{"paper_id":"0ac45d4c-dd51-4f34-a624-40772fd9c679","body_text":"Fifteen-year epidemiological profile of animal rabies in the Marmara region of Türkiye: Evidence for a wildlife-livestock spillover cycle | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Fifteen-year epidemiological profile of animal rabies in the Marmara region of Türkiye: Evidence for a wildlife-livestock spillover cycle Züleyha PESTIL¹, İbrahim SÖZDUTMAZ², Muhammed Arif, Serkan KÖKKAYA³, and 8 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8758251/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Rabies remains a significant endemic disease in Türkiye, showing evolving transmission dynamics despite intensive control efforts. This retrospective study investigates the epidemiological characteristics of animal rabies in the Marmara Region, a critical transitional zone, from 2010 to 2024. A total of 4,017 brain samples obtained from passive surveillance were examined using the fluorescent antibody test (FAT). Partial sequencing of the G gene was performed on selected positive samples to determine viral lineages. Of the examined samples, 651 (16.2%) were confirmed positive. The findings characterize a distinct epidemiological shift from historical dog-mediated transmission toward a sylvatic cycle spilling over to livestock. Cattle accounted for the majority of confirmed cases (65.7%), with infections clustered in provinces characterized by extensive forest-pasture interfaces. Phylogenetic analysis revealed that circulating viruses belonged to the Cosmopolitan-Middle East 2 (ME2) subclade. Following the implementation of nationwide oral rabies vaccination (ORV) campaigns, a marked reduction in laboratory-confirmed rabies cases was observed across the Marmara Region. Wildlife-associated cases declined to zero detections after 2020, accompanied by a parallel decrease in rabies cases among domestic animals. These findings indicate substantial suppression of rabies circulation consistent with the impact of ORV, although continued surveillance is required to confirm sustained control. These results demonstrate that ORV campaigns have successfully suppressed viral circulation in wildlife reservoirs and reduced spillover to livestock in the Marmara Region. However, the persistence of sporadic cases highlights the necessity of sustained wildlife vaccination and enhanced surveillance within a One Health framework to achieve permanent elimination. Rabies Türkiye Marmara oral rabies vaccine Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Introduction Rabies remains one of the most lethal zoonotic diseases worldwide, causing an estimated 59,000 human deaths annually despite the long-standing availability of highly effective vaccines (WHO, 2024 ). Lyssavirus Rabies , formerly referred to as Rabies virus and renamed by the International Committee on Taxonomy of Viruses (ICTV) in 2022, is a single-stranded, negative-sense RNA virus belonging to the genus Lyssavirus within the family Rhabdoviridae and the order Mononegavirales . The viral genome is approximately 12 kb in length and encodes five structural proteins arranged in the conserved order 3′-N-P-M-G-L-5′. The genus Lyssavirus comprises a diverse group of zoonotic viruses, most of which are associated with bat reservoirs, while Lyssavirus Rabies is uniquely maintained in both terrestrial and chiropteran hosts (ICTV, 2024 ). While dog-mediated transmission accounts for most human cases in low- and middle-income countries, many parts of Europe have undergone a marked epidemiological transition in which wildlife, most notably the red fox ( Vulpes vulpes ), became the primary maintenance host (WHO, 2018 ). In the Near East, rabies epidemiology is more heterogeneous, with sylvatic transmission involving multiple canid species, including red foxes and golden jackals ( Canis aureus ), reported across the region (Seimenis, 2008 ; Taylor et al., 2021 ). This transition highlights the inherent complexity of rabies ecology within a One Health framework, where dynamic interactions among wildlife, domestic animals, and human populations jointly shape transmission patterns. Türkiye occupies a strategically important geographic and ecological position at the intersection of Europe, the Middle East, and the Asia region. For several decades, rabies epidemiology in the country was dominated by dog-mediated transmission, reflecting patterns widely observed across the Mediterranean region (Johnson et al., 2010 ). However, following a sustained spill-over from dogs to foxes, fox rabies spread rapidly in the Aegean region of Türkiye. In order to control the outbreak, a program of oral vaccination of foxes against rabies was introduced (Un et al., 2012 ). Accumulating evidence indicates a substantial transition toward wildlife-associated cycles in western Türkiye, particularly involving foxes and jackals (Atıcı and Oğuzoğlu, 2022 ; Aylan et al., 2024 ). Molecular studies have shown that the circulating strains belong mainly to the Cosmopolitan lineage, specifically the Middle East 2 subclade, which is frequently associated with sylvatic transmission across this region (Bourhy et al., 2008 ; Atıcı and Oğuzoğlu, 2022 ). In line with these changing epidemiological dynamics, Türkiye has progressively expanded large-scale oral rabies vaccine (ORV) campaigns, beginning in the Aegean region between 2008 and 2010 (Un et al., 2012 ) and subsequently expanding into central and northwestern provinces. The launch of large-scale ORV in 2019 marked a major strategic milestone, paralleling successful European programs in which fox rabies was eliminated over one to two decades of sustained bait distribution (Freuling et al., 2013 ; Müller et al., 2015 ). Although early findings suggest a substantial reduction in wildlife rabies following ORV (Aylan et al., 2024 ), comprehensive long-term and region-specific epidemiological evaluations remain limited. The Marmara Region is one of Türkiye’s densely populated and ecologically diverse areas, characterized by extensive forest-pasture interfaces, high livestock density, and frequent interactions among domestic animals, stray dogs, and wildlife. Provinces such as Balıkesir, Bursa, and Çanakkale have been repeatedly identified as hotspots for wildlife-mediated rabies (Aylan et al., 2024 ). Within these ecosystems, domestic livestock, including cattle, face increased risk of rabies exposure at the wildlife-livestock interface, especially in areas neighbouring to wildlife habitats where interactions with rabid wild animals are more likely (Atuheire et al., 2024 ). Despite significant national investments in rabies control, including intensified dog vaccination and expanded ORV, the long-term epidemiological impact of these efforts in transitional zones such as Marmara has not been comprehensively documented. Most prior studies are either short-term, limited to molecular characterization, or national in scope without region-level trend analyses. The present study provides a 15-year retrospective evaluation of laboratory-confirmed rabies cases across domestic and wild animals in the Marmara Region (2010–2024). By analyzing temporal patterns, species distribution, and geographic hotspots, this study offers a detailed assessment of the evolving rabies landscape and the measurable influence of large-scale ORV campaigns. The findings generate critical evidence to inform targeted control strategies, strengthen One Health preparedness, and support Türkiye’s long-term rabies elimination objectives. Materials and Methods Ethics and biosafety All diagnostic procedures were conducted in Biosafety Level 2 (BSL-2) laboratories at the Pendik Veterinary Control Institute, following national biosafety regulations and World Organisation for Animal Health (WOAH) standards. All brain samples originated from naturally deceased animals submitted through routine surveillance activities coordinated by the Turkish Ministry of Agriculture and Forestry; therefore, additional ethical approval was not required (Pendik Veterinary Control Institute Animal Experiments Local Ethics Committee Decision No. 03/2023). Oral rabies vaccine and field implementation The Ministry of Agriculture and Forestry implemented Türkiye’s ORV programme in cooperation with the European Commission. The vaccine used, Fuchsoral (SAD B19 strain), is a cell culture-derived attenuated rabies virus vaccine widely adopted in European wildlife control programmes. Each batch was quality-verified at the Etlik Veterinary Control Central Research Institute to confirm a minimum titre of ≥ 10⁶.⁵ FFU/mL before field distribution (Aylan et al., 2024 ). Aerial baiting campaigns were conducted during spring seasons between 2019 and 2021, targeting forested and rural habitats with high fox and jackal densities. Post-distribution monitoring included tetracycline biomarker detection in fox teeth and field surveys conducted in accordance with Türkiye’s national ORV monitoring guidelines (Aylan et al., 2024 ). Study area The study encompassed the Marmara Region of Türkiye, comprising 11 provinces: Balıkesir, Bursa, Çanakkale, Yalova, Sakarya, Kocaeli, İstanbul, Tekirdağ, Edirne, Kırklareli, and Bilecik (Fig. 1 ). This region is characterized by heterogeneous landscapes, including coastal plains, forest-pasture interfaces, and densely populated urban centers, which facilitate frequent interactions among domestic livestock, free-roaming dogs, and wildlife reservoirs. Study design and case definition This retrospective observational study evaluated animal rabies cases submitted to the Pendik Veterinary Control Institute from January 2010 to October 2024. Suspected cases were defined according to WOAH ( 2023 ) criteria: animals exhibiting acute neurological symptoms such as aggression, ataxia, disorientation, dysphagia, and hypersalivation; unexplained sudden death; or a recent history of wildlife interaction or bite exposure Sample collection and transportation Brain samples, including whole heads or specific anatomical regions such as the brainstem, hippocampus, cerebellum, and medulla oblongata, were collected by provincial veterinary authorities during routine field investigations. All samples were transported under cold-chain conditions at 4–8°C and delivered to the reference laboratory within 2–48 hours, in accordance with WHO and WOAH recommendations to ensure diagnostic quality and prevent antigen degradation (Meslin et al., 1996 ; WHO, 2018 ). Laboratory diagnosis and molecular analysis Rabies diagnosis was performed in accordance with the WOAH standards, using the fluorescent antibody test (FAT) as the confirmatory method. Impression smears prepared from brainstem, hippocampus, cerebellum, and medulla oblongata were stained with fluorescein isothiocyanate (FITC)-labelled anti-rabies monoclonal antibody conjugate (Bio-Rad, USA). Slides were examined under a fluorescence microscope for characteristic apple-green fluorescence, indicating the presence of rabies virus antigen. FAT-positive samples were classified as confirmed cases (Ashwini et al., 2024 ). For molecular characterization, FAT-positive samples were utilized in this study. Total RNA extraction was performed using the guanidine-thiocyanate-phenol-chloroform method for FAT-positive tissue samples (Chomczynski and Sacchi, 1987 ). Then, the obtained RNA was converted to complementary DNA (cDNA) according to the RevertAid kit procedure (Thermo Fisher Scientific, USA). Subsequently, cDNA synthesis and PCR were performed using primers targeting the Rabies G gene, as described by Yang et al. ( 2011 ). The amplicon sizes for the G gene were generated at 1052 and 711 bp, respectively. RT-PCR-positive samples were purified from agarose gel using a commercial purification kit (Nucleogene, Türkiye). The purified samples were sent to the Life Sciences sequencing service (Ankara, Türkiye). The Sanger sequence results were assembled and trimmed with