isolate clustering
Topography may play a significant role in preventing spread
of fox-rabies
The Danube appears to block movement between Romania
and Bulgaria
Such factors could assist in future vaccination campaigns

14. Acknowledgements Co-Authors
Veterinary Laboratories Agency (UK) AR Fooks
FLI-Wusterhausen (Germany) T Muller, C Freuling
IDT (Germany) A Vos
Etlik CVRI (Turkey) O Aylan
H Un
Natl. Diag. & Res Vet Inst (Bulgaria) R Valtchovski
Inst. Diag. & Animal Health (Romania) M Turcitu
F Dumistrescu
V Vlad
Univ. Sarajevo (Bosnia-Hervegovina) R Velic
Vet. Inst. Of Republika of Srpska V Sandrac
Funding
Defra (UK)