SYLVATIC RABIES IN THE NORTH-EAST OF ITALY: MONITORING AND EVALUATION OF THE EFFECTIVENESS OF PROPHYLAXIS IN WORKERS AT RISK AND TRAVELERS

Rabies is a global zoonotic disease that occurs in developing and developed countries, producing consistently fatal encephalitis in 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 in an area bordering Slovenia, spread to Veneto region (Belluno province) and to the autonomous province of Trento and Bolzano. Since then, 287 animal cases have been detected in wild and domestic animals; the last one has been 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 accompanied by efficacy monitoring and extensive surveillance of territories affected by the epidemic have been implemented together with education and preventive vaccination of workers at risk of viral exposure (i.e. forestry and wildlife workers, veterinarians, shelters ‘operators and laboratory personnel). The aim of this work was the evaluation of the rabies antibodies level and persistence in workers at risk of exposure and travelers. A total of 347 serum samples were collected: 169 after pre-exposure prophylaxis and 178 after post-exposure prophylaxis performed with different immunization schedules. All sera have been tested to detect rabies virus anti-glycoprotein antibodies by a commercial quantitative indirect ELISA (Platelia TM Rabies II kit; Biorad) and with the reference method FAVN (Fluorescent Antibody Virus Neutralization), according to the procedure recommended by the WHO. The results on the protection level, persistence of antibodies and the comparison between the ELISA and FAVN test will be discussed.