Bioedit (version 7.7.1) (Hall et al., 2011) and analyzed with MEGA 11 by using ClustralW and Neighbor-joining (Tamura, et al., 2021 ). After constructing the phylogenetic tree, it was visualized and colored using the iToL online database (Interactive Tree of Life, 2026 ). The lineage names used for the phylogenetic analysis were obtained based on the study by Bourhy et al. ( 2008 ) and Troupin (2016). Temporal trend analysis Temporal trends in rabies incidence were assessed descriptively by evaluating the annual counts of tested samples and FAT-confirmed cases from 2010 to 2024. Yearly positivity rates and graphs were used to illustrate changes over time, including the period before and after the implementation of the ORV campaign. Statistical analysis To evaluate the impact of ORV on regional rabies positivity, two complementary statistical approaches were applied. First, a 2×2 contingency table was constructed to compare laboratory-confirmed rabies positivity between the pre-ORV period (2010–2018) and the post-ORV period (2020–2024). Fisher’s exact test was used to assess differences in positivity rates between periods, given its suitability for categorical data with unequal group sizes. Second, a Chi-square test for trend (Cochran-Armitage test) was conducted to examine whether rabies positivity displayed a statistically significant decreasing trend over time. This approach allowed evaluation of temporal directionality consistent with ORV implementation. All analyses were performed using GraphPad Prism software (version 9.5; GraphPad Software Inc., USA). Results General overview of diagnostic outcomes Between January 2010 and October 2024, a total of 4017 brain samples from animals suspected of rabies were submitted to the Pendik Veterinary Control Institute from the Marmara Region. Among these samples, 651 (16.2%) tested positive by the fluorescent antibody test (FAT), while 3366 (83.8%) were negative. Domestic animals accounted for the majority submissions (97.8%), whereas wildlife species represented a small proportion of samples (2.1%). However, the positivity rate among wildlife species was proportionally higher than that observed in domestic animals. Annual distribution and temporal trends Rabies case numbers fluctuated considerably throughout the fifteen-year study period. An initial increase was observed between 2013 and 2015, followed by a more distinct rise between 2017 and 2019. After the large-scale ORV campaign was initiated in 2019, a marked decline occurred across the region. Confirmed cases dropped from 103 in 2019 to 26 in 2020, and many provinces reported zero cases between 2021 and 2023. Only one cattle case was detected in early 2024, indicating that rabies activity had been substantially reduced (Fig. 2 ). Species distribution of confirmed cases Rabies virus was detected in several domestic and wildlife species throughout the study period. Cattle represented the largest proportion of confirmed cases (n = 428; 65.7%), followed by dogs (n = 68; 10.4%). Notably, only one dog case was detected after 2019. Wildlife-associated cases included foxes (n = 32), jackals (n = 24), and also martens (n = 2), accounting for 8.9% of all confirmed cases. These wildlife detections occurred predominantly before 2020, with no fox-positive samples identified thereafter. Sporadic cases were also observed in cats, sheep, goats, and equines without a consistent temporal pattern (Table 1 ; Figs. 3 – 4 ). Table 1 Distribution of rabies-positive cases by animal species and year in the Marmara Region, Türkiye (2010–2024). The table summarizes the annual number of confirmed rabies cases across seven animal groups: dogs, cats, cattle, goats, sheep, wildlife species (including foxes and jackals), and equines. Years with no positive cases for a specific species are marked as zero. Animals/ Years Dog Cat Cattle Goat Sheep Fox, jackal and marten Horse and donkey Pos. Neg. Pos. Neg. Pos. Neg. Pos. Neg Pos. Neg. Pos Neg. Pos Neg. Pos. for the year Neg. for the year TOTAL 2010 16 80 1 61 14 4 3 2 3 6 3 2 0 4 40 159 199 2011 9 83 4 84 30 13 4 1 2 3 8 3 0 7 57 194 251 2012 12 116 3 107 21 5 0 2 2 0 8 4 1 3 47 237 284 2013 5 101 3 105 39 1 0 0 3 2 12 2 0 10 62 221 283 2014 4 103 3 153 10 1 2 0 5 0 6 0 1 6 31 263 294 2015 6 92 3 181 33 7 7 1 2 0 10 2 0 0 61 283 344 2016 3 77 2 202 46 4 2 0 1 3 4 4 2 1 60 291 351 2017 6 95 0 176 46 7 1 1 4 6 3 2 0 7 60 294 354 2018 6 75 0 209 88 7 1 1 4 6 3 2 0 7 102 307 409 2019 0 73 5 179 81 18 6 2 10 2 1 2 0 1 103 277 380 2020 1 52 3 123 18 1 0 0 4 0 0 2 0 2 26 180 206 2021 0 53 0 95 1 2 0 0 0 2 0 0 0 2 1 154 155 2022 0 42 0 90 0 1 0 0 0 7 0 0 0 0 0 140 140 2023 0 59 0 145 0 2 0 2 0 1 0 2 0 0 0 211 211 2024* 0 53 0 101 1 0 0 0 0 1 0 0 0 0 1 155 156 68 1154 27 2011 428 73 26 12 40 39 58 27 4 50 651 3366 4017 *The data up to October 2024 was taken. Geographic distribution and identification of hotspots Rabies cases were unevenly distributed across the Marmara Region. More than ninety percent of all confirmed cases were concentrated in the provinces of Balıkesir, Çanakkale, and Bursa (Fig. 5 ). These provinces are characterized by extensive forest and pasture ecosystems. In contrast, highly urbanized provinces, including İstanbul, Tekirdağ, and Kocaeli, recorded only sporadic cases throughout the study period. Molecular characterization and bioinformatic analysis Six RT-PCR positive samples obtained from dogs, cattle, and a fox were successfully sequenced targeting the rabies virus glycoprotein (G) gene. All six sequences met quality criteria and were included in subsequent analyses. Sequence alignment demonstrated a high degree of nucleotide similarity among the isolates. The resulting nucleotide sequences were deposited in the GenBank database under accession numbers PV158098-PV158103. Phylogenetic analysis based on the partial G gene region showed that all six isolates clustered within the Cosmopolitan lineage, specifically within the Middle East 2 clade (Fig. 6 ). The isolates grouped closely with previously reported rabies virus strains from Türkiye and neighboring regions. Impact of oral rabies vaccination campaigns Following the ORV campaign from 2019 to 2022, a substantial reduction in confirmed rabies cases was observed across both wildlife and domestic species. Wildlife-associated cases, particularly those in foxes, disappeared after 2020, indicating a marked decrease in viral circulation within the primary reservoir host. A parallel decline in cattle cases suggests that spillover events from wildlife to livestock were also greatly reduced. The consistently low numbers of confirmed cases recorded between 2022 and 2024 support the conclusion that ORV significantly diminished regional rabies activity and disrupted the wildlife-livestock transmission cycle. Statistical analysis A comparison of pre- and post-ORV periods showed a significant reduction in rabies positivity. The positivity rate decreased from 18.8% in the pre-ORV period (520/2769) to 10.5% in the post-ORV period (131/1248). This decline was statistically significant (Fisher’s exact test, p < 0.0001). Temporal trend analysis using the Cochran-Armitage chi-square test indicated a significant downward trend in annual rabies positivity rates (χ² = 56.80, df = 1, p < 0.0001). Discussion This long-term retrospective study, to our knowledge, provides one of the most comprehensive epidemiological assessments of animal rabies in the Marmara Region of Türkiye since the documented shift from dog-mediated to wildlife-associated rabies that began in the late 1990s. Historically, domestic dogs served as the principal reservoir in Türkiye (Johnson et al., 2010 ), and earlier investigations similarly reported high positivity rates among dogs (Akkoca et al., 2004 ). Consistent with these reports, dogs remained an important source of rabies in the Marmara Region until 2018. However, only one dog case was detected between 2019 and 2024. This decline coincided with intensified national control measures, including compulsory vaccination, microchipping, and continued immunization of stray populations, as well as reductions in the circulation of rabies in wildlife, both of which may have contributed to decreased dog-mediated transmission. A critical observation in our study is the synchronized elimination of rabies cases in both wildlife and dogs following the ORV campaigns (2019–2022). Prior to 2019, dog cases were consistently reported annually; however, following the suppression of the virus in red foxes and jackals, dog-mediated cases dropped to near zero (Table 1 ). This parallel decline strongly suggests that the rabies cases observed in dogs in the Marmara Region were predominantly spillover events from a sylvatic reservoir, rather than an independent dog-to-dog transmission cycle. If an autonomous urban rabies cycle had been active among dogs, the wildlife-targeted vaccination (ORV) would not have resulted in such a rapid cessation of canine cases. Therefore, the control of the sylvatic reservoir via ORV appears to have been the decisive factor in interrupting the transmission chain to dogs. Parallel to this decline, wildlife reservoirs, particularly red foxes and golden jackals, appear to have played an increasing role in shaping regional rabies epidemiology. Our findings align with recent molecular and ecological studies showing that sylvatic rabies has become the dominant cycle in western Türkiye (Atıcı and Oğuzoğlu, 2022 ; Aylan et al., 2024 ). Although wildlife submissions accounted for a small proportion of all samples in this study, their positivity rates were relatively high, and case investigations frequently linked livestock infections to exposure near forest edges. These observations parallel patterns described in Europe, where fox-maintained rabies cycles historically caused recurrent spillover to livestock species (Müller et al., 2015 ; Robardet et al., 2019 ; Johnson et al., 2003 ). Cattle were by far the most affected species in the Marmara Region, accounting for 65.7% of all confirmed cases, a pattern also reported in other endemic settings where livestock frequently represent a substantial proportion of rabies detections (Vos et al., 2014 ; Payette-Stroman et al., 2025 ). Field investigations suggested that several infected livestock had recent exposure in areas where domestic animals and wildlife overlap, a context widely recognized as increasing opportunities for cross-species transmission and underscoring the relevance of One Health-based control strategies (Mahamed, 2025 ). The concentration of cases in Balıkesir, Çanakkale, and Bursa underscores the ecological features of these provinces: high livestock density, widespread pasture systems, and close proximity to wildlife habitats. These findings emphasize the importance of considering targeted livestock vaccination, especially in high-risk zones where wildlife-mediated transmission is well established. A notable finding of this study is the profound decline in rabies incidence following Türkiye’s large-scale ORV campaigns. The temporal association between ORV implementation and reductions in confirmed cases is supported by statistical analyses demonstrating significant decreases in positivity rates. These quantitative results provide epidemiological evidence that ORV effectively disrupted viral circulation in wildlife reservoirs and substantially reduced spillover to livestock. Comparable reductions have been reported in European fox rabies elimination programs, where sustained baiting campaigns similarly achieved rapid declines in both wildlife cases and livestock spillover (Freuling et al., 2013 ). The magnitude and direction of the decline observed in the Marmara Region closely mirror these international experiences, supporting the conclusion that ORV has been a decisive driver of rabies control in Türkiye. Nevertheless, as highlighted in previous wildlife rabies studies, the low proportion of