Given that the symptomatic rabies leads to death in 100% of cases currently, wouldn’t it make sense to try a version of this in those few cases when someone in North America does get rabies?
They already tried the experimental Milwaukee protocol even though it wasn’t clinically established (and in fact didn’t work)
Once again, every single comment is picking apart the least important aspect of a comment. Though it works a small percentage of the time or not, the Milwaukee protocol is evidently not nearly effective enough, thus necessitating this research into a cure.
Your question stands: why not test it? There's precedent for testing unproven drugs on humans in extremis, so it's not that.
As a halfhearted stab in the direction of an answer: I assume they will try it in human rabies victims in a later phase, they're just testing it in mice first.
That is not true anymore. There are two known protocols with a small chance of working but which have already saved about a few dozen lives. They are called "the Milwaukee protocol" and "the Recife protocol" after the cities they were developed.
towards the end of the article, they say it makes sense to test in India because they get large numbers of advanced rabies cases whereas north america supposedly gets zero.
Rabies is such an unfortunate disease. It can live in you with no symptoms for months, and sometimes even years, and then one day you start presenting symptoms and the next day you’re dead. There’s no way to test for it because the way it’s tested for is by cutting your spine/brain apart…
I was exposed to a rabid bat a couple of weeks ago (captured, tested and confirmed to have rabies, unfortunately). While I’m not ecstatic about the cost of rabies treatment in America (it can be up to $40k a person, and 2 of us were exposed), I’m so glad we were able to get the bat tested and get in for the vaccines fairly easily.
The vaccines themselves are reasonably priced, but you have to get Human Immunoglobulin as well, which is only available at ERs and ranges from 2-12k per dose… and we needed 3 doses for each person (it’s by weight). In addition to those 3 shots, we had to get 4 vaccine shots, spread out over a 2 week period. Each shot caused symptoms. Luckily our symptoms were primarily just extreme fatigue or hot skin near the injection site, so it was not a fun 2 weeks but not the end of the world for us.
This alternative treatment sounds like it could be significantly cheaper and easier than that, and that it could possibly work in later stages, so that’s awesome to hear! I wasn’t clear from the article if they think it’ll be usable in humans once the symptoms begin though. If it’s before symptoms begin only, then it’s not much different than the current vaccine regimen other than cost/simplicity (which is still an awesome improvement, but not helpful for the people who don’t know they were exposed).
I’ve had rabies vaccines twice now; a bat flew into us out hiking and then a raccoon jumped me in our yard.
In no case neither myself or my kids had any discernible side effects. That’s interesting that was possible; considering the vagueness of early onset rabies (fever, fatigue, headache) that must have been worrying.
The worst about rabies is that it can linger for years; I heard of a case where a woman was traveling overseas and had exposure to a rabid monkey, and couldn’t get treatment for a week and then only got the vaccine, no HRIG. They told they won’t really know if it worked until 2 years, if she doesn’t die.
I strongly consider getting my family vaccinated before traveling to any place that doesn’t have ready HRIG and vax, since delay can be so dangerous. It’s a low likelihood but high consequences risk, but the vax is pretty low risk but expensive. Spouse doesn’t think it’s necessary so will have to cross that bridge.
This seems like a trial that doesn't need a placebo group. We have a lot of data on people being infected with rabies and it's exceedingly rare for them to spontaneously recover. Basically, you could say the placebo trials have been carried out already.
No IRB would sign on to allowing a placebo group for a disease that has basically* 100% mortality after symptoms show, and the research group that tried would almost certainly be charged criminally for some murder charge or another.
*There's maybe a dozen known recoveries from symptomatic rabies, ever. So, 100%.
“ Low levels of the virus remained in the mice that received the antibody, but those levels didn't increase and signs of rabies did not immediately return, the results showed.”
I’m a little troubled by this outcome. Having the virus linger longer in a living host — is there chance it could mutate or exchange genetic material with another virus like an airborne one?
I don’t know how we would even measure when a human is truly cleared the virus; in mice they know because of an autopsy.
> Low levels of the virus remained in the mice that received the antibody, but those levels didn't increase and signs of rabies did not immediately return, the results showed.
Question: for the cost of a single treatment for symptomatic rabies, how many vaccinations could be administered? We might not be able to properly cure rabies, but we could possibly wipe it out. Even in animals, eatable rabies vaccinations might work.
Rabies lives in a LOT of animal populations (many asymptomatically).
Let's get a working cure for humans before we start worrying about sci-fi methods to eliminate a disease that's endemic in wild animals in many regions.
