Clinical rabies: is cure possible?

Mithun C Mohan, Sudeep K, Nived ., Pramod V K, Ajith Kumar, Prasanna Kv S, Narayanan P V

Abstract


Rabies is a fatal disease in humans and till date survivors of the disease after the clinical onset of the illness are rare. The approach to management of rabies is usually palliative. In rare cases of paralytic rabies a trial for cure has been tried. No single therapeutic agent is likely to be effective, but a combination of specific therapies could be considered, including rabies vaccine, rabies immunoglobulin, monoclonal antibodies, ribavirin, interferon alpha, ketamine etc. the only reported cases in literature were with rare success of the Milwaukee protocol. This is the case report of a 45 year old male who presented with clinical rabies and was started on the trial. Has the treatment had any benefit is to be debated and further options discussed.


Keywords


Rabies, Milwaukee protocol, Therapeutic coma

Full Text:

PDF

References


Hemachudha, T., Wilde, H., Willoughby, R. E. Jr., Rupprecht, C. E. (2005). Survival after Treatment of Rabies. NEJM 353: 1068-1069.

Gode GR, Raju AV, Jayalakshmi TS, Kaul HL, Bhide NK. Intensive care in rabies therapy: clinical observations. Lancet 1976;2:6-8.

Jackson AC, Warrell MJ, Rupprecht CE, et al. Management of rabies in humans. Clin Infect Dis 2003;36:60-63.

Gadre Girish, Satishchandra P, Mahadevan Anita, Suja M S, Madhusudana S N, Sundaram C, Shankar S K. Rabies Viral Encephalitis: Clinical determinants in diagnosis with special reference to paralytic form, Journal of Neurology, Neurosurgery and psychiatry 2010;81(7):812-20.