Introduction. On the territory of Russia four species of lyssaviruses (genus Lyssavirus) were identified, three of them caused human deaths. The aim of work: to characterize fatal cases in humans after contacts with bats in the Far East in 20182021 and to perform typing of isolated pathogens. Materials and methods. Lyssavirus infection was confirmed in samples of sectional material from people who died in the Amur Region in 2019, in the Primorsky Krai in 2019 and 2021. Diagnostics was performed by fluorescent antibody test (FAT) and RT-PCR using diagnostic kits of domestic production. Viruses were isolated in a bioassay. The nucleoprotein sequences were analyzed after 1st passage. The analysis of phylogenetic relationships and the construction of a dendrogram were performed using the MEGA7 software. Results. The viruses that caused the fatal cases in humans in the Amur Region and Primorsky Krai share more than 90% identity to Lyssavirus irkut detected in Russia and China. Together they form a separate monophyletic cluster with 100% bootstrap support. Conclusion. On the territory of Russia, monitoring of bat populations for infection with lyssaviruses is relevant. The material of people who died from encephalomyelitis of unknown etiology within 1015 days from the onset of the disease must be examined for lyssavirus infection. It is necessary to develop PCR assays that employ genus-specific primers. The use of molecular biological methods is promising for improving the diagnosis of rabies and epidemiological surveillance, as well as increasing the efficiency of the system of biological safety of the population of the Russian Federation.

In this report, we document and analyze a case in which the Irkut virus (IRKV) (Mononegavirales: Rhabdoviridae) caused a fatal human case following a bat bite in June 2021. Unfortunately, the available data did not permit a detailed taxonomic classification of the carrier bat (Chiroptera). The event occurred in the southwestern part of the Sikhote-Alin mountain region (Russian Far East) covered by the Ussuri taiga forest. The symptoms of the illness began with the following: fever; pronounced psychomotor and motor agitation; tremor of the lower jaw and tongue; aphasia; dyslexia; and dysphagia. These rapidly developed, leading to a severe and fatal encephalitis. The patient was not vaccinated for rabies and did not receive rabies immunoglobulin. Using brain sections prepared from the deceased, molecular diagnostics were performed: immunofluorescence (polyclonal anti-rabies immunoglobulin) indicating the presence of the lyssavirus antigen; and RT-PCR indicating traces of viral RNA. Sectional material (brain) was used for whole-genome sequencing, resulting in a near-complete sequence of the lyssavirus genome. The obtained genomic sequence was identified as the Irkut virus. A comparative analysis of the new sequence and other currently available IRKV sequences (NCBI) revealed differences. Specifically, amino acid differences between antigenic sites in the isolate and those of the rabies vaccine strain used regionally were noted. The patient history and subsequent analysis confirm human IRKV infection following bat contact. Like other fatal cases of IRKV infection described earlier, this case occurred in the southern part of the Russian Far East. Two have occurred in the southwestern part of the Sikhote-Alin mountain region. This indicates the possible existence of an active, natural viral focus.

Objective:To evaluate the historical long-term forecast of the spatial spread of rabies in Siberia and Far East and to characterize modern approaches to spatial forecasting. The concept of spatial spread of rabies in the Asian part of Russia, developed in the 80s of the twentieth century, is subjected to critical analysis based on information on rabies registration for 1881–1980 and zoogeographic data. At that time, 5 rabies enzootic regions were identified, and the most probable directions of further exportation of infection suggested. At first, a review of published data on human and animal rabies cases for the period of 1985–2019 was undertaken (including reference publications). Data on cases of rabies among humans and animals were selected for which geographical coordinates could be determined. Mapping was performed using GIS (QGIS 3.12.0 software and “Natural Earth” and “OpenStreetMap” electronic maps). Comparison of maps for different time periods demonstrated that rabies incidence was recorded mainly within the previously identified risk areas. However, the occurrence of human disease in different regions did not always correspond to the intensity of epizootics and the predicted risk. Next, in an attempt to correct the prognosis of the spatiotemporal rabies spread, we reviewed publications that incorporated virus genetic data along with GIS technology and modeling application. The distribution of the three major rabies virus lineages (“steppe”, “Arctiс-like”, “Arctic”) corresponded to the regions that were previously identified. The spread of fox rabies (the “steppe” rabies virus lineage) in the north-east direction was described. In several instances, rabies outbreaks in southern Siberia and Far East were associated with cross-border movement of the virus from Kazakhstan, Mongolia and China. Data on the speed of the epizootic waves, pathways, and natural barriers for virus spread are discussed. The correction of the forecast for rabies virus circulation and spread is important for the development of control strategies in the region, including oral vaccination of wildlife virus reservoirs.

