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Writing a New Chapter Medical History With a Treatment for Rabies
NY Times ^ | June 28, 2005 | LAWRENCE K. ALTMAN, M.D.

Posted on 06/27/2005 9:41:26 PM PDT by neverdem

When Jeanna Giese, 15, arrived at Children's Hospital of Wisconsin last October with rapidly worsening neurological symptoms, the fact that she had handled a bat a month earlier raised the possibility that she had rabies.

Dr. Rodney E. Willoughby Jr., who examined Jeanna, did not think it was likely. But as a pediatric infectious disease specialist, he called the Centers for Disease Control and Prevention to seek the agency's help in performing rabies tests.

Dr. Willoughby told the C.D.C. rabies expert that over a five-day period Jeanna had developed fatigue, tingling and numbness in her left hand, double vision, an unsteady gait, nausea, vomiting and a fever.

Brain scans had showed no abnormality, and her doctors at St. Agnes Hospital in Fond du Lac, Wis., had sent her to the hospital in Milwaukee because they could not determine the cause of her acute encephalitis, an inflammation of the brain.

"There was this long silence at the other end such that I wondered if I had lost the connection," Dr. Willoughby said. "When I said I did not like the silence, and am I to interpret it that this child is the real McCoy, the C.D.C. specialist said, 'It sounds like the real thing to us.' "

Then the Milwaukee doctors took a piece of Jeanna's skin, performed a spinal tap to collect cerebrospinal fluid and obtained samples of blood and other body fluids, rushing to finish before the last pickup from the package express service that would carry the specimens to the disease control agency in Atlanta.

By the next afternoon, the agency's scientists confirmed that Jeanna had rabies.

What followed made medical history. Jeanna is the first person to survive the disease without having rabies immunization. She apparently owes her life to a novel...

(Excerpt) Read more at nytimes.com ...


TOPICS: Culture/Society; Extended News; News/Current Events; US: Wisconsin
KEYWORDS: health; immunization; medicine; rabies; vaccination
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1 posted on 06/27/2005 9:41:26 PM PDT by neverdem
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To: El Gato; JudyB1938; Ernest_at_the_Beach; Robert A. Cook, PE; lepton; LadyDoc; jb6; tiamat; PGalt; ..
FReepmail me if you want on or off my health and science ping list.

The Claim: Never Swim After Eating

2 posted on 06/27/2005 9:48:35 PM PDT by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: neverdem

Wow, amazing that girl survived. By the end of the article it seems like it may have been a miracle, rather than an advance, but I guess the jury is still out on that. Good on this doctor, for sure. He saved her life, they should make a TV movie about this.

How the heck did those Germans get rabies from those organs? I forget. There was more than one person affected iirc. I guess the question is how did the organ donor come to have rabies and why did it remain undiagnosed?


3 posted on 06/27/2005 9:50:34 PM PDT by jocon307 (Can we close the border NOW?)
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To: neverdem
She apparently owes her life to a novel...

Not having access to the New York Times, I wonder who was the author.

4 posted on 06/27/2005 10:00:42 PM PDT by Doctor Stochastic (Vegetabilisch = chaotisch is der Charakter der Modernen. - Friedrich Schlegel)
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To: Doctor Stochastic

Didn't Stephen King write Cujo?

Oh, wait, that was about a dog, not a bat...


5 posted on 06/27/2005 10:05:32 PM PDT by LibertarianInExile ("Property must be secured or liberty cannot exist." -- John Adams. "F that." -- SCOTUS, in Kelo.)
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To: Doctor Stochastic

That would be "novel drug regimen," not a novel ... though I like the idea of her treatment being inspired by a novel. Would have made a better story!


6 posted on 06/27/2005 10:12:08 PM PDT by Hetty_Fauxvert (Kelo must GO!! ..... http://sonoma-moderate.blogspot.com/)
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To: Doctor Stochastic


Wait...wait...

Isn't this "Free Republic"

I despise having to subscribe to news services...

Still interesting... Maybe I can find this story in its entirety somewhere else...


7 posted on 06/27/2005 10:15:03 PM PDT by Miykayl
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To: Hetty_Fauxvert

One must be careful with context breaks.


8 posted on 06/27/2005 10:16:00 PM PDT by Doctor Stochastic (Vegetabilisch = chaotisch is der Charakter der Modernen. - Friedrich Schlegel)
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To: neverdem

Moral of story:

1. Do not touch bats.

2. Report ANY animanl bite, no matter how small.

3. Be proactive.


9 posted on 06/27/2005 10:18:17 PM PDT by Conservatrix ("He who stands for nothing will fall for anything.")
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To: Miykayl

Thanks for the warning. Registration pages are absolute thread-killers for me. I don't care what the subject is: if you can't directly link to the whole damned article, don't post it!


10 posted on 06/27/2005 10:19:10 PM PDT by Luddite Patent Counsel (Theyre digging through all of your files, stealing back your best ideas.)
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To: jocon307
I guess the question is how did the organ donor come to have rabies and why did it remain undiagnosed?

