Rabies control in Europe: an overview of past, current and future strategies.

Europe's step-by-step approach to tackling canine and wildlife-mediated rabies has proven that the disease can be controlled and eliminated at the animal source. A decade of development work and support by the European Union has resulted in a successful oral rabies vaccination campaign for foxes and raccoon dogs, and provided the blueprint for eliminating wildlife-mediated rabies. In this paper, the authors examine the historical stages of animal rabies control and its eventual elimination in parts of Europe, particularly Western Europe. In addition, they consider current control measures and predict future challenges, many of which are faced by the vast and sparsely populated, rabies-endemic areas of Eastern Europe.

L'approche par étapes appliquée en Europe pour combattre la rage canine ainsi que celle transmise par la faune sauvage a démontré que cette maladie peut être contrôlée et éliminée à sa source animale. La stratégie conçue et soutenue par l'Union européenne pendant une décennie s'est concrétisée par une campagne de vaccination antirabique orale des renards et des chiens viverrins qui a été couronnée de succès et constitue un modèle pour l'élimination de la rage transmise par les animaux sauvages. Les auteurs examinent le déroulement des étapes successives de la lutte contre la rage animale et de son élimination dans certaines régions européennes, en particulier en Europe occidentale. Ils examinent également les mesures actuelles de lutte et annoncent les difficultés auxquelles il faudra faire face à l'avenir, en particulier dans les vastes régions d'Europe orientale où la population est clairsemée et la rage endémique.

El método gradual (por etapas) aplicado en Europa para combatir la rabia canina y la transmitida por animales silvestres ha demostrado que es posible controlar y eliminar la enfermedad en su foco animal de origen. Diez años de trabajo de desarrollo y de apoyo de la Unión Europea desembocaron en una fructífera campaña de vacunación antirrábica oral de zorros y mapaches, convertida ahora en un modelo para eliminar la rabia transmitida por animales silvestres. Los autores repasan las etapas históricas de la lucha contra la rabia animal hasta su eliminación final en ciertas partes de Europa, en particular en Europa Occidental. Además, examinan las medidas de control vigentes y auguran futuras dificultades, muchas de ellas en las vastas zonas de Europa Oriental donde la población es escasa y dispersa y la rabia es endémica.

Vaccines against pseudorabies virus (PrV).

Aujeszkýs disease (AD, pseudorabies) is a notifiable herpesvirus infection of pigs causing substantial economic losses to swine producers. AD in pigs is controlled by the use of vaccination with inactivated and attenuated live vaccines. Starting with classically attenuated live vaccines derived from low virulent field isolates, AD vaccination has pioneered novel strategies in animal disease control by the first use of genetically engineered live virus vaccines lacking virulence-determining genes, and the concept of DIVA, i.e. the serological differentiation of vaccinated from field-virus infected animals by the use of marker vaccines and respective companion diagnostic tests. The basis for this concept has been the molecular characterization of PrV and the identification of so-called nonessential envelope glycoproteins, e.g. glycoprotein E, which could be eliminated from the virus without harming viral replication or immunogenicity. Eradication of AD using the strategy of vaccination-DIVA testing has successfully been performed in several countries including Germany and the United States. Furthermore, by targeted genetic modification PrV has been developed into a powerful vector system for expression of foreign genes to vaccinate against several infectious diseases of swine, while heterologous vector systems have been used for expression of major immunogens of PrV. This small concise review summarizes the state-of-the-art information on PrV vaccines and provides an outlook for the future.

Reverse genetics in high throughput: rapid generation of complete negative strand RNA virus cDNA clones and recombinant viruses thereof.

