A Case Report of Successful Administration of Rabies Post-Exposure Prophylaxis in an Abandoned Newborn

A newborn found abandoned was admitted to our hospital with moderate hypothermia (33.5 °C), a blood sugar level of 60 mg/dl, and an oxygen saturation of 96% on room air. The baby weighed 1821 g, indicating a gestational age of 32 to 34 weeks. Examination revealed a muscle-deep wound on the left thigh measuring 5 cm x 4 cm x 1 cm, a 2 cm x 1 cm bite mark on the left shoulder, and several superficial abrasions. The infant received intravenous fluids and antibiotics.

Given the dog bite injuries, rabies post-exposure prophylaxis was necessary. Rabishield™ (a monoclonal rabies antibody) was administered at a dose of 3.3 IU/kg around the wound, and the baby tolerated the injection well without any adverse reactions. Additionally, a purified Vero cell rabies vaccine (Rabivax-S™) was given. Routine blood tests were normal, though C-reactive protein (CRP) was elevated at 14 mg/dl, while blood and wound cultures were sterile, allowing for the discontinuation of antibiotics on day 3. Wound care and dressings were provided, and a rapid fluorescent focus inhibition test (RFFIT) showed rabies virus neutralizing antibody titers of 64 IU/ml, suggestive of seroprotection.

Monoclonal rabies antibodies, such as Rabishield™, provide a reliable alternative to blood-derived rabies immune globulin (RIG), addressing concerns about cost, supply, and safety. Rabishield™ consists of a single recombinant human monoclonal antibody (IgG1) targeting a specific epitope of the rabies virus glycoprotein. In this case, it was successfully administered to a day-old newborn, with effective rabies antibody titers observed at 28 days of life, demonstrating the safety and efficacy of Rabishield™.

Source: Kulkarni R, Khwaja TA, Badgujar G. et al. Use of Rabies Monoclonal Antibodies in an Abandoned Newborn. Indian J Pediatr (2025). https://doi.org/10.1007/s12098-025-05459-0

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