This month, 24-year-old Birgitte Kallestad died of rabies, as the first case on mainland Norway for more than 200 years.
Rabies is known as one of the world's deadliest diseases and usually ends with death once the symptoms have materialized.
However, there are some exceptions where people have survived rabies even after the disease broke out.
It was referred to as when the American Jeanna Giese was diagnosed with rabies in 2004 and survived.
The matter was then discussed in the Norwegian media and was recently reviewed by forskning.no.
Giese, who works as a speaker today, told The Guardian in 2016 how she was the first to survive rabies in the world without being vaccinated after infection.
Bit like a 15 year old
It started to get bitten by a bat when she was 15 years old. She cleaned the wound but didn't think about it anymore.
Three weeks later the first symptoms came, with double vision and poor physical form. Then nobody put it in the context of the bat chisel and it took a long time for her to get the right diagnosis.
"Then we called it the little bat. I was taken to the children's hospital and I was diagnosed with rabies. I don't remember anything from that time, but I heard later that I started producing amounts of saliva and got muscle twitches in my arm. My parents got too hear that I only had a few hours left to live, "she explained to The Guardian in 2016.
The rescue was a doctor who did not want to give up – and tried alternative treatment to stop the disease.
The treatment, in which the patient was brought into artificial coma, is called the Milwaukee protocol, and later research has shown that it produces very variable results.
Warns against treatment
Consultant Kristine Mørch from Haukeland University Hospital warns about the treatment.
She is head of the Tropical Disease Competence Service and is one of the foremost experts in the field of rabies.
She knows well about the research in the area and would like to report that rabies is a disease with approximately one hundred percent death.
– The Milwaukee protocol was used for the first time as an experimental treatment for this girl. When she survived, she finally hoped to find treatment for rabies. It has since been published in 30 trials where the Milwaukee protocol in rabies patients unfortunately did not work, she says.
She points out that Giese is not the first in the world to survive rabies, but that she is the first survivor who has not been vaccinated before or after disease outbreaks.
– 25 safe cases
60,000 people are affected by rabies each year, while only 25 people in the world know for certain that they have been surrendered after disease outbreaks, according to Mørch.
"Of these, only two had no brain damage, while three had minor brain damage and the rest had major brain damage," says superior.
She says the researchers assume that someone survives because of supportive intensive care until the body has formed antibodies, but unfortunately with serious brain damage.
– Important with realistic information
However, some of those reported as survivors of the Milwaukee Protocol were found not to have rabies or died after a while, says Mørch, referring to a 2015 research report.
"There are probably no international academic communities that recommend the Milwaukee protocol because the effect is not confirmed and research does not support deep coma theory, spasms of blood vessels or disruptions in neurotransmitters in the brain," says the Norwegian physician.
She discourages experimental drug treatments that may have adverse effects, but says supportive intensive care may be appropriate for some patients.
– But as with other serious illnesses, it is important to provide realistic information about the serious state of affairs, and fortunately, in Western hospitals, good treatment can be provided. Experimental coma has shown no effect, but on the contrary, depriving family members of contact with their loved ones.
Can be treated before an outbreak
It is important to emphasize that rabies being able is prevented after infection – as long as it occurs during the incubation period, ie before the disease breaks out.
It can vary greatly, but is usually between 1-3 months and sometimes a year.
The Norwegian Institute of Public Health writes on its pages.
So it can take a long time before you are infected with rabies, until you notice that something is wrong.
It is important to get started quickly if you suspect that you have been bitten, chlorinated or otherwise infected by a rabid animal.
There is an effective rabies vaccine that can be taken after you have been infected.
The vaccine allows you to develop rabies antibodies.
There is also a treatment called rabies immunoglobin, the last antibody.
In some cases, the vaccine is recommended in advance for people traveling to countries where rabies occurs.
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