wildlife submissions warrants caution, since reduced detection rather than complete elimination may partially contribute to the apparent disappearance of fox cases (Robardet et al., 2019 ). Continued active wildlife surveillance is therefore essential to confirm sustained viral interruption. Although extensive molecular analysis was beyond the scope of this study, Sanger sequencing of selected positive samples revealed that samples from Balıkesir and Bursa clustered within the Cosmopolitan-Middle East 2 (ME2) subclade. Previous phylogenetic studies have consistently shown that ME2 is the predominant lineage circulating in western Türkiye (Atıcı and Oğuzoğlu, 2022 ; Bourhy et al., 2008 ). The detection of this lineage across fox, dog, and cattle isolates supports the conclusion that the same viral variant circulates within interconnected wildlife-livestock networks. A single cattle case detected in early 2024 illustrates that although transmission has sharply declined, the virus has not yet been completely eliminated from the region, and sustained surveillance remains essential. National surveillance data further complement these findings. Rabies-related human exposure reports (PEP applications) increased markedly between 2021 and 2023, despite the decline in confirmed animal cases. Dogs accounted for the vast majority of these exposures. This trend reflects increased human-dog interactions in urban settings rather than widespread dog-mediated rabies. Previous policies allowed municipalities to vaccinate and neuter stray dogs before releasing them back into their environment, contributing to high human-animal contact rates. Although confirmed human rabies cases remain very low, the rising number of exposures imposes substantial economic and public health burdens. Recent policy changes requiring municipalities to shelter stray animals rather than release them may reduce unnecessary exposures, but the long-term impact of these measures warrants further evaluation within a One Health framework. This study has several limitations. The reliance on passive surveillance likely resulted in under reporting, particularly among wildlife and livestock that may die unobserved in remote areas. Annual variation in sample submissions may reflect reporting practices rather than true epidemiological trends. Moreover, the absence of comprehensive molecular characterization and vaccination coverage data limits detailed assessment of viral dynamics and immunization impacts. Nonetheless, the long-term dataset and clear temporal and geographical patterns provide robust evidence supporting the effectiveness of combined control measures, particularly ORV. Conclusion The results of this study highlight the critical importance of coordinated rabies control strategies that target both domestic and wildlife reservoirs. The decline in rabies incidence following ORV implementation demonstrates the effectiveness of wildlife vaccination campaigns. In contrast, the continued success of dog vaccination and identification programs has reduced dog-mediated transmission to historically low levels. Sustained investment in ORV, improved sheltering strategies for stray dogs, and enhanced collaboration between veterinary, wildlife, and public health sectors will be essential for Türkiye to maintain its recent progress and advance toward the global “Zero by 30” rabies elimination goal. Declarations Disclosures The authors declare that they have no competing financial or non-financial interests. Study Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Author Contribution Z.P., İ.S., and H.B. conceived and designed the study and conducted the experimental procedures. A.Ö., M.G., A.S., O.Ü., and M.T. performed the fluorescent antibody test. S.K. and M.A.T. carried out the statistical analyses and contributed to data interpretation. A.V. and O.A. contributed to the conceptual development of the study and to the writing of the manuscript. All authors reviewed and approved the final version of the manuscript. Acknowledgement The authors would like to thank the Pendik Veterinary Control Institute for providing access to the rabies diagnostic data and supporting sample processing. We also thank the staff members of the Regional Veterinary Directorates in the Marmara Region for their assistance in sample collection and data reporting. This study did not receive any specific grant from public, commercial, or not-for-profit funding agencies. 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PLoS Pathog 12(12):e1006041 Un H, Eskiizmirliler S, Unal N, Freuling CM, Johnson N, Fooks AR, Müller T, Vos A, Aylan O (2012) Oral vaccination of foxes against rabies in Turkey between 2008 and 2010. Berl Munch Tierarztl Wochenschr 125(5–6):203–208 Vos A, Un H, Hampson K, De Balogh K, Aylan O, Freuling CM, Müller T, Fooks AR, Johnson N (2014) Bovine rabies in Turkey: patterns of infection and implications for costs and control. Epidemiol Infect 142(9):1925–1933 WHO (2018) WHO Expert Consultation on Rabies: Third report (WHO Technical Report Series No. 1012). World Health Organization, Geneva WHO (2024) Rabies. https://www.who.int/news-room/fact-sheets/detail/rabies . Accessed 29 Jan 2026 WOAH (2023) Manual of diagnostic tests and vaccines for terrestrial animals. World Organisation for Animal Health, Paris Yang DK, Park YN, Hong GS, Kang HK, Oh YI, Cho SD, Song JY (2011) Molecular characterization of Korean rabies virus isolates. J Vet Sci 12(1):57–63 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 09 Mar, 2026 Reviewers invited by journal 04 Mar, 2026 Editor assigned by journal 11 Feb, 2026 Submission checks completed at journal 11 Feb, 2026 First submitted to journal 01 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-8758251\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":false,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":602162970,\"identity\":\"615e0daa-ec5d-42b0-aa26-fda17e51feb4\",\"order_by\":0,\"name\":\"Züleyha PESTIL¹\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"İstanbul Pendik Veteriner Kontrol Enstitüsü\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Züleyha\",\"middleName\":\"\",\"lastName\":\"PESTIL¹\",\"suffix\":\"\"},{\"id\":602162971,\"identity\":\"a518ec50-a0c0-4475-80da-a75b25b8c47a\",\"order_by\":1,\"name\":\"İbrahim SÖZDUTMAZ²\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABB0lEQVRIiWNgGAWjYBACNhDBA2YyHwASEhBhHsJaDEDMBBQtEnitgmjhMUAWwa2Fj//w4Q9v2/5E8/ef+fi4osYisZ//AOODt20MdeYNOBwmkZZgOLfNIHfGgbObDc8ck0icOSOBGSjCICFzAJcWHoNkXqCWhoO92yQbGyQSN9xgYJPmBWrB5TI2/jMGh0Fa5h/mef4TpGX/+QPsv/FqYcgxbAZp2XCMh40RbAtDAhszXi0SacmMc84Z5248w2Ys2XBMwnjGjcRmyTnnJCRn4NAi3w8MsTdlcrnzzh9++LGhpk62v//wQaCIDT/+iEECjg0MjA0MhGISBdgTr3QUjIJRMApGCgAAcHRVXiXmlO8AAAAASUVORK5CYII=\",\"orcid\":\"\",\"institution\":\"Erciyes University\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"İbrahim\",\"middleName\":\"\",\"lastName\":\"SÖZDUTMAZ²\",\"suffix\":\"\"},{\"id\":602162972,\"identity\":\"b96d94d5-31e1-43c4-a4ae-3662d5ae3c07\",\"order_by\":2,\"name\":\"Muhammed Arif\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Erciyes University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Muhammed\",\"middleName\":\"\",\"lastName\":\"Arif\",\"suffix\":\"\"},{\"id\":602162973,\"identity\":\"7780d972-0d3a-4206-a02f-291f2acda700\",\"order_by\":3,\"name\":\"Serkan KÖKKAYA³\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Bozok Universitesi\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Serkan\",\"middleName\":\"\",\"lastName\":\"KÖKKAYA³\",\"suffix\":\"\"},{\"id\":602162977,\"identity\":\"106f2732-c02d-4e47-ad2e-f2eda89a5843\",\"order_by\":4,\"name\":\"Ali ÖZKARA¹\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"İstanbul Pendik Veteriner Kontrol Enstitüsü\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Ali\",\"middleName\":\"\",\"lastName\":\"ÖZKARA¹\",\"suffix\":\"\"},{\"id\":602162978,\"identity\":\"620f4c52-e2c0-4e5c-9860-63cead45822d\",\"order_by\":5,\"name\":\"Murat GÜVEN¹\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"İstanbul Pendik Veteriner Kontrol Enstitüsü\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Murat\",\"middleName\":\"\",\"lastName\":\"GÜVEN¹\",\"suffix\":\"\"},{\"id\":602162981,\"identity\":\"8700d019-d6fa-49e1-92fd-cd3269a5d3c4\",\"order_by\":6,\"name\":\"Ahmet SAİT¹\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"İstanbul Pendik Veteriner Kontrol Enstitüsü\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Ahmet\",\"middleName\":\"\",\"lastName\":\"SAİT¹\",\"suffix\":\"\"},{\"id\":602162985,\"identity\":\"a3f1810f-0180-42f9-b7bb-b857bcab476c\",\"order_by\":7,\"name\":\"Onur ÜRGENALP¹\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"İstanbul Pendik Veteriner Kontrol Enstitüsü\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Onur\",\"middleName\":\"\",\"lastName\":\"ÜRGENALP¹\",\"suffix\":\"\"},{\"id\":602162986,\"identity\":\"8f1acd4c-c49a-4b66-95d5-e67fe7ffbd81\",\"order_by\":8,\"name\":\"Mustafa TÜRKDOĞAN¹\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"İstanbul Pendik Veteriner Kontrol Enstitüsü\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Mustafa\",\"middleName\":\"\",\"lastName\":\"TÜRKDOĞAN¹\",\"suffix\":\"\"},{\"id\":602162995,\"identity\":\"3bd56587-f3b3-48d3-ad25-0f1a98c6f2bb\",\"order_by\":9,\"name\":\"Ad VOS\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Impfstoffwerk Dessau Tornau GmbH\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Ad\",\"middleName\":\"\",\"lastName\":\"VOS\",\"suffix\":\"\"},{\"id\":602162997,\"identity\":\"d1488974-de03-4566-888f-9130e1156839\",\"order_by\":10,\"name\":\"Orhan AYLAN\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Etlik Central Veterinary Control and Research Institute\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Orhan\",\"middleName\":\"\",\"lastName\":\"AYLAN\",\"suffix\":\"\"},{\"id\":602162999,\"identity\":\"f2114926-a007-4f53-a8d9-a1913884277a\",\"order_by\":11,\"name\":\"Hakan BULUT\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Tekirdağ Namık Kemal University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Hakan\",\"middleName\":\"\",\"lastName\":\"BULUT\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2026-02-01 18:26:10\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-8758251/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-8758251/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":104337880,\"identity\":\"15e72eb1-e2f3-4bd4-ac9b-2211096a7d04\",\"added_by\":\"auto\",\"created_at\":\"2026-03-10 16:16:37\",\"extension\":\"png\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":457879,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eRabies sample collection and oral vaccination activities in Türkiye. Blue-shaded provinces indicate regions where rabies-suspected animal samples were collected between 2010 and 2024. Red-shaded provinces represent areas where oral rabies vaccination campaigns were implemented in 2019. Red-striped provinces show regions with rabies-positive samples (2010-2024) and ORV in 2019. Red diagonal-striped provinces indicate areas where ORV was conducted in both 2008-2010 and 2019 (Map created using \\u003ca href=\\\"http://www.mapchart.net/\\\"\\u003ewww.mapchart.net\\u003c/a\\u003e.)\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"1.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8758251/v1/e5f26d08ed923cd69542dde4.png\"},{\"id\":104337882,\"identity\":\"6ac936ab-7914-4f2f-babb-4ab82340342b\",\"added_by\":\"auto\",\"created_at\":\"2026-03-10 16:16:37\",\"extension\":\"png\",\"order_by\":2,\"title\":\"Figure 2\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":130292,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eAnnual distribution of rabies-positive cases in domestic and wild animals from 2010 to 2024. Although domestic animal cases dominated the study period, a peak was observed around 2014, followed by a gradual decline. Although the number of samples from wild animals was small, the positivity rate was higher. The number of cases decreased significantly in both animal groups after the intensified ORV campaign in 2019. The green line represents the total number of positive cases per year.