Posted on 11/24/2004 3:05:57 PM PST by Jean S
Her fragile nervous system was rapidly deteriorating when Milwaukee doctors tested fate and allowed her body to develop natural immunity against the deadly rabies virus.
And on Tuesday, the gamble paid off as doctors declared Jeanna Giese the first person to survive rabies without prior vaccination. The 15-year-old Fond du Lac teen - who had been in grave condition and on a ventilator for a month - is now in an intermediate care unit for intensive rehabilitation.
She's weak, can't move or talk, but most important to her parents, she's still alive.
"I told the doctors, this is the one that's going to walk away," said John Giese, her father. "It took a while for everyone to believe us, but I think they all believe us now."
Using an innovative approach, a team of eight specialists at Children's Hospital of Wisconsin in Wauwatosa intentionally placed Giese into a coma within an hour after her diagnosis on Oct. 19.
The goal was to protect her brain while the virus ran its course through her body, said Rodney E. Willoughby, the pediatric infectious disease physician who headed the care team.
Within three days, Giese was on a four-drug cocktail - two anti-virals that helped salvage her brain and two anesthetics. She was never given a rabies vaccine because it is considered ineffective once clinical symptoms develop.
"It was an informed gamble," Willoughby said. "We had an idea of what we wanted to do, but no one had done this in an animal model, so, yes, we jumped out of thin air."
Prior to Giese, there were only five documented cases of survival once clinical symptoms from rabies appeared, but each person had been immunized against the virus after being bitten, said Charles E. Rupprecht, current chief of the rabies unit at the Centers for Disease Control and Prevention in Atlanta.
Rupprecht, who was at the news conference on Tuesday, called the announcement "a very historic occasion."
"Basically, we had a race, and Jeanna won," he said.
"This is pretty astounding," said Thomas Bleck, a professor of neurology and a director of the Neuroscience Intensive Care Unit at the University of Virginia.
"There's nothing about induction (of coma) that's new," he said. "But the risk here was that the treatment might not have worked."
Rabies is a potentially fatal viral disease that is usually transmitted through a bite from an infected animal.
Early symptoms in humans include fever, headache and general malaise, but as the disease progresses, neurological symptoms appear and may include insomnia, anxiety, confusion, slight or partial paralysis, hallucinations and difficulty swallowing. Death usually occurs within days of the onset of symptoms.
Giese reported being bitten by a bat at church Sept. 12 after picking it up by its wings, and indicated that the wound had been thoroughly washed after the incident. She did not receive medical treatment after the bite.
She was admitted to Children's Hospital on Oct. 18 with periods of unconsciousness, double vision, slurred speech, and weakness in her left arm, which was also jerking, Willoughby said.
"After the worrisome exam, I knew there was not much to offer," he said.
But friends and family of Giese thought differently.
John Giese told doctors to do whatever they could to save his daughter. He and wife, Ann, called upon a greater force to help save Jeanna.
"The day after we found out, I called on everyone we knew for prayer," John Giese said. "We believe a lot of that snowballed and that it really made a difference.
"Miracles can happen," he said. "We really believe it - and it did."
When classmates at St. Mary's Springs High School in Fond du Lac learned of Giese's condition, they began doing whatever they could to help.
Some sent letters, others made ribbons and posters, and many offered their prayers.
They have also posted angels on lockers that carry a single word - believe.
Ann Giese has read every card to her daughter and says she continues to talk to her.
While Giese was still in a coma, Ann read aloud one card from a mother who had lost her child. Giese's face turned red and her heart rate jumped, said her father.
"We believed she could hear us," he said.
Though doctors remain cautiously optimistic about Giese's progress, the battle is far from over.
"She has to do her exercises and see how far she can go," Willoughby said. "She had a major attack on her brain and every peripheral nerve in her body. She's not out of danger until she's home."
No one knows how long it will take Giese to fully recover, nor if there will be any long-term effects from the illness.
But the novelty of what happened has the CDC rethinking the treatment protocol for rabies, Rupprecht said.
"This is encouraging, but we obviously need to know more details about exactly how the patient was treated," said Alan C. Jackson, a rabies expert and a professor in medicine at Queen's University in Kingston, Ontario.
"This isn't necessarily the combination that will allow all patients to survive who have rabies," he said. "But it does give optimism that a patient with rabies can live even if they did not receive a rabies vaccine prior to onset of the disease."
BTTT
And I am sure the Miracle Worker had a hand in it somewhere.
I am certain a young boy was the first to survive rabies. I think he was in NJ. I know he suffered severe neurologic damage.
a lucky miracle - moral:If your kid gets bit by a freaking bat - get them to a hospitol immediately = most of this might have been avoided...
Those wacky Unitarians.
I also remember about 8 years ago, the report of a man (I thought) that survived rabies (my memory is very cloudy, but I thought Ohio).
Anyway, the shots are not useful after clinical symptoms appear and maybe this is a possible approach to treatment in cases where the shots cannot be used. Yes, if a wild animal bites you, kill it. Its brain can be tested for the virus and then the shots continued, or discontinued, depending on the results.
In the US we don't worry so much about rabies, since it is rare, but people should be advised that rabies is endemic in many areas of the world and when they travel, this is a thing they should watch out for.
"She was never given a rabies vaccine because it is considered ineffective once clinical symptoms develop."
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She wasn't given the vaccine, but I wondered if she received the immunoglobulin. The vaccine, containing the antigen, helps the body to produce antibodies against the virulent agent. Whereas the immunoglobulin itself contains the antibodies that targets the antigen. I bet she received the rabies immunoglobulin.
I'd like to be a fly on the wall at her family's Thanksgiving dinner.
i was attacked by my cat yesterday. very severe bite to my hand. went to doctor today. he never asked if it was my cat or a stray, never even mentioned rabies. i was kind of surprised. my hand is very swollen and very, very painful. typing with one finger on pain meds so excuse any typos.
Why did you're own cat attack you?
i don't know. she's never been very nice but this was beyond her normal nasty disposition. she was on my lap, i was petting her. carried her to the kitchen to get something and she went nuts. felt like a vise griping my hand and seemed like it went on forever.
bump
one the best horror movies ever is called "I drink your blood" a kids injects meat pies with rabies-blood from a dead dog, and feeda the meat pies to a Manson-like cult. hijinks ensue! get the dvd!
Is your cat very old? She could be senile, and unable to recognize you.
Pinging some experts.
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