1Pasteur Institute of Iran, a WHO Collaborating Center for Reference and Research on Rabies, Tehran, Iran Find articles by.
1Pasteur Institute of Iran, a WHO Collaborating Center for Reference and Research on Rabies, Tehran, Iran Find articles by.
Tehran, Iran’s Pasteur Institute of Iran, Department of Vaccination, Treatment and Prevention of Rabies Center Find articles by.
Tehran, Iran’s Pasteur Institute of Iran, Department of Vaccination, Treatment and Prevention of Rabies Center Find articles by.
1Pasteur Institute of Iran, a WHO Collaborating Center for Reference and Research on Rabies, Tehran, Iran Find articles by.
1Pasteur Institute of Iran, a WHO Collaborating Center for Reference and Research on Rabies, Tehran, Iran Find articles by.
1Pasteur Institute of Iran, a WHO Collaborating Center for Reference and Research on Rabies, Tehran, Iran Find articles by.
Background: Rabies is a fatal infectious disease, and the preferred method for preventing human rabies is rabies post-exposure prophylaxis.
Case series: We report the levels of anti-rabies antibodies found in the cord blood and serum of expectant mothers who were bitten by animals thought to be rabies-carrying and who received the purified Vero cell rabies vaccine (PVRV) and human rabies immunoglobulin (HRIG) serum vaccinations. Six pregnant women between the ages of 22 and 35 were admitted to the Tehran-based Pasture Institute of Iran’s rabies treatment and prevention center between 2007 and 2010. Of those, two cases occurred during the first trimester of pregnancy, one during the second, and three during the third. The time between biting and delivery ranged from 5-265 days (with a mean of 121 days).
Immunoglobulin results show that rabies antibody levels in maternal sera and fetuses are not equal and uniform, but it is demonstrated that the baby will find effective immunity with a minimal protective level of 0. 5 IU/ml in all instances, with the exception of a newborn who was born just 5 days after the mother’s immunization and sooner than the mother’s second vaccination course’s recommended immunization interval.
Among all infectious diseases, rabies has a 100% fatality rate (1), poses a risk for maternal death, and the risk to the fetus is unknown (2, 3). Let’s review the ACIP’s (Advisory Committee on Immunization Practices) recommendation for rabies vaccination for expectant and nursing mothers. Clean the wound with soap and water before starting rabies post-exposure prophylaxis. Second, the suspected animal should be watched for 10 days if an owned dog, cat, or stray animal is available for testing. If the animal remains alive, vaccination will be ceased. Thirdly, getting bitten by an animal from the wild that isn’t readily available calls for the administration of PVRV and HRIG as well as a vaccine to the deltoid area (4).
Currently, the preferred method for preventing rabies is rabies post-exposure prophylaxis. Any expecting mother who is bitten by a stray animal faces danger They need proper post-exposure management. Vaccination is not contraindicated in pregnancy and breast feeding. Numerous studies support the safety of anti-rabies vaccinations during pregnancy. According to one study, post exposure prophylaxis was given to 21 pregnant women, and neither the mothers nor the fetuses experienced any negative effects (5).
Another study (6) has emphasized that treatment should never be withheld or delayed if a patient is possibly exposed to rabies and has confirmed the safety of vaccination in post-exposure pregnant women. One case study from Mexico mentioned two patients who received vaccinations after being exposed to rabies during their second and third trimesters of pregnancy.
Mothers who received prophylaxis reported no negative side effects; prophylaxis appears to be safe when administered during pregnancy. This case recommends that pregnancy not be a contraindication to rabies post-exposure prophylaxis due to the fatal risk associated with a rabid animal bite (7).
Current vaccines produce an acceptable antibody response in 7–10 days, but to fill the 7–10 day gap, immunoglobulin passive immunization (with a half-life of 21 days) is used (4). We must emphasize that rabies is endemic in Iran, but rabies post-exposure prophylaxis for pregnant women has been shown to be safe in various studies. We will evaluate the effectiveness of rabies antibodies in Iranian pregnant women and newborns, as well as the correlation of antibody levels between them.
We describe six cases of pregnant women who contracted rabies after being bitten by suspected rabid animals and were sent to the Prevention and Treatment of Rabies Center at the Department of Vaccination in Pasture Institute of Iran in Tehran, Iran, between 2007 and 2010.
In five of these cases, the injuries were superficial, but in the sixth, the wounds ranged from superficial to semi-deep. In three of these cases, dogs and cats respectively bit the victims. The cases ranged in age from 22 to 35, and the gestational ages were between 6 and 39 weeks. The patients agreed to receive purified Vero cell rabies vaccine (PVRV), recommended by the World Health Organization, and anti-rabies HRIG serum treatment (in five cases) after being informed of the risk of developing human rabies.
Other people who were bitten by street cats received 5 doses on the days 0, 3, 7, 14, and 28 after exposure in addition to HRIG, while three cases who had been bitten by home dogs received three doses of vaccine on the days 0, 3, and 7 after exposure. There were 5-265 days between post-exposure vaccinations and delivery ()
The serum and vaccine had no negative effects on the women or the newborns. The outcome of the pregnancy was satisfactory. Three of the cases involved vaginal birth, while the other cases involved cesarean sections. None of the newborns had any congenital abnormalities, and they were all in good health. We collected cord blood samples from the mother and the newborn at delivery to evaluate the effectiveness of anti-rabies immunization in a mother and her newborn.