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"2.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8758251/v1/127d201fb8016ac47e72cb23.png\"},{\"id\":104337884,\"identity\":\"74e01f96-30f9-4654-84a5-68e9425c87d8\",\"added_by\":\"auto\",\"created_at\":\"2026-03-10 16:16:37\",\"extension\":\"png\",\"order_by\":3,\"title\":\"Figure 3\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":168427,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eAnnual number of tested and FAT-positive animal rabies cases in the Marmara Region, Türkiye (2010-2024). Bars represent the yearly counts of FAT-positive (blue) and FAT-negative (tan) samples submitted through passive surveillance. The sharp reduction in both total submissions and positive detections after 2020 coincides with the nationwide oral rabies vaccination (ORV) campaigns targeting wildlife reservoirs.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"3.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8758251/v1/522e936e41ae3811c20a559f.png\"},{\"id\":104405351,\"identity\":\"9f58b9d7-fb09-4234-9cf5-a02d1c7b0870\",\"added_by\":\"auto\",\"created_at\":\"2026-03-11 12:22:40\",\"extension\":\"png\",\"order_by\":4,\"title\":\"Figure 4\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":58603,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eDistribution of rabies-positive cases among domestic and wild animal species.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"4.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8758251/v1/1cd0759229073944fd9b3151.png\"},{\"id\":104337883,\"identity\":\"01fed6d4-ec34-48b8-91a3-db8155f7fce2\",\"added_by\":\"auto\",\"created_at\":\"2026-03-10 16:16:37\",\"extension\":\"png\",\"order_by\":5,\"title\":\"Figure 5\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":35111,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eTotal number of laboratory-confirmed rabies-positive cases by province in the Marmara Region (2010-2024). The majority of positive cases were reported from Balıkesir (n=270), Çanakkale (n=244), and Bursa (n=58), which together accounted for over 90% of all confirmed cases.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"5.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8758251/v1/2ad6181209c6913240ac28d9.png\"},{\"id\":104337885,\"identity\":\"a1381ac5-d7b5-4031-998b-48e2443c4566\",\"added_by\":\"auto\",\"created_at\":\"2026-03-10 16:16:37\",\"extension\":\"jpg\",\"order_by\":6,\"title\":\"Figure 6\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":317743,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003ePhylogenetic analysis based on partial G gene sequences of Rabies virus isolates. The circular phylogenetic tree was constructed to compare the genetic relationship of our isolates (marked with a black dot) to other globally circulating Rabies virus strains. The sequences are color-coded according to their geographic origin, as indicated in the legend on the left. Our isolate clustered within the Cosmopolitan-Middle East 2 (ME2) lineage, showing close similarity to strains from Türkiye, suggesting regional transmission patterns.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"6.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8758251/v1/9a7417fc0729239a753eb02e.jpg\"},{\"id\":104409274,\"identity\":\"5b6e84fb-1ed7-4f26-8a29-5df1f06c2ce9\",\"added_by\":\"auto\",\"created_at\":\"2026-03-11 12:44:36\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":2092273,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8758251/v1/9a7e170a-974c-4746-802f-ddc284391628.pdf\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Fifteen-year epidemiological profile of animal rabies in the Marmara region of Türkiye: Evidence for a wildlife-livestock spillover cycle\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eRabies remains one of the most lethal zoonotic diseases worldwide, causing an estimated 59,000 human deaths annually despite the long-standing availability of highly effective vaccines (WHO, \\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e2024\\u003c/span\\u003e). \\u003cem\\u003eLyssavirus Rabies\\u003c/em\\u003e, formerly referred to as \\u003cem\\u003eRabies virus\\u003c/em\\u003e and renamed by the International Committee on Taxonomy of Viruses (ICTV) in 2022, is a single-stranded, negative-sense RNA virus belonging to the genus \\u003cem\\u003eLyssavirus\\u003c/em\\u003e within the family \\u003cem\\u003eRhabdoviridae\\u003c/em\\u003e and the order \\u003cem\\u003eMononegavirales\\u003c/em\\u003e. The viral genome is approximately 12 kb in length and encodes five structural proteins arranged in the conserved order 3\\u0026prime;-N-P-M-G-L-5\\u0026prime;. The genus \\u003cem\\u003eLyssavirus\\u003c/em\\u003e comprises a diverse group of zoonotic viruses, most of which are associated with bat reservoirs, while \\u003cem\\u003eLyssavirus Rabies\\u003c/em\\u003e is uniquely maintained in both terrestrial and chiropteran hosts (ICTV, \\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e2024\\u003c/span\\u003e). While dog-mediated transmission accounts for most human cases in low- and middle-income countries, many parts of Europe have undergone a marked epidemiological transition in which wildlife, most notably the red fox (\\u003cem\\u003eVulpes vulpes\\u003c/em\\u003e), became the primary maintenance host (WHO, \\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e2018\\u003c/span\\u003e). In the Near East, rabies epidemiology is more heterogeneous, with sylvatic transmission involving multiple canid species, including red foxes and golden jackals (\\u003cem\\u003eCanis aureus\\u003c/em\\u003e), reported across the region (Seimenis, \\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e2008\\u003c/span\\u003e; Taylor et al., \\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e2021\\u003c/span\\u003e). This transition highlights the inherent complexity of rabies ecology within a One Health framework, where dynamic interactions among wildlife, domestic animals, and human populations jointly shape transmission patterns.\\u003c/p\\u003e \\u003cp\\u003eT\\u0026uuml;rkiye occupies a strategically important geographic and ecological position at the intersection of Europe, the Middle East, and the Asia region. For several decades, rabies epidemiology in the country was dominated by dog-mediated transmission, reflecting patterns widely observed across the Mediterranean region (Johnson et al., \\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e2010\\u003c/span\\u003e). However, following a sustained spill-over from dogs to foxes, fox rabies spread rapidly in the Aegean region of T\\u0026uuml;rkiye. In order to control the outbreak, a program of oral vaccination of foxes against rabies was introduced (Un et al., \\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e2012\\u003c/span\\u003e). Accumulating evidence indicates a substantial transition toward wildlife-associated cycles in western T\\u0026uuml;rkiye, particularly involving foxes and jackals (Atıcı and Oğuzoğlu, \\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e2022\\u003c/span\\u003e; Aylan et al., \\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e2024\\u003c/span\\u003e). Molecular studies have shown that the circulating strains belong mainly to the Cosmopolitan lineage, specifically the Middle East 2 subclade, which is frequently associated with sylvatic transmission across this region (Bourhy et al., \\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e2008\\u003c/span\\u003e; Atıcı and Oğuzoğlu, \\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e2022\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eIn line with these changing epidemiological dynamics, T\\u0026uuml;rkiye has progressively expanded large-scale oral rabies vaccine (ORV) campaigns, beginning in the Aegean region between 2008 and 2010 (Un et al., \\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e2012\\u003c/span\\u003e) and subsequently expanding into central and northwestern provinces. The launch of large-scale ORV in 2019 marked a major strategic milestone, paralleling successful European programs in which fox rabies was eliminated over one to two decades of sustained bait distribution (Freuling et al., \\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e2013\\u003c/span\\u003e; M\\u0026uuml;ller et al., \\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e2015\\u003c/span\\u003e). Although early findings suggest a substantial reduction in wildlife rabies following ORV (Aylan et al., \\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e2024\\u003c/span\\u003e), comprehensive long-term and region-specific epidemiological evaluations remain limited.\\u003c/p\\u003e \\u003cp\\u003eThe Marmara Region is one of T\\u0026uuml;rkiye\\u0026rsquo;s densely populated and ecologically diverse areas, characterized by extensive forest-pasture interfaces, high livestock density, and frequent interactions among domestic animals, stray dogs, and wildlife. Provinces such as Balıkesir, Bursa, and \\u0026Ccedil;anakkale have been repeatedly identified as hotspots for wildlife-mediated rabies (Aylan et al., \\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e2024\\u003c/span\\u003e). Within these ecosystems, domestic livestock, including cattle, face increased risk of rabies exposure at the wildlife-livestock interface, especially in areas neighbouring to wildlife habitats where interactions with rabid wild animals are more likely (Atuheire et al., \\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e2024\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eDespite significant national investments in rabies control, including intensified dog vaccination and expanded ORV, the long-term epidemiological impact of these efforts in transitional zones such as Marmara has not been comprehensively documented. Most prior studies are either short-term, limited to molecular characterization, or national in scope without region-level trend analyses.\\u003c/p\\u003e \\u003cp\\u003eThe present study provides a 15-year retrospective evaluation of laboratory-confirmed rabies cases across domestic and wild animals in the Marmara Region (2010\\u0026ndash;2024). By analyzing temporal patterns, species distribution, and geographic hotspots, this study offers a detailed assessment of the evolving rabies landscape and the measurable influence of large-scale ORV campaigns. The findings generate critical evidence to inform targeted control strategies, strengthen One Health preparedness, and support T\\u0026uuml;rkiye\\u0026rsquo;s long-term rabies elimination objectives.\\u003c/p\\u003e\"},{\"header\":\"Materials and Methods\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eEthics and biosafety\\u003c/h2\\u003e \\u003cp\\u003eAll diagnostic procedures were conducted in Biosafety Level 2 (BSL-2) laboratories at the Pendik Veterinary Control Institute, following national biosafety regulations and World Organisation for Animal Health (WOAH) standards. All brain samples originated from naturally deceased animals submitted through routine surveillance activities coordinated by the Turkish Ministry of Agriculture and Forestry; therefore, additional ethical approval was not required (Pendik Veterinary Control Institute Animal Experiments Local Ethics Committee Decision No. 03/2023).\\u003c/p\\u003e \\u003c/div\\u003e\\n\\u003ch3\\u003eOral rabies vaccine and field implementation\\u003c/h3\\u003e\\n\\u003cp\\u003eThe Ministry of Agriculture and Forestry implemented T\\u0026uuml;rkiye\\u0026rsquo;s ORV programme in cooperation with the European Commission. The vaccine used, Fuchsoral (SAD B19 strain), is a cell culture-derived attenuated rabies virus vaccine widely adopted in European wildlife control programmes. Each batch was quality-verified at the Etlik Veterinary Control Central Research Institute to confirm a minimum titre of \\u0026ge;\\u0026thinsp;10⁶.