Reverse genetics approaches are indispensable tools for proof of concepts in virus replication and pathogenesis. For negative strand RNA viruses (NSVs) the limited number of infectious cDNA clones represents a bottleneck as clones are often generated from cell culture adapted or attenuated viruses, with limited potential for pathogenesis research. We developed a system in which cDNA copies of complete NSV genomes were directly cloned into reverse genetics vectors by linear-to-linear RedE/T recombination. Rapid cloning of multiple rabies virus (RABV) full length genomes and identification of clones identical to field virus consensus sequence confirmed the approache's reliability. Recombinant viruses were recovered from field virus cDNA clones. Similar growth kinetics of parental and recombinant viruses, preservation of field virus characters in cell type specific replication and virulence in the mouse model were confirmed. Reduced titers after reporter gene insertion indicated that the low level of field virus replication is affected by gene insertions. The flexibility of the strategy was demonstrated by cloning multiple copies of an orthobunyavirus L genome segment. This important step in reverse genetics technology development opens novel avenues for the analysis of virus variability combined with phenotypical characterization of recombinant viruses at a clonal level.

Lyssavirus distribution in naturally infected bats from Germany.

In Germany, to date three different lyssavirus species are responsible for bat rabies in indigenous bats: the European Bat Lyssaviruses type 1 and 2 (EBLV-1, EBLV-2) and the Bokeloh Bat Lyssavirus (BBLV) for which Eptesicus serotinus, Myotis daubentonii and Myotis nattereri, respectively, are primary hosts. Lyssavirus maintenance, evolution, and epidemiology are still insufficiently explored. Moreover, the small number of bats infected, the nocturnal habits of bats and the limited experimental data still hamper attempts to understand the distribution, prevalence, and in particular transmission of the virus. In an experimental study in E. serotinus a heterogeneous dissemination of EBLV-1 in tissues was detected. However, it is not clear whether the EBLV-1 distribution is similar in naturally infected animals. In an attempt to further analyze virus dissemination and viral loads within naturally infected hosts we investigated tissues of 57 EBLV-1 positive individuals of E. serotinus from Germany by RT-qPCR and compared the results with those obtained experimentally. Additionally, tissue samples were investigated with immunohistochemistry to detect lyssavirus antigen in defined structures. While in individual animals virus RNA was present only in the brain, in the majority of E. serotinus viral RNA was found in various tissues with highest relative viral loads detected in the brain. Interestingly, viral antigen was confirmed in various tissues in the tongue including deep intralingual glands, nerves, muscle cells and lingual papillae. So, the tongue appears to be a prominent site for virus replication and possibly shedding.

Twenty years of active bat rabies surveillance in Germany: a detailed analysis and future perspectives.

SUMMARY: In Germany, active bat rabies surveillance was conducted between 1993 and 2012. A total of 4546 oropharyngeal swab samples from 18 bat species were screened for the presence of EBLV-1- , EBLV-2- and BBLV-specific RNA. Overall, 0·15% of oropharyngeal swab samples tested EBLV-1 positive, with the majority originating from Eptesicus serotinus. Interestingly, out of seven RT-PCR-positive oropharyngeal swabs subjected to virus isolation, viable virus was isolated from a single serotine bat (E. serotinus). Additionally, about 1226 blood samples were tested serologically, and varying virus neutralizing antibody titres were found in at least eight different bat species. The detection of viral RNA and seroconversion in repeatedly sampled serotine bats indicates long-term circulation of the virus in a particular bat colony. The limitations of random-based active bat rabies surveillance over passive bat rabies surveillance and its possible application of targeted approaches for future research activities on bat lyssavirus dynamics and maintenance are discussed.

Bovine rabies in Turkey: patterns of infection and implications for costs and control.

The incidence of rabies in livestock is an important factor for estimating the economic impact of the disease, but obtaining reliable data is hindered by inadequate surveillance. In order to understand the contribution of livestock rabies to the overall burden of disease, the rabies incidence in cattle was investigated in detail for Turkey between 2008 and 2011. Data were compiled on cattle numbers, samples submitted for rabies diagnosis, vaccinated animals and positive rabies cases in animals for seven regions in Turkey. Rabies incidence in cattle fluctuated annually and differed between regions from 0·10 to 3·87 cases/100 000 animals. The positive influence of compensation schemes was observed. Livestock losses were conservatively estimated at around $250 000 international dollars per annum, although in areas where compensation schemes are not operating this could be an underestimate of the economic burden. Vaccination of cattle remains an option for disease prevention, although oral rabies vaccination through aerially distributed baits should be implemented to prevent the further spread of fox-mediated rabies, which could result in much greater economic costs.

