World rabies day. The epidemiological situation and the initiatives in Italy

On 30 September 2019, the Ministry of Health organises a training-workshop event on the occasion of the World Rabies Day . The workshop aims to give visibility to the topic, in particular:

• to increase the knowledge on the subject of prevention, surveillance and control of rabies both in human and animal environment;

• to present experiences of international cooperation that contribute to the implementation of the global "Zero by 30" strategy.

WHO, the World Organisation for Animal Health (OIE), the Food and Agriculture Organization of the United Nations (FAO) and the Global Alliance for Rabies Control (GARC) have established a global “United Against Rabies” collaboration to provide a common strategy to achieve "Zero human rabies deaths by 2030".

Rabies is an infectious viral disease that is almost always fatal following the onset of clinical symptoms. In up to 99% of cases, domestic dogs are responsible for rabies virus transmission to humans. Yet, rabies can affect both domestic and wild animals. It is spread to people through bites or scratches, usually via saliva.

Rabies is one of the neglected tropical diseases that predominantly affects poor and vulnerable populations who live in remote rural locations. Although effective human vaccines and immunoglobulins exist for rabies, they are not readily available or accessible to those in need. Globally, rabies deaths are rarely reported and children between the ages of 5–14 years are frequent victims. Every year, more than 15 million people worldwide receive a post-bite vaccination. This is estimated to prevent hundreds of thousands of rabies deaths annually. For details of the procedures to be adopted after exposure, the WHO report can be consulted “ WHO Recommendations on Rabies Post-Exposure Treatment and the Correct Technique of Intradermal Immunization against Rabies ”.

Episodes of high mortality in cattle have been reported, particularly in Latin America, but also in Africa.

Since 2002, the Istituto zooprofilattico sperimentale delle Venezie is the national reference center for rabies and it is involved in European projects and international collaborations on this disease.

Italy is currently a country free from rabies. The last outbreak, after almost 13 years of absence and in relation to the epidemiological situation in neighbouring Slovenia and Croatia, has affected the northeast Italian territories from autumn 2008 to February 2011; in particular Friuli Venezia Giulia, the province of Belluno and the provinces of Trento and Bolzano.

Numerous foxes oral vaccination campaigns have been carried out for this epidemic, which have allowed the eradication of the disease from the territory. The last case occurred on February 2011.

After two years of the vaccination campaigns and in the absence of new cases, Italy in 2013 has regained the status of “disease free”.

As a precautionary measure and in line with what has been achieved in Slovenia, the oral vaccination of foxes is still performed twice a year along a border strip of about 2,300 km².

References

https://www.who.int/news-room/fact-sheets/detail/rabies

https://www.epicentro.iss.it/rabbia/gm08

http://www.salute.gov.it/portale/news/p3_2_2_1_1.jsp?lingua=italiano&menu=eventi&p=daeventi&id=558

https://rabiesalliance.org/