⁵ FFU/mL before field distribution (Aylan et al., \\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e2024\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eAerial baiting campaigns were conducted during spring seasons between 2019 and 2021, targeting forested and rural habitats with high fox and jackal densities. Post-distribution monitoring included tetracycline biomarker detection in fox teeth and field surveys conducted in accordance with T\\u0026uuml;rkiye\\u0026rsquo;s national ORV monitoring guidelines (Aylan et al., \\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e2024\\u003c/span\\u003e).\\u003c/p\\u003e\\n\\u003ch3\\u003eStudy area\\u003c/h3\\u003e\\n\\u003cp\\u003eThe study encompassed the Marmara Region of T\\u0026uuml;rkiye, comprising 11 provinces: Balıkesir, Bursa, \\u0026Ccedil;anakkale, Yalova, Sakarya, Kocaeli, İstanbul, Tekirdağ, Edirne, Kırklareli, and Bilecik (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e). This region is characterized by heterogeneous landscapes, including coastal plains, forest-pasture interfaces, and densely populated urban centers, which facilitate frequent interactions among domestic livestock, free-roaming dogs, and wildlife reservoirs.\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e\\n\\u003ch3\\u003eStudy design and case definition\\u003c/h3\\u003e\\n\\u003cp\\u003eThis retrospective observational study evaluated animal rabies cases submitted to the Pendik Veterinary Control Institute from January 2010 to October 2024. Suspected cases were defined according to WOAH (\\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e2023\\u003c/span\\u003e) criteria: animals exhibiting acute neurological symptoms such as aggression, ataxia, disorientation, dysphagia, and hypersalivation; unexplained sudden death; or a recent history of wildlife interaction or bite exposure\\u003c/p\\u003e\\n\\u003ch3\\u003eSample collection and transportation\\u003c/h3\\u003e\\n\\u003cp\\u003eBrain samples, including whole heads or specific anatomical regions such as the brainstem, hippocampus, cerebellum, and medulla oblongata, were collected by provincial veterinary authorities during routine field investigations. All samples were transported under cold-chain conditions at 4\\u0026ndash;8\\u0026deg;C and delivered to the reference laboratory within 2\\u0026ndash;48 hours, in accordance with WHO and WOAH recommendations to ensure diagnostic quality and prevent antigen degradation (Meslin et al., \\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e1996\\u003c/span\\u003e; WHO, \\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e2018\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cdiv id=\\\"Sec8\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eLaboratory diagnosis and molecular analysis\\u003c/h2\\u003e \\u003cp\\u003e Rabies diagnosis was performed in accordance with the WOAH standards, using the fluorescent antibody test (FAT) as the confirmatory method. Impression smears prepared from brainstem, hippocampus, cerebellum, and medulla oblongata were stained with fluorescein isothiocyanate (FITC)-labelled anti-rabies monoclonal antibody conjugate (Bio-Rad, USA). Slides were examined under a fluorescence microscope for characteristic apple-green fluorescence, indicating the presence of rabies virus antigen. FAT-positive samples were classified as confirmed cases (Ashwini et al., \\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2024\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eFor molecular characterization, FAT-positive samples were utilized in this study. Total RNA extraction was performed using the guanidine-thiocyanate-phenol-chloroform method for FAT-positive tissue samples (Chomczynski and Sacchi, \\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e1987\\u003c/span\\u003e). Then, the obtained RNA was converted to complementary DNA (cDNA) according to the RevertAid kit procedure (Thermo Fisher Scientific, USA). Subsequently, cDNA synthesis and PCR were performed using primers targeting the Rabies G gene, as described by Yang et al. (\\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e2011\\u003c/span\\u003e). The amplicon sizes for the G gene were generated at 1052 and 711 bp, respectively.\\u003c/p\\u003e \\u003cp\\u003eRT-PCR-positive samples were purified from agarose gel using a commercial purification kit (Nucleogene, T\\u0026uuml;rkiye). The purified samples were sent to the Life Sciences sequencing service (Ankara, T\\u0026uuml;rkiye). The Sanger sequence results were assembled and trimmed with Bioedit (version 7.7.1) (Hall et al., 2011) and analyzed with MEGA 11 by using ClustralW and Neighbor-joining (Tamura, et al., \\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e2021\\u003c/span\\u003e). After constructing the phylogenetic tree, it was visualized and colored using the iToL online database (Interactive Tree of Life, \\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e2026\\u003c/span\\u003e). The lineage names used for the phylogenetic analysis were obtained based on the study by Bourhy et al. (\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e2008\\u003c/span\\u003e) and Troupin (2016).\\u003c/p\\u003e \\u003c/div\\u003e\\n\\u003ch3\\u003eTemporal trend analysis\\u003c/h3\\u003e\\n\\u003cp\\u003eTemporal trends in rabies incidence were assessed descriptively by evaluating the annual counts of tested samples and FAT-confirmed cases from 2010 to 2024. Yearly positivity rates and graphs were used to illustrate changes over time, including the period before and after the implementation of the ORV campaign.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec10\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eStatistical analysis\\u003c/h2\\u003e \\u003cp\\u003eTo evaluate the impact of ORV on regional rabies positivity, two complementary statistical approaches were applied. First, a 2\\u0026times;2 contingency table was constructed to compare laboratory-confirmed rabies positivity between the pre-ORV period (2010\\u0026ndash;2018) and the post-ORV period (2020\\u0026ndash;2024). Fisher\\u0026rsquo;s exact test was used to assess differences in positivity rates between periods, given its suitability for categorical data with unequal group sizes.\\u003c/p\\u003e \\u003cp\\u003eSecond, a Chi-square test for trend (Cochran-Armitage test) was conducted to examine whether rabies positivity displayed a statistically significant decreasing trend over time. This approach allowed evaluation of temporal directionality consistent with ORV implementation. All analyses were performed using GraphPad Prism software (version 9.5; GraphPad Software Inc., USA).\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cdiv id=\\\"Sec12\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eGeneral overview of diagnostic outcomes\\u003c/h2\\u003e \\u003cp\\u003eBetween January 2010 and October 2024, a total of 4017 brain samples from animals suspected of rabies were submitted to the Pendik Veterinary Control Institute from the Marmara Region. Among these samples, 651 (16.2%) tested positive by the fluorescent antibody test (FAT), while 3366 (83.8%) were negative. Domestic animals accounted for the majority submissions (97.8%), whereas wildlife species represented a small proportion of samples (2.1%). However, the positivity rate among wildlife species was proportionally higher than that observed in domestic animals.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec13\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eAnnual distribution and temporal trends\\u003c/h2\\u003e \\u003cp\\u003eRabies case numbers fluctuated considerably throughout the fifteen-year study period. An initial increase was observed between 2013 and 2015, followed by a more distinct rise between 2017 and 2019. After the large-scale ORV campaign was initiated in 2019, a marked decline occurred across the region. Confirmed cases dropped from 103 in 2019 to 26 in 2020, and many provinces reported zero cases between 2021 and 2023. Only one cattle case was detected in early 2024, indicating that rabies activity had been substantially reduced (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec14\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eSpecies distribution of confirmed cases\\u003c/h2\\u003e \\u003cp\\u003eRabies virus was detected in several domestic and wildlife species throughout the study period. Cattle represented the largest proportion of confirmed cases (n\\u0026thinsp;=\\u0026thinsp;428; 65.7%), followed by dogs (n\\u0026thinsp;=\\u0026thinsp;68; 10.4%). Notably, only one dog case was detected after 2019. Wildlife-associated cases included foxes (n\\u0026thinsp;=\\u0026thinsp;32), jackals (n\\u0026thinsp;=\\u0026thinsp;24), and also martens (n\\u0026thinsp;=\\u0026thinsp;2), accounting for 8.9% of all confirmed cases. These wildlife detections occurred predominantly before 2020, with no fox-positive samples identified thereafter. Sporadic cases were also observed in cats, sheep, goats, and equines without a consistent temporal pattern (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e; Figs.\\u0026nbsp;\\u003cspan refid=\\\"Fig3\\\" class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e\\u0026ndash;\\u003cspan refid=\\\"Fig4\\\" class=\\\"InternalRef\\\"\\u003e4\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eDistribution of rabies-positive cases by animal species and year in the Marmara Region, T\\u0026uuml;rkiye (2010\\u0026ndash;2024). The table summarizes the annual number of confirmed rabies cases across seven animal groups: dogs, cats, cattle, goats, sheep, wildlife species (including foxes and jackals), and equines. Years with no positive cases for a specific species are marked as zero.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"21\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c7\\\" colnum=\\\"7\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c8\\\" colnum=\\\"8\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c9\\\" colnum=\\\"9\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c10\\\" colnum=\\\"10\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c11\\\" colnum=\\\"11\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c12\\\" colnum=\\\"12\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c13\\\" colnum=\\\"13\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c14\\\" colnum=\\\"14\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c15\\\" colnum=\\\"15\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c16\\\" colnum=\\\"16\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c17\\\" colnum=\\\"17\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c18\\\" colnum=\\\"18\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c19\\\" colnum=\\\"19\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c20\\\" colnum=\\\"20\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c21\\\" colnum=\\\"21\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\" morerows=\\\"1\\\" rowspan=\\\"2\\\"\\u003e \\u003cp\\u003eAnimals/ Years\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c3\\\" namest=\\\"c2\\\"\\u003e \\u003cp\\u003eDog\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c5\\\" namest=\\\"c4\\\"\\u003e \\u003cp\\u003eCat\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c7\\\" namest=\\\"c6\\\"\\u003e \\u003cp\\u003eCattle\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c9\\\" namest=\\\"c8\\\"\\u003e \\u003cp\\u003eGoat\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c11\\\" namest=\\\"c10\\\"\\u003e \\u003cp\\u003eSheep\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c13\\\" namest=\\\"c12\\\"\\u003e \\u003cp\\u003eFox, jackal and marten\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c15\\\" namest=\\\"c14\\\"\\u003e \\u003cp\\u003eHorse and donkey\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c16\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c18\\\" namest=\\\"c17\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c20\\\" namest=\\\"c19\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"1\\\" nameend=\\\"c21\\\" namest=\\\"c21\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ePos.