Sunday’s Statesman ran a couple of articles on rabies in Texas. Briefly, there was a 30% increase in reported cases over 2010; the drought is being blamed for that. Here’s an interesting list of the most rabid counties in Texas by way of the TM Daily Post. (That links back to one of the Statesman articles.)
The aspect of the coverage that intrigued me, as an amateur neurologist, was Brenda Bell’s article about treating rabies. As I’m sure many of you know, once symptoms develop, rabies has been pretty much 100% fatal. I recall reading that there was one documented case of a 6 year old boy in Ohio surviving in the 1970s, but other than that nothing. (And I can’t find a reference now.) (Edited to add: This site claims that there were actually three documented cases in the 1970s, all involving patients who were given vaccine before symptoms presented.)
This was the case until a few years ago, when a 15-year-old girl survived after being given highly aggressive treatment (an induced coma, combined with antivirals). That course of treatment became known as the “Milwaukee protocol”. There are two problems:
- It doesn’t always work, and nobody knows why. Four other people have survived treatment with the Milwaukee protocol: 32 have died.
- It is expensive; way too expensive for treatment in poorer countries, where rabies is most common.
(Edited to add: If you want to get really technical, here’s an article from the CDC’s “Morbidity and Mortality Weekly Report” (aka the lazy journalist’s friend; at least every other week, I can find an article pulled straight out of MMWR) about the 17-year-old patient in Houston mentioned by the Statesman.)
In other news, the NYT is sad that the black golf caddie is disappearing. Gee, I wonder why that is? Oh, yeah:
Plus, golf carts, and fewer caddie training programs. Plus:
