Jeanna Giese

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Jeanna Giese (born 1989) is the first person known to have survived symptomatic rabies without receiving the rabies vaccine. She is only the sixth person known to have survived rabies after the onset of symptoms; the other survivors suffered from vaccine failures.

1 Infection with rabies
2 Induced coma treatment
3 Theories about survival
4 Other attempts
5 Life after rabies
6 Documentary
7 References
8 External links

[edit] Infection with rabies

In September 2004, Giese, then fifteen years old, and a student at St. Mary Springs High School, picked up a bat that she found in St. Patrick's Church in her hometown of Fond du Lac, Wisconsin. She sustained a small bite on her left index finger, and having treated it with hydrogen peroxide, her mother decided not to seek medical attention^[1]. Thirty-seven days after the bite Giese developed neurological symptoms. She was admitted to the hospital with tremors and trouble walking. Her condition continued to deteriorate, and she was referred to the Children's Hospital of Wisconsin in Wauwatosa, Wisconsin. Doctors there began to suspect rabies, and their diagnosis was confirmed by laboratory tests at the Centers for Disease Control.

[edit] Induced coma treatment

Rabies had been considered universally fatal in unvaccinated patients after the onset of symptoms (with treatment generally limited to palliative care), but Giese’s parents agreed to an experimental treatment proposed by her doctors at the Children's Hospital of Wisconsin. It was known that most rabies deaths were caused by temporary brain dysfunction, not permanent brain damage. Her physicians consequently decided to use drugs to put Giese into a coma to protect her brain, and hoped that she would survive long enough for her body to fight off the virus. Giese was given a cocktail of ketamine, midazolam and phenobarbital to suppress brain activity and the antiviral drugs (ribavirin and amantadine) while waiting for her immune system to produce antibodies to attack the virus. Giese was brought out of the coma after seven days.

After thirty-one days in the hospital, Giese was declared virus-free and removed from isolation. There was some initial concern about the extent of brain damage she had suffered, but while she had suffered some, the disease seemed to have left her cognitive abilities largely intact. She spent several weeks undergoing rehabilitation therapy and was discharged on January 1, 2005. By November 2005 she was able to walk on her own, had returned to school, and had started driving automobiles. She graduated from high school in 2007. Later attempts to use the same treatment have failed, but on April 10, 2008 in Cali, Colombia, it was reported (by local newspapers) that an 11-year-old may have recovered successfully after induction of coma.^[2] This patient was infected on February 15 when several children were bitten by a cat in Santander de Quilichao, a small town near Cali.

[edit] Theories about survival

The reasons for her survival remain controversial. While the treatment appears to have worked as planned, her doctors suggest Giese might have been infected with a particularly weak form of the virus, or that the fact that she was bitten in a site far from the brain bought her unusually strong immune system sufficient time to fight the virus. When admitted to the hospital no live virus, only antibodies, could be isolated from her body, and the bat was not recovered for testing.

[edit] Other attempts

At least six later attempts to cure symptomatic rabies using a similar medical protocol have been unsuccessful. In May 2006, doctors at the Texas Children's Hospital applied a similar treatment as used on Giese to Zachary Jones, a 16 year-old stricken with symptomatic rabies, but they were unable to save him. From early October to early November of 2006, 10-year old Shannon Carroll was also unsuccessfully treated. This protocol is commonly being referred to as the "Jeanna Treatment", at the Springs. An article written by her primary care physician in the April 2007 Scientific American calls this the Milwaukee protocol^[1]; he indicates that those who attempted to follow this protocol actually violated it, failing to use the combination of drugs he first described.

[edit] Life after rabies

Jeanna Giese returned to school, and with the extra help of teachers, was able to complete her sophomore year with her class. Despite the obvious setback, she kept at the same level as the rest of her classmates. She graduated high school with honors in May 2007. She expressed her intention to become a veterinarian after graduating.^[1]^[3] She is attending Marian College in Fond du Lac.^[4] Mayo Clinic neurologist Dr. Kenneth Mack described her condition as she entered college: she's recovered "remarkably well" and should continue to improve.^[4]