Rabies - Treatment - Induced Coma

Induced Coma

In 2004, American teenager Jeanna Giese survived an infection of rabies unvaccinated. She was placed into an induced coma upon onset of symptoms and given ketamine, midazolam, ribavirin, and amantadine. Her doctors administered treatment based on the hypothesis that detrimental effects of rabies were caused by temporary dysfunctions in the brain and could be avoided by inducing a temporary partial halt in brain function that would protect the brain from damage while giving the immune system time to defeat the virus. After 31 days of isolation and 76 days of hospitalization, Giese was released from the hospital. She survived with almost no permanent after effects, and as of 2009, was starting her third year of university studies.

Giese's treatment regimen became known as the "Milwaukee protocol", which has since undergone revision with the second version omitting the use of ribavirin. Two of 25 patients survived when treated under the first protocol. A further 10 patients have been treated under the revised protocol, with a further two survivors. The anesthetic drug ketamine has shown the potential for rabies virus inhibition in rats, and is used as part of the Milwaukee protocol.

On April 10, 2008, in Cali, Colombia, a boy of 11 was reported to have survived rabies and the induced coma without noticeable brain damage.

On June 12, 2011, Precious Reynolds, an eight-year-old girl from Humboldt County, California, became the third reported person in the world and the second in the United States to have recovered from rabies without receiving PEP.