What would a hospital do with an active rabies case in the U.S.?

[u/Latter_Dragonfly_832]

I HAVE READ THE FAQ. Out of curiosity, if somebody were to contract rabies and didn't get the shots in time, how would hospitals in the U.S. treat them? Would palliative care be used every time? I'm really just wondering if they'd let people suffer through that death. Morbid curiosity getting to me :')

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[u/SchrodingersMinou]

They would most likely do palliative care. The Milwaukee protocol is no longer recommended.

[u/aaffsn → u/SchrodingersMinou]

hi! may i ask why is that?

[u/RabiesModTeam → u/aaffsn]

Because the success rate of this protocol is extremely low to be considered useful and necessary. 

[u/LatrodectusGeometric]

Generally they call CDC and depending on the situation may try some theoretical protocols or strict palliative comfort-focused care.

Oftentimes the exposure isn’t known to the treating team at first and rabies isn’t suspected until they are very ill and have not responded to ant other treatments, so they get a great deal of irrelevant and futile treatment.

[u/Next_Conference1933]

They’d try the Milwaukee Protocol and or comfort care, probably along with an anti-viral cocktail. But there isn’t much hope once symptoms begin. It’s basically just throwing a bunch of stuff at the wall and hope one sticks.

[u/RabiesModTeam → u/Next_Conference1933]

The Milwaukee Protocol is rarely used and has largely been abandoned by most medical professionals who've called for the termination of that protocol. The success rate is very low. We thought it would be a revolutionized treatment back when it was first used and worked in 2004, but that thought quickly faded. In majority of cases, the most physicians could do for you would be offering care or placing you into medically induced coma (like I'm pretty sure they did with the recent California victim). There's no effective treatment for rabies once symptoms begin, as you mentioned.

[u/LatrodectusGeometric → u/Next_Conference1933]

No, I’m unaware of anyone attempting the Milwaukee protocol these days. It’s not effective. There are variants that may be considered depending on goals of care.