Bat rabies surveillance in Europe.

Rabies is the oldest known zoonotic disease and was also the first recognized bat associated infection in humans. To date, four different lyssavirus species are the causative agents of rabies in European bats: the European Bat Lyssaviruses type 1 and 2 (EBLV-1, EBLV-2), the recently discovered putative new lyssavirus species Bokeloh Bat Lyssavirus (BBLV) and the West Caucasian Bat Virus (WCBV). Unlike in the new world, bat rabies cases in Europe are comparatively less frequent, possibly as a result of varying intensity of surveillance. Thus, the objective was to provide an assessment of the bat rabies surveillance data in Europe, taking both reported data to the WHO Rabies Bulletin Europe and published results into account. In Europe, 959 bat rabies cases were reported to the RBE in the time period 1977-2010 with the vast majority characterized as EBLV-1, frequently isolated in the Netherlands, North Germany, Denmark, Poland and also in parts of France and Spain. Most EBLV-2 isolates originated from the United Kingdom (UK) and the Netherlands, and EBLV-2 was also detected in Germany, Finland and Switzerland. Thus far, only one isolate of BBLV was found in Germany. Published passive bat rabies surveillance comprised testing of 28 of the 52 different European bat species for rabies. EBLV-1 was isolated exclusively from Serotine bats (Eptesicus serotinus and Eptesicus isabellinus), while EBLV-2 was detected in 14 Daubenton's bats (Myotis daubentonii) and 5 Pond bats (Myotis dasycneme). A virus from a single Natterer's bat (Myotis nattereri) was characterized as BBLV. During active surveillance, only oral swabs from 2 Daubenton's bats (EBLV-2) and from several Eptesicus bats (EBLV-1) yielded virus positive RNA. Virus neutralizing antibodies against lyssaviruses were detected in various European bat species from different countries, and its value and implications are discussed.

Molecular epidemiology of bat lyssaviruses in Europe.

Bat rabies cases in Europe are principally attributed to two lyssaviruses, namely European bat lyssavirus type 1 (EBLV-1) and European bat lyssavirus type 2 (EBLV-2). Between 1977 and 2011, 961 cases of bat rabies were reported to Rabies Bulletin Europe, with the vast majority (>97%) being attributed to EBLV-1. There have been 25 suspected cases of EBLV-2, of which 22 have been confirmed. In addition, two single isolations of unique lyssaviruses from European insectivorous bats were reported in south-west Russia in 2002 (West Caucasian bat virus) and in Germany in 2010 (Bokeloh bat lyssavirus). In this review, we present phylogenetic analyses of the EBLV-1 and EBLV-2 using partial nucleoprotein (N) gene sequences. In particular, we have analysed all EBLV-2 cases for which viral sequences (N gene, 400 nucleotides) are available (n = 21). Oropharyngeal swabs collected from two healthy Myotis daubentonii during active surveillance programmes in Scotland and Switzerland also yielded viral RNA (EBLV-2). Despite the relatively low number of EBLV-2 cases, a surprisingly large amount of anomalous data has been published in the scientific literature and Genbank, which we have collated and clarified. For both viruses, geographical relationships are clearly defined on the phylogenetic analysis. Whilst there is no clear chronological clustering for either virus, there is some evidence for host specific relationships, particularly for EBLV-1 where more host variation has been observed. Further genomic regions must be studied, in particular for EBLV-1 isolates from Spain and the EBLV-2 isolates to provide support for the existence of sublineages.

A quantitative release assessment for the noncommercial movement of companion animals: risk of rabies reintroduction to the United kingdom.

