03/10/2025
Rabies Survivor’s Story:
Rabies has long carried the reputation of being almost universally fatal. Yet in recent years, a handful of rare survival stories have emerged—21 documented cases so far, with the possibility of being more unreported.
🔹 Exposure: Every known survivor had sustained WHO Category III dog bites. Nearly all received anti-rabies vaccination (ARV), though rabies immunoglobulin (RIG) was either delayed, given inadequately, or not administered at all.
🔹 Clinical Course: The incubation ranged from 15 to 90 days. Presentations often strayed from the textbook “furious” or “paralytic” rabies, appearing atypical in many.
🔹 Management:
No specific antiviral has ever been effective.
The so-called Milwaukee Protocol has not delivered consistent success.
What saved lives was supportive intensive care—airway protection, ventilation, fluid and electrolyte balance, seizure control, and stabilization of autonomic disturbances.
Some patients received RIG late, but most had completed multiple ARV doses.
📌 The 21st Case: Pakistan
The recently reported survivor from Pakistan fits this global pattern. What made the difference was not a miracle drug, but early ICU admission, aggressive supportive management, and careful stabilization of complications, followed by long-term rehabilitation.
So survival from rabies, while possible, remains the exception. The real weapon is still prevention—immediate wound washing, timely vaccination, and appropriate RIG administration. Supportive critical care may occasionally save lives, but stopping rabies before it starts is far more effective.
