title: Epidemiological management of rabies in Romania.
abstract: BACKGROUND
  Transmission of rabies to humans occurs rarely in Europe but in the absence of vaccination, it almost invariably leads to a fatal disease. In 2007, Romania implemented a program for rabies eradication in foxes.
  
  
  METHODS
  We performed a descriptive study evaluating the trend of rabies disease in Romania, both in animals and in humans, between 2008-2012.
  
  
  RESULTS
  In the past years, a large number of adults have presented to the Antirabic Center of the National Institute for Infectious Diseases "Prof.Dr. Matei Balş", Bucharest, Romania. The major bite-inflicting animals were cats and dogs, particularly stray dogs (more than two thirds of the cases). Most cases of animal rabies were recorded in 2008 (1089 cases), with a subsequent decline in the following years: 516 in 2009, 469 in 2010, and 195 in 2011. Six cases of human rabies have been reported in Romania from 2008 to 2012, two of which were located in the Bacău district. Four of the cases occurred in females, and two in males; half were children and half adults. The animals inflicting the bites were domestic cats and stray dogs in half of the cases.
  
  
  CONCLUSIONS
  Domestic animals, particularly cats, appear to be a major cause of rabies transmission to humans. Therefore, vaccination after cat bites should be taken into account. There is stringent need for specific measures to increase the awareness regarding the problem. People should be educated that cats in rural areas or in the vicinity of forests pose the same level of risk as dogs or wild animals.
  
  
  CONCLUSIONS
  There is need for a new strategy regarding the prevention of animal rabies and its transmission to humans. Proper surveillance systems and continuous monitoring for the disease in wildlife and cities is of utmost importance and should be continued, together with the programs for vaccination of stray dogs and foxes in order to eliminate rabies infection.
authors.affiliation: Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Ramat Gan, Israel.
authors.forename: Hagit
authors.initials: H
authors.lastname: Najar
authors.affiliation: MD, PhD, Lecturer, Department of Infectious Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, National Institute for Infectious Diseases 'Prof. Dr. Matei Balş', Romania.
authors.forename: Anca
authors.initials: A
authors.lastname: Streinu-Cercel
keywords: Rabies; cats; dog bite; epidemiology; eradication; lyssavirus