I had 90 minutes to kill at the US Embassy yesterday. Between meetings, type of thing. So after I grabbed some lunch -- the Embassy has a rather decent little cafeteria -- I parked myself in the little library with my laptop. The library is all reference books and magazines, and seems to be mostly used for language lessons. Still, it was a place to be. After an hour or so, I decided to give myself a short break. Strolled over and browsed the magazine section. National Geographic, no. Time, definitely no. The Economist, would take too long. Scientific American... sure, okay. And that's how I found out about the Milwaukee Protocol.
Rabies is really scary. You can get it from even small bites or scratches, and if you don't start treatment before symptoms appear, you die. Period, full stop. The only treatment at that point is to alleviate your symptoms, i.e. make dying easier. Decades of determined effort have made rabies rare in the US, but it's still horribly common in the rest of the world, with tens of thousands of people dying every year. Except. I didn't know it until yesterday, but since 2005 there has been one (1) unvaccinated survivor of full-onset rabies. She's walking around today. She's fine. She's from Fond du Lac, Wisconsin. Her name is Jeanna Giese. (There have been some other rabies survivors -- wikipedia says six, another article says two -- but they all got vaccines first. And most of them seem to have ended up with lasting damage.) So how'd she survive? Well, her doctor made some assumptions. (1) Rabies doesn't necessarily destroy your brain and nervous system; it just messes it up for a while. In medical-speak, "Death is primarily attributable to reversible dysfunction rather than irreversible destruction of brain, spinal cord and nerves." The infected brain sends mad signals to the heart, lungs, and muscles, leading (2) The rabies virus is eminently killable; the body's own immune response can deal with it, given time. (The key fact here was that autopsies of dead rabies victims sometimes showed quite low levels of the virus.) Also, rabies antiodies can be injected to accelerate the process. I'm going to oversimplify some way complicated medical thinking and say, the doctor looked at these assumptions and said, let's put her into a coma. An induced one, with drugs. His thinking was, shut down the infected brain and keep it from damaging the body, thus giving the immune system time to go after the virus. It worked. She was in a coma for over a month, and in pretty awful shape when she got out of it. But she slowly recovered, and today she's completely fine. She has a numb spot on one finger and a couple of minor neurological issues, but she's going to college. Now, before we get too enthusiastic, let's note that nobody has been able to duplicate this success. There have been several attempts, and they've failed. The patients have died. There is reasonable and skeptical debate over whether the coma was really necessary. So it's not yet clear whether this treatment -- the "Milwaukee Protocol" -- really works. Maybe the bat gave her an unusually weak strain of rabies. Maybe Ms. Giese had an unusually strong immune system. Still... what a story. Full medical description of the Protocol, if you're interested (.pdf). (Coming soon: that Chinese map again, and more on the Persian Embassy.)