Rabies (fox), Italy (OIE-WAHID) - Immediate Notification Report and follow-up reports.

[Giuseppe]

Caso di Rabbia in Una Volpe (OIE)

Rabies, Italy

[full text: http://www.oie.int/wahid-prod/public.php?page=single_report&pop=1&reportid=7444]

Information received on 21/10/2008 from Dr Romano Marabelli, Direttore Generale, Direzione Generale Sanita Veterinaria e Alimenti , Ministero della Salute, ROME, Italy

? Summary
Report type Immediate notification
Start date 10/10/2008
Date of first confirmation of the event 17/10/2008
Report date 21/10/2008
Date submitted to OIE 21/10/2008
Reason for notification Reoccurrence of a listed disease
Date of previous occurrence 1995
Causal agent Rabies virus Serotype RABV
Nature of diagnosis Laboratory (advanced)
This event pertains to a defined zone within the country

? New outbreaks
* Outbreak 1 (1 RABIES) - RESIA, UDINE, FRIULI-VENEZIA GIULIA
Date of start of the outbreak 10/10/2008
Outbreak status Continuing (or date resolved not provided)
Epidemiological unit Not applicable
Affected animals: Species - Susceptible - Cases - Deaths - Destroyed - Slaughtered
* Wild species - 1 - 1 - 0 - 1 - 0
Affected population: The fox attacked and bit a person who was walking in a forest, and then it was killed by this person, who is now undergoing all the necessary treatments.

? Summary of outbreaks
Total outbreaks: 1
Outbreak statistics: Species - Apparent morbidity rate - Apparent mortality rate - Apparent case fatality rate - Proportion susceptible animals lost*
* Wild species - 100.00% - 0.00% - 0.00% - 100.00%

* Removed from the susceptible population through death, destruction and/or slaughter

? Epidemiology
Source of the outbreak(s) or origin of infection
* Unknown or inconclusive

? Epidemiological comments
This is the first case of sylvatic rabies in Italy after 13 years and the infection may have been introduced in Italy from the East.

? Control measures
Measures applied

* Control of wildlife reservoirs
* No vaccination
* No treatment of affected animals

Measures to be applied

* No other measures

? Diagnostic test results
Laboratory name and type Experimental Zooprophylactic Institute (IZS), Venezie - Padova, National Reference Laboratory (National laboratory)
Tests and results: Species - Test - Test date - Result
* Wild - species polymerase chain reaction (PCR) - 17/10/2008 - Positive

? Future Reporting
The event is continuing. Weekly follow-up reports will be submitted.

? Map of outbreak locations
Location of current outbreaks <form name="mapform" action="public.php" method="post" target="map_window" onsubmit="return validate_map_click(this)"> <input name="map" src="https://www.oie.int/wahid-prod/mapserver/temp/122460358355361.png" class="framed_map" alt="Please wait while the map is generated for your request" type="image" width="400" height="400"> <input name="map_file" value="public868ccdeb271afe58d8dbb4e5439621231224603583" type="hidden"> <input name="page" value="country_map_interactive" type="hidden"> <input name="page_title" value="Location of current outbreaks" type="hidden"> <input name="page_refer" value="weekly_report_item" type="hidden"> <input name="page_info" value="" type="hidden"> <input name="public_country" value="ITA" type="hidden"> <input name="extent" value="6.0294485092163, 35.33216381073, 18.614400482178, 47.917115783691" type="hidden"> <input name="exsize" value="4.1949839909871" type="hidden"> <input name="pop" value="0" type="hidden"> <input name="button_action" value="" type="hidden"> <input name="map_size" value="400 400" type="hidden"> </form> -
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[Giuseppe]

Re: Rabies (fox), Italy (OIE-WAHID) **Immediate Notification Report**

Re: Rabies (fox), Italy (OIE-WAHID) **Immediate Notification Report**

RABIES, FOX - ITALY (FRIULI-VENEZIA GIULIA): HUMAN EXPOSURE [ProMedMail.org]

RABIES, FOX - ITALY (FRIULI-VENEZIA GIULIA): HUMAN EXPOSURE
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A ProMED-mail post <http: org="">
ProMED-mail is a program of the International Society for Infectious Diseases <http: org="">
Date: 24 Oct 2008
Source: Health Protection Report, The Health Protection Agency (UK), Volume 2 Number 43 [edited] <http: uk="" hpr="" archives="" 2008="" italy="">

Rabies in Italy, October 2008
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On 21 Oct 2008, the national reference laboratory for rabies in Italy confirmed a case of rabies in a fox in the Friuli-Venezia Giulia Region of north-eastern Italy (marked in red on the map) [see the above URL].

