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Newborns can safely receive rabies post-exposure prophylaxis
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Data recently published in Infection Control and Hospital Epidemiology indicate that preterm infants can safely receive rabies post-exposure prophylaxis, or PEP.
The study began when hospital staff working on a neonatal ICU in the Austin, Texas, area found two live bats in the facility: one in a sink in the NICU and another in a hallway not used by patients. The Austin area is home to an extremely large bat population and has the highest number of confirmed rabies cases in the state. The bats in the hospital, however, were captured and released before they could be tested for rabies, prompting care givers to administer rabies PEP.
“Due to the lack of evidence or recommendations for the safety and efficacy of rabies PEP in neonates, the infection prevention team used this opportunity to evaluate the immune responses, medical complications and clinical outcomes in these patients,” Ann L. Bailey, BSN, RNC-NIC, MBA, CIC, and colleagues wrote.
Bailey and colleagues administered PEP to seven infants who were in the NICU when the bats were discovered. Researchers stratified the babies into three categories: those who were lying unclothed in open warmers (n = 6) at the time of exposure were “high risk,” those with only their heads and faces exposed (n = 13) were “low risk” and those in incubators (n = 9) were “no risk.” The families of five high-risk infants and two low-risk infants agreed to participate. Parents brought the infants back to the hospital after 6 months so researchers could measure serologic response.
Only three infants returned to the hospital for follow-up and testing, Bailey and colleagues wrote. None of the original 28 infants developed rabies, and researchers reported that rabies titers were adequate, all being at least 0.5 IU/mL among those who were tested.
“Despite the small sample size, we can conclude that preterm infants are capable of mounting an adequate immune response to rabies PEP without medical complications,” the researchers wrote. “The absence of medical complications in this report cannot be assumed for all neonates, given the small number of patients studied here.” – by Andy Polhamus
Disclosure: The researchers report no relevant financial disclosures.
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