The current state of rabies prevention in Europe

Abstract

In Europe, from the late 1970s, the main reservoirs of rabies virus have been wild animals, mainly foxes, except in Turkey, where dog rabies account for almost all cases. Between 1977 and 1994, 198 human rabies cases were reported in Europe. In most of these cases vaccination had not been performed. In Europe, both tissue culture and nerve tissue vaccines are used with or without rabies immunoglobulin or serum, though the tissue culture vaccines have largely replaced the nerve tissue vaccines. In Hungary, where immune serum or immunoglobulin is not prescribed, no cases of human rabies among actively vaccinated individuals have been reported in the last 40 years of observation. There have, however, been two cases in which the cat, the source of infection, proved to be negative for rabies using both the fluorescent antibody and mouse inoculation tests, and therefore vaccination either did not start or was interrupted. These cases clearly question the recommendation, that a report from a reliable laboratory, indicating negative results justify cessation of treatment.