Until a few years ago, rabies was described as "invariably fatal" in people. A case of rabies in a 15-year-old girl in Wisconsin a few years ago changed that. She managed to survive this deadly disease due to a very aggressive treatment protocol, that was subsequently named the Milwaukee Protocol. This led people to call start calling rabies "almost invariably fatal". Unfortunately, subsequent attempts to treat people with this protocol failed, and there has been some debate about whether the treatment was really effective – rabies virus was never actually isolated from the first survivor, and some have speculated that the girl was in fact infected with "defective" virus that was less virulent. The patient also developed a very high antibody level against rabies virus, and this abnormally profound immune response to the infection may have also played a role in her survival. Regardless, the failure of anyone to report similar success using the Wisconsin Protocol dampened optimism about this treatment.
That was until a recent case from Brazil, where another successful treatment was reported in a 12-year-old boy who was apparently infected with rabies. He was recently released from the critical care unit, but still has some neurological problems as a result of his ordeal.
It’s heartening that there has been another survivor of this dreadful disease, but I think we still need to consider rabies "almost invariably fatal". We can’t afford to relax one bit about the severity of this disease. It is likely that only a very small percentage of people treated with this protocol will survive, and even fewer (if any) will recover fully. Survival likely depends on very aggressive treatment started very early in disease, as well as a host of other factors such as a strong immune response by the patient and, probably, a lot of luck. Prevention of this disease remains, by far, the best protection for both people and animals.
More information on rabies can be found in our Rabies archives and on the Worms & Germs Resources page.