Surviving Rabies

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Though rabies is easy to prevent through vaccination, once symptoms set in it's almost 100% fatal. According to Medical News Today (link via Medpundit) a 15 year old girl in Wisconsin has survived without vaccination:
Her doctors induced a coma in order to stop the spread of the infection. They then started administering a cocktail of drugs. A spinal tap after treatment showed that her immune system was effectively fighting off the virus. She was kept in coma for a week.

Dr Rodnay Willoughty, Wisconsin's Children's Hospital, said "No one had really done this before, even in animals. None of the drugs are fancy. If this works it can be done in a lot of countries."

...

Rabies is a fairly big killer - about 100 people a day die from it (worldwide).

This is obviously a great result if it can be replicated, but I'm a little skeptical of how big an impact it will have. First, because vaccination is so readily available (40,000 or so people in the US receive rabies post-exposure prophylaxis each year, according to CDC), most people who get exposed already get vaccinated. My guess is that most rabies deaths occur in areas where medical care is lousy and vaccination is unavailable, making a week of fully supportive care a little problematic.

The second question is what shape the patient is in now. Rabies attacks the nervous system and I seem to remember reading that the people who have survived in the past had some fairly serious sequelae. So, is she just alive or did she make a full reovery? We'll need to wait for the journal article, I guess.

Even if this treatment works perfectly, it's going to be a pretty poor second best to vaccination. Vaccines have come a long way since Pasteur and the current series is 5 shots in the arm (rather than the belly), and side effects are minimal, so it's still the treatment of choice in cases of suspected rabies exposure.

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1 Comments

This girl's doc was on NPR.

She has not fully recovered, but he seemed quite confident she would. It seemed to me that, while not fancy or high-tech, the approach used to save this girl's life was quite resource-intensive. This may not be an issue in areas with well-developed infrastructure, but in such areas, there are probably relatively few people who wind up needing such intervention.

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