More historical rabies coming soon (along with parotid tumors and other ear afflictions).
Once known as hydrophobia due to the characteristic “fear” (really just reflexive gagging caused by the virus) of water, rabies always has been deadly once symptoms appear. It looks like it still will be for a good while longer, given that our current protocol (vaccinate animals, give vaccine to those who work with rabid animals and those exposed by injury, give immune globulin to those actively exposed to virus) results in only 3-4 human deaths per decade on average, and all of them appear to be from unnoticed bat bites from a rare genus of bat (rabies is rare in bats in the US, and it’s even rarer that bats bite people in the US).
More recent history:
Jeanna Giese of Milwaukee, WI, contracted rabies from a bat she caught in her church to put back outside, in 2004. Thinking it was only a tiny scratch, probably from the feet, she did nothing but put a small bandaid over the wound. Three weeks later, she began feeling tired, vomiting, and her left arm - where the bat had bitten - began tingling. The last symptom was a result of the rabies virus moving through the neurons - and only the neurons - to her Central Nervous System, and eventually to her brain.
Where almost all patients at this point will die within a week (as the antivirus vaccine will only speed up death), Jeanna Giesse was admitted to Children’s Hospital in Milwaukee, WI, and Dr. Rodney Willoughby decided to put her into a medically induced coma in order to “shut down the brain and wait for the cavalry to come”. He was banking on the fact that her body would eventually build up enough antibodies to fight off the virus itself when the virus was both unable to advance through her CNS to propagate, and had antivirals preventing any advance it may make on its own (without brain stimulation to allow it to jump between neurons). It was a treatment never tried before, but it worked - Jeanna survived and just graduated from college this last May.
This became known as the Milwaukee protocol, and has since had one of the two antiviral medications (ribavarin) removed from the regimen, as it was believed to have actually hindered the cellular processes of some aspects of the immune system. Combined with the fact that the bite was on her hand (very far away from her brain, given that rabies has to travel only through the neurons) so that her body had already built up a lot of antibodies, keeping her artificially alive while the body produced the remainder it needed to fight off the disease was actually feasable.
Though rabies causes encephalitis (swelling of the brain), it doesn’t actually damage the brain structures per se…death comes from inability to control muscles, so that the patient chokes on their saliva, can’t breathe, or has a fatal heart arrhythmia. When these factors are able to be controlled for - and it’s much harder than it seems - and the patient is not comatose for an excessively long period, survival can occur, thanks to the body’s amazing ability to kill off invaders even when incapacitated. Of the original Milwaukee protocol, 3/25 patients survived, and of the modified one (without the ribavarin), 3/11 have now survived. The debate whether the protocol is the determining factor in survival, instead of the fact that the rabies strains in survivors have been noted to be weak ones, continues.