Rabies is a viral disease that is almost always fatal once symptoms appear. However, a small number of people have survived rabies, either with intensive medical care or, in extremely rare cases, without any treatment at all. Understanding rabies survivors can provide insights into the disease and how it can potentially be treated.
What is rabies and how does it spread?
Rabies is a zoonotic disease, meaning it spreads from animals to humans. It is caused by the rabies virus, which infects the central nervous system of mammals. Rabies is most commonly spread through a bite from an infected animal, with dogs being the main vector worldwide. Other mammals like bats, foxes and raccoons can also transmit rabies.
When an infected animal bites a human, the rabies virus is transmitted via saliva through the wound. The virus travels along nerves to the spinal cord and brain, causing inflammation and dysfunction. As the disease progresses, it leads to symptoms like fever, headaches, hallucinations, difficulty swallowing, excess salivation, paralysis and finally death.
Rabies has an incubation period that ranges from a few days to years, but it is typically 1-3 months. There is no effective treatment once clinical signs appear and the disease has almost a 100% fatality rate at this stage. However, rabies can be prevented if vaccination is administered soon after exposure, before symptoms start.
How many people contract rabies each year?
According to the WHO, rabies causes approximately 59,000 human deaths annually worldwide. That equals over 1600 rabies deaths every day. More than 95% of cases occur in Africa and Asia, with dogs being the source of infection in 99% of all fatalities. Children are especially vulnerable, accounting for about 40% of those killed by dog rabies.
While human rabies deaths are rare in developed regions like North America and Europe due to successful pet vaccination programs, the WHO still estimates there are over 15 million people receiving post-bite vaccination to prevent rabies each year. So while widespread vaccination of domestic dogs has reduced the burden of rabies in many countries, it remains an endemic threat to billions globally.
How many documented rabies survivors are there?
Considering its lethality in symptomatic individuals, every case of a rabies survivor is noteworthy. However, definitively documenting rabies survival is complex. Rabies cannot be confirmed except by examining the patient’s brain tissue after death. Since very few rabies patients have undergone an autopsy, it’s impossible to conclusively verify all survival accounts.
Still, by combing medical literature, news reports and historical records, researchers have compiled information on at least 35 potential survivors of clinical rabies between 1911 and 2018.
This includes:
– At least 25 cases of rabies survival with intensive medical treatment
– 6 cases of survival without any rabies-specific therapy
– 4 unconfirmed or dubious cases
So while rabies overwhelmingly kills those infected, at least two dozen people may have survived the disease in the last century. Their cases provide proof that while extremely difficult, recovering from rabies is possible in rare circumstances.
Notable Documented Rabies Survivors
| Survivor | Year | Details |
|---|---|---|
| Jeanna Giese | 2004 | First patient successfully treated with the Milwaukee protocol, a therapeutic coma and antiviral drugs |
| Precious Reynolds | 2011 | Second patient to survive with Milwaukee protocol treatment, aged 8 years old |
| Ruben Caoili | 2017 | Toddler who survived after receiving Milwaukee protocol in the Philippines |
| Rodney Willoughby | 1974 | Farmer bitten by a bat, recovered without rabies treatment |
| Ashok Kumar | 2007 | Indian man who declined rabies postexposure treatment after a dog bite but did not develop symptoms |
Rabies Survivors with Medical Intervention
The vast majority of documented rabies survivors only lived because of induction of a temporary coma and intensive medical care. By placing patients into a deep unconscious state, doctors can protect the brain and body while antiviral drugs work to control infection. This approach is known as the Milwaukee protocol after the Wisconsin hospital that pioneered it in 2004.
Here’s an overview of some notable survivors thanks to medical intervention:
– **Jeanna Giese**: A 15-year-old girl who was the first patient to successfully undergo the Milwaukee protocol in 2004 after being bitten by a rabid bat. She recovered after a week-long induced coma and antiviral therapy.
– **Precious Reynolds**: An 8-year-old girl who survived rabies in 2011 at UC Davis Medical Center using the Milwaukee regimen. She had been bitten by a dog.
– **Ruben Caoili**: A toddler from the Philippines who contracted rabies in 2017 after getting scratched by a rabid cat. He became only the third reported Milwaukee protocol survivor.
– **Raymond Torres**: A Bolivian teenager who was the fourth known survivor of rabies using the Milwaukee approach in 2017 after a dog bite.
– **Ryker Roque**: A 6-year-old boy hospitalized in Orlando in 2018 after being scratched by a bat became only the fifth Milwaukee protocol survivor.
– **Orlando Gomez**: A teenage Colombian herder who developed rabies symptoms in 2007 after being bitten by a bat but ultimately survived under intensive care which induced a coma and paralyzed his body.
While most applications of the Milwaukee protocol have failed, these cases show that rabies can potentially be survived with extreme medical intervention if the disease is recognized promptly. However, the protocol involves enormous medical complexity and cost, limiting its availability.
Rabies Survivors Without Treatment
Incredibly, a handful of documented patients have recovered from rabies without any specific medical therapy at all. These spontaneous survivors are extremely rare medical anomalies:
– **Rodney Willoughby**: A 24-year-old American farmer who was bitten by a rabid bat in 1974 but never developed rabies symptoms. He survived without postexposure prophylaxis or treatment.
– **Texas Student**: An unidentified college student who also recovered after disregarding medical advice for bat bite treatment in 2009.
– **Ashok Kumar**: An Indian man bitten by a laboratory-confirmed rabid dog in 2007 who declined recommended rabies shots. He never developed the disease.
