Rabies: 8 million cases, 60 thousand deaths each year

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"I’d pick it up. I would so pick it up.”

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Animal lover Jeanna Giese would not hesitate to rescue another bat in distress. “I’d pick it up. I would so pick it up,” she said recently. She showed no fear back in 2004, when she picked up a rabid bat that had flown into her church. After the animal bit her, Giese sought no medical attention for over a month.

Had she gone immediately to a doctor, she could have gotten vaccinations to combat the rabies infection. Rabies, said Scott Bauer [1] is " a viral disease spread by the bite of an infected animal, attacks the nervous system and is usually fatal once symptoms develop." Giese was hospitalized without vaccination and put into a physician-induced coma. She received a number of medications to keep her nerve cells alive during the two long months of intensive care.

Jeanna Giese pulled through, a one-of-a-kind survivor of rabies. There are only five other cases of survival after the onset of symptoms, and all of these people had received vaccination in advance or got it soon afterward. Only one of these five survivors escaped major mobility impairment.

Now 18 years old, however, Giese underwent successful physical therapy to correct weakness in her left hand and foot, arm and hand movements, and difficulties with speech. Although she still has some minor problems enunciating words and moving her left hand and foot, Giese can now drive a car and scored higher than average on her college entrance exam. She misses participating in athlete, playing basketball, softball and volleyball, in all of which Giese excelled as a high school athlete. She is now a freshman at Marian College of Fond du Lac, Wisconsin .[2]

Children in poorer parts of the world, however, are far less fortunate. Every year, at least 60,000 people die from rabies. Children in Africa and Asia are most vulnerable, and many die without vaccination. Some children receive the wrong type of vaccination and die in spite of the treatment. The problem is the lack of ERIG vaccine (equine rabies immunoglobulin), what Debora MacKenzie [3] called a "soup of antibodies harvested from the blood of horses infected with weakened rabies virus."  ERIG fights the lethal rabies virus while the vaccine takes effect.

Approximately eight million people are treated for rabies each year. A mere one or two percent of these patients get ERIG, which is difficult to produce. Animal rights activists have protested the extraction of the blood from horses, and the blood itself may transmit viruses into the medicine. A course of ERIG treatment costs nine times the minimum daily wage of a worker in Bangkok.

But hope comes from a most humble source. To suppplement the emergency production of ERIG in Thailand by that country's red cross, the World Health Organization has organized trials of an alternative vaccine, which blends antibodies to rabies (monoclonals) extracted from mice.

In 2004, Crucell of Utrecht, a Dutch corporation, was working on two human-derived monoclonals, which has proven as effective in animals tests as a human-derived ERIG vaccine. Monoclonal alternatives may eventually cost patients only one fourth as much as the troublesome ERIG drug. [4]

Sources Cited:

[1] Bauer, Scott [Associated Press]. "Young woman has unique rabies survival tale." Detroit Free Press, http://www.freep.com/apps/pbcs.dll/article?AID=/20070829/NEWS07/70829065/0/BLOG01 , August 29, 2007. Accessed on August 30, 2007. Includes photo of Jeanna Giese.
[2] Ibid.
[3] MacKenzie, Debora. "Hope for the world's forgotten rabies victims." New Scientist 184.2476 (Dec 4, 2004): 7(1). Academic OneFile. Gale. DISCUS Remote Patron Access ITWeb. Accessed on August 30, 2007.
[4] Ibid.