03 January 2005


When I was around 5 or 6 years old, our family dog Doremi bit me in the face real bad. That was my first brush with death. My whole left face was mangled and I lost a lot of blood before my dad was able to bring me to a hospital for treatment. My mom was too shocked and feared she'd lose me at that time.

But I survived and I'm blogging about it now. Doremi was observed for ten days, and it turned out that he was clear for signs of rabies. Nonetheless, I received a full anti-rabies vaccine regimen.

Back in those days, there was only one type of anti-rabies vaccine available for use in our province --- the purified equine rabies immunoglobulin, and this was delivered (very painfully) daily for several days intramuscularly (IM) to my buttocks (gluteal region). Nowadays, the hip thing about rabies vaccination is intradermal delivery (ID) for minimal pain. I was too young to understand what was happening back then. All I remember now is that it was so traumatic for me, and the midwife had a hard time dealing with all my crying and furious struggling.

That is why when I read the story below, it brought back memories of my dog bite.

CHICAGO (Reuters) - A 15-year-old Wisconsin girl who received an experimental treatment to become the first person known to survive rabies without a vaccination has been released from hospital, a spokeswoman for the hospital said on Sunday.

Jeanna Giese of Fond du Lac, Wisconsin, was released on Saturday from Children's Hospital of Wisconsin in Milwaukee, where she had been treated for the disease since mid-October.

The deadly virus, which attacks the nervous system and is usually transmitted through an animal bite, can be prevented with a vaccine if treated immediately.

But the teenager, who contracted the virus from an infected bat on Sept. 12, did not seek medical care until symptoms appeared and it was too late for the vaccine.

Doctors at Children's Hospital devised a new treatment that involved inducing a coma to allow Giese's body to better fight the infection, and administering a cocktail of drugs, Children's Hospital spokeswoman Jackie Gauger said.

The hospital said in a statement on its website that Giese was "...the first person in the world to survive the disease without receiving a vaccination after infection."

[Reuters ]

The Children's Hospital of Wisconsin in its press release promised to publish soon the new rabies treatment protocol initiated by Dr. Rodney Willoughby and his medical team on the 15-year-old girl. I am excited to see how it worked and how it was done.

The new treatment involved inducing a protective coma and a cocktail of drugs to protect her nervous system while her natural immunity caught up to totally destroy the rabies virus in her. As I've said before in previous posts, in cases of infectious diseases, nothing beats natural immunity. The only setback is that it takes time for this to kick in.

Here in the Philippines, the mortality rate from human rabies is about 8 per million population, with an average annual reported incidence of 400 cases (WHO Expert Committee Meeting). I think the actual figure is much higher because most cases are not reported or diagnosed.

In 1993, the Philippines was ranked 5th worldwide in terms of reported rabies cases. This got worse in 2000, when a World Health Organization (WHO) survey pushed us up further to 3rd place worldwide.

The major obstacle in post-exposure prophylaxis for rabies in this country is the cost of administration of the full anti-rabies treatment course. According to a 1997 comparative anti-rabies vaccine cost study, the cheapest regimen is still the Semple vaccine 16-day regimen, followed by the Purified Vero Cel Vaccine (PVCV) given intradermally in multiple sites.

I'm excited about the new rabies treatment protocol. I hope we can reproduce that here in the Philippines.

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