Relevance. Post-exposure prophylaxis (PEP) is the most effective method for reducing the morbidity and mortality of human rabies. Since 2000, in Russia, domestically produced cultural purified and concentrated rabies vaccine (COCAV) and equine immunoglobulin (AIG) are used as the main drugs for PEP.Aims. To assess the epidemiological effectiveness of post-exposure rabies prophylaxis and possible causes of failure in the Russian Federation in 2001–2018.Materials & methods. A comprehensive retrospective epidemiological study of 167 cases of rabies in humans and PEP statistics in the Russian Federation was carried out. To test the hypotheses about the relationship between PEP failures and risk factors, namely (gender, age, place of residence of the sick, nature of the injuries received, source of infection), two main comparison groups were formed: «vaccinated» (n = 28) and «not vaccinated» (n = 139). In addition, we compared the groups who received PEP correctly and those vaccinated with violations of instructions. The failure rate was assessed in relation to the total number of vaccinated and the number of vaccinated after contact with rabid animals.Results.During the analyzed period, the incidence of human rabies decreased from 0.015 to 0.0013 per 100 thousand population. Of the patients, 83.2% did not receive PEP (did not apply, vaccinations were not prescribed, refused). In the group «vaccinated» in 53.6% (n = 15), the schemes of PEP prescribing and administering were violated, including in 35.7% (n = 10) of cases AIG was not administered. The rest 46.4% (n = 13), received vaccinations in accordance with the instructions. Before the end of the vaccination course, 85.7% (n = 24) fell ill; the rest fell ill with an incubation period of more than three months. Only one person received AIG and all 6 vaccine injections. The group «vaccinated» differed from the group «not vaccinated» by a higher frequency of category III injuries (χ2 = 9.99, p = 0.019) and injuries caused by wild animals, especially wolves (χ2 = 22.24, p < 0.001).Conclusions.Among people who developed rabies in 2001–2018, 16.8% received PEP. The proportion of the number of cases and the total number of those who received PEP was 1: 240.0 thousand. The failure rate of PEP after contact with rabid animals was 0.03% (excluding the nature of the contact and the animal species). More than 70% of all failures are associated with wolf and fox bites, more than 85% with category III injuries.

Rabies is the deadliest zoonotic disease caused by the rabies virus, a member of the genus Lyssavirus. The disease occurs after a bite from a wild or domestic animal. The paper presents a clinical case of rabies with early diagnostic difficulties, particularlyclinical, epidemiological, and laboratory diagnostic features, in a patient suffering from alcoholism. The victim sought medical help 20 days after the dog bite. On day 29, a hydrophobia clinic was observed. The patient exhibited signs of visual and auditory hallucinations, aggressiveness, and disorientation in place and time, which resembled the development of alcoholic psychosis. Saliva samples were collected on day 3 of the disease, and its polymerase chain reaction test was negative for rabies virus. On day 29, the patient died. The diagnosis of rabies was confirmed antemortem and posthumously. The virus was detected in the saliva on day 9 of the disease and posthumously in the cerebral cortex, medulla oblongata, cerebellum, and salivary glands. Histologically, Babesh–Negri bodies were found in the brain tissue. Necessary preventive measures were implemented. The unfavorable outcome in the described case of rabies emphasizes the lack of awareness of the population (especially rural) about the risk of contracting rabies infection through contact with animals and the importance of timely post-exposure prophylaxis. Timely anti-rabies care remains the only effective means of preventing related deaths.

Introduction: Efficacy of rabies immunoprophylaxis has been convincingly proven, but establishing the links between vaccination coverage and changes in rabies incidence in practice can be difficult if epizootics continue. Objective: To identify associations between animal and human vaccination and rabies incidence at the regional level. Materials and Methods: We conducted a retrospective descriptive epidemiological study for the years 2011 to 2024 using data from the veterinary service and the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) on confirmed rabies cases (n = 326), vaccination coverage, and emergency department visits for animal bite injuries. We compared the periods before and after the introduction of oral fox vaccination (2011–2018 vs 2019–2024). The chi-square test, Spearman correlation, and confidence intervals for p < 0.05 (95 % CI) were used in the statistical data analysis while the Natural Earth electronic map and QGIS 3.2.1 software were used for mapping. Results: Until 2011, only dogs were vaccinated. Following the onset of epizootics among foxes (Vulpes vulpes), vaccination coverage was expanded to include farm, pet, and wild animals. Compared to 2011–2018, the growth rate of the number of doses of vaccines for various purposes was +167.3 % in 2019–2014. At the same time, the number of rabies cases decreased at a rate of –59.5 %. The share of farm animals decreased to 13–45 %, while that of wild animals increased to 45–68 %. Rabies in dogs and cats remained sporadic. A high posterior probability (p < 0.001) was demonstrated for the relationship between animal rabies and vaccination coverages of livestock and wild animals. Mapping revealed a reduction in the area of rabies-affected areas. We observed that 5,700 people received post-exposure prophylaxis annually, and 3,600 people received preventive vaccination. The incidence of animal bites ranged from 266.4 to 338.6 per 100,000 population. No cases of human rabies were registered. Conclusion: A significant correlation was established between increased vaccination coverage and the spread of rabies among animals. A change in the type of epizootics and systematic vaccination of the population contributed to the decreased risk of human rabies.