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See Inside April 2007

A Cure for Rabies?

The survival of a Wisconsin teenager who contracted rabies may point the way to a treatment for this horrifying disease

Rabies is one of the oldest and most feared diseases. It attacks the brain, causing agitation, terror and convulsions. Victims suffer painful throat spasms when they try to drink or eat. Paralysis follows, yet people infected with rabies are intermittently alert until near death and can communicate their fear and suffering to family and caregivers. Although vaccines against the rabies virus can prevent the illness from developing, until recently doctors could hold out no hope for patients who failed to get immunized soon after being bitten by a rabid animal. Once the symptoms of rabies appeared--typically within two months of the bite--death was inevitable, usually in less than a week.

In 2004, however, I was a member of a team of physicians at Children's Hospital of Wisconsin in Milwaukee that rescued a 15-year-old girl from a similar fate. Jeanna Giese of Fond du Lac, Wis., became the first known unimmunized survivor of rabies. (Five other people who had been immunized but developed rabies anyway have also survived.) Our novel treatment, dubbed the Milwaukee protocol, has stirred controversy among medical specialists; some claim that Jeanna's cure was a fluke. Although the few attempts to replicate the treatment have not saved the lives of any other rabies patients, I fervently hope that we are on the right track. At the very least, researchers should initiate animal studies to determine which of the elements in our protocol can help defeat rabies.

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