In 2004, the European Union (EU) implemented a pet movement policy (referred to here as the EUPMP) under EU regulation 998/2003. The United Kingdom (UK) was granted a temporary derogation from the policy until December 2011 and instead has in place its own Pet Movement Policy (Pet Travel Scheme (PETS)). A quantitative risk assessment (QRA) was developed to estimate the risk of rabies introduction to the UK under both schemes to quantify any change in the risk of rabies introduction should the UK harmonize with the EU policy. Assuming 100 % compliance with the regulations, moving to the EUPMP was predicted to increase the annual risk of rabies introduction to the UK by approximately 60-fold, from 7.79 × 10(-5) (5.90 × 10(-5), 1.06 × 10(-4)) under the current scheme to 4.79 × 10(-3) (4.05 × 10(-3), 5.65 × 10(-3)) under the EUPMP. This corresponds to a decrease from 13,272 (9,408, 16,940) to 211 (177, 247) years between rabies introductions. The risks associated with both the schemes were predicted to increase when less than 100 % compliance was assumed, with the current scheme of PETS and quarantine being shown to be particularly sensitive to noncompliance. The results of this risk assessment, along with other evidence, formed a scientific evidence base to inform policy decision with respect to companion animal movement.

The WHO Rabies Bulletin Europe: a key source of information on rabies and a pivotal tool for surveillance and epidemiology.

Rabies is one of the most, if not the most, prominent and feared zoonotic diseases in the world and the World Health Organization (WHO) estimates that 55,000 people die of the disease every year. Most of these deaths occur in Asia and Africa and are usually the result of dog-mediated rabies. In Europe, the red fox is considered the main reservoir species for wildlife rabies caused by the rabies virus. Besides foxes, bats have also been identified as a reservoir for European bat lyssaviruses in many European countries. Here, the authors present the rabies surveillance data for Europe in recent years, as reported to the WHO Rabies Bulletin Europe. This journal has evolved into a web-based platform for rabies information (including an online accessible database) that on average receives more than 60,000 visitors each year.

Molecular diversity and evolutionary history of rabies virus strains circulating in the Balkans.

Molecular studies of European classical rabies viruses (RABV) have revealed a number of geographically clustered lineages. To study the diversity of Balkan RABV, partial nucleoprotein (N) gene sequences were analysed from a unique panel of isolates (n = 210), collected from various hosts between 1972 and 2006. All of the Balkan isolates grouped within the European/Middle East Lineage, with the majority most closely related to East European strains. A number of RABV from Bosnia & Herzegovina and Montenegro, collected between 1986 and 2006, grouped with the West European strains, believed to be responsible for the rabies epizootic that spread throughout Europe in the latter half of the 20th Century. In contrast, no Serbian RABV belonged to this sublineage. However, a distinct group of Serbian fox RABV provided further evidence for the southwards wildlife-mediated movement of rabies from Hungary, Romania and Serbia into Bulgaria. To determine the optimal region for evolutionary analysis, partial, full and concatenated N-gene and glycoprotein (G) gene sequences were compared. Whilst both the divergence times and evolutionary rates were similar irrespective of genomic region, the 95 % highest probability density (HPD) limits were significantly reduced for full N-gene and concatenated NG-gene sequences compared with partial gene sequences. Bayesian coalescent analysis estimated the date of the most common recent ancestor of the Balkan RABV to be 1885 (95 % HPD, 1852-1913), and skyline plots suggested an expansion of the local viral population in 1980-1990, which coincides with the observed emergence of fox rabies in the region.

Improved safety for molecular diagnosis of classical rabies viruses by use of a TaqMan real-time reverse transcription-PCR "double check" strategy.

