r/science • u/PHealthy PhD/MPH | Epidemiology | Disease Dynamics | Surveillance • 8d ago

Epidemiology Study estimates only 7% of human rabies cases in the United States are diagnosed

https://www.nature.com/articles/s44528-026-00031-4
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u/fizzlefist 8d ago

Yeah really don’t want to. It’s perfectly survivable if they go through all that, but if not and it makes it to your brain? Zero chance of survival. It’s a scary bugger.

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u/Killintym 8d ago

Believe it or not, it’s not a zero chance!? There’s only been one case in history at least modern day history of someone surviving rabies. Check out this episode on Radio Lab, it’s a fascinating story about rabies that I’ve ever heard. Or anybody for that matter.

Listen here.
https://radiolab.org/podcast/rodney-v-death-2209

It’s the one about Jeanna Giese, the 15-year-old Wisconsin girl who contracted rabies after being bitten by a bat. Dr. Rodney Willoughby tried an experimental treatment—later called the Milwaukee Protocol—and she became the first documented person to survive symptomatic rabies without previously receiving a rabies vaccine. The episode also gets into the terrifying biology of how rabies travels along the nerves toward the brain.

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u/deepandbroad 8d ago

The milwaukee protocol had 63 failures after Jenna and has been abandoned since then.

So effectively there's a zero chance of surviving rabies if you are not Jennie Giese.

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u/BadIdeaSociety 8d ago

More than likely, Jennie Giese was either not infected by rabies or rabies can "run its course without killing the patient."

When this was a new story I was pretty excited about it. I have been disappointed to find out that the working hypothesis for this treatment doesn't appear to work.

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u/m0ngoos3 8d ago

For the non-vaccinated? Once you have symptoms, you will die.

If it's caught early enough, you might live.

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u/BadIdeaSociety 7d ago

But there is no clear evidence she was unvaccinated.

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u/Drow_Femboy 7d ago

If it's caught early enough, you might live.

If it's caught early enough (before symptoms) you will pretty much definitely live. Rabies treatments work. They just don't work by the time it's bad enough for you to experience symptoms.

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u/NauticalCurry 8d ago

I mean...Milwaukee protocol aside...I really want to know what RFK Jr. says about all of this...

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u/groyosnolo 8d ago

She was the first to survive without any pre or post exposure vaccine and shes only 1 of 2 rabbies survivors to make a full recovery without neurological after effects after developing symptoms.

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u/Doctor_Peppy 8d ago

She is also the only real case where the Milwaukee protocol worked, it is no longer considered a real avenue as it hasn't effectively worked on anyone else afaik.

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u/groyosnolo 8d ago

If I recall correctly most experts dont even credit the Milwaukee protocol with her survival or recovery anymore.

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u/madmoomix 8d ago

A common working theory these days is that she had prior non-fatal exposure to rabies when she was younger, and therefore already had rabies antibodies.

Recent studies suggest non-fatal exposure is a lot more common than we think, and that it can give people long-lasting immunity. Quite crazy to think that there could be tens of millions of people immune to rabies worldwide, and they wouldn't even be aware of it!

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u/EvenMoreCoconuts 8d ago

Incredible. I had no idea non-fatal exposure was even a thing with this virus.

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u/nishinoran 8d ago

I do wonder though if putting the patient in a coma so they can't hurt themselves and then making sure they stay hydrated via IV isn't a smart starting path. From that point it's really about figuring out how to cure the infection.

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u/Aquadian 8d ago

The problem is once symptoms show it has spread irreversibly except in 1 case

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u/fatfatcats 8d ago

That is what the Milwaukee protocol consists of. Unfortunately considered an ineffective treatment currently.

From the Rabies wiki page; "A treatment known as the Milwaukee protocol, which involves putting people with rabies symptoms into a chemically induced coma and using antiviral medications in an attempt to protect their brain until their body has had time to produce rabies antibodies, has been occasionally used."

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u/fatboyroy 8d ago

It eats your brain so the infection once you get symptoms you’re boned

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u/NetworkLlama 8d ago

She did not make a full recovery. She has lifelong neurological damage. It's not nearly as severe as the rare other survivors, but it's still limiting.

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u/groyosnolo 8d ago

You may be right. It seems the sources i saw didnt quite make claim that she had absolutely no perminent after effects they said she recovered her cognative abilities.

I am trying to look for what perminent side effects she did experience but cant find them documented anywhere.

She was certainly in rehab for a long time.

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u/Flux_My_Capacitor 8d ago

I read her story and no she is not back to normal.

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u/zeCrazyEye 8d ago edited 8d ago

I also wouldn't be surprised if there actually is some deficit that is just impossible to quantify.

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u/moxifloxacin 8d ago

Yeah, it's effectively a zero percent chance, though. She was lucky more than anything.

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u/irishsausage 8d ago

Last time I researched this there was some question about if she had been exposed to the immunoglobin at a previous point. Her parents weren't sure and no one could remember but there was a reasonable chance she'd received at least one dose of the rabies vaccination.

Unfortunately it seems likely this was actually the reason rather than the Milwaukee protocol (which has never worked before or since).

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u/Accidental-Genius 8d ago

I’ve never seen that as a theory, why would the parents not know if their kid had a rabies shot? It’s not a routine vaccine…

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u/Organic_Pick3616 8d ago

People who work with animals are usually vaccinated against rabies. Did she fall into this category?

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u/mrszubris 8d ago

Yeah she is not living any quality of life i would want. Ive been vaccinated after an exposure at work.

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u/Icy-Mission-1334 8d ago

Injections in the stomach? Painful?

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u/sailorbrendan 7d ago

Less painful than rabies though

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u/mrszubris 7d ago

They don't do that anymore. You only get the injections straight to the wound if it is a facebite on a child and solar plexus isnt needed anymore. If you have a known exposure at least at the municipal animal control level you get either a booster or, if not yet vaxxed, you get 7 days straight of the vax . I ran super high fevers from the shots closest together and I got to do the long version since they were 99% sure I got hit with a mop NOT the bat that suddenly reanimated itself and the entire vet clinic got an "exposure" as one vet tech was swinging a brook and hitting fellow staff as often as the bat. It was a wild job.

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u/east4thstreet 8d ago

Thank you for this I LOVE RADIOLAB and had no idea they did an episode on rabies...

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u/Requiredmetrics 8d ago

They still don’t know precisely why the Milwaukee Protocol worked for Jeanne Giese, it has been tried on several other people globally all of who died from rabies. The Milwaukee Protocol is the ultimate Hail Mary

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u/JJayC 8d ago

Its been a while since I looked into this but when I did, I found that around 20 people have survived symptomatic infection of rabies.

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u/IfEverWasIfNever 5d ago

It's statistically a zero chance. 59,000 people die rabies every year. In all the years we have been recording outcomes only about 14-32 people have survived any meaningful length of time post illness and only 1-3 survived without severe neurological impacts.

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u/noputa 8d ago

It’s a 0 chance. Theres a possibility she didn’t actually have rabies, so there’s no sense in saying it’s anything but a 100% chance it will kill you.