Sylvatic rabies in the North Est of Italy: monitoring and evaluation of the effectiveness of prophylaxis in workers at risk and travelers

Rabies is a zoonotic viral encephalitis almost invariably fatal in both humans and animals. Rabies virus infects mammals through infected saliva via bites or scratches, although atypical exposures have been documented. In late 2008, wildlife rabies re emerged in Northeastern Italy. Since then, 287 animal cases have been documented with the last one diagnosed in a red fox in February 2011. No human cases have been reported linked to the recent epidemic and Italy has been declared as free from rabies in February 2013. Several oral fox vaccination campaigns and extensive monitoring of territories subject to the epidemic have been implemented together with education and preventive vaccination of workers at risk of viral exposure as forestry and wildlife workers, veterinarians, shelters ‘operators and laboratory personnel. We have evaluated the level and persistence of serological response in workers at risk and travelers vaccinated following different immunization schedules. In 113 cases post exposure prophylaxis has been administered, five or four doses, with Rabipur (Novartis), Verorab (Sanofi Pasteur) vaccine. Serum samples from about 300 vaccinated volunteers at risk and travelers were collected from the Northeastern territories recently subject to the epidemic. All sera have been tested using an ELISA (Enzyme Linked Immunosorbent Assay) and a neutralising test, namely FAVN (Fluorescent Antibody Virus Neutralisation). The results of the ongoing analysis will be reported.