“There are a lot of stray animals now. They often come into contact with wild animals, so the risk of rabies infection has increased dramatically. We see 5–10 people with bites a day. Sometimes whole families come to us,” explains Dr Oleksandr Kovalchuk, an orthopaedic traumatologist working in Ukraine.
Since the start of the full-scale war in 2022, frontline areas of Ukraine have become a dangerous environment for the spread of rabies, one of the world’s deadliest viruses.
The Balakliya Clinical Hospital in the Kharkiv region reports that the number of bite cases has increased several times. Many pets and cattle were left unattended when their owners were forced to evacuate urgently. At the same time, wild animals – foxes, wolves, raccoons – are migrating from combat zones to safer places, which often means populated areas.
When wild animals enter cities, they can attack unexpectedly: at petrol stations and even in courtyards. There have also been more frequent cases of cats attacking children and adults. The hostilities have therefore changed not only the lives of people, but also those of animals.
“People try to help stray animals, which poses a danger,” adds Dr Kovalchuk about the threat of rabies in the frontline regions.
Fewer animals vaccinated
The war has also led to a decrease in animal vaccination rates. In several areas, especially in forests near regions which border the frontline, physical access is restricted. These areas are now inhabited by large animal populations.
Preventive and anti-epidemic measures, including animal vaccination and particularly the aerial distribution of vaccines, are limited in these areas due to the security situation.
Animal culling is also restricted under martial law, to avoid gunshots being misinterpreted.
Supplying vaccines and saving lives
The threat is real for everyone. Dr Kovalchuk recalls an incident where a rabid cat attacked a baby in a pram. The parents quickly sought medical help and managed to avoid serious consequences.
“Once the rabies virus infects the nervous system, there is no cure. If you don’t get vaccinated quickly before symptoms appear, the mortality rate is 100%,” explains Yuriy Hniedushkin, head of the trauma department at Balakliya Clinical Hospital in Kharkiv region.
Post-exposure prophylaxis consists of thorough washing of the wound, a series of rabies vaccine doses promptly started after an exposure and, if indicated, infiltrating rabies immunoglobulins into and around the wound.
Having a sufficient supply of vaccines and immunoglobulin in hospitals is therefore critical to saving lives.
WHO continues to provide technical support to Ukraine and supplies it with the necessary immunobiological products. Hospitals are stocked with vaccines delivered by the WHO Country Office in Ukraine, with the support of the King Salman Humanitarian Aid and Relief Centre.