The incubation time, i.e. the time from exposure until clinical symptoms, is quite variable, from one week to more than a year, with the mean 1 - 2 months.(Harrison's Internal Medicine, C. 2001)

They don't routinely test for it with organ transplants. IIRC, they had three cases here this country in the midwest from the same organ donor last year.

11 posted on 06/27/2005 10:20:30 PM PDT by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: neverdem

Ping...for later.


12 posted on 06/27/2005 10:25:04 PM PDT by Fruit of the Spirit
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To: Doctor Stochastic
Not having access to the New York Times, I wonder who was the author.

The author is an M.D. He added his professional initials to the byline. You can have free access just like me. No subscription fee is required, but they will start charging in September for parts of the paper. They mentioned that they will charge for their OpEd columnists, e.g. Mo Dowd, et al. Don't laugh too hard. I'll miss Brooks and Tierney, but they won't get my dough. I can probably find them free on the net. You can try bugmenot.com, if you don't want to register for free.

13 posted on 06/27/2005 10:34:07 PM PDT by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: neverdem

Hi, please put me on your ping list. Thank you very much!


14 posted on 06/27/2005 11:11:04 PM PDT by pbmaltzman
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To: Miykayl

The Milwaukee Journal ran a long continuing story about this from last Sunday until last Tuesday. It was a wonderful read full of the prayers and faith of family, friends, doctors and many.


15 posted on 06/28/2005 3:26:11 AM PDT by Bellflower (A new day is Coming!)
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To: neverdem
Thanks for the ping, neverdem.

More on this New England Journal of Medicine Publishes Jeanna Giese Rabies Cure June 16, 2005, 09:06 PM By Jerry Burke

The experimental treatment doctors at Children's Hospital of Wisconsin used to save a Fond du Lac teenager with rabies is being published in the prestigious New England Journal of Medicine.

The teen was slightly bitten by a downed bat last September. She considered it minor and didn't seek medical treatment until a month later when her condition worsened. Then she was diagnosed with advanced rabies and almost died.

The doctors who saved Jeanna's life continue to call her their "miracle patient." They met the media Wednesday at Children's Hospital near Milwaukee. They say saving Jeanna's life is so far the highlight of their medical careers, but they add there was an element of luck involved.

"It's a miracle in that no one is supposed to survive rabies, and we're not quite sure what we did and what worked and we're not sure it can be reproduced," Dr. Rodney Willoughby said.

The doctors say what really helped them is that Jeanna's parents emphatically told them 'Do what you have to do,' which ethically allowed them to improvise a plan to save Jeanna's life.

That plan included putting Jeanna in an induced coma for a week, allowing her immune system to fight the rabies. They also concocted what they call a special medical cocktail of carefully selected drugs that worked.

Doctor Willoughby said he saw Jeanna two weeks ago and still projects a full recovery. He said, "She shocked me last time I saw here by walking down the hall by herself, and I have rumors of her trying to shock me even when I see her in August, something involving wheels and high speed."

Jeanna celebrated her 16th birthday earlier this month. Jeanna's dad says it will be a while before Jeanna gets her drivers license but he says she's busy practicing with go-karts.

Doctors call Jeanna the perfect patient for their improvised treatment, and they're glad the rest of the medical community will now get to read about her medical miracle and use it for future rabies cases.


16 posted on 06/28/2005 3:35:25 AM PDT by syriacus (George Felos and the Three Schiavoteers --at your service to provide death-dealing testimony)
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To: syriacus
Rabies treatment that saved girl being given to others, BY KAWANZA NEWSON AND MARK JOHNSON Milwaukee Journal Sentinel
MILWAUKEE - (KRT) - An untested rabies treatment used by doctors in 2004 to save Jeanna Giese, the world's only unvaccinated survivor, has already been administered to others infected with the virus. [snip]

Jeanna Giese was diagnosed with rabies Oct. 19 and within two days entered a medically induced coma.

Her parents had been given the option of hospice care for their daughter or allowing the doctors to take a more aggressive approach based on an untested strategy that involved the use of four drugs: ketamine and midazolam to protect her brain; and amantadine and ribavirin to fight the rabies virus. Ketamine also helped to fight against the rabies virus.


17 posted on 06/28/2005 3:43:38 AM PDT by syriacus (George Felos and the Three Schiavoteers --at your service to provide death-dealing testimony)
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To: neverdem

Thanks for the reply. I had no idead rabies was so unpredictable in terms of time of sympton manifestation. I didn't remember the US cases.


18 posted on 06/28/2005 4:26:55 AM PDT by jocon307 (Can we close the border NOW?)
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To: neverdem

Thanks and wow, hits close to home. In the spring we had one of our cats bring in a bat and had to have it tested.
Thankfully it was negative.


19 posted on 06/28/2005 4:52:10 AM PDT by MarMema
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To: Miykayl; Luddite Patent Counsel
http://www.bugmenot.com
20 posted on 06/28/2005 4:57:06 AM PDT by Ladysmith ((NRA) Wisconsin Hunter Shootings: If you want on/off the WI Hunters ping list, please let me know.)
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