Medicine: Recovery from Rabies?

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Rabies, a virus infection transmitted to humans through bites from infected animals, has always been considered fatal. So far, all those known to have contracted it have died, often after long, horrible illnesses. Now there is an apparent exception to this deadly rule. Matthew Winkler, 7, of Willshire, Ohio, has not only managed to survive the disease for two months, but last week he made medical history by showing signs of recovery.

Matthew's ordeal began last Oct. 10, when a bat flew into his bedroom and bit the sleeping child on the thumb. Determining from tests that the bat was rabid, doctors began almost immediately to administer vaccine made from rabies virus grown in duck embryos and then killed. For 15 days, they injected massive doses of the serum into the muscles of Matthew's abdomen, a painful prophylaxis that usually prevents the disease if begun early enough. This time, the effort failed. By the end of October, Matthew complained of muscular stiffness and dizziness; by early November, he was experiencing difficulty in speaking and moving his left arm.

Fatal Symptoms. Suspecting an adverse reaction to the vaccine, doctors admitted the boy to St. Rita's Hospital in Lima, where tests strongly suggested that he had contracted the disease. They then began a desperate battle to save the youngster by treating not the infection itself—which responds to drugs poorly, if at all, once it has begun —but the secondary effects that kill its victims. Placing Matthew in intensive care, they put a tube in his throat to enable him to breathe and prevent him from choking on his own saliva. They also monitored his heart to assure the proper rhythm and administered drugs to prevent the violent convulsions that characterize rabies.

The doctors obviously did something right. Though Matthew became critically ill in mid-November and was semicomatose for several days, he has made remarkable progress since then. The tracheotomy tube has been removed from his throat, he has regained the use of his left arm and has begun to undergo speech therapy to overcome impairment to his vocal cords. Other rabies victims have survived longer, but none has shown so much improvement at this stage of the illness.

Though cautious about calling it a complete recovery, doctors are understandably elated by Matthew's progress, which could make him the first person ever to survive a documented case of rabies. But they are uncertain whether to credit the vaccine or his medical management for the apparent recovery. The two other Americans who contracted rabies last year were also treated with anti-rabies vaccine. Both died.