4 ms·

I heard that about it not being recommended too but find it to be one of the stupidest things in medicine ever. Because while it's no longer recommended, the on

I heard that about it not being recommended too but find it to be one of the stupidest things in medicine ever. Because while it's no longer recommended, the only other "treatment" is painkillers and wait until the patient is dead which has throughout history had a fatality rate of >99.99% So yeah I really don't understand why any doctor wouldn't want to try the Milwaukee protocol. Even if it had 99% fatality rate it would still be a huge improvement and afaik it's more like 80-90% i.e. from 10 tries it worked twice or so. Also there are plenty of small changes to it that might make a difference. We just don't know, we do know however that untreated rabies is fatal in the closest to 100% fatality of any disease ever known. Hell, rabies (post the 24h post exposure vaccination period) has a higher fatality rate than lethal injection and the electric chair!

SolaceQuantum 8y ago
There are massive consequences to survivors of the protocol who arguably may have been better off succumbing to the disease, iirc. There’s no point in using a protocol that keeps people alive with no quality of life. (This kind of handoff is discussed in ethics classes in healthcare, the cost/benefit analysis of a treatment on a patient.)
- vorpalhex 8y ago
  Sources? Anything I've found seems to indicate survivors have gone to have kids and reasonably functional lives - not side effect free, but not by any means worse than death.
jeswin 8y ago
Minor nit: it's important to take the vaccine even if 24 hours has passed, and you're most likely going to be fine. The vaccine takes 10 to 22 days to produce antibodies, but the disease gives you more time than that (weeks to months). So to summarize, the protocol is to vaccinate even if late.
- BenjiWiebe 8y ago
  Several in my family were exposed to rabies via trying to save a rabid calf (before we knew it was rabies). We started the vaccination protocol ~3 days later. That was more than 2 years ago, and we are all fine. Definitely not only a 24hr window, thankfully. Was still pretty scary...
vidarh 8y ago
There are lot of confounding factors. It is not certain it has worked even once. All we know is a few patients that have been on MP has survived. But so hav a few patients that have not been on MP, and most patients on MP have died, as have several of the "successful" MP patients subsequent to overcoming the initial stage of the disease. A further problem is that many of the patients have had the PEP treatment partially or wholly first. In those cases we don't know if the outcome was due to MP or PEP. Several other (single digit numbers) patients have survived without MP. It is not clear why. It's not clear that their treatments had any effect. Or it might have saved them. It may be genetics. It may be difference in virulence. It may be specific aspect of the treatments. It may be aspects of how the patients are treated that are not part of the protocol itself. It may be dumb luck. The problem is that this is not a matter of MP or nothing. It's a matter of MP or trying to find other alternatives. If MP serves no purpose in saving these patients - and it may very well not - then focusing on MP may hinder exploration of other options.

SolaceQuantum 8y ago

There are massive consequences to survivors of the protocol who arguably may have been better off succumbing to the disease, iirc. There’s no point in using a protocol that keeps people alive with no quality of life. (This kind of handoff is discussed in ethics classes in healthcare, the cost/benefit analysis of a treatment on a patient.)

vorpalhex 8y ago
Sources? Anything I've found seems to indicate survivors have gone to have kids and reasonably functional lives - not side effect free, but not by any means worse than death.

jeswin 8y ago

Minor nit: it's important to take the vaccine even if 24 hours has passed, and you're most likely going to be fine. The vaccine takes 10 to 22 days to produce antibodies, but the disease gives you more time than that (weeks to months). So to summarize, the protocol is to vaccinate even if late.

BenjiWiebe 8y ago
Several in my family were exposed to rabies via trying to save a rabid calf (before we knew it was rabies). We started the vaccination protocol ~3 days later. That was more than 2 years ago, and we are all fine. Definitely not only a 24hr window, thankfully. Was still pretty scary...

vidarh 8y ago

There are lot of confounding factors. It is not certain it has worked even once. All we know is a few patients that have been on MP has survived. But so hav a few patients that have not been on MP, and most patients on MP have died, as have several of the "successful" MP patients subsequent to overcoming the initial stage of the disease. A further problem is that many of the patients have had the PEP treatment partially or wholly first. In those cases we don't know if the outcome was due to MP or PEP. Several other (single digit numbers) patients have survived without MP. It is not clear why. It's not clear that their treatments had any effect. Or it might have saved them. It may be genetics. It may be difference in virulence. It may be specific aspect of the treatments. It may be aspects of how the patients are treated that are not part of the protocol itself. It may be dumb luck. The problem is that this is not a matter of MP or nothing. It's a matter of MP or trying to find other alternatives. If MP serves no purpose in saving these patients - and it may very well not - then focusing on MP may hinder exploration of other options.