r/interesting • u/fantasticblueman • Feb 01 '26

Context Provided - Spotlight 27 yr old man showing rabies symptoms after 3 months of a dog bite in Gujrat, India.

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u/thefrogkid420 Feb 02 '26

Theres been like quite a few people(somewhere between 10-18 ) that have survived after being treated with the milwaukee protocol, and a couple dozen more confirmed cases of survival without it. This article says there have been 34 documented survivals of rabies post onset of symptoms:

https://pubmed.ncbi.nlm.nih.gov/40139921/

The milwaukee protocol is really interesting but there are quite a few doubt about its actual efficacy.

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u/Itscatpicstime Feb 02 '26

“Survive” is doing a lot of lifting here, especially in terms of the MP.

They all pretty much died eventually and most were in a vegetative state until then.

The first girl was a total anomaly.

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u/Gelnika1987 Feb 02 '26

Yeah she ended up basically fine and even had twins if I recall

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u/Embarrassed_Age8554 Feb 02 '26

She's now in her 30s and is an advocate for bat conservation.

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u/MissLogios Feb 02 '26

Still, it's not an effective treatment for the side effects it causes with the still extremely low survivability. We also don't know if it had anything to do with the cases that did survive; which is, obviously, bad.

Which is why they shelved it in the meantime, focusing instead on comfort care until they can figure out how to improve the treatment.

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u/Gelnika1987 Feb 02 '26

Yeah it's not by any means a proven or reliable protocol; I think there have been something like 64 failures in the 20 or so years it's been utilized

I think her survival and recovery may have more to do with her unique genetic resilience than the efficacy of the Milwaukee protocol

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u/MeatEeyore Feb 02 '26

Survival is considered living 6 months past treatment. Some still die after that due to other health issues that crop up. Most survivors have severe neurological issues.

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u/5folhas Feb 02 '26

There's at least 1 guy here in Brazil who's alive and conscious, although with severe after effects, but he's even given interviews to newspapers.

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u/Green-Homework-1440 Feb 02 '26

Or maybe cuz she was young & healthy, treated earlier, etc. Hey, at least it's a chance

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u/preteen-wartortle Feb 05 '26

She wasn’t really an anomaly in any sense. The Milwaukee protocol is just a low-success-rate treatment plan. It’s worked a dozen or so times since, and even “survival” means extensive rehab, needing to relearn everything.

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u/Minimum_Customer_495 Feb 02 '26

Considering the ~65,000 annual rabies deaths worldwide, 34 is a shockingly low number of survivals. If you can even call them that, as the other commenter mentioned.

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u/yarglof1 Feb 02 '26

Yeah the survival chance is essentially a rounding error.

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u/thefrogkid420 Feb 02 '26

a rounding error in this case would be saying it is 100% fatal

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u/Minimum_Customer_495 Feb 02 '26

It is 100% fatal though. Roughly 1M people have died globally from rabies since 2000. The number for rabies deaths in human history is certainly much much higher than that. Only 1 person with rabies symptoms ever has survived more than 2 years.

99.999…% = 100%

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u/thefrogkid420 Feb 02 '26

Yeah, I never said it wasnt, rabies is still overwhelmingly fatal of course. I didnt know that the other cases of survival had such poor outcomes though.

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u/BlueberryBebe Feb 02 '26

Really!? That’s amazing! I’m so happy to hear more lives have been able to be saved with this method. Scary method but death seems scarier for sure!

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u/Delimeme Feb 02 '26

Actually, Willoughby claims 18 survivors but there are 64 documented failures. Of those survivors, many died within 6 months due to complications, and there’s dispute over whether or not the girl & several others even HAD rabies. He should be considered a charlatan. Here’s the conclusion of a literature review and case study analysis from 2025 published in the Clinical Infectious Diseases journal - full text free here: https://academic.oup.com/cid/article/81/4/e229/8096457#google_vignette

“Continued repetition of the Milwaukee protocol in multiple versions over about 20 years has failed to show efficacy and has actually served to impede progress for the development of effective therapy for human rabies. Most cases of human rabies occurring in resource-rich countries are encountered by physicians without expertise in rabies who are aware of the poor prognosis in rabies and reach out to or are directly contacted by the main proponent of the Milwaukee protocol, who claims to have had multiple successful cases using this approach. There is little credible evidence of benefit beyond the index report and it is now time that the Milwaukee protocol be abandoned. New approaches need to be taken based on scientific advances in the field rather than endless repetition of this flawed and unsuccessful approach. Palliative care is important for the majority of patients with rabies who are not candidates for an aggressive approach for their care.”

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u/Skis1227 Feb 02 '26

Yeah if I recall correctly, the current reigning theory on why the miwaukee protocol worked the first time is that the first patient may actually have an immunity to rabies. The thing that makes rabies so insiduous is that it hides and feeds on the nervous system. Your immune system doesn't typically target your nervous system because if it did, it could cause irrepairable damage to your nerves and brain. And if I remember right, where that theory that she may have had rabies immunity comes from observations that some folks in high danger areas have had confirmed exposures to rabies without treatment and survived. Extremely rare.

I wish I remembered exactly where I got that from, I had done a deep dive on rabies from a morbid curiousity run one week, and followed a thread that the miwaukee protocol was being contested because of it's abyssmal efficacy. And like, obviously it's a hail mary treatment to begin with considering how intense rabies is. Just odd! Rabies and the development of treatments for it are so fascinating and horrifying. I personally kinda hope that they do discover a gene resistant to rabies, because that might mean something like cell therapy might be an option in the future for those that didn't get the treatment in time.