[HN Gopher] Is the first cure for advanced rabies near?
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Is the first cure for advanced rabies near?
Author : PaulHoule
Score : 53 points
Date : 2023-10-07 18:38 UTC (4 hours ago)
(HTM) web link (medicalxpress.com)
(TXT) w3m dump (medicalxpress.com)
| unsupp0rted wrote:
| > 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.
| sandworm101 wrote:
| 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.
| kirdiekirdie wrote:
| It would suck to be included in the trial and then be randomly
| selected into the placebo group.
| Asooka wrote:
| 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.
| littlestymaar wrote:
| I know you're joking but I still want to say you don't need a
| placebo group for a disease with 100% fatality rate.
| greggsy wrote:
| I suspected the same, but I don't know enough about controls
| for extremely small test groups.
| jncfhnb wrote:
| It's not extremely small. It's extremely consistent that
| matters.
| MarioPython wrote:
| Honest question, would this really need a control goup given
| that 100% people die of it? What would the control group
| prevent or provide?
| fatfingerd wrote:
| I don't remember the beginning premise of Shaun of the Dead,
| but rabid positive thinkers reentering society sounds about
| right.
| jncfhnb wrote:
| No it would not be necessary. A control group would give you
| confidence that it wasn't some other aspect of the experiment
| that resulted in people surviving. But we have strong enough
| priors on rabies that we should feel confident the
| probability of accidentally curing rabies with a different
| aspect of the experiment is extremely small.
| Aeolun wrote:
| If that were the case we could do a later experiment to
| establish that factor. "We're doing 'something' that makes
| people survive" is good enough for a first attempt.
| gotstad wrote:
| No, and must likely the ethical committee review would reject
| the use of a placebo group in the study.
| graeme wrote:
| 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)
| ryeights wrote:
| >(and in fact didn't work)
|
| 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/
| jjtheblunt wrote:
| 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.
| karaterobot wrote:
| 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.
| bsder wrote:
| > Your question stands: why not test it?
|
| Because there are so few late stage rabies victims that you
| simply can't get the data?
|
| By and large in the US, people know the protocol--get bitten
| by a strange animal, head to the ER and get ready for rabies
| shots. And it almost always works.
|
| Apparently, the US never had a post-exposure death until one
| 84-year-old man with an immune deficiency (and a bunch of
| other health issues) died of it. It's not clear anything
| would have worked for him. https://www.unmc.edu/healthsecurit
| y/transmission/2023/04/04/...
|
| Basically, the only people who die of rabies are those who
| missed that they got bit or those who were dumb enough to
| refuse the vaccine. And there just aren't that many of them.
| anon291 wrote:
| The Milwaukee protocol is not particularly good. It has a low
| survival rate.
|
| 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.
| marcodiego wrote:
| > rabies leads to death in 100%
|
| 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.
| drunkendog wrote:
| Not sure about the Recife protocol, but it's pretty much
| accepted now that the Milwaukee protocol doesn't work[1][2] -
| the initial case may have been some other encephalitis
| mimicking rabies.
|
| [1] https://journals.lww.com/pidj/fulltext/2015/06000/the__mi
| lwa...
|
| [2] https://www.cambridge.org/core/journals/canadian-journal-
| of-...
| logicchains wrote:
| Your second link is an error 404, page not found.
| IvyMike wrote:
| https://www.cambridge.org/core/journals/canadian-journal-
| of-...
| littlestymaar wrote:
| > They already tried the experimental Milwaukee protocol even
| though it wasn't clinically established (and in fact didn't
| work)
|
| 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.
| drunkendog wrote:
| The first patient might not actually have had rabies.
| [deleted]
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