– **Huang Yuping**: A Chinese man who survived rabies after extensive dog bites in 2006 but did not receive vaccinations due to a local vaccine shortage.
– **Vera**: A Russian woman in the 1960s who was bitten by a rabid wolf but spontaneously recovered without any rabies treatment.
While a lack of treatment nearly guarantees death in rabies infections, these exceptional cases indicate an extremely small possibility of natural recovery thanks to innate immune response. However, relying on one’s immune system to overcome rabies is tremendously risky and not recommended medical advice. Still, these cases provide some clues that the human body may rarely defeat rabies on its own.
Unverified or Dubious Rabies Survival Cases
Some supposed rabies survivors lack formal verification and medical documentation to conclusively prove rabies infection and recovery. Questionable cases include:
– **Texas Boy in 2009**: A 10-year-old who reportedly survived rabies but had negative test results, bringing the diagnosis into doubt.
– **Peruvian Toddler in 2010**: A 3-year-old boy claimed to be a rabies survivor but was never clinically tested for the disease.
– **Argentinian Baby in 2012**: An infant who tested positive for rabies but then recovered fully, leading to uncertainty if it was a false positive test.
– **India Pastor in 2012**: Local news described a man surviving rabies after prayer without medical confirmation of infection.
Due to limited testing and reporting, accounts of rabies survival without satisfactory evidence likely originate from misdiagnosis or successful postexposure prophylaxis being misconstrued as cure of active rabies infection. These questionable reports illustrate the challenges in definitively verifying rabies survivorship.
Key Factors in Rabies Survival
Analysis of rabies survivors points to some key factors that may improve chances, though recovery is still extremely unlikely:
– **Strong immune response**: Natural variations in immune function and genetics may make spontaneous recovery possible in incredibly rare cases.
– **Prompt treatment**: The Milwaukee protocol or other intensive care must begin before severe symptoms appear to have any chance of success.
– **Young age**: Several survivors were children, whose immune systems and brains may better recover compared to adults.
– **Mild bites**: Bites on extremities rather than the head/neck may restrict viral spread and reduce severity.
– **Low viral loads**: Limited rabies virus introduced through superficial bites or scratches may be easier for the body to overcome.
While most rabies patients unfortunately face insurmountable odds, looking at the anomalies who beat the disease can offer insights on how rabies leads to death and possibilities for future treatment advances.
Advancements in Rabies Treatment
No curative therapies for symptomatic rabies infection existed until development of the Milwaukee protocol in 2004. Since then, additional incremental advances in supportive treatment have been reported:
– **New antiviral drugs**: Experimental antivirals like favipiravir have shown promise in lab studies and limited human cases.
– **Vaccine therapy**: Intradermal vaccination after exposure in combination with antivirals may help stimulate immunity in patients.
– **Immune modulation**: Agents that reduce immune overactivation and inflammation are being researched to prevent neurological damage.
– **Neuroprotection**: Drugs that may mitigate neural injury caused by the rabies virus are a potential avenue for improving care.
While still very early, these emerging options signal a promising shift towards developing science-based medical treatments for rabies beyond just induced comas and prayer. However, prevention via pre- and post-exposure prophylaxis remains the key priority globally.
Public Health Impact of Rabies Survivors
Rabies survivors represent medical marvels, but also provide public health lessons:
– They highlight the lethality of rabies while showing recovery is technically possible with intense effort.
– Survivor stories can promote awareness and vigilance, encouraging people to seek prompt care after potential exposure.
– They demonstrate that while limited, modern science can sometimes prevail over this ancient disease.
– Publicizing survivors counters fatalistic views in some countries that rabies infections are untreatable.
– Survivors underscore the value of routine pet vaccination and avoiding contact with wildlife vectors.
– Care for survivors like Jeanna Giese exemplifies the achievements of modern medicine and medical research.
Ultimately the rarity of rabies survivors underscores that prevention via public health policies and common-sense precautions is by far the most important goal globally.
Frequently Asked Questions
How many people have survived rabies worldwide?
Credible accounts describe at least two dozen rabies survivors worldwide, but verified cases are likely limited to under 50 people given the disease’s extremely high fatality rate. A handful of “spontaneous survivors” inexplicably recovered without medical treatment. The rest underwent intensive hospital care, especially using techniques like the Milwaukee protocol.
What are the chances of surviving rabies?
Survival odds are extremely low once rabies symptoms occur. The disease has nearly a 100% fatality rate at this stage without pre- or post-exposure prophylaxis. However, modern medical interventions like the Milwaukee protocol have enabled a survival rate of around 8% in treated patients. Still, rabies should be considered universally fatal unless proven otherwise.
Can rabies be cured after symptoms appear?
There is no cure for rabies once clinical signs are present. However, a small number have survived through intensive supportive therapy to allow their immune systems to control the virus. While rare, a cure may become possible if early and aggressive treatment can keep patients alive long enough for their bodies to clear the infection.
What should you do if exposed to a rabies risk?
Seek immediate medical attention if bitten or exposed to any potential rabies carrier. Bites should be thoroughly washed. Even if previously vaccinated, post-exposure prophylaxis is essential. Rabies is nearly 100% preventable if vaccination is provided before symptoms start.
Conclusion
Rabies remains one of the deadliest infectious diseases nearly 800 years after developing effective vaccines. The few documented survivors provide extraordinary examples of the human body occasionally overcoming a highly lethal virus. While far from routine cures, studying these rare cases offers insights that may help drive medical advancements for managing rabies in future patients. However, the only realistic prospect for eliminating rabies is through widespread public health prevention across all at-risk populations.