For centuries, humans who were infected with the rabies virus had a fatality rate of 100 percent. A new treatment is providing hope, but its effectiveness is being called into question:
Not long ago, the medical response to this grim situation would have been little more than ‘comfort care’: administration of sedatives and painkillers to ease the suffering. Untreated, this suffering can be unbearable to watch, let alone experience. That telltale difficulty in swallowing, known as hydrophobia, results in desperately thirsty patients whose bodies rebel involuntarily whenever drink is brought to their lips. Soon fevers spike, and the victims are subject to violent convulsions as well as sudden bouts of aggression; their cries of agony, as expressed through a spasming throat, can produce the impression of an almost animal bark. Eventually the part of the brain that controls autonomic functions, like respiration and circulation, stops working, and the patients either suffocate or die in cardiac arrest. A decade ago, the only choice was to sedate them so their deaths would arrive with as little misery as possible.
But today, after millennia of futility, hospitals have an actual treatment to try. It was developed in 2004 by a pediatrician in Milwaukee named Rodney Willoughby, who, like the vast majority of American doctors, had never seen a case of rabies before. (In the US, there are usually fewer than five per year.) Yet Willoughby managed to save a young rabies patient, a girl of 15, by using drugs to induce a deep, week-long coma and then carefully bringing her out of it. It was the first documented case of a human surviving rabies without at least some vaccination before the onset of symptoms.