Earlier this April in the Journal of Venomous Animals and Toxins including Tropical Disease s, Chinese doctors reported an extremely rare case of rabies — one that ended with a remarkable, if bittersweet, story of survival.

In May 2013, a 25-year-old woman living in a rural region of the Henan Province was bitten by a dog she didn’t know was rabid while she was four months pregnant. Although the bite was quickly treated by her local village clinic, the woman never received the vaccine needed to prevent rabies and eventually developed symptoms right as she entered labor. Two days after she successfully delivered her child via cesarean section, she died from the viral disease. Somehow though, her newborn son made it through without having caught the infection, as did her husband.

The doctors couldn’t be certain how the baby escaped transmission, but they theorized that the mother’s placenta may have played a protective role. Though there was ample opportunity for the virus to spread to the child during her final moments of labor, it’s possible it hadn’t spread widely enough throughout the mother’s bloodstream for that to happen. The son and husband were also given a preventative rabies shot following her death, another possible factor.

An Ingenious Virus

Rabies has a well-earned reputation for its brutal ingenuity. Able to call just about any warm blooded animal home, the virus typically hijacks the central nervous system of its victim, causing them to excessively salivate, fear water, and become unnaturally aggressive. It then stows away in the animal’s salivary glands, waiting for its mojo to provoke the animal into biting or scratching another animal, thus starting the chain all over again. The original carrier, depending on the species, often dies soon after. In humans specifically, the virus is almost 100 percent fatal.

While frightening, these symptoms take a long time to appear — anywhere from one to three months after the virus enters our system — and rabies can be stopped dead in its tracks by the timely application of a vaccine, either before or immediately after exposure. Human cases of rabies in the developed world have virtually disappeared, thanks not only to human vaccination but massive vaccination programs for our dogs as well — according to the World Health Organization, there were only 10 documented cases of dog-transmitted rabies worldwide in 2010.

In China, it’s thought that dogs attack hundreds of pregnant women annually. And while most receive a rabies shot afterwards, the vaccine is oftentimes too expensive a precaution for those living in less developed areas. Indeed, it’s the poorest people who make up the majority of deaths caused by rabies; a toll that reaches in the tens of thousands globally every year.

As for how rare the above situation is? According to the authors, there have only been six other documented cases of a pregnant woman with full blown rabies delivering a baby, with five out of six newborns surviving. As with the current case, the mothers themselves weren’t so lucky.

However rare they are, preventing these needless tragedies will require the same sort of dedicated public health measures seen elsewhere, like widespread dog vaccinations and monitoring centers in areas where rabies is known to exist, the authors wrote.

“[Past] successful experiences suggest that it is possible to fight the disease by means of virus control and prevention,” they concluded.

Source: Qu Z-Y, Li G-W, Chen Q-C, et al. Survival of a newborn from a pregnant woman with rabies infection. BMC Journal of Venomous Animals and Toxins including Tropical Diseases. 2016.