Rabies - A survivors story

I've blogged once before about rabies, and how it's a severe and often fatal disease. As a matter of fact, it's so severe that only one survivor who did not receive the rabies vaccine after being bitten is known of. Her story is up at the Scientific American website.

How did she manage to become the lone survivor? Not by luck. She had some pretty smart doctors.

Instead of giving her up for dead, the doctors decided to "shut the brain down and wait for the cavalry to come" by inducing a coma to give her own immune system time to build up antibodies against the virus, says Rodney Willoughby, an infectious disease specialist who treated Giese at the Children's Hospital of Wisconsin in Milwaukee. Willoughby devised the treatment credited with saving Giese there, which has since become known as the Milwaukee protocol.

Rabies kills by compromising the brain's ability to regulate breathing, salivation and heartbeat; ultimately, victims drown in their own spit or blood, or cannot breathe because of muscle spasms in their diaphragms. One fifth die from fatal heart arrhythmia. Doctors believed that Giese might survive if they suppressed her brain function by sedating her while her immune system attacked the rabies virus.

This was the first time the therapy was attempted, and doctors had no clue if it would work or, if it did, whether it would leave her brain damaged. But Willoughby says it was the only chance doctors had of saving her.

This protocol is being used to treat another girl in Colombia (she's mentioned on the first page), and it appears to be working. If so, this is a great (but rather expensive) break through.

Avoid those vampire bats ...

... they can cause rabies. Well, only vampire bats which have the disease, and certainly not all of them do.

At least 38 Warao Indians have died in remote villages in Venezuela, and medical experts suspect an outbreak of rabies spread by bites from vampire bats.

Rabies is caused by the Rabies virus, a single stranded RNA (ssRNA) virus, from the family Rhabdoviridae. It is typically transferred via bite, since the virus is present in saliva. Symptoms start as flu-like, but then progress into the neurological. Partial paralysis, anxiety, insomnia, abnormal behavior, paranoia, hallucinations, delirium ... all eventually leading to (most often) death within two to ten days after the symptoms start. All in all, infection typically ranges from between two to twelve weeks.

So, what about the foaming-at-the-mouth symptoms? It's known as "hydrophobia". The throat and jaw slowly become paralyzed in rabid animals. The foam is a build-up of saliva which hasn't been swallowed for hours, possibly days. It's not a pretty disease.