I was horrified to read a report recently on how a young man bitten by a dog on the campus of a Chennai college met with an untimely death. In fact, rabies is one of the few viral diseases that can be almost totally prevented by vaccination. Thanks to Louis Pasteur, who created a vaccine that has saved scores of human lives.

The rabies virus is ubiquitous, occurring almost everywhere except in Antarctica. It is spread by the bite of a rabid animal and all mammals are susceptible. Even a scratch by or exposure to mucous membranes, open wounds, or saliva of a rabid animal could transmit the virus. All biting animals, such as dogs, foxes, skunks, coyotes and bats, can be carriers. The disease is almost 100 per cent fatal unless vaccination is done before symptoms show up. Post-exposure, vaccination is recommended even for those previously vaccinated.

The miraculous escape of Jeanna of the U.S. who survived an attack in 2004, has often been cited. She was bitten by a bat while trying to rescue it in her church. Her mother did not know she needed to be vaccinated. She developed flu-like symptoms a month later, and then she had double-vision. The classic hydrophobia symptom developed. She was rushed to the Children’s Hospital of Wisconsin where she tested positive for rabies.

Dr. Willoughby, a paediatric infectious disease specialist who treated her, inferred that rabies does not kill by destroying neurons or causing inflammation in the brain but causes excitotoxicity that over-stimulates the brain and causes cells to die. He decided her brain had to be protected before the virus reached it. He put her in induced coma to save her brain from overstimulation and allowing time for her immune system to work. This is the Milwaukee Protocol. It worked in Jeanne’s case and it is still the only regimen recognised to save rabies patients.

Yet, many have died despite it. Perhaps the survivors were the ones hit by a weakened strain of the virus.

manju _in_00@yahoo.com

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