To improve the diagnosis of classical rabies virus with molecular methods, a validated, ready-to-use, real-time reverse transcription-PCR (RT-PCR) assay was developed. In a first step, primers and 6-carboxyfluorescien-labeled TaqMan probes specific for rabies virus were selected from the consensus sequence of the nucleoprotein gene of 203 different rabies virus sequences derived from GenBank. The selected primer-probe combination was highly specific and sensitive. During validation using a sample set of rabies virus strains from the virus archives of the Friedrich-Loeffler-Institut (FLI; Germany), the Veterinary Laboratories Agency (VLA; United Kingdom), and the DTU National Veterinary Institute (Lindholm, Denmark), covering the global diversity of rabies virus lineages, it was shown that both the newly developed assay and a previously described one had some detection failures. This was overcome by a combined assay that detected all samples as positive. In addition, the introduction of labeled positive controls (LPC) increased the diagnostic safety of the single as well as the combined assay. Based on the newly developed, alternative assay for the detection of rabies virus and the application of LPCs, an improved diagnostic sensitivity and reliability can be ascertained for postmortem and intra vitam real-time RT-PCR analyses in rabies reference laboratories.

Molecular epidemiology of rabies virus in Romania provides evidence for a high degree of heterogeneity and virus diversity.

Rabies has been present in Romania since antiquity and remains a continual threat to veterinary and public health. The current epizootic of rabies in Romania is fox mediated. However, little is known about the genetic diversity among rabies virus isolates from this part of the Balkan region. In this study, we analyzed a cohort of 64 rabies viruses isolated from infected animals in Romania collected between 2005 and 2008. Partial nucleoprotein sequence data (322 bp) were obtained and compared to a panel of available sequence data of Eurasian classical rabies virus (genotype 1) isolates. The Romanian sequences were identified as belonging to the cosmopolitan lineage of rabies viruses that have been reported throughout the world. The sequences showed a high degree of heterogeneity and six different lineages were identified. Single isolates clustered with the formerly established Eastern European group, the North-Eastern European group or with isolates from the Southwest of Russia. However two lineages were unique to Romania. This sequence diversity is unprecedented in European countries and could be a result of trans-border movement or remnants of previous epidemic waves.

Analysis of vaccine-virus-associated rabies cases in red foxes (Vulpes vulpes) after oral rabies vaccination campaigns in Germany and Austria.

To eradicate rabies in foxes, almost 97 million oral rabies vaccine baits have been distributed in Germany and Austria since 1983 and 1986, respectively. Since 2007, no terrestrial cases have been reported in either country. The most widely used oral rabies vaccine viruses in these countries were SAD (Street Alabama Dufferin) strains, e.g. SAD B19 (53.2%) and SAD P5/88 (44.5%). In this paper, we describe six possible vaccine-virus-associated rabies cases in red foxes (Vulpes vulpes) detected during post-vaccination surveillance from 2001 to 2006, involving two different vaccines and different batches. Compared to prototypic vaccine strains, full-genome sequencing revealed between 1 and 5 single nucleotide alterations in the L gene in 5 of 6 SAD isolates, resulting in up to two amino acid substitutions. However, experimental infection of juvenile foxes showed that those mutations had no influence on pathogenicity. The cases described here, coming from geographically widely separated regions, do not represent a spatial cluster. More importantly, enhanced surveillance showed that the vaccine viruses involved did not become established in the red fox population. It seems that the number of reported vaccine virus-associated rabies cases is determined predominantly by the intensity of surveillance after the oral rabies vaccination campaign and not by the selection of strains.

Epidemiology of bat rabies in Germany.

Rabies in European bats was first reported in Germany in 1954. In concordance with Denmark and the Netherlands, Germany has reported one of the highest numbers (n = 187) of European bat lyssavirus (EBLV)-positive cases in bats in Europe so far (1954-2005). A combined descriptive epidemiological and phylogenetic analysis on bat rabies and prevailing EBLVs is presented, comprising the past 50 years. So far, only the two lineages of EBLV-1 (genotype 5), a and b, have been detected. Although only 50% of the rabies-positive bats have been identified by species, the Serotine bat (Eptesicus serotinus) is the bat species most frequently infected. Single rabies cases have also been detected in a further five indigenous bat species. There is proven evidence for a substantial bias in the frequency of bat rabies cases in the north of Germany, with an endemic cluster in the northwesternmost low-lying plain areas adjacent to the Netherlands and Denmark. Improvements to bat rabies surveillance and research are discussed.