\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eNeg.\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePos.\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eNeg.\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003ePos.\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eNeg.\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003ePos.\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003eNeg\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003ePos.\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003eNeg.\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003ePos\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003eNeg.\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003ePos\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003eNeg.\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003ePos. for the year\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003eNeg. for the year\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eTOTAL\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2010\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e16\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e80\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e61\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e14\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e40\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e159\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e199\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2011\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e83\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e84\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e30\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e13\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e57\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e194\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e251\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2012\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e12\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e116\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e107\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e21\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e47\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e237\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e284\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2013\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e101\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e105\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e39\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e12\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e62\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e221\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e283\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2014\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e103\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e153\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e31\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e263\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e294\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2015\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e92\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e181\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e33\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e61\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e283\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e344\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2016\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e77\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e202\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e46\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e60\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e291\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e351\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2017\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e95\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e176\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e46\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e60\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e294\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e354\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2018\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e75\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e209\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e88\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e102\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e307\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e409\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2019\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e73\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e179\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e81\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e18\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e103\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e277\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e380\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2020\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e52\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e123\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e18\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e26\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e180\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e206\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2021\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e53\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e95\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e154\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e155\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2022\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e42\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e90\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e140\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e140\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2023\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e59\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e145\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e211\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e211\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2024*\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e53\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e101\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e155\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e156\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e68\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e1154\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e27\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e2011\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e428\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e73\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e26\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e12\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e40\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c11\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e39\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c12\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e58\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c13\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e27\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c14\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e4\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c15\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e50\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c17\\\" namest=\\\"c16\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e651\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c19\\\" namest=\\\"c18\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e3366\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c21\\\" namest=\\\"c20\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e4017\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003ctfoot\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"21\\\"\\u003e*The data up to October 2024 was taken.\\u003c/td\\u003e\\u003c/tr\\u003e \\u003c/tfoot\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec15\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eGeographic distribution and identification of hotspots\\u003c/h2\\u003e \\u003cp\\u003eRabies cases were unevenly distributed across the Marmara Region. More than ninety percent of all confirmed cases were concentrated in the provinces of Balıkesir, \\u0026Ccedil;anakkale, and Bursa (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig5\\\" class=\\\"InternalRef\\\"\\u003e5\\u003c/span\\u003e). These provinces are characterized by extensive forest and pasture ecosystems. In contrast, highly urbanized provinces, including İstanbul, Tekirdağ, and Kocaeli, recorded only sporadic cases throughout the study period.\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec16\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eMolecular characterization and bioinformatic analysis\\u003c/h2\\u003e \\u003cp\\u003eSix RT-PCR positive samples obtained from dogs, cattle, and a fox were successfully sequenced targeting the rabies virus glycoprotein (G) gene. All six sequences met quality criteria and were included in subsequent analyses. Sequence alignment demonstrated a high degree of nucleotide similarity among the isolates.\\u003c/p\\u003e \\u003cp\\u003eThe resulting nucleotide sequences were deposited in the GenBank database under accession numbers PV158098-PV158103. Phylogenetic analysis based on the partial G gene region showed that all six isolates clustered within the Cosmopolitan lineage, specifically within the Middle East 2 clade (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig6\\\" class=\\\"InternalRef\\\"\\u003e6\\u003c/span\\u003e). The isolates grouped closely with previously reported rabies virus strains from T\\u0026uuml;rkiye and neighboring regions.\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec17\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eImpact of oral rabies vaccination campaigns\\u003c/h2\\u003e \\u003cp\\u003eFollowing the ORV campaign from 2019 to 2022, a substantial reduction in confirmed rabies cases was observed across both wildlife and domestic species. Wildlife-associated cases, particularly those in foxes, disappeared after 2020, indicating a marked decrease in viral circulation within the primary reservoir host. A parallel decline in cattle cases suggests that spillover events from wildlife to livestock were also greatly reduced. The consistently low numbers of confirmed cases recorded between 2022 and 2024 support the conclusion that ORV significantly diminished regional rabies activity and disrupted the wildlife-livestock transmission cycle.