There has been an increase in the number of rabies cases in animals in Belarus, starting from 1996 with 27 cases, with peaks in 2003 (1077 cases) and 2006 (1628 cases) [1,2]. In comparison, a decade earlier (1988-1995) only sporadic cases of rabies in animals were registered.

Although most cases of rabies in Belarus are found in foxes, raccoon dogs are increasingly affected, with steeply increasing numbers of cases in this species, in line with data from the World Health Organization indicating the increased role of this animal in the rabies epizootic in the European territory. In 1999, in Belarus, there were 65 cases of rabies reported in foxes and five in raccoon dogs, whereas in 2003, 666 foxes and 133 raccoon dogs were found to be infected (a 10- and 27-fold increase respectively). An increase of rabies incidence in other animal species has also been observed, albeit to a lesser extent (grey wolves – seven-fold increase, domestic dogs – eight-fold, domestic cats – four-fold, farm animals – five-fold) [1].

In 2001, a three-year programme was implemented to combat the growing spread of rabies among animals. It consisted of three elements: immunisation of wild animals with oral vaccine in bait, immunisation of domestic animals, and capturing of stray dogs and cats. As a result of these measures, the number of registered rabies cases in animals dropped to 224 in 2004, according to the official data provided by the Belarusian authorities [1].

However, in the following two years, the number of cases peaked again, and the most recent data for January 2007 do not indicate any change in this trend. In 2005, Belarus registered 632 cases of rabies in animals; in 2006 this number increased sharply, reaching 1628, even more than the previous peak noted in 2003 [2]. This year, 91 cases of rabies in animals were reported in January, almost the same number as in the same period last year (92 cases in January 2006) [3].

Data gathered by the WHO Rabies Information System shows lower numbers of cases reported in 2005 and 2006 – 591 and 849 respectively. However, the information on 2006 is not complete and covers only the first half of the year [4].

Rabies cases in humans
The incidence of rabies among animals does not seem to have affected the number of people seeking post-exposure rabies treatment in Belarus. During times when only sporadic cases of rabies in animals were reported, as well as when these numbers peaked, the frequency of requests for post-exposure rabies treatment remained rather high but stable (around 200-250 per million population since the 1990s) [1]. On average, more than 70% of people needing post-exposure rabies treatment had been bitten by dogs, approximately 14% by cats, more than 2% by farm animals and 4.5% by wild animals [1]. For vaccinating humans, cell-culture inactivated rabies vaccine is used routinely.

Between 1951 and 2003, 135 people were reported to have died from rabies [1]. There were no cases of rabies in humans registered in 2004 and 2005. In 2006, however, two people died of this illness: a 43-year-old woman bitten by a cat and a young man bitten by a racoon dog. Neither of them sought medical help before the onset of symptoms [5]*.

Discussion
At present, the epizootic and epidemiologic situation in Belarus is of concern. Due to changes in lifestyle (tourism, summer houses), the number of people, including inhabitants of big cities and tourists who are in contact with potentially rabid wild or domestic animals, is growing. An additional challenge is posed by the neighbouring countries – the highest numbers of rabies cases in animals have been in the north-western region of Belarus, bordering with Latvia and Lithuania. In 2003, in Belarus, about 5 cases of rabies were registered per 1 000 km2, while in Latvia and Lithuania the corresponding figures were 15 and 17 respectively [1]. In 2004, all three countries observed a decrease in the number of reported cases, but this downward trend continued in 2005 and 2006 only in Latvia, In Belarus and Lithuania, the numbers of rabies cases in animals rose again during this time [4].

This report was adapted from reference 1.

*The epidemiological data published monthly on the website of the Belarusian centre of hygiene, epidemiology and public health (http://rcheph.by) only includes rabies cases in animals. The situation in humans is described in the official bulletin: “Rabies in the Republic of Belarus”. The most recent edition, however, covers the first half of 2006 and therefore does not contain information about the human cases, both of which occurred in July. http://rcheph.by/ru/catalog/page_56.html?page=1