This is probably a dumb question, but if we eliminate the hydrophobia caused by rabies, would it increase the survival rate of active rabies?

I’ve been learning some about rabies and learned about rabies causing hydrophobia. This is just a theory, I’m not saying I know anything about this topic to be knowledgeable, but if we could get someone with rabies to not fear water, could they survive?

amio ,

No. Rabies is destroying neurons, causing the symptoms. The hydrophobia is not literal fear of water (like phobias so often aren't) but a result of your brain being fried to the point where you have issues swallowing. If it were an issue of hydration, just IV fluids would be a given, and you would probably want IV access anyway.

Not a doctor or anything, though.

Kalkaline ,
@Kalkaline@leminal.space avatar

The “cure” for rabies is to treat it with a vaccine prior to symptoms appearing. The rabbies vaccine is 100% effective and you will not become symptomatic if you treat soon after the bite. The Milwaukee protocol has been tried and it’s a last ditch effort for people who didn’t get the vaccine shortly after the bite and are now showing symptoms. They don’t even know if the Milwaukee Protocol is what prevented death or if the people it worked on were somehow resistant to rabies.

Anticorp ,

Why can’t we just get a rabies vaccine when we’re kids, or every few years, like most other vaccines? Why does it have to be after the bite event?

Kalkaline ,
@Kalkaline@leminal.space avatar

Because unless you’re living and working in a high risk environment, there’s no need for a human to go get a rabies vaccine because they can just avoid mammals that are acting strangely. It’s not like it’s airborne, you have to get a penetrating bite from a symptomatic animal to get it, so when that happens you just go to the doctor. You’d still likely get the vaccine even after a bite even if you had been previously vaccinated.

Anticorp ,

What if you’re backpacking or something when you get bit? How long of a safety window do you have between getting bit and getting the vaccine?

Kalkaline ,
@Kalkaline@leminal.space avatar

Incubation period is as little as a week, but as great as a year. You would want to be vaccinated ASAP because otherwise it’s a death sentence.

Anticorp ,

Thanks!

howrar , (edited )

Considering that it has to go through the belly button, I’d rather not, thanks.

This is apparently not the case anymore since the 1980s.

emergencyfood ,

Modern rabies vaccines are injected into the upper arm.

howrar ,

Oh, that’s good to know. Thanks.

emergencyfood ,

Vets and people who work in animal shelters often get the rabies vaccines beforehand. But even if you have been vaccinated previously, you still have to get it again if you are bitten.

Anticorp ,

Then what’s the point of getting it beforehand?

Senshi ,

The efficacy of vaccines usually declines over time after administration. The immune system starts to “forget” how to fight a pathogen it doesn’t encounter. It doesn’t completely forget, but it puts the treatment data way back in the archives. So when it encounters the real deal, it can take quite a while to boot up production of antibodies. It also varies by the type of disease.

This is fine for some slow diseases ( which is why sometimes a single vaccination can suffice ), but can be risky if the disease progresses faster than the immune system can ramp up the defenses.

Administering the vaccine as soon as possible after suspected exposure to deadly or highly contagious diseases simply helps the immune system to get the necessary blueprints to get in the fight quicker.

Administering the vaccine before any exposure at regular, long intervals is done to decrease the baseline risk. Sometimes you don’t know you have been infected. Many diseases are not only transmitted by dramatic, obvious vectors. In those cases, it’s definitely better to have some old defense than none at all.

Anticorp ,

Thank you for the in-depth explanation! I appreciate it.

emergencyfood ,

In addition to what Senshi said, if you have recieved the full course of vaccines (4-5 doses spread over a month), any future bites need only 1-3 doses. Also the time within which you have to take the first dose increases from 24 hours to 2-3 days, which can be quite useful to vets in remote places.

count_of_monte_carlo Mod ,

The Milwaukee Protocol is a treatment plan that is essentially a more advanced version of what you’re asking. The patient is put in a medically induced coma and then given antivirals and IV fluids, which avoids the issue of hydrophobia.

It got a lot of press because one person survived on it (a big deal given that rabies is a death sentence once symptoms appear) but this success hasn’t been reproduced with other patients. A paper on the protocol has a remarkably blunt title: Critical Appraisal of the Milwaukee Protocol for Rabies: This Failed Approach Should Be Abandoned.

A_Random_Idiot ,
@A_Random_Idiot@lemmy.world avatar

and didnt they use it on that girl that survived cause she didnt report the bite until it was too late, so it was either try something dangerously crazy like Mulwaukee Protocol, or just die miserably?

rudyharrelson ,
@rudyharrelson@kbin.social avatar

I guess whether this protocol should be abandoned, rather than iterated on to improve its chances of success, to me, depends on the effect the coma has on the patient's quality of life while the protocol is attempted. It's arguably more humane to put someone in a medically induced coma while they're still sane. If the protocol fails, the patient is at least not conscious while their brain is deteriorating.

I'm gonna go watch House.

PrincessLeiasCat ,

It seems like this would be the most humane way to “treat” it, but maybe I’m missing something?

Dogyote ,

Critical Appraisal of the Milwaukee Protocol for Rabies: This Failed Approach Should Be Abandoned

Well you got a better idea?

I looked, and they don’t.

xkforce ,

Yes. Get vaccinated before symptoms appear. If you don’t, you are almost guaranteed to die no matter what intervention is attempted.

GluWu ,

We should make a new protocol where if you didn’t get the vaccine, we just fucking kill you.

catloaf ,

Unlikely. Rabies kills by infecting brain cells. This means they’re converted into virus factories instead of doing brain things. That also causes swelling as an immune response, which further damages the brain. Both of these result in coma and death. Eliminating hydrophobia and increasing water consumption would not really help treat an infection (at least any more than treating any infection, which is to say, not very much on its own).

justJanne ,

No. You can fix the dehydration relatively easily by just giving the person liquid intravenously.

But the primary way rabies kills you is liquifying your brain, which is independent of how hydrated you are.

Empricorn ,

So that’s what The Shape of Water is about, never saw it.

DigitalTraveler42 ,

Nah that movie was about how human men are biologically flawed and that our cock and balls should be internal in some kind of clam shell like thing.

CanadaPlus , (edited )

Happy reptile noises.

For whatever reason sperm cells just come out better when kept a couple degrees colder, though, so here we are with our insides out.

Aussiemandeus ,
@Aussiemandeus@aussie.zone avatar

Yeah its the prime example that evolution isn’t perfect just happy with good enough.

Also a great detriment to the “grand design”

CanadaPlus , (edited )

It also illustrates a funny bit of the logic of multicellular non-clonal creatures: the germ line is the species. The other 99.9…% of you is just a fancy delivery mechanism, so it makes sense to add something seemingly super impractical to the anatomy if it slightly helps the sex cells.

Agent641 ,

Many organs function poorly when liquefied.

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