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec18\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eStatistical analysis\\u003c/h2\\u003e \\u003cp\\u003eA comparison of pre- and post-ORV periods showed a significant reduction in rabies positivity. The positivity rate decreased from 18.8% in the pre-ORV period (520/2769) to 10.5% in the post-ORV period (131/1248). This decline was statistically significant (Fisher\\u0026rsquo;s exact test, p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.0001).\\u003c/p\\u003e \\u003cp\\u003eTemporal trend analysis using the Cochran-Armitage chi-square test indicated a significant downward trend in annual rabies positivity rates (χ\\u0026sup2; = 56.80, df\\u0026thinsp;=\\u0026thinsp;1, p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.0001).\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eThis long-term retrospective study, to our knowledge, provides one of the most comprehensive epidemiological assessments of animal rabies in the Marmara Region of T\\u0026uuml;rkiye since the documented shift from dog-mediated to wildlife-associated rabies that began in the late 1990s. Historically, domestic dogs served as the principal reservoir in T\\u0026uuml;rkiye (Johnson et al., \\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e2010\\u003c/span\\u003e), and earlier investigations similarly reported high positivity rates among dogs (Akkoca et al., \\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e2004\\u003c/span\\u003e). Consistent with these reports, dogs remained an important source of rabies in the Marmara Region until 2018. However, only one dog case was detected between 2019 and 2024. This decline coincided with intensified national control measures, including compulsory vaccination, microchipping, and continued immunization of stray populations, as well as reductions in the circulation of rabies in wildlife, both of which may have contributed to decreased dog-mediated transmission.\\u003c/p\\u003e \\u003cp\\u003eA critical observation in our study is the synchronized elimination of rabies cases in both wildlife and dogs following the ORV campaigns (2019\\u0026ndash;2022). Prior to 2019, dog cases were consistently reported annually; however, following the suppression of the virus in red foxes and jackals, dog-mediated cases dropped to near zero (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e). This parallel decline strongly suggests that the rabies cases observed in dogs in the Marmara Region were predominantly spillover events from a sylvatic reservoir, rather than an independent dog-to-dog transmission cycle. If an autonomous urban rabies cycle had been active among dogs, the wildlife-targeted vaccination (ORV) would not have resulted in such a rapid cessation of canine cases. Therefore, the control of the sylvatic reservoir via ORV appears to have been the decisive factor in interrupting the transmission chain to dogs.\\u003c/p\\u003e \\u003cp\\u003eParallel to this decline, wildlife reservoirs, particularly red foxes and golden jackals, appear to have played an increasing role in shaping regional rabies epidemiology. Our findings align with recent molecular and ecological studies showing that sylvatic rabies has become the dominant cycle in western T\\u0026uuml;rkiye (Atıcı and Oğuzoğlu, \\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e2022\\u003c/span\\u003e; Aylan et al., \\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e2024\\u003c/span\\u003e). Although wildlife submissions accounted for a small proportion of all samples in this study, their positivity rates were relatively high, and case investigations frequently linked livestock infections to exposure near forest edges. These observations parallel patterns described in Europe, where fox-maintained rabies cycles historically caused recurrent spillover to livestock species (M\\u0026uuml;ller et al., \\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e2015\\u003c/span\\u003e; Robardet et al., \\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e; Johnson et al., \\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e2003\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eCattle were by far the most affected species in the Marmara Region, accounting for 65.7% of all confirmed cases, a pattern also reported in other endemic settings where livestock frequently represent a substantial proportion of rabies detections (Vos et al., \\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e2014\\u003c/span\\u003e; Payette-Stroman et al., \\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e2025\\u003c/span\\u003e). Field investigations suggested that several infected livestock had recent exposure in areas where domestic animals and wildlife overlap, a context widely recognized as increasing opportunities for cross-species transmission and underscoring the relevance of One Health-based control strategies (Mahamed, \\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e2025\\u003c/span\\u003e). The concentration of cases in Balıkesir, \\u0026Ccedil;anakkale, and Bursa underscores the ecological features of these provinces: high livestock density, widespread pasture systems, and close proximity to wildlife habitats. These findings emphasize the importance of considering targeted livestock vaccination, especially in high-risk zones where wildlife-mediated transmission is well established.\\u003c/p\\u003e \\u003cp\\u003eA notable finding of this study is the profound decline in rabies incidence following T\\u0026uuml;rkiye\\u0026rsquo;s large-scale ORV campaigns. The temporal association between ORV implementation and reductions in confirmed cases is supported by statistical analyses demonstrating significant decreases in positivity rates. These quantitative results provide epidemiological evidence that ORV effectively disrupted viral circulation in wildlife reservoirs and substantially reduced spillover to livestock. Comparable reductions have been reported in European fox rabies elimination programs, where sustained baiting campaigns similarly achieved rapid declines in both wildlife cases and livestock spillover (Freuling et al., \\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e2013\\u003c/span\\u003e). The magnitude and direction of the decline observed in the Marmara Region closely mirror these international experiences, supporting the conclusion that ORV has been a decisive driver of rabies control in T\\u0026uuml;rkiye. Nevertheless, as highlighted in previous wildlife rabies studies, the low proportion of wildlife submissions warrants caution, since reduced detection rather than complete elimination may partially contribute to the apparent disappearance of fox cases (Robardet et al., \\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e). Continued active wildlife surveillance is therefore essential to confirm sustained viral interruption.\\u003c/p\\u003e \\u003cp\\u003eAlthough extensive molecular analysis was beyond the scope of this study, Sanger sequencing of selected positive samples revealed that samples from Balıkesir and Bursa clustered within the Cosmopolitan-Middle East 2 (ME2) subclade. Previous phylogenetic studies have consistently shown that ME2 is the predominant lineage circulating in western T\\u0026uuml;rkiye (Atıcı and Oğuzoğlu, \\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e2022\\u003c/span\\u003e; Bourhy et al., \\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e2008\\u003c/span\\u003e). The detection of this lineage across fox, dog, and cattle isolates supports the conclusion that the same viral variant circulates within interconnected wildlife-livestock networks. A single cattle case detected in early 2024 illustrates that although transmission has sharply declined, the virus has not yet been completely eliminated from the region, and sustained surveillance remains essential.\\u003c/p\\u003e \\u003cp\\u003eNational surveillance data further complement these findings. Rabies-related human exposure reports (PEP applications) increased markedly between 2021 and 2023, despite the decline in confirmed animal cases. Dogs accounted for the vast majority of these exposures. This trend reflects increased human-dog interactions in urban settings rather than widespread dog-mediated rabies. Previous policies allowed municipalities to vaccinate and neuter stray dogs before releasing them back into their environment, contributing to high human-animal contact rates. Although confirmed human rabies cases remain very low, the rising number of exposures imposes substantial economic and public health burdens. Recent policy changes requiring municipalities to shelter stray animals rather than release them may reduce unnecessary exposures, but the long-term impact of these measures warrants further evaluation within a One Health framework.\\u003c/p\\u003e \\u003cp\\u003eThis study has several limitations. The reliance on passive surveillance likely resulted in under reporting, particularly among wildlife and livestock that may die unobserved in remote areas. Annual variation in sample submissions may reflect reporting practices rather than true epidemiological trends. Moreover, the absence of comprehensive molecular characterization and vaccination coverage data limits detailed assessment of viral dynamics and immunization impacts. Nonetheless, the long-term dataset and clear temporal and geographical patterns provide robust evidence supporting the effectiveness of combined control measures, particularly ORV.\\u003c/p\\u003e\"},{\"header\":\"Conclusion\",\"content\":\"\\u003cp\\u003eThe results of this study highlight the critical importance of coordinated rabies control strategies that target both domestic and wildlife reservoirs. The decline in rabies incidence following ORV implementation demonstrates the effectiveness of wildlife vaccination campaigns. In contrast, the continued success of dog vaccination and identification programs has reduced dog-mediated transmission to historically low levels. Sustained investment in ORV, improved sheltering strategies for stray dogs, and enhanced collaboration between veterinary, wildlife, and public health sectors will be essential for T\\u0026uuml;rkiye to maintain its recent progress and advance toward the global \\u0026ldquo;Zero by 30\\u0026rdquo; rabies elimination goal.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e \\u003ch2\\u003eDisclosures\\u003c/h2\\u003e \\u003cp\\u003eThe authors declare that they have no competing financial or non-financial interests.\\u003c/p\\u003e \\u003c/p\\u003e\\u003cp\\u003e \\u003ch2\\u003eStudy Funding\\u003c/h2\\u003e \\u003cp\\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\\u003c/p\\u003e \\u003c/p\\u003e\\u003ch2\\u003eAuthor Contribution\\u003c/h2\\u003e\\u003cp\\u003eZ.P., İ.S., and H.B. conceived and designed the study and conducted the experimental procedures. A.\\u0026Ouml;., M.G., A.S., O.\\u0026Uuml;., and M.T. performed the fluorescent antibody test. S.K. and M.A.T. carried out the statistical analyses and contributed to data interpretation. A.V. and O.A. contributed to the conceptual development of the study and to the writing of the manuscript. All authors reviewed and approved the final version of the manuscript.\\u003c/p\\u003e\\u003ch2\\u003eAcknowledgement\\u003c/h2\\u003e\\u003cp\\u003eThe authors would like to thank the Pendik Veterinary Control Institute for providing access to the rabies diagnostic data and supporting sample processing. We also thank the staff members of the Regional Veterinary Directorates in the Marmara Region for their assistance in sample collection and data reporting. This study did not receive any specific grant from public, commercial, or not-for-profit funding agencies.