Delivery and follow-up of a healthy newborn from a mother with clinical rabies

Iehlé, Catherine; Dacheux, Laurent; Ralandison, Stéphane; Andrianarivelo, Mala Rakoto; Rousset, Dominique; Bourhy, Hervé

doi:10.1016/j.jcv.2007.11.015

Cited by 8 publications

(6 citation statements)

References 8 publications

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“…Cell-culture rabies vaccines are safe. In the two cases described here, PEP was well tolerated, with only a short episode of moderate fever in one case, confirming previous observations (28,29). The ability of newborns to respond adequately to vaccines is well documented (45).…”

Section: Should Pep Be Administered To Protect Infants Born From Rabisupporting

confidence: 89%

“…In an early study, placenta extracts collected after delivery of a rabid woman who delivered a healthy baby after C-section were found to be non-infectious (20). In another, similar case report, no evidence of rabies virus dissemination in utero was found (29). Placenta and umbilical cord specimens collected immediately after delivery were negative for RABV antigen detection by FAT and rapid rabies enzyme immuno-diagnosis, for virus isolation by mouse injection and in cell culture after four successive passages on murine neuroblastoma cells, and for viral RNA by nested RT-PCR (29).…”

Section: Some Cases Of Vertical Transmission Have Been Reported In Rumentioning

confidence: 94%

“…The ability of newborns to respond adequately to vaccines is well documented (45). Follow-up of the immune response in an infant vaccinated three days after birth showed high serum titres of both rabies neutralizing antibodies and specific anti-rabies glycoprotein IgG after immunization, (29). The absence of subcutaneous padding makes intradermal injection in the newborn challenging and injecting a full dose of vaccine in small muscles may cause pain.…”

Section: Should Pep Be Administered To Protect Infants Born From Rabimentioning

confidence: 99%

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Rabies transmission risks during peripartum – Two cases and a review of the literature

Aguèmon

Tarantola

Zoumenou

et al. 2016

Vaccine

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We report two cases of probable rabies in near-term/at-term pregnant women in sub-Saharan Africa and Asia. One baby was delivered by caesarean section and the other one vaginally. Both received post-exposure prophylaxis (PEP), including RIG and vaccine and both are alive and healthy, at 9 and 24 months, respectively. We found 14 other published cases of infants born from rabid mothers. One confirmed case of rabies transmission occurred. The other children born from rabid mothers, with or without caesarean section, did not acquire rabies, and were still healthy at the time of reporting, with or without post-exposure prophylaxis. Mother-to-child transmission of rabies is possible, but rare, because rabies virus is not present in blood and exposure of the baby's mucosa to maternal infectious fluids and tissue seems limited. A conservative approach should however, be adopted, and rabies PEP, including RIG, be administered as soon as possible to babies born from probably rabid mothers. Whether cesarean-section clearly provides prevention remains unclear. Rabies can be prevented in pregnant women by PEP administration. Rabies cell-culture vaccines are safe and effective and can be administered to pregnant and lactating women, as well as newborns. Efforts must focus on raising rabies awareness in the general population, as well as in healthcare workers.

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Section: Should Pep Be Administered To Protect Infants Born From Rabisupporting

confidence: 89%

Section: Some Cases Of Vertical Transmission Have Been Reported In Rumentioning

confidence: 94%

Section: Should Pep Be Administered To Protect Infants Born From Rabimentioning

confidence: 99%

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Rabies transmission risks during peripartum – Two cases and a review of the literature

Aguèmon

Tarantola

Zoumenou

et al. 2016

Vaccine

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“…Rabies infection via placental transmission is possible in humans [3], but it does not seem to depend on mode of delivery (cesarean or vaginal) [4]. The neonate in the present case showed no adverse effects 6 months after vaccination, confirming previous reports [4].…”

Section: Conflict Of Interestsupporting

confidence: 79%

Rabies in a pregnant woman and delivery of a live fetus

Mondal¹,

Char²,

Mandal³

et al. 2014

International Journal of Gynecology & Obstetrics

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“…They include aerosol contamination [45][46][47], contact with and the preparation of infected meat or carcasses [48] and human-to-human transmission through the transplantation of various solid organs and tissues, including the cornea and vascular conduits [49][50][51]. The transplacental transmission of rabies seems to be rare, as most of the infants born to rabid mothers are healthy [52]. After inoculation, RABV may reach the peripheral nerves directly, via the nAChR present at the neuromuscular junction.…”

Section: Pathogenesismentioning

confidence: 99%

Human Rabies Encephalitis Prevention and Treatment: Progress Since Pasteurs Discovery

Dacheux¹,

Delmas²,

Bourhy

2011

IDDT

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Rabies remains one of the most ancient and deadly of human infectious diseases. This viral zoonosis is transmitted principally by the saliva of infected dogs, inducing a form of encephalomyelitis that is almost invariably fatal. Since the first implementation, by Louis Pasteur in 1885, of an efficient preventive post-exposure treatment, more effective protocols and safer products have been developed, providing almost 100% protection if administered early enough. However, this disease still represents a major, but neglected public health problem, with an estimated 55,000 human deaths due to rabies reported each year, mostly in Africa and Asia. Once the first clinical signs appear, there is no effective treatment. A ray of hope emerged in 2004, with the report of a patient recovering from rabies after aggressive, innovative treatment. However, this case was not clearly reproduced and the identification of targets for antiviral treatment in cases of rabies infection remains a major challenge. In this context, this review presents the state-of-the art in the prevention and curative treatment of human rabies. We begin by describing the viral etiological agent and the disease it causes, to provide an essential background to rabies. An overview of the post-exposure prophylaxis of rabies in humans is then given, from its initial implementation to possible future developments. Finally, an analysis of the various antiviral compounds tested in rabies in vitro, in animal models or in humans is presented, focusing in particular on potential new strategies.

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Delivery and follow-up of a healthy newborn from a mother with clinical rabies

Cited by 8 publications

References 8 publications

Rabies transmission risks during peripartum – Two cases and a review of the literature

Rabies transmission risks during peripartum – Two cases and a review of the literature

Rabies in a pregnant woman and delivery of a live fetus

Human Rabies Encephalitis Prevention and Treatment: Progress Since Pasteurs Discovery

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