Two Sylvatic Rabies Re-Emergences in Central-Eastern Europe over the 2021-2022 Period: An Unprecedented Situation in Recent Years.

The implementations of coordinated, standardised, and sustained oral rabies vaccination (ORV) campaigns over large areas have led to the almost elimination of sylvatic rabies from the European Union (EU) territory at the approach of 2020. The annual number of rabies cases reported within EU territory indeed dropped from around 13,000 cases in 1990 to less than 10 cases over the 2017-2019 period. Unfortunately, since 2020, the EU territory has faced two major rabies re-emergence events of rabies lyssavirus in non-flying animals. The first sylvatic rabies outbreak, already described, occurred in 2021 and 2022 in Poland in the Mazowieckie voivodeship, involving the Central Europe variant, while the second one affecting Romania, Hungaria, and Slovakia, increased considerably at the end of 2022 and involved the North East Europe variant only. Thus, Hungary and Slovakia that did not record a single case since 5-7 years, respectively, faced new rabies outbreaks in 2022. This article, therefore, presents these two epidemiological events and discusses the importance and challenges of maintaining ORV programmes and immune belts in the long term, particularly in a complicated context of a pandemic affecting organisation of human societies and of geopolitical conflicts.