5 ms·
There's actually an experimental treatment for rabies that can be administered if post-exposure prophylaxis fails (called the "Milwaukee Protocol"). It involves
by rlue 8y ago
There's actually an experimental treatment for rabies that can be administered if post-exposure prophylaxis fails (called the "Milwaukee Protocol"). It involves a drug-induced coma followed by a cocktail of antivirals, and the success rate is around 20% in the best case (n.b. the sample size for the study that figure was 10).
Not that it would have helped here, when the diagnosis came at such a late stage.
The case report for the patient treatment that pioneered the Milwaukee Protocol—the first-ever successful treatment of a rabies patient—is worth a skim, if you're into this sort of thing.
[0]: https://www.nejm.org/doi/pdf/10.1056/NEJMoa050382 https://www.nejm.org/doi/pdf/10.1056/NEJMoa050382
- SolaceQuantum 8y agoI believe it’s also associated with severe health consequences and the only survivor has stated regretting the protocol... EDIT: Seems I'm misinformed. Thanks for clarifying, commenters below.
- AuthorizedCust 8y agoI don't see much regret: http://www.jeannagiese.com/my-personal-story.html http://www.jeannagiese.com/my-personal-story.html
- corpMaverick 8y ago>> Being the animal lover that I was, I was bit in my finger by a puppy that I was trying to feed when I was up in the desert doing mountain biking. A few days later, I had to get vaccinated because we could not bring the dog for observation. The vaccination itself can be risky. But it is preferable than risking rabies. I was told it is a horrible way of dying. Lesson learned.
- crescentfresh 8y ago> I had less than 4 hours left to live. Dr. ... was not ready to let me die. He researched the internet and found a few key phrases that helped him devise a treatment Well I guess in desperate times all treatments started somewhere, a quick goog is probably as good as any.
- jacquesm 8y agoInteresting how one doctor casually dismissed a bite from a bat. Bats are pretty well known for carrying all kinds of interesting diseases.
- raverbashing 8y agoThere has been more than one survivor (wikipedia is outdated) and I don't think they really regret it
- dragonwriter 8y ago> There has been more than one survivor That seems to be a matter of debate. The other reported Milwaukee protocol survivors apparently include: (1) people who died of the rabies infection, but were characterized as “survivors” in some reports because they survived past the initial acute phase, (2) People who received both post-exposure vaccination and the Milwaukee protocol, (3) One survivor who, based on antibody tests, probably was never infected with rabies in the first place. https://www.cambridge.org/core/journals/canadian-journal-of-neurological-sciences/article/critical-appraisal-of-the-milwaukee-protocol-for-rabies-this-failed-approach-should-be-abandoned/8A47C583B24B2B2E43248770F78CC35A https://www.cambridge.org/core/journals/canadian-journal-of-...
- throwaway080383 8y agoMore severe than death?
- kstrauser 8y agoThere are lots of things more severe than death. Imagine the treatment gave you an aggressive form of Alzheimers, for instance - would you really rather have that?
- deleted 8y ago[deleted]
- lostlogin 8y agoAgreed, yet most countries have laws that assume we would all offer to live, no matter what. “Sanctity of life” somehow means maximum suffering is best.
- nraynaud 8y agoSome metrics use quality of life instead of survival at 5 years.
- vorpalhex 8y agoFrom what I can find, the original survivor had a child and seems to have a functional adult life. Not to say there weren't side effects (and it seems like she was in therapy for several months), but she seems to have a normal enough life.
- epmaybe 8y agoThat's a fascinating report, thank you for sharing. Especially the detailed data visualizations of the patient course, I don't normally see those on case reports.
- deleted 8y ago[deleted]
- sandworm101 8y agoIt has seen success with children, small children. Their brains are plastic. I'm not sure the protocol would work for a symptomatic adult.
- dragonwriter 8y ago> It has seen success with children AFAICT, the use of the plural is unwarranted; there seems to be one uncontroversial case of someone infected with rabies treated with the Milwaukee protocol and not podt-infection vaccination, who survived the rabies infection.
- Paul-ish 8y agoThe Wikipedia page seems to indicate that the success rate is closer to 8%. * https://en.wikipedia.org/wiki/Rabies#Milwaukee_protocol https://en.wikipedia.org/wiki/Rabies#Milwaukee_protocol
- meowface 8y agoTo be clear, only one person has survived after receiving the Milwaukee protocol - the first person it was tried on. No one else has survived. It was tried on 25 other people, and it failed every time. It's very possible the initial patient was a fluke and the protocol isn't effective at all. https://pandorareport.org/2014/05/01/no-rabies-treatment-after-all-failure-of-the-milwaukee-protocol/ https://pandorareport.org/2014/05/01/no-rabies-treatment-aft...
- village-idiot 8y agoThat would be one hell of a fluke. Rabies kills about 17,000 people a year, and excluding the Milwaukee protocol survivor, only 13 untreated survivors are known to have ever existed. It is basically completely and utterly fatal if left untreated.
- Retric 8y agoDepends how many people get experimental treatments. If say ~10+% of people got experimental treatments, and you have ~10% of the survivors that revived experimental treatments, then the odds are very good it's a fluke.
- throwaway5752 8y agohttp://www.ajtmh.org/content/journals/10.4269/ajtmh.2012.11-0689#html_fulltext http://www.ajtmh.org/content/journals/10.4269/ajtmh.2012.11-... 11% RVNA positive, evidence of abortive rabies infection.
- village-idiot 8y agoI should specify, it’s basically 100% fatal once you’re symptomatic.
- bitcurious 8y agohttps://www.wnycstudios.org/story/312245-rodney-versus-death https://www.wnycstudios.org/story/312245-rodney-versus-death There is a radio lab episode on how this protocol was established.