This fox was euthanized on 10 Oct 2008 after it attacked a person who was out walking in a forest in Resia district, close to the borders with Austria and Slovenia.

The results were positive for 'classical' rabies virus by PCR testing [1].

Italy has been rabies free since 1995, although rabies has been found in foxes in this area previously, most recently in 1992.

In previous cases foxes appear to have crossed the border from Slovenia and Austria, although the risk of rabies in the northern and eastern border regions of Italy has long been recognised.

Local routine preventive policies in Italy reflect the ongoing risk across the borders, and include compulsory vaccination of domestic animals and livestock which graze outside in those districts close to the border.

Local controls put in place in response to the present case include vaccination and restriction of movement of dogs in the Chiusaforte, Resiutta, Resia, and Venzone districts, enhanced surveillance of wildlife, and oral vaccination of wild foxes.

This area is alpine and forested and not a major tourist destination.

However the following advice has been given for travellers from the UK:
Those who are travelling to the northern and eastern border regions of Italy should avoid contact with wild and domestic animals. However, if they are licked, scratched or bitten by a wild or domestic animal they should wash the area thoroughly with soap and water and seek urgent medical advice either in Italy, or on their return from their GP [general practitioner physician] or NHS [National Health Service] Direct.

Expert advice for health professionals is available from the HPA Centre for Infections (CfI), Virus Reference Department (0208 200 4400) or the CfI duty doctor at (0208 200 6868).

Reference
1. Rabies, Italy: Report to OIE [World Organisation fro Animal Health], 22 Oct 2008. Available at: <http: int="" prod="" page="single_report&pop=1&reportid=7444">.
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Communicated by: ProMED-mail


[The Italian report to the OIE (ref.1 in the above article), includes a map. Its Epidemiological comments say: "This is the 1st case of sylvatic rabies in Italy after 13 years and the infection may have been introduced in Italy from the East." Located in northeastern Italy, Friuli-Venezia Giulia borders the region of Veneto to the west, the republics of Austria and Slovenia to the north and east, and the Adriatic Sea to the south. - Mod.AS]

[see also:
2005
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Rabies, fox - Western Europe (02) 20050416.1090

1997
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Rabies, fox - Europe 19971129.2386]
....................arn/ejp/jw
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[Giuseppe]

Re: Rabies (fox), Italy (OIE-WAHID) **Immediate Notification Report**

Re: Rabies (fox), Italy (OIE-WAHID) **Immediate Notification Report**

Rabies, Italy (update, 10/29/2008) [WAHID Interface - OIE]

Rabies, Italy

Information received on 29/10/2008 from Dr Romano Marabelli, Direttore Generale, Direzione Generale Sanita Veterinaria e Alimenti , Ministero della Salute, ROME, Italy

? Summary

Report type Follow-up report No. 1
Start date 10/10/2008
Date of first confirmation of the event 17/10/2008
Report date 29/10/2008
Date submitted to OIE 29/10/2008
Reason for notification Reoccurrence of a listed disease
Date of previous occurrence 1995
Causal agent Rabies virus Serotype RABV
Nature of diagnosis Laboratory (advanced), Necropsy

This event pertains to a defined zone within the country

Related reports
* Immediate notification (21/10/2008)
* Follow-up report No. 1 (29/10/2008)

? New outbreaks
* Outbreak 1 (2 RABIES) - VENZONE, UDINE, FRIULI-VENEZIA GIULIA
Date of start of the outbreak 19/10/2008
Outbreak status Continuing (or date resolved not provided)
Epidemiological unit Not applicable
Affected animals: Species - Susceptible - Cases - Deaths - Destroyed - Slaughtered
* Wild species - ... - 1 - 1 - 0 - 0
Affected population: The positivity regards a fox found dead.

