The first in a new series of Wednesday Wonders, here is the story of a girl who became the first person to survive the horrific Rabies virus, without receiving the usual post-exposure prophylaxis (PEP) after being infected. She was treated with what was to become known as the Milwaukee protocol.
Known nearly 4000 years, Rabies was first mentioned in the Mesopotamian Codex of Eshnunna in around 1930 BC. Since then, it has been a source of terror for all who have come into contact with it. Indeed, people often used to commit suicide or were killed when bitten by an animal that was thought to be rabid. In 1885 Louis Pasteur and Émile Roux created a vaccine, which was the first step in combating this deadly virus. Today, post-exposure prophylaxis, or PEP, if administered within 24 hours of exposure to the virus, and before the symptoms of Rabies become visible, can stop the disease in its tracks. But what if PEP is not administered?
Well, until 2004, there was a 100% fatality rate. That was when Dr. Rodney Willoughby, Jr. met Rabies sufferer Jeanna Giese, and the world gained a little sliver of hope.
Jeanna Giese was bitten by a little black bat in a church in Fond du Lac, Wisconsin, on 12th September 2004, when she was 15 years old. It was flying around the church when one of the congregation hit it to the ground. Being an animal lover, Jeanna picked it up and took it outside. It was then that it bit her. Thinking nothing of it, her parents cleaned up the wound, and went home. Three weeks later, symptoms started to occur, The hospital ran tests, but of course no one suspected, or tested for, Rabies. When her doctor realised what he was dealing with, Jeanna was sent to the Intensive Care Unit at Children's hospital, Milwaukee.
Dr. Rodney Willoughby, Jr was the doctor on call, and it was his refusal to let this 15 year old girl died on his watch that lead to a revolutionary new treatment. Having never encountered a Rabies case before, Dr. Willoughby went on a desperate search for something which would help him prepare a treatment. Everything he read told him nothing could be done. Finally he found an obscure paper which said that, while the Rabies virus sends people insane, using the brain against its host body, it leaves the brain undamaged. Dr. Willoughby seized on this information, and devised a treatment which involved putting Jeanna into a deep, medically-induced coma, to protect her from her own virus-infected brain.
Once Jeanna's samples had returned from the Centre for Disease Control confirming the presence of Rabies, Dr. Willoughby could get to work. He gave Jeanna a mixture of ketamine and midazolam to shut down the brain, while also pumping her full of the antiviral drugs ribavirin and amantadine. All they could do then was wait to see if Jeanna's body could produce the antibodies to kill off the virus. Thankfully, Jeanna responded. The main worries were than Jeanna would have severe brain damage or that she would be suffering from "Locked-In" syndrome. By early 2005, she was able to walk unaded and had returned to school. She learned to drive, and in 2011 she graduated as a Biology major.
Of about 41 patients who have been treated under the Milwaukee Protocol, about 5 have survived, the latest being eight-year-old Precious Reynolds from from Willow Creek, California in 2011. There are many arguments against the Protocol, ranging from suggestions that the strain of the virus was particularly weak to the idea that Jeanna and her co-survivors had unusually strong immune responses. What no-one can deny, however, is that Dr. Willoughby's success, and Jeanna's miraculous recovery, has given hope where there was none.
Check out the video below for the full story about Jeanna's remarkable recovery. Please be advised that there are disturbing images of Rabies sufferers.