Sep 06 2011

Girl survives rabies without treatment

In May of 2011, an 8 year old girl recovered from a rabies infection without receiving post-rabies exposure injections. According to UC Davis Children’s Hospital and news reports, she is the third person in the U.S. to do so. The girl, who lives in California, was exposed to rabies after being scratched by a feral cat outside her school in April. Her first sign of illness were flu-like symptoms, but she quickly became worse, ultimately developing encephalitis, inflammation of the brain. Even though she survived, she required extensive medical treatment. By the time doctors determined that she had rabies, it was too late to give her the post-exposure injections. Doctors instead treated her with a protocol called the “Milwaukee Protocol”, which includes antiviral injections and a drug-induced coma. She remained in the intensive care unit for two weeks, and then was transferred into the general pediatric unit for several weeks. Her recovery is considered to be miraculous.

Although human cases of rabies are relatively rare in North America (there were only 4 cases of human rabies in the US in 2009), rabies as a disease is still present in wildlife and pet animals can easily become infected. The risk that a stray cat or dog has become infected is very real, and it is important to recognize the risk of contracting rabies from animal scratches or bites. Unfortunately, since the disease is relatively rare in humans, it is not high on the list of diagnostic possibilities when medical doctors are presented with a case such as this, unless they are made aware of the prior injury/exposure. Lack of awareness of the risks also means that people often minimize the importance of apparently minor injuries from animals, especially dogs and cats. Once a person is scratched or bitten by an infected animal, the virus works its way into the brain and spinal cord and eventually causes encephalitis. Rabies encephalitis often causes death within a week after symptoms first appear.

People need to be aware that it is important to avoid contact with wild animals, and to be extremely careful when approaching stray dogs or cats. Talk to your children about the risks of any kind of animal scratching or biting them, and make sure they know that it is important to let you know if any injuries do happen. If you do get bitten or scratched, contact your doctor or report the injury to your local health unit. If the animal has escaped, you need to get vaccinated immediately. Contrary to popular belief, the new injections are not particularly painful. With post-exposure vaccines and rabies immune globulin injections, prevention of rabies is extremely effective; close to 100 percent. Without it, almost all victims die. Over 55,000 people die annually from rabies, mostly in 3rd world countries

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