Press kits

Rabies in France in 2007

The first World Rabies Day gives us the opportunity for an update on the rabies situation in France, where nearly 8,500 consultations suspecting rabies took place in 2006, and where the number of post-exposure treatments among travellers bitten in endemic regions has more than doubled in 20 years.


The first World Rabies Day gives us the opportunity for an update on the rabies situation in France, where nearly 8,500 consultations suspecting rabies took place in 2006, and where the number of post-exposure treatments among travellers bitten in endemic regions has more than doubled in 20 years.

Although the eradication of fox rabies in France was pronounced on 30 April 2001* by order of the minister for agriculture, the disease remains of current interest for several reasons. On one hand, rabies remains widespread across the world: importation cases are thus always to be feared, either through a bite in an endemic country, or through contact with an animal brought back illegally; in summer 2004, a pup imported from Morocco triggered a rabies alert across French territory. Furthermore, some "reservoirs" exist in Europe and France- for example, bats, which host different viruses than those of dogs or foxes, although these viruses are also communicable to humans, and the rabies treatments are not as well adapted for use against them. Finally, rabies is a fearsome disease, always fatal in the absence of treatment.

Hence the importance of the vast network of Rabies Treatment Centres set up in 1977: 66 centres and 21 posts are spread throughout French territory and are coordinated by the National Reference Centre (NRC) for Rabies at the Institut Pasteur in Paris. For background, each year this NRC takes more than a thousand animal samples connected with a suspected animal-to-human transmission of rabies (1,181 in 2006). In 2006, 8,497 consultations were performed in the rabies centres, which gave rise to 4,280 post-exposure treatments.

While no case of human rabies acquired in France has been reported since 1924, this is partly due to the feasibility of performing the post-exposure treatment: it begins with a nonspecific treatment (cleaning of wounds, antibiotic therapy, tetanus prophylaxis). It is followed by a specific treatment that includes vaccination, with a rabies serotherapy in some cases, and must be performed as quickly as possible after exposure, before the appearance of the first symptoms, which signals an inexorably fatal development. It consists of 4 or 5 intramuscular injections spread over a month.

"It is necessary to stress a significant drop in the number of treatments: 60% since 1989, which reflects the fact that native rabies has for the moment disappeared in France. The sole risks of native infection are bats: between 1989 and 2006, 28 bats have been diagnosed positive for rabies in France. Significant precautions also remain to be taken with regard to wild and domestic animals for travellers in endemic regions, and with regard to animals imported illegally into France", explains Yolande Rotivel, co-director of the NRC for rabies and supervisor of the Institut Pasteur’s Rabies Centre.

In fact, 24 cases of illegal importation of rabid animals have been reported from 1968 to 2006 in France: mostly dogs, but also a cat and a bat. The bat imported in 1999 led to more than a hundred rabies treatments.
Moreover, 20 human cases acquired outside French territory have been reported since 1977, and the number of travellers treated for rabies after having been bitten in a region of the world most often plagued by dog rabies has more than doubled in 20 years.

Concerning bat rabies, Hervé Bourhy, director of the WHO Collaborating Centre for rabies at the Institut Pasteur, stresses: "The small number of human cases recorded shows that the effectiveness of the passage from animals to humans seems low. But the epidemiological situation is not static. New viral variants can appear and present a clearly superior infectivity for humans, as is the case currently in the United States." Hence the importance of maintaining a rabies surveillance network in France.**

* The last case of fox rabies in France was diagnosed in Moselle in 1998. The epizootic of vulpine rabies had reached French territory in 1968, originating from a Polish focus. It was eradicated with the oral vaccination of foxes, distributed in bait form.
** The following take part in the surveillance of rabies in France: the Directorate General for Health, the Institut de Veille Sanitaire (InVS, Sanitary Watch Institute), the NRC located at the Institut Pasteur, and the rabies centres for human rabies; and for animal rabies, the Directorate General for Food, the French Food Safety Agency AFSSA-Nancy, the Departmental Directorates for Veterinary Services, the National Veterinary Schools, and amateur chiropterologists who make it possible to collect bats.


The rabies centres (in red) and posts (in green) in France