During the last few decades, bat lyssaviruses have become the topic of intensive molecular and epidemiological investigations. Since ancient times, rhabdoviruses have caused fatal encephalitis in humans which has led to research into effective strategies for their eradication. Modelling of potential future cross-species virus transmissions forms a substantial component of the recent infection biology of rabies. In this article, we summarise the available data on the phylogeography of both bats and lyssaviruses in Europe and the adjacent reg ions, especially in the contact zone between the Palearctic and Ethiopian realms. Within these zones, three bat families are present with high potential for cross-species transmission and the spread of lyssaviruses in Phylogroup II to Europe (part of the western Palearctic). The lack of effective therapies for rabies viruses in Phylogroup II and the most divergent lyssaviruses generates impetus for additional phylogenetic and virological research within this geographical region.

Rhinoviruses (RV) are one of the most common causative agents of respiratory infections, with significant socioeconomic impact. RV infections are not notifiable in Bulgaria, and little is known about the different RV genotypes circulating in the country. This study aims to investigate the diversity of RV genotypes that were circulating in Bulgaria in the period 2018–2021 in samples from ILI/ARI patients. Genotype assignment was based on sequencing and phylogenetic analysis of the 5′ untranslated region and the VP4-VP2 region. Out of a total of 1385 nasopharyngeal swabs tested, 166 were RV-positive (RV detection rate: 11.99% (166/1385)). Those with a cycle threshold <25 were selected for genotyping (n = 63). RV isolates were successfully genotyped and classified into 34 genotypes within Rhinovirus A (RV-A), Rhinovirus B (RV-B) and Rhinovirus C (RV-C) species. Presumptive recombination events between the 5′UTR and VP4-VP2 regions were detected in three of the isolates. RV-A and RV-C were the prevalent RV species, with significantly more frequent detections of RV-A in the years before the COVID-19 pandemic compared to the post-pandemic period, when RV-C prevailed. The present study is the first to determine RV genotypes in Bulgaria and the circulation of RV-C has been described for the first time in the country.

In 2018, an increase in echovirus 30 (E30) detections was reported in some European countries. To assess the circulation and phylogenetic relationships of E30 in Bulgaria, E30 samples identified at the National Reference Laboratory for Enteroviruses, National Centre of Infectious and Parasitic Diseases, Bulgaria (NRL for Enteroviruses) in 2017 and 2018 were subjected to sequencing and phylogenetic analysis. The present study revealed that sample positivity did not significantly increase in Bulgaria during the European upsurge. E30 was identified in six patients, two of whom were epidemiologically linked. The maximum-likelihood phylogenetic tree showed that sequences from five patients belonged to the G1 lineage (clades G1a and G1b). The sequence from one patient belonged to the G2 lineage and was grouped closer to sequences from the last E30 outbreak in Bulgaria in 2012. No recombination events were detected. The European E30 upsurge in 2018 was caused by two clades, and one of them was G1. The fact that the majority of the Bulgarian samples belonged to G1 indicated that the virus was present in the country but did not cause a local upsurge. Phylogenetic and epidemiological data indicated sporadic E30 cases and a possible shift towards G1 lineage in 2017 and 2018.

The communication practices of general practitioners in relation with vaccines have not been a topic of wide scientific interest. In this article, we outline them in the context of Bulgaria. A representative, cross-sectional, quantitative, face-to-face survey was conducted among 358 Bulgarian general practitioners in 2022 using simple random sampling. We conducted an exploratory factor analysis using questions about the role of the GPs, which measure models of communication. Based on the factor analysis, we distinguished four communication styles. They were called: active communicator, restrictive communicator, informing communicator, and strained communicator. One-way ANOVA and the T-test were carried out to explore the connections between factor scores (communication styles) and other variables. One of the most important results in the study was that the informing physician (emphasizing the choice of the parents) was the most common model in Bulgaria. This is somewhat contradictory, because of the mandatory status of most vaccines. We found connections between the communication styles and other variables—such as the type of settlement, having a hesitant parent in the practice, recommendations of non-mandatory vaccines, and experience with vaccine-preventable diseases. On the basis of the factor analysis and analysis of relationships with other variables, we reached the conclusion that in Bulgaria, hesitant parents are not sufficiently involved in active, effective communication about vaccines by GPs.

Background: Human non-polio enteroviruses (NPEVs) are a diverse group of RNA viruses belonging to the genus Enterovirus within the subfamily Ensavirinae of the family Picornaviridae. They are responsible for a wide range of diseases, ranging from mild febrile illnesses to severe neurological conditions. Accurate isolation and genetic identification are critical for understanding their epidemiology, evolution, and pathogenic potential. Aim: This study aimed to isolate NPEVs from clinical specimens, perform molecular identification through RT-PCR, and analyze viral sequences of parts the viral genome to elucidate their molecular genotyping. Materials and methods: Clinical specimens from patients presenting with neurological, febrile illnesses, or HFMD were collected between 2021 and 2024 and were sent to NRL “Enteroviruses” for testing. All samples were tested using viral isolation and microneutralization. Direct molecular detection of enterovirus RNA was performed by real-time RT-PCR. Partial VP1 gene sequences were used for genotyping after Sanger sequencing of the target region. Results: Successful serotyping via microneutralization was obtained for 9 isolates, which resulted in the identification of 4 echovirus 11 (E11), one echovirus 2 (E2), two coxsackievirus B (CVB), one echovirus 25 (E25), and one echovirus 6 (E6) strains. Molecular genotyping revealed multiple genotypes predominantly belonging to Enterovirus alphacoxsackie species, including CVA6, CVA16, CVA4, CVA2, and EV-A71. From Enterovirus betacoxsackie species E11, E9, E3, and E2 were detected. Conclusion: Despite the incomplete enterovirus surveillance in Bulgaria and nonsystematic approach for NPEV detection, we managed to identify different virus strains in various clinical settings. Our study underscores the importance of combining virus isolation with molecular techniques for accurate identification of NPEVs, as well as the necessity of continuous monitoring of NPEVs.