Her parents cleaned the superficial wound and she says they did not believe it was necessary to seek further medical treatment. "We never thought of rabies," she says. By the time Giese began displaying signs of rabies three weeks later—fatigue, double vision, vomiting and tingling in her left arm—it was too late for the antirabies vaccine cocktail.
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.
When she arrived at the hospital, Giese couldn't talk, sit or stand and fell in and out of consciousness—she also needed to be intubated to help her breathe. "She was critically ill," Willoughby recalls, "and looked as if she might die within the day."
In addition to inducing the coma, doctors also gave her the antivirals ribavarin and amantadine. They tapered off the anesthetics after about a week, when tests showed that Giese's immune system was battling the virus. For about six months after awakening from the coma, physicians also gave her a compound called tetrahydrobiopterin that is chemically similar to the B-complex vitamin folic acid, which may have improved her speech and ability to eat, Willoughby says.
He notes that physicians gave her the supplement after tests showed that she had a deficiency of the compound, which is known to boost production of serotonin and dopamine neurotransmitters needed to perform motor, speech and other routine bodily functions.
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13 Comments
Add CommentAfter reading this news, I came up with an idea that another Nobelist for medicine will be born soon. Despite the restrictions of the method performed on that little girl, we may believe in that rabies will not be the horrible killer in the near future.
Reply | Report Abuse | Link to thisI seem to recall a young boy from Pittsburgh, PA. surviving rabies a couple of decades ago.
Reply | Report Abuse | Link to thisHe was also bitten by a rabid bat but was unable to take the vaccine because he was allergic to the vaccine available at the time.
His symptoms were treated as they arose and he was placed in a coma to prevent seizures and other symptoms.
I'm sure I read about this many, many years ago, and if true it would mean this young lady isn't the first or only survivor of full blown rabies.
Anyone else remember anything regarding this? Or am I just getting senile? ;-)
The boy's name was Matthew Winkler. He did get the rabies vaccine, but developed rabies anyway, probably because the vaccine was started too late. But the vaccine gave him a partial immunity so he was able to fight the disease off. This happened in 1971.
Reply | Report Abuse | Link to thisThank you,
Reply | Report Abuse | Link to thisI googled Matthew Winkler and found this article from the FDA:
"In 1970 Matthew Winkler was exposed [to rabies], treated [with postexposure vaccine], and because vaccines were not as good then, experienced a vaccine failure. He recovered despite the vaccine failure, which is a far different thing than catching the disease, [not being treated,] and recovering," he points out. "Some people question to this day whether that case meets all the criteria [of a human known to survive rabies without treatment]."
I guess I forgot all the facts, thanks for the information, it really is appreciated.
Hi, even before these 2 cases, there was a boy named Abdul Karim in India in the early 1900s perhaps who was treated after he was declared "no cure for him".
Reply | Report Abuse | Link to thisActually, in the early 1900s another boy Abdul Karim survived Rabies after he was labelled "no cure for him". I have his account, if anyone needs it, ask for it. Its amazing.
Reply | Report Abuse | Link to thisIs it possible to get infected by an animal who have not shown the symptom of rabies? or maybe still in the incubation period? I live in an epidemic area and two week ago had met 3 astray puppies not far from my place. One died couple of days after that, I thought the caused is distemper so I brought the other 2 home. After reading more about rabies..., I have a second thought, cause the symptom is a bit similar with the description above. It is almost 10 days now and they seem fine, eat a lot and play a lot. I just a bit worry.... can someone give me an information? thanks a lot
Reply | Report Abuse | Link to thisJeanna Giese's parents were very stupid if they knew she received a bat bite and didn't seek prophylactic treatment. They only cleaned the wound? They could have gotten her much less expensive treatment before she became ill. They should have at least sought medical advice regarding a bat bite. It's so sad that people in this country are so uneducated. Poor children suffer people's idiocy. They are LUCKY that the girl survived. I hope they know that and make an effort not to be so stupid.
Reply | Report Abuse | Link to thisI think God must have been watching out for Jeanna. Rabies is such an intractable and horrible disease, no one survives more than a few weeks (at the very most) It sounds like she was nearly dead when she got to the hospital, although her case study says that she had sought medical help early in the course of the disease. God shows us that he still perform miracles!! Still, I am extremely hopeful for the people who suffer from this horrible virus, clearly the worst on the face of the Earth.
Reply | Report Abuse | Link to thisI remembered Matthew Winkler's story incompletely too and searching for it, brought me here. Thank you for supplying his name.
Reply | Report Abuse | Link to thisMatthew Winkler was featured in a Reader's Digest issue in the early 1970s. i think the title of the article is "The Boy Who Didn't Die." i was in elementary school at that time.
Reply | Report Abuse | Link to thisI arrived here by Google search "human rabies survivor," because I remembered the Mattew Winkler story, but not his name or dates. Thanks for posting, alamosaurus. I didn't know he was placed in a coma, but followed long enough to know any light, sound or other stimulus resulted in severe convulsions, so I'm glad they did so. Thankfully, Total Parenteral Nutrition is also much better now, so patients' bodies can be better supported through a long convalescence. This plus steroids and IV hypertonic solution to reduce brain swelling if it occurs offers real hope that more people may survive.
Reply | Report Abuse | Link to thisI arrived here by Google search "human rabies survivor," because I remembered Matthew Winkler's story, but not his name or the date. I didn't know he'd been placed in a coma, but followed long enough to know that any light, sound or other stimulous resulted in dangerous convulsions, so I'm glad they did. That, plus modern Total Parenteral Nutrition, steroids and hypertonic IV solution for possible brain swelling give me hope that more sufferers may survive.
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