The Pasteur Institute of Iran’s laboratory evaluated the levels of anti-rabies antibodies. Anti-rabies antibody results revealed that the majority of cases had protective values of at least 0. 5 IU/ml, with the exception of one infant who was born just five days after the mother had received her immunizations (by HRIG and PVRV) and less than the recommended amount of time needed for immunization. Newborns whose mothers received more vaccine doses showed higher antibody levels ()
Public health authorities advise against considering pregnancy as a contraindication to rabies post-exposure prophylaxis because numerous studies have shown the safety of anti-rabies vaccination during pregnancy and there is no link between treatment and unfavorable outcomes (2, 3).
The department’s policy remains unchanged: Despite reports from Abazeed about a pregnant woman who was exposed to a bat but refused to seek treatment because the bat was fortunately uninfected, some doctors and patients are still hesitant to receive vaccinations.
In a case study, neither the mother nor the child experienced any negative effects after receiving rabies post-exposure prophylaxis for 21 pregnant women (4). Our most recent report states that using PVRV and HRIG has not resulted in any serious side effects.
In order to determine the immunogenicity of rabies post-exposure vaccination in expectant mothers, Sudarshan measured antibody levels in children whose mothers had received PVRV during pregnancy after being bitten by a suspected animal. He discovered that PVRV had an effective immunity in the mother and the child and was also safe during pregnancy (9)
Another point is that vaccination not only provides adequate protection but also has no negative effects on the mother or the child, and the infant will develop immunity as a result. Numerous studies have confirmed the safety of rabies vaccination during pregnancy, but our goal was to measure the rabies antibody level and the effectiveness of the vaccination in both pregnant women and new mothers.
Options for Vaccinating a Pregnant Dog for Rabies
The fact that rabies vaccines are “killed” as opposed to live vaccines is one way that they differ from other types of vaccines. Therefore, a veterinarian may advise giving it during pregnancy, especially if it’s for safety reasons. If your state requires rabies vaccinations and your veterinarian cannot give you a legal delay, they may also advise you to administer the vaccine. Even though a killed vaccine is less dangerous, it still might cause a spontaneous abortion depending on the health of the puppies while they were inside the mother and whether it was administered in the first four weeks of pregnancy.
The best course of action is to wait until after the baby is born before revaccinating your dog if she is due for another shot while pregnant. In the same way, if she hadn’t received rabies vaccination before getting pregnant, it’s best to wait to give her the shot if your veterinarian agrees and you can do so legally.
What happens if a pregnant dog is vaccinated?
On average, the canine gestation period lasts 63 days. The dog’s human guardian has a duty of care during this time. Once we notice the signs a dog is pregnant, these should be specified during the veterinary confirmation. To ensure the health of the mother and puppies, they will be able to offer advice on creating a stress-free environment and providing the best diet. More information is available in our article on what to feed a pregnant dog.
Understanding that a dog’s pregnancy and the development of her puppies is a particularly delicate time will help us decide whether or not to vaccinate a pregnant dog. Many medicines and even certain foods should be avoided. Never administer any pharmaceuticals, not even antiparasitic drugs, unless specifically instructed to do so by a veterinarian. See our article on deworming a pregnant dog for more information.
This is because some substances that are injected into dogs’ bloodstream can pass the placental barrier. They will thus enter the mother’s uterus and the fetuses there. The fetuses will be too vulnerable to the drug’s side effects, even though the mother will be sufficiently developed to do so. The result may be miscarriages, developmental disorders or physical malformation.
Vaccines occasionally cause mild fevers or even allergic reactions. Although the mother should recover, it is not advisable to risk any health issues while pregnant.
Should a pregnant dog be vaccinated?
According to the information above, a pregnant dog should typically not receive a vaccination. This is a generalization because each pregnant dog’s circumstances must be considered individually. A dog should ideally be fully dewormed and immunized before getting pregnant. However, this is not always possible. This might occur, for instance, when a dog is saved from the streets.
The veterinarian can determine whether the dog needs a vaccination if they think the animal is significantly at risk of contracting a disease. This method of weighing benefits and risks will be most effective. But even in these situations, they won’t administer live virus vaccines. They are more likely to cross the placental barrier for this reason. They probably will internally deworm them before giving them this vaccination.
After receiving a vaccination, a dog’s immune system will respond seven to ten days later. The peak antibody level will be attained around two weeks after administration. Additionally, if the puppies are immunized in a timely manner, they should be protected even after birth. This is due to the fact that they are probably present in the colostrum milk given to the puppies at their first meal.
FAQ
Can a pregnant dog get a rabies vaccine?
The fact that rabies vaccines are “killed” as opposed to live vaccines is one way that they differ from other types of vaccines. Therefore, a veterinarian may advise giving it during pregnancy, particularly if it’s for safety reasons.
Is it OK to vaccinate a pregnant dog?
Dog Pregnancy Care Most veterinarians advise against immunizing expectant dogs, so dogs should receive their shots well in advance of conception. Get your dog dewormed.
Is rabies vaccination safe during pregnancy?
Pregnant and nursing women can use rabies PEP without risk, and studies have found no link between PEP use and an increased risk of spontaneous abortion, premature birth, or fetal abnormalities.