? Summary of outbreaks
Total outbreaks: 1
Outbreak statistics: Species - Apparent morbidity rate - Apparent mortality rate - Apparent case fatality rate - Proportion susceptible animals lost*
* Wild species - ** - ** - 100.00% **
* Removed from the susceptible population through death, destruction and/or slaughter
** Not calculated because of missing information

? Epidemiology
Source of the outbreak(s) or origin of infection
* Unknown or inconclusive

? Control measures
Measures applied
* Control of wildlife reservoirs
* No vaccination
* No treatment of affected animals
Measures to be applied
* No other measures

? Diagnostic test results
Laboratory name and type Experimental Zooprophylactic Institute (IZS), Venezie - Padova, National Reference Laboratory (National laboratory)
Tests and results: Species - Test - Test date - Result
* Wild species - direct immunofluorescence (DIF) test - 27/10/2008 - Positive

? Future Reporting
The event is continuing. Weekly follow-up reports will be submitted.
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<cite cite="http://www.oie.int/wahid-prod/public.php?page=single_report&pop=1&reportid=7463">WAHID Interface - OIE World Animal Health Information Database</cite>

 

[Giuseppe]

Re: Rabies (fox), Italy (OIE-WAHID) - Immediate Notification Report and follow-up reports.

Emergence of fox rabies in north-eastern Italy [Eurosurveillance]

Eurosurveillance, Volume 13, Issue 45, 06 November 2008

Rapid communications

Emergence of fox rabies in north-eastern Italy

P De Benedictis 1, T Gallo2, A Iob3, R Coassin2, G Squecco3, G Ferri4, F D'Ancona5, S Marangon1, I Capua1, F Mutinelli1

1. Istituto Zooprofilattico Sperimentale delle Venezie, National Reference Centre for Rabies, Legnaro (Padova), Italy
2. Direzione Centrale Salute e Protezione Sociale, Regione Friuli Venezia Giulia, Trieste, Italy
3. Dipartimento di Prevenzione, Azienda per i Servizi Sanitari 3, Alto Friuli, Gemona del Friuli, Italy
4. Ministero del Lavoro della Salute e delle Politiche Sociali, Direzione Generale per la Sanit? Animale e il Farmaco Veterinario, Roma, Italy
5. Istituto Superiore di Sanit?, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Roma, Italy

Citation style for this article:
De Benedictis P, Gallo T, Iob A, Coassin R, Squecco G, Ferri G, D'Ancona F, Marangon S, Capua I, Mutinelli F. Emergence of fox rabies in north-eastern Italy. Euro Surveill. 2008;13(45)ii=19033.

Available online:
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19033

Date of submission: 03 November 2008

Italy has been classified as rabies-free since 1997. In October 2008, two foxes have been diagnosed with rabies in the Province of Udine, north-east Italy. One case of human exposure caused by a bite from one of the foxes has occurred and was properly treated.


On 17 October 2008, the national reference centre for rabies at the Istituto Zooprofilattico Sperimentale delle Venezie of Legnaro in Padova, Italy, identified a rabid red fox (Vulpes vulpes) in the municipality of Resia (Province of Udine, Northeast of Italy) (Figure 1) [1].

The fox had bitten a 69-year-old man on the ankle on 10 October. The victim received first aid assistance and complete post-exposure treatment at the local health unit. The exposed person is currently under active health surveillance.

Laboratory analysis
A brain sample from the fox initially tested negative in the fluorescent antibody test (FAT) for rabies virus (RABV). However, the virus was successfully isolated on murine neuroblastoma cell culture [2], and was confirmed as RABV by RT-PCR using specific primers. When the FAT was repeated on other brain specimens, the test was weakly positive.

The complete open reading frame (1,350 nt) of the gene encoding the nucleoprotein (N) was sequenced (GenBank Acc. Number FJ424484) and compared to the sequences available in public databases. Phylogenetic analysis was performed using the neighbour-joining method with 1,000 times bootstrapping, as implemented by the Mega 4 programme [3].

Phylogenetic analysis (Figure 2) identified the isolate as Lyssavirus genotype 1, "classical" rabies virus, according to the classification made by Kissi et al. [4], clustered in the Western European group [5]. As expected, it was closely related to RABV isolated from eastern neighbouring countries (Slovenia, Bosnia and Herzegovina and the former Federal Republic of Yugoslavia) and shared 99% homology with the complete N gene sequence of the strain 86111YOU and 100% homology with a 400 nt fragment of the N gene sequence of the strain 9494SLN, red fox isolates from Bosnia-Herzegovina and Slovenia, respectively.

