Spencer is served pizza in Italy and starts to use a fork but is told by the chef fold the slices and eat them by hand. The type of pizza he is served is not meant to be in slices, it's meant to be eaten whole with a fork and knife and the folding of slices was started in NYC in the early 1900s. Still to this day pizza in Italy is eaten with a fork and knife.
The syringes that the doctor and Cara use to inject the anti rabies shots to Elizabeth appear to be plastic, rather than the glass the time period would have.