|8-Year-Old Survives Rabies Without Vaccine|
|By KIM CAROLLO, ABC News Medical Unit||Jun 13, 2011, 2:56 PM|
Precious Reynolds of Willow Creek, Calif., is a typical 8-year-old who's spunky and loves sports. But this ordinary little girl has an extraordinary claim to fame: she's only the third person in the U.S. to survive rabies without getting the rabies vaccine shots normally given to anyone who becomes infected.
Precious' grandmother, Shirley Roby, told Good Morning America her condition started out mildly, but then got much worse.
"Her first symptom was she had a real bad stomachache, and then she was paralyzed."
She couldn't swallow and had pain in her neck and back. Eventually, she couldn't even stand up.
After she was flown to UC Davis Children's Hospital, Precious developed brain inflammation, or encephalitis, and tests revealed she had rabies, which she got from a stray cat near her school that scratched her on the arm during recess.
"The cat looked like a regular cat," Precious said.
Anyone who is infected generally receives rabies shots, but Precious did not because no one knows exactly when she contracted the disease. Experts say the shots are only effective if given very soon after exposure.
The American Society for the Prevention of Cruelty to Animals says there are few cases of people getting rabies from feral cats. In previous deaths from rabies, and the two other cases in which people survived, the rabies came from bats.
"Contracting rabies from a feral cat is extremely rare," said Jesse Oldham, ASPCA's senior administrative director for community outreach. "It's also rare to come in contact with them because feral cats usually try to steer clear of humans." But he said that when a person does come into contact with feral cats, there's a chance for scratches and bites.
Doctors treated her with a regimen called the Milwaukee Protocol. It includes antiviral medications and a medically-induced coma to let the brain rest. It was the same regimen used to successfully treat a 15-year-old Wisconsin girl who had rabies in 2004. Despite its past success, doctors never expected Precious to leave the pediatric intensive care unit. She left that unit after two weeks, and is currently recovering in a general pediatric unit at the hospital.
Girl's Recovery Incredible, Say Experts
Infectious disease specialists say Precious' case is incredible, not only because rabies is very rare in the U.S. and survival from it is even rarer. They say her survival was possible in large part because of the efforts of medical staff who treated her.
"This is an extraordinary event -- very gratifying," said Dr. William Schaffner, professor and chairman of the Department of Preventive Medicine at Vanderbilt University School of Medicine. "All the doctors, nurses, respiratory therapists, etc., who cared for this young girl deserve medals -- they did a fantastic job."
Once a person is scratched or bitten by an infected animal, the virus works its way into the brain and spinal cord and eventually causes encephalitis. Rabies encephalitis often causes death within a week after symptoms first appear.
Dr. Greg Poland, a professor of medicine at the Mayo Clinic in Rochester, Minn., says this case is very unusual.
"This is indeed a very, very unusual course of events. There are something like 8 to 10 people known to have survived rabies without receiving vaccine and rabies immune globulin," he said. Rabies immune globulin is typically given along with the vaccine after exposure.
Debate Over Role of Treatment Protocol
s Dr. Rodney Willoughby, the author of the Milwaukee Protocol and professor of pediatrics at the Medical College of Wisconsin in Milwaukee says there's been some discussion over the role the treatment plays in recovery.
"Whether this is just a natural tendency for an occasional survivor or whether our therapy is providing added value is up for discussion," he said. "Some people may be able to survive naturally."
He pointed out the case of a patient in Texas in 2009 who also survived rabies but needed no intensive care treatment at all.
Willoughby also believes that survival rate may be closer to 20 percent, not zero.
Regardless of what may be up for debate, Roby knows one thing for certain: Precious is a survivor. The little girl is starting to walk again and will go home next week. She wants Precious and eveyone else to know it's important to avoid wild animals, but if they do get bitten or scratched, they need to get vaccinated right away.
"Talk to your kids about any kind of animal scratching or biting them. The shots don't hurt. They're a little expensive — but not half as expensive as having a loved one go through this."
ABC News' Jane Kurtzman, Sharde Miller, Angela Ellis and Neal Karlinsky contributed to this report.