Ukraine remains the only country in Europe where rabies is widespread among animals and humans. Annually there are about 1,600 rabies cases in animals in Ukraine and sporadic cases in humans have been registered despite the conducting of preventive measures. Therefore, the aim of the study was to inspect the failures in rabies prevention, indicate the top reasons for human cases and highlights the risk of animal attacks in view of their species and geographical distribution in Ukraine during 1996–2020. The following archival state materials were used for analysis: from the Ministry of Health of Ukraine and from the annual reports of oblast departments of the State Service of Ukraine for Food Safety and Consumer Protection. In general, more than 84,000 people (187.4 per 100,000 of the population) were affected by bites or harmful contact with animals every year, among them, 2,155 people were victims of rabid animals. Post-exposure prophylaxis (PEP) was prescribed annually, on average, for 21,434 patients (25.5% of all victims). Most people were attacked by cats and dogs that had owners (71.5%). The frequency of the proportion of the risk of attacks by rabid dogs on humans was (1:124), from cats (1:25), wild animals (1:7), and farm animals (1:2), but the largest general proportion of animal attacks on people was from dogs – 838,635 attacks (77.7%). Thus, due to the permanently higher level of contact with people, attacks by dogs remains more dangerous. Geographically attacks on humans by domestic carnivores were observed most commonly in the east part of Ukraine due to the high urbanization of the region and the high density of the human population. A large number of attacks by foxes was observed in the west part of Ukraine due to the larger area of forests and fields. During the last 25 years, there have been 63 human rabies cases. The main sources of rabies were dogs (24 cases) and cats (22 cases). The main causes of development of rabies were: failure to receive the PEP due to the absence of a visit to a hospital after an attack of an animal (n = 38), failures in prescribing PEP (n = 15), failure of PEP (n = 10). In conclusion, the gaps in the control measures against rabies are the lack of agreed coordination of inter-sectoral links, the lack of significant efforts to raise public awareness and the lack of funding for prophylaxis programmes for humans and animals. Our future research will be aimed at modelling the transmission of rabies from the pet population to humans.

Rabies remains the oldest viral zoonotic disease, which always ends in death and which is now widespread throughout the world and causes an annual death of about 60 thousand people. Since rabies eradication in Ukraine continues over 135 years, our goal was to remind about the problems and successes of providing control rabies in different periods of the epizootic process in the last century, to remind the main specific features of infection and show real problems today. Materials for the analysis were archival data of reports of regional sanitary-epidemiological agencies, LV Gromashevsky Institute of Epidemiology and Infectious Diseases, Laboratory of Neuroinfections of IVM NAAS of Ukraine, as well as the reports of regional departments of veterinary medicine of the State Food and Consumer Service of Ukraine. It has been shown that epizootic peaks were observed in certain historical periods. During the first period of urban rabies (dogs), mass vaccinations of dogs in combination with strict regulation of the number of homeless animals proved to be effective. The second period of fox rabies lasted 30 years, of which almost 20 years were relatively successful, which was facilitated by the strictest implementation of measures to regulate the density of foxes in all regions of Ukraine. At the beginning of the XXI century, the intensity of the epizootic process sharpened. At the same time, in all areas, the density of foxes was no longer maintained at an accep­table level and the incidence of foxes increased almost 20 times. Oral vaccination started in 2001, is still not fully implemented. Vaccination of domestic carnivores also does not reach the required level of coverage of 70 % of the population. Homeless animals are also vaccinated, although it has long been proven that under constant stress and hypothermia, the vaccine does not cause the production of antibody titers to a protective level. Thus, currently, the main problem in order to preserve a human from rabies is dogs. Thus, in 2019, 51,232 people were attacked by dogs. In total, in 2019, 73,962 people applied for rabies assistance, and 21,980 people were vaccinated. There were 4039 people with severe bites, of which 1161 were bitten by sick animals with a confirmed diagnosis and 777 people were attacked by wild animals (1938 people were saved from death), and 16,113 people were injured by light bites (73.3 % of the total vaccinated) were given 10 days to determine the danger of the bite, but failed to do so as the animal escaped. Due to this category of victims, the number of vaccinated increases sharply. It is important to note that each bite by a stray dog for the people is a punishment, and a course of rabies vaccinations costs about 6 thousand UAH depending on the degree of the bite, so the question of regulation of the number of stray dogs and the feasibility of their vaccination remains open.