Medical Mystery: Only One Person Has Survived Rabies without Vaccine--But How?

ScientificAmerican.com talks with the first known survivor of rabies four years later















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Remarkably, Giese survived. She recovered most of her cognitive functions within a few months, and other skills within a year, Willoughby says. She got her driver's license and is now a sophomore at Marian University in Fond du Lac, where she is majoring in biology. There are lingering signs of her illness: Giese, once an avid athlete, says she now lists to one side when she runs and walks and no longer plays volleyball, basketball and softball as she once did. She also speaks more slowly and sometimes not as clearly as before her illness, but Willoughby says these effects may fade over time.

Giese is "pretty much normal," says Willoughby, an associate professor of pediatrics at the Medical College of Wisconsin in Milwaukee. "She continues to get better, counter to conventional medical thinking."

Rabies has an incubation period of two weeks to three months and kills within a week of the symptoms showing up. The vaccine series and other immune therapies are useless at this point and may even speed up and increase the severity of the symptoms. Usually, patients are made as comfortable as possible in the hospital or, in countries without sophisticated health care, sent home to die an agonizing death.

Antiviral drugs and immune therapies including steroids, disease-fighting interferon-alpha and poly IC (which stimulates the body's own production of interferon-alpha) have been tried, but none have been shown to be lifesaving on their own, Willoughby says.

Over the past four years, the Milwaukee protocol to differing degrees has been used a dozen times, but until now Giese was the sole survivor. Exactly why she lived—and the others died—is still a mystery.

In a 2005 report on her case in The New England Journal of Medicine, Willoughby speculated that she may have been infected with a rare, weakened version of the virus. Today, he chalks Giese's survival up to aggressive intensive care, the decision to sedate her "and 10 percent sheer luck." Which element of that combination made the difference, and whether the antivirals she was given helped save her is unknown.

"In all honesty, we were probably just pretty lucky," he says. Only another survivor, and then animal and clinical trials, will show if the therapy works, and why, he says. The U.S. Centers for Disease Control and Prevention (CDC) plans to test the protocol on rabies-infected ferrets; Thai and Canadian doctors, who unsuccessfully treated a 33-year-old man with rabies with the Milwaukee protocol, recommended in the Journal of NeuroVirology two years ago that physicians exercise "caution" in using the treatment, because it is too expensive and lacks " a clear scientific rationale." Willoughby says it cost about $800,000 to treat Giese.



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  1. 1. yanghuansailing 11:32 PM 10/9/08

    After 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.

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  2. 2. raveneapoe 04:56 PM 10/30/08

    I seem to recall a young boy from Pittsburgh, PA. surviving rabies a couple of decades ago.
    He 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? ;-)

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  3. 3. alamosaurus 09:23 PM 12/19/08

    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.

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  4. 4. raveneapoe 10:11 AM 12/20/08

    Thank you,
    I 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.

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  5. 5. KashMD 02:02 AM 9/26/09

    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".

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  6. 6. KashMD 02:03 AM 9/26/09

    Actually, 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.

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  7. 7. vagabond 04:02 AM 2/10/10

    Is 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

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  8. 8. KAT SNOD 03:56 AM 5/11/10

    Jeanna 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.

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  9. 9. mszach 03:33 PM 7/27/10

    I 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.

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  10. 10. orwhut in reply to alamosaurus 04:04 PM 6/14/11

    I remembered Matthew Winkler's story incompletely too and searching for it, brought me here. Thank you for supplying his name.

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  11. 11. boyet 02:04 AM 2/5/12

    Matthew 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.

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  12. 12. Auntie Ba 11:42 PM 10/17/12

    I 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.

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  13. 13. Auntie Ba 11:49 PM 10/17/12

    I 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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