Jeanna Giese (born 1989) is the first person known to have survived symptomatic rabies without receiving the rabies vaccine. She is only the sixth person known to have survived rabies after the onset of symptoms; the other survivors suffered from vaccine failures.
Infection with Rabies
In September 2004, Giese, then fifteen years old, picked up a bat that she found in St. Patrick's Church in her hometown of Fond du Lac, Wisconsin. She sustained a small bite on her left index finger, and having treated it with hydrogen peroxide, her mother decided to not seek medical attention. Thirty-seven days after the bite Giese developed symptoms of rabies. She was admitted to the hospital with tremors and trouble walking. Her condition continued to deteriorate, and she was referred to the Children's Hospital of Wisconsin in Wauwatosa, Wisconsin. Doctors there began to suspect rabies, and their diagnosis was confirmed by laboratory tests at the Centers for Disease Control.
Induced Coma Treatment
Rabies had been considered universally fatal in unvaccinated patients after the onset of symptoms (with treatment generally limited to palliative care), but Giese’s parents agreed to an experimental treatment proposed by her doctors at the Children's Hospital of Wisconsin. The doctors used drugs to put Giese into a coma with the aid of ketamine and midazolam. During the following week she was administered phenobarbital (a sedative) and she was given a cocktail of antiviral drugs (ribavirin and amantadine) while waiting for her immune system to produce antibodies to attack the virus. Giese was brought out of the coma after seven days.
After thirty-one days in the hospital, Giese was declared virus-free and removed from isolation. There was some initial concern about the level of brain damage she had suffered, but while she had suffered nerve damage, the disease seemed to have left her cognitive abilities largely intact. She spent several weeks undergoing rehabilitation therapy and was discharged on January 1, 2005. By November 2005 she was able to walk on her own, had returned to school, and had started driving automobiles.
Theories about Survival
The reasons for her survival remain controversial. Giese's doctors knew most rabies deaths were caused by temporary brain dysfunction, not permanent brain damage. They reasoned that if they protected Giese's brain by intentionally putting her into a coma, she would survive long enough for her body to fight off the virus. While the treatment appears to have worked as planned, other rabies researchers suggest Giese might have been infected with a particularly weak form of the virus, or that she might have an unusually strong immune system. The bat that bit Giese was not recovered for testing, and doctors were unable to isolate the virus from her body.
At least six later attempts to cure symptomatic rabies using a similar medical protocol have been unsuccessful. In May 2006, doctors at the Texas Children's Hospital applied a similar treatment as used on Giese to Zachary Jones, a 16 year-old stricken with symptomatic rabies, but they were unable to save him. From early October to early November of 2006, 10-year old Shannon Carroll was also unsuccessfully treated. This protocol is commonly being referred to as the "'Jeanna Treatment", at the Springs. An article written by her primary care physician in the April 2007 Scientific American calls this the Milwaukee protocol; he indicates that those who attempted to follow this protocol actually violated it, failing to use the combination of drugs he first described.
Life After Rabies
Jeanna Giese returned to school, and with the extra help of teachers, was able to complete her sophomore year with her class. Despite the obvious setback, she kept at the same level as the rest of her classmates. She graduated high school with honors in May 2007. She expressed her intention to become a veterinarian after graduating. She is attending Marian College in Fond du Lac. Mayo Clinic neurologist Dr. Kenneth Mack described her condition as she entered college: she's recovered "remarkably well" and should continue to improve.
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- Rodney E. Willoughby, Jr., M.D.; et al. (2005-06-16). "Survival after Treatment of Rabies with Induction of Coma". New England Journal of Medicine. 352 (24): 2508–2514. PMID 15958806. Cite uses deprecated parameter
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