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With very few exceptions, rabies is occurring around the globe. The clinical course of this mammal-transmitted infection is almost universally fatal. Thus, the disease is causing more human deaths than any other zoonosis. Due to the lack of effective therapeutic options, pre- or post-exposure vaccination remains the only effective means to avoid development of fatal disease. Save and highly effective cell culture vaccines which have been available for decades provide long-lasting protection. Various vaccination schedules have been tested and are being recommended.

The Mediterranean region is a popular destination for tourists during the summer. However, European tourists, who are travelers within their own continent, do not consider themselves exposed to possible, travel-associated infections, since problem awareness among tourists as well as doctors is rather weak. The objective of this consensus paper is to outline guidelines with regard to relevant travel immunizations for Mediterranean destinations. These recommendations are mainly based on risk calculations according to country-specific incidences and prevalences of vaccine-preventable diseases such as hepatitis A, hepatitis B, typhoid fever, meningococcal meningitis, rabies, and tick-borne encephalitis.

It is reported about a field trial of oral vaccination of foxes against rabies, started in some Bavarian districts. The planning stage, the preparation of baits and their distribution, and the subsequent investigations to evaluate the field trial are outlined. The vaccine will be produced by the Federal Research Institute for Animal Diseases at Tübingen. 110,000 vaccine baits were laid out in 4 vaccination campaigns within 2 years. In no instance vaccine virus could be reisolated from animals collected in the vaccination zone. About 50% of the foxes were successfully immunized.

A case of rabies in a pregnant woman who spontaneously delivered a premature baby before dying is presented. Although not vaccinated the baby did not develop rabies. The possibility of displacental transmission of rabies in humans is judged as highly improbable on the basis of findings in other publications and in the case presented here.

The increasing animal rabies infection in the Federal Republic of Germany and the growing risk for man - in 1974 two people died from rabies consequences although inoculated - shows the necessily to protect all bitten patients and those exposed to a risk of rabies by a well-timed prophylactic immunization. Unfortunately the HEMPT-vaccine used in this country up to the beginning of 1974 did not the requirements because of the low rate of circulating neutralizing antibodies and the numerous neurological complications associated with this vaccination. The now commonly used duck embryo rabies vaccine (DEV) also induces only low antibody titers, therefore the active immunization in uncertain. A new type of vaccine cultivated on human diploid cells (HDCS-vaccine) is currently being investigated upon but is due to produce quickly antirabies antibody still in incubation and should be put on the market if it has been sufficiently tested. The question of cost for pre-exposure vaccination for man to be carried by the state is discussed.

In the past Hempt-rabies vaccine produced in the GDR proved to be effective and relatively innocent like other brain-tissue-vaccines. Connected with progress in virology and genetics the production of rabies-vaccines changed to cell culturing techniques. The rabies viruses got adapted to embryonated eggs of chicken and duck, and it multiplies now in tissue-cultures like hamster kidney cells, chicken fibroblasts and human diploid cells too. It is possible now to produce a cell culture vaccine of high efficacy and innocuity, such as those done by Selimov and co-workers in the Soviet-Union. Strain Wnukovo-32 is multiplied on primary kidney cells of syrian hamsters. From 1971 to 1976 about 45,000 persons were vaccinated with the new lyophilized vaccine in the USSR. From April 1976 till October 1977 a comparison in the clinical field was performed in the GDR applying either the Soviet cell culture vaccine or the rabies vaccine after Hempt of the GDR. The results of this test including serological control of induced antibodies allow the pharmaceutical registration of the Soviet vaccine and its exclusive use in a shortened application schedule.