\\u003c/p\\u003e\\u003ch2\\u003eData Availability\\u003c/h2\\u003e\\u003cp\\u003eThe datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eAkkoca N, Economides P, Maksoud G, Mestom M (2004) Rabies in Turkey, Cyprus, Syria and Lebanon. In: King AA, Fooks AR, Aubert M, Wandeler AI (eds) Historical perspective of rabies in Europe and the Mediterranean basin. Office International des \\u0026Eacute;pizooties, Paris, pp 157\\u0026ndash;169\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAshwini MA, Pattanaik A, Mani RS (2024) Recent updates on laboratory diagnosis of rabies. Indian J Med Res 159(1):48\\u0026ndash;61\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAtıcı YT, Oğuzoğlu T\\u0026Ccedil; (2022) The comparison of full G and N gene sequences from Turkish rabies virus field strains. Virus Res 315:198790\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAtuheire CGK, Okwee-Acai J, Taremwa M, Ssajjakambwe P, Munyeme M, Kankya C, Terence O, Ssali SN, Mwiine FN, Buhler KJ, Tryland M (2024) Households neighboring wildlife protected areas may be at a higher risk of rabies than those located further away: a community-based cross-sectional cohort study at Pian Upe game reserve, Bukedea district, Eastern Uganda. Front Trop Dis 5:1272141\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAylan O, Sertkaya B, Demeli A, Vos A, Hacioglu S, Atıcı YT, Yıldız DA, M\\u0026uuml;ller T, Freuling CM (2024) Oral rabies vaccination of foxes in T\\u0026uuml;rkiye, 2019\\u0026ndash;2022. One Health 19:100877\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBourhy H, Reynes JM, Dunham EJ, Dacheux L, Larrous F, Huong VTQ, Xu G, Yan J, Miranda MEG, Holmes EC (2008) The origin and phylogeography of dog rabies virus. J Gen Virol 89(Pt 11):2673\\u0026ndash;2681\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eChomczynski P, Sacchi N (1987) Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction. Anal Biochem 162(1):156\\u0026ndash;159\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eFreuling CM, Hampson K, Selhorst T, Schr\\u0026ouml;der R, Meslin FX, Mettenleiter TC, M\\u0026uuml;ller T (2013) The elimination of fox rabies from Europe: determinants of success and lessons for the future. Philos Trans R Soc Lond B Biol Sci 368(1623):20120142\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eHall T (2011) BioEdit: an important software for molecular biology. GERF Bull Biosci 2(1):60\\u0026ndash;61\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eICTV (2024) Subfamily: Alpharhabdovirinae. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://ictv.global/taxonomy/taxondetails?taxnode_id=202401733\\u0026amp;taxon_name=Lyssavirus%20rabies\\u003c/span\\u003e\\u003cspan address=\\\"https://ictv.global/taxonomy/taxondetails?taxnode_id=202401733\\u0026amp;taxon_name=Lyssavirus%20rabies\\\" targettype=\\\"URL\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e. Accessed 29 Jan 2026\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eInteractive Tree of Life (2026) \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://itol.embl.de/upload.cgi\\u003c/span\\u003e\\u003cspan address=\\\"https://itol.embl.de/upload.cgi\\\" targettype=\\\"URL\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e. Accessed 29 Jan 2026\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eJohnson N, Black C, Smith J, Un H, McElhinney LM, Aylan O, Fooks AR (2003) Rabies emergence among foxes in Turkey. J Wildl Dis 39(2):262\\u0026ndash;270\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eJohnson N, Un H, Fooks AR, Freuling C, M\\u0026uuml;ller T, Aylan O, Vos A (2010) Rabies epidemiology and control in Turkey: past and present. Epidemiol Infect 138(3):305\\u0026ndash;312\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMahamed SA (2025) Rabies at human-livestock-wildlife interface and its control through One Health approach in Ethiopia. CABI One Health 4(1):0017\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMeslin FX, Kaplan MM, Koprowski H (1996) Laboratory techniques in rabies, 4th edn. World Health Organization, Geneva\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eM\\u0026uuml;ller TF, Schr\\u0026ouml;der R, Wysocki P, Mettenleiter TC, Freuling CM (2015) Spatio-temporal use of oral rabies vaccines in fox rabies elimination programmes in Europe. PLoS Negl Trop Dis 9(8):e0003953\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePayette-Stroman A, Ross Y, Ma X, Boutelle C, Holschbach C, Blanton JD, Wallace R (2025) Rabies in livestock in the United States (2012\\u0026ndash;2021). Am J Vet Res 86(10):ajvr.25.01.0019\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRobardet E, Bosnjak D, Englund L, Demetriou P, Mart\\u0026iacute;n PR, Cliquet F (2019) Zero endemic cases of wildlife rabies (classical rabies virus, RABV) in the European Union by 2020: an achievable goal. Trop Med Infect Dis 4(4):124\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSeimenis A (2008) The rabies situation in the Middle East. Dev Biol (Basel) 131:43\\u0026ndash;53\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTamura K, Stecher G, Kumar S (2021) MEGA11: molecular evolutionary genetics analysis version 11. Mol Biol Evol 38(7):3022\\u0026ndash;3027\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTaylor E, Del Rio Vilas V, Scott T, Coetzer A, Prada JM, Alireza G, Alqadi NA, Berry A, Bazzal B, Barkia A, Davlyatov F, Farahtaj F, Harabech K, Imnadze P, Mahiout F, Majeed MI, Nedosekov V, Nel L, Rich H, Soufi A, Horton D (2021) Rabies in the Middle East, Eastern Europe, Central Asia and North Africa: building evidence and delivering a regional approach to rabies elimination. J Infect Public Health 14(6):787\\u0026ndash;794\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTroupin C, Dacheux L, Tanguy M, Sabeta C, Blanc H, Bouchier C, Vignuzzi M, Duchene S, Holmes EC, Bourhy H (2016) Large-scale phylogenomic analysis reveals the complex evolutionary history of rabies virus in multiple carnivore hosts. PLoS Pathog 12(12):e1006041\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eUn H, Eskiizmirliler S, Unal N, Freuling CM, Johnson N, Fooks AR, M\\u0026uuml;ller T, Vos A, Aylan O (2012) Oral vaccination of foxes against rabies in Turkey between 2008 and 2010. Berl Munch Tierarztl Wochenschr 125(5\\u0026ndash;6):203\\u0026ndash;208\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eVos A, Un H, Hampson K, De Balogh K, Aylan O, Freuling CM, M\\u0026uuml;ller T, Fooks AR, Johnson N (2014) Bovine rabies in Turkey: patterns of infection and implications for costs and control. Epidemiol Infect 142(9):1925\\u0026ndash;1933\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWHO (2018) WHO Expert Consultation on Rabies: Third report (WHO Technical Report Series No. 1012). World Health Organization, Geneva\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWHO (2024) Rabies. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://www.who.int/news-room/fact-sheets/detail/rabies\\u003c/span\\u003e\\u003cspan address=\\\"https://www.who.int/news-room/fact-sheets/detail/rabies\\\" targettype=\\\"URL\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e. Accessed 29 Jan 2026\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWOAH (2023) Manual of diagnostic tests and vaccines for terrestrial animals. World Organisation for Animal Health, Paris\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eYang DK, Park YN, Hong GS, Kang HK, Oh YI, Cho SD, Song JY (2011) Molecular characterization of Korean rabies virus isolates. J Vet Sci 12(1):57\\u0026ndash;63\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"european-journal-of-wildlife-research\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"ejwr\",\"sideBox\":\"Learn more about [European Journal of Wildlife Research](http://link.springer.com/journal/10344)\",\"snPcode\":\"10344\",\"submissionUrl\":\"https://submission.nature.com/new-submission/10344/3\",\"title\":\"European Journal of Wildlife Research\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"Springer Hybrid\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":false},\"keywords\":\"Rabies, Türkiye, Marmara, oral rabies vaccine\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-8758251/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-8758251/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003eRabies remains a significant endemic disease in T\\u0026uuml;rkiye, showing evolving transmission dynamics despite intensive control efforts. This retrospective study investigates the epidemiological characteristics of animal rabies in the Marmara Region, a critical transitional zone, from 2010 to 2024. A total of 4,017 brain samples obtained from passive surveillance were examined using the fluorescent antibody test (FAT). Partial sequencing of the G gene was performed on selected positive samples to determine viral lineages. Of the examined samples, 651 (16.2%) were confirmed positive. The findings characterize a distinct epidemiological shift from historical dog-mediated transmission toward a sylvatic cycle spilling over to livestock. Cattle accounted for the majority of confirmed cases (65.7%), with infections clustered in provinces characterized by extensive forest-pasture interfaces. Phylogenetic analysis revealed that circulating viruses belonged to the Cosmopolitan-Middle East 2 (ME2) subclade. Following the implementation of nationwide oral rabies vaccination (ORV) campaigns, a marked reduction in laboratory-confirmed rabies cases was observed across the Marmara Region. Wildlife-associated cases declined to zero detections after 2020, accompanied by a parallel decrease in rabies cases among domestic animals. These findings indicate substantial suppression of rabies circulation consistent with the impact of ORV, although continued surveillance is required to confirm sustained control. These results demonstrate that ORV campaigns have successfully suppressed viral circulation in wildlife reservoirs and reduced spillover to livestock in the Marmara Region. However, the persistence of sporadic cases highlights the necessity of sustained wildlife vaccination and enhanced surveillance within a One Health framework to achieve permanent elimination.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Fifteen-year epidemiological profile of animal rabies in the Marmara region of Türkiye: Evidence for a wildlife-livestock spillover cycle\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2026-03-10 16:16:28\",\"doi\":\"10.21203/rs.3.rs-8758251/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0},{\"type\":\"reviewerAgreed\",\"content\":\"145760899398896050421470436088486015889\",\"date\":\"2026-03-09T17:24:22+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewersInvited\",\"content\":\"\",\"date\":\"2026-03-04T15:58:24+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorAssigned\",\"content\":\"\",\"date\":\"2026-02-11T14:31:02+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"checksComplete\",\"content\":\"\",\"date\":\"2026-02-11T14:30:22+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"submitted\",\"content\":\"European Journal of Wildlife Research\",\"date\":\"2026-02-01T18:11:00+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"european-journal-of-wildlife-research\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"ejwr\",\"sideBox\":\"Learn more about [European Journal of Wildlife Research](http://link.springer.com/journal/10344)\",\"snPcode\":\"10344\",\"submissionUrl\":\"https://submission.nature.com/new-submission/10344/3\",\"title\":\"European Journal of Wildlife Research\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"Springer Hybrid\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":false}}],\"origin\":\"\",\"ownerIdentity\":\"8374d68e-e696-4a43-826a-da969bf03688\",\"owner\":[],\"postedDate\":\"March 10th, 2026\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"under-review\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2026-03-10T16:16:28+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2026-03-10 16:16:28\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-8758251\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-8758251\",\"identity\":\"rs-8758251\",\"version\":[\"v1\"]},\"buildId\":\"XKTyCvWXoU3ODBz1xrDgd\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}