According to the characteristics of the isolate it seems reasonable to believe that the emergence of sylvatic rabies in north-eastern Italy could be linked to infection in the bordering territories of Slovenia, although no cases are currently reported in the area.

Rabies situation in Italy
The north-eastern territories of the Italian region of Friuli Venezia Giulia have been affected by rabies in the 1970s and 1980s, and more recently in the period from 1991 to 1995 [6]. The municipality of Resia was affected until 1992. At that time, the epidemic of sylvatic rabies was linked to the epidemiological situation of infection in Austria and the nearby territories of former Yugoslavia, now Slovenia. For this reason, the risk of rabies in the northern and eastern border regions of Italy has long been recognised. The rabies surveillance carried out in that region accounted for an annual number of 310, 210, 123, 94 and 85 foxes analysed from 2004 to October 2008, respectively. Vaccination campaigns using oral rabies vaccine baits have been conducted targeting the wild fox population in these areas in 1989 and between 1992 and 2004. The last case of rabies in Italy was diagnosed in a fox in the province of Trieste on the border with Slovenia in December 1995.

Italy has been classified as rabies-free since 1997.

At present, Austria is rabies free, while in Slovenia, rabies cases in foxes are still being reported from the South Eastern regions bordering Croatia [7]. In this area oral vaccination campaigns are systematically conducted in the fox population since the mid-1990s in the framework of a national rabies eradication programme [8].

On 27 October 2008, a second fox was found dead and diagnosed with rabies in the municipality of Venzone (Province of Udine) (Figure 1), 12 km west to the one infected earlier the same month. No human exposure has been reported related to this second infected fox.

Measures taken
Following these outbreaks, the preventative measures implemented in the affected areas of Italy include compulsory rabies vaccination of dogs and domestic herbivores at risk of infection (i.e. cows, horses, sheep and goats kept outdoors), prohibition of hunting with dogs, enhanced surveillance in the wild animal population and implementation of oral vaccination of foxes (Figure 1).

Furthermore, an informative campaign on the risk for the local population, as well as visitors and tourists, has been implemented and a protocol for post-exposure prophylaxis and recommendations for pre-exposure immunisation for individuals at high risk (such as hunters, forest workers, game wardens, veterinarians) have been sent to all healthcare facilities and medical associations in the affected area.

References
1. OIE [World Organisation for Animal Health]. Rabies, Italy. Immediate notification report no. 7444. 21 Oct 2008. Available from: http://www.oie.int/wahid-prod/reports/en_imm_0000007444_20081021_173357.pdf.
2. OIE [World Organization for Animal Health]. Rabies. In: OIE Terrestrial Manual 2008. 6th ed. Available from: http://www.oie.int/eng/normes/mmanual/2008/pdf/2.01.13_RABIES.pdf
3. Tamura K, Dudley J, Nei M, Kumar S. MEGA4: Molecular Evolutionary Genetics Analysis (MEGA) software version 4.0. Mol Biol Evol. 2007;24(8):1596-99.
4. Kissi B, Tordo N, Bourhy H. Genetic polymorphism in the rabies virus nucleoprotein gene. Virology. 1995;209(2):526-37.
5. Bourhy H, Kissi B, Audry L, Smreczak M, Sadkowska-Todys M, Kulonen K, et al. Ecology and evolution of rabies virus in Europe. J Gen Virol. 1999;80(Pt 10):2545-57.
6. Mutinelli F, Stankov S, Hristovski M, Seimenis A, Theoharakou H, Vodopija I. Rabies in Italy, Yugoslavia, Croatia, Bosnia, Slovenia, Macedonia, Albania and Greece. In: King AA, Fooks AR, Aubert M, Wandeler AI, editors. Historical perspectives of rabies in Europe and the Mediterranean Basin. Paris: OIE; 2004. p. 93-118.
7. World Health Organization. Rabies Bulletin Europe. 2008; 32(1) January-March. Available from: http://www.who-rabies-bulletin.org/Journal/Default.aspx?Issue=2008_1
8. Hostnik P, Toplak I, Barlič-Maganja D, Jo?e G, Bidovec A. Control of rabies in Slovenia. J Wildl Dis. 2006;42(2):459-65
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<cite cite="http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19033">Eurosurveillance - View Article</cite>