2008-2011 sylvatic rabies epidemic in Italy: challenges and experiences.

After more than 10 years of absence, in 2008 rabies re-emerged and spread in wild foxes in north-eastern Italy. In order to control the infection and to minimize the risk of human exposure, three oral foxes vaccination campaigns were first carried out by manual distribution of baits between January and September 2009, followed by four emergency oral rabies vaccination (ORV) campaigns by aerial distribution in the affected regions starting in December 2009. Ordinary aerial ORV campaigns followed in spring and fall 2011 and 2012, although no cases were reported after February 2011. In our paper, we describe the main characteristics of the rabies epidemic that occurred in north-eastern Italy in 2008-2011, with particular focus on the innovative systems that were implemented to manage and evaluate the efficacy of the aerial ORV. The Italian experience in containing and eliminating rabies in less than 3 years may provide information and suggestions for countries affected by rabies, and sharing a similar geomorphological conformation as Italy.