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Rabies is not so awesome

The other day I was talking to someone (since I don’t know his real name we’ll call him Phil. No, wait. Bill. Bill sounds better) who had quite an interesting encounter with a bat. He (Bill, not the bat) had just stepped outside onto his patio with a glass of wine in one had and a newspaper in the other. The bat (the one I was talking about, not the person I was talking to) promptly landed on Bill’s nose. At first, Bill thought he was being attacked by a moth. Probably more than a little startled, Bill grabbed the bat. Upon seeing that he was holding a winged rodent and not a winged caterpillar, Bill somehow had the presence of mind to hold onto it so that it could be checked for rabies.

Unfortunately for Bill, dealing with rabies isn’t very common in the U.S. Add to this the fact that it was a Friday afternoon and even if anyone knew how to test a bat for rabies, it probably wouldn’t be started until Monday morning. So Bill started the rabies vaccination. Upon hearing this, I imagined poor Bill taking jab after jab of painful injections in his belly with some very, very large needles. Luckily for him, the series of injections necessary has been shortened and doesn’t go in the stomach anymore.

Most of the rabies vaccine is injected intramuscularly in four sets. One as soon as possible after the encounter, another three days later, another 7 days later and the final 14 days later. However, one part of the vaccine is injected as close as possible to the contamination site. Human Rabies Immune Globulin (HRIG) is made from the blood of people who have already been given the rabies vaccine. As you can imagine, a vaccine made from the blood another human is fairly expensive and hard to come by. HRIG makes up the bulk of the expenses for the vaccine, which costs several thousand dollars.

The symptoms for rabies (which start with flu symptoms and then progress to cerebral dysfunction, hydrophobia, paranoia, anxiety and delirium) can take months or years to first present themselves, but once they do it’s usually only about ten days before the infected victim dies. There are ways around this though. When rabies infects the brain, it reduces the ability for antiviral medicine and cells to bypass the blood brain barrier. It’s be theorized that by increasing the permeability of the barrier could allow these cells to pass through and would be a way to treat advanced cases. This hasn’t been attempted yet, partly because rabies cases or so rare in America.

One of the other interesting ways that was found to treat rabies is by inducing a coma into the victims. Doctors believe that death and other harmful side effects from rabies results from temporary dysfunctions of the brain. By stopping these processes in the brain, you can stop the effect of rabies and give the body time to fight the virus. In a few cases, this has worked with little or no detrimental effect on the victim.

Testing for rabies is done by taking a tissue sample of the brain. This is why it was so important that Bill brought in the bat, and why it’s rather hard to test and see whether or not humans have caught rabies or not. Generally, the doctors would prefer you to be dead before they extract part of your brain. Even then, I think the doctors would prefer you to be alive and not have to extract part of your brain. Once the brain sucking extraction has taken place, they other perform a viral culture on it, or they test it through something called Polymerase chain reaction, which, if I’m understanding things correctly, extracts a piece of the viral DNA and replicates it numerous, numerous times so that it can be “viewed” and analyzed.

Well, what of poor Bill? He started the vaccinations. Luckily they decided to give him the HRIG in the arm and not administer it directly to the likely infection source, his face. Before the third round of immunizations could be started, it was found that the bat was not rabid. At that point he decided to stop the immunization process. It’s a damn shame, too, because if he had gone through the whole process he could’ve started going Crocodile Hunter on a bunch of wildlife with no fear of catching rabies from them. At least for a year, when the vaccination would wear off.

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