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Surviving rabies is now possible

Until 2004, rabies was an invariably fatal disease in humans. Without treatment, death usually occurs within a week after symptoms first appear. Even with medical intervention, the onset of neurological symptoms used to be a certain death sentence.

An experimental treatment called the Milwaukee Protocol is changing that. The treatment involves putting the patient in a medically-induced coma and administering antiviral drugs to supplement the patient's own immune response. It was developed and named by Dr. Rodney Willoughby, Jr. after its first successful use in 2004 on Jeanna Giese, a Wisconsin teenager who became the first person ever to survive symptomatic rabies without a prophylactic vaccine.

Giese was bitten by a bat. She didn't seek treatment until she developed neurological symptoms 37 days later. Rabies was quickly suspected and later confirmed. Willoughby initiated a desperate attempt to keep Giese alive by shutting her brain down to protect it from viral attack, while also allowing her immune system time to produce antibodies and fight the virus.

The virus kills by disrupting the brain's ability to regulate crucial body functions like respiration and heart rate, but not by damaging the brain itself.

Doctors administered a mixture of drugs to suppress brain activity and two antiviral drugs. Then they waited for signs of progress. Giese was brought out of the coma after six days, once her immune response seemed strong enough. She was declared free of the virus after 31 days and discharged to her home on the 76th day. She required a year of rehabilitation and sustained minor neurological impairments, mostly noticeable in her speech. However, her cognitive abilities are largely intact. And she is now attending college.

In June 2011, an eight-year-old California girl became the third American and the sixth person ever to survive symptomatic rabies, because of the Milwaukee Protocol. Prevention of rabies, and immediate vaccination upon exposure to the virus, is still vital.

Rabies remains one of the most lethal infectious diseases for humans, and the Milwaukee Protocol is not a panacea. It appears to be most successful in older children and teenagers. And even then, survival or full recovery is not certain. However, shutting the brain down to protect it from injury offers a promising new direction for what was once a hopeless diagnosis. 

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