[+] [-] graeme|2 years ago|reply
They already tried the experimental Milwaukee protocol even though it wasn’t clinically established (and in fact didn’t work)
[+] [-] karaterobot|2 years ago|reply
Your question stands: why not test it? There's precedent for testing unproven drugs on humans in extremis, so it's not that.
As a halfhearted stab in the direction of an answer: I assume they will try it in human rabies victims in a later phase, they're just testing it in mice first.
[+] [-] marcodiego|2 years ago|reply
That is not true anymore. There are two known protocols with a small chance of working but which have already saved about a few dozen lives. They are called "the Milwaukee protocol" and "the Recife protocol" after the cities they were developed.
[+] [-] ryeights|2 years ago|reply
This review [1] cites 11 documented survival outcomes of the Milwaukee and related Recife protocols. Is there a basis to your claim?
[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670764/
[+] [-] anon291|2 years ago|reply
However considering the normal survival rate is zero... It's a lot better
I mean.. you can't say it doesn't work if it led to the first ever documented case of rabies survival. That's amazing.
[+] [-] unknown|2 years ago|reply
[deleted]
[+] [-] littlestymaar|2 years ago|reply
It worked for the first patient on which it's been tried though! Which is still an objective win even if it wasn't particularly successful afterwards.
[+] [-] jjtheblunt|2 years ago|reply
[+] [-] lukevp|2 years ago|reply
I was exposed to a rabid bat a couple of weeks ago (captured, tested and confirmed to have rabies, unfortunately). While I’m not ecstatic about the cost of rabies treatment in America (it can be up to $40k a person, and 2 of us were exposed), I’m so glad we were able to get the bat tested and get in for the vaccines fairly easily.
The vaccines themselves are reasonably priced, but you have to get Human Immunoglobulin as well, which is only available at ERs and ranges from 2-12k per dose… and we needed 3 doses for each person (it’s by weight). In addition to those 3 shots, we had to get 4 vaccine shots, spread out over a 2 week period. Each shot caused symptoms. Luckily our symptoms were primarily just extreme fatigue or hot skin near the injection site, so it was not a fun 2 weeks but not the end of the world for us.
This alternative treatment sounds like it could be significantly cheaper and easier than that, and that it could possibly work in later stages, so that’s awesome to hear! I wasn’t clear from the article if they think it’ll be usable in humans once the symptoms begin though. If it’s before symptoms begin only, then it’s not much different than the current vaccine regimen other than cost/simplicity (which is still an awesome improvement, but not helpful for the people who don’t know they were exposed).
[+] [-] foobarian|2 years ago|reply
[+] [-] nytesky|2 years ago|reply
In no case neither myself or my kids had any discernible side effects. That’s interesting that was possible; considering the vagueness of early onset rabies (fever, fatigue, headache) that must have been worrying.
The worst about rabies is that it can linger for years; I heard of a case where a woman was traveling overseas and had exposure to a rabid monkey, and couldn’t get treatment for a week and then only got the vaccine, no HRIG. They told they won’t really know if it worked until 2 years, if she doesn’t die.
I strongly consider getting my family vaccinated before traveling to any place that doesn’t have ready HRIG and vax, since delay can be so dangerous. It’s a low likelihood but high consequences risk, but the vax is pretty low risk but expensive. Spouse doesn’t think it’s necessary so will have to cross that bridge.
[+] [-] chasil|2 years ago|reply
https://m.youtube.com/watch?v=4u5I8GYB79Y&pp=ygURa3Vyemdlc2F...
[+] [-] askiiart|2 years ago|reply
Invidious: https://invidious.askiiart.net/watch?v=4u5I8GYB79Y
[+] [-] kirdiekirdie|2 years ago|reply
[+] [-] MarioPython|2 years ago|reply
[+] [-] Asooka|2 years ago|reply
[+] [-] littlestymaar|2 years ago|reply
[+] [-] CatWChainsaw|2 years ago|reply
*There's maybe a dozen known recoveries from symptomatic rabies, ever. So, 100%.
[+] [-] nytesky|2 years ago|reply
I’m a little troubled by this outcome. Having the virus linger longer in a living host — is there chance it could mutate or exchange genetic material with another virus like an airborne one?
I don’t know how we would even measure when a human is truly cleared the virus; in mice they know because of an autopsy.
[+] [-] unsupp0rted|2 years ago|reply
[+] [-] sandworm101|2 years ago|reply
[+] [-] ang_cire|2 years ago|reply
Let's get a working cure for humans before we start worrying about sci-fi methods to eliminate a disease that's endemic in wild animals in many regions.
[+] [-] jki275|2 years ago|reply
[+] [-] cliffccc|2 years ago|reply
[deleted]