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This is an old revision of this page, as edited by Anon126 (talk | contribs) at 04:24, 27 February 2024 (→‎Semi-protected edit request on 25 February 2024: edit URL as requested). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Former good articleRabies was one of the good articles, but it has been removed from the list. There are suggestions below for improving the article to meet the good article criteria. Once these issues have been addressed, the article can be renominated. Editors may also seek a reassessment of the decision if they believe there was a mistake.
Article milestones
DateProcessResult
February 5, 2006Good article nomineeListed
January 21, 2009Good article reassessmentDelisted
On this day...Facts from this article were featured on Wikipedia's Main Page in the "On this day..." column on July 6, 2006, and July 6, 2007.
Current status: Delisted good article

Tragedy in Germany: six transplants have rabies

Terrible tragedy looms in Germany: more recent news say all six transplants have rabies now. Added to the article. See: http://news.bbc.co.uk/1/hi/world/europe/4271453.stm

Mentioned in FoxTrot

This article was mentioned in a FoxTrot comic strip (the image) about Wikipedia today (May 7 2005), though it obviously didn't get the same attention that Warthog did as a result [1]. Just thought I'd mention it. --Phoenix-forgotten 17:52, 2005 May 7 (UTC)

Milwaukee Protocol needs nuance

The wiki article implies the Milwaukee Protocol is a viable treatment for rabies, but this is increasingly controversial. There is some evidence it may not actually be helpful.

https://www.medrxiv.org/content/10.1101/2022.12.14.22283490v1.full

https://www.mjdrdypu.org/article.asp?issn=0975-2870%3Byear%3D2017%3Bvolume%3D10%3Bissue%3D2%3Bspage%3D184%3Bepage%3D186%3Baulast%3DAgarwal&ref=connortumbleson.com

https://www.wired.com/2012/07/ff-rabies/

https://pandorareport.org/2014/05/01/no-rabies-treatment-after-all-failure-of-the-milwaukee-protocol/ Jamescobalt (talk) 00:33, 19 September 2023 (UTC)[reply]

It's discredited, and somehow misinformation from poor sources had crept back into the article. Have fixed. This has been discussed at some length here before.[2] Bon courage (talk) 19:18, 1 October 2023 (UTC)[reply]
The current section on the Milwaukee Protocol is blatantly incorrect. While I do agree it's a controversial medical protocol, it's flat out not true that there was only a single survivor. [3] This review from 2020 reports 11 survivors and notes that all of them were under 18. Within the US, there are three known survivors. The original in 2004, a 17 year old girl in 2010, and the third was in 2011 [4]. The current section is just false. Not only that, the CDC still lists Milwaukee Protocol as one of two options for management of rabies [5]. I feel like we can't be out here saying it's discredited and not mentioning that the CDC still suggests it. 162.248.150.100 (talk) 09:13, 30 November 2023 (UTC)[reply]
The CDC does not "list it as an option" on that page. As I recall our cited review goes into some detail on why any cases of survival cannot confidently be ascribed to the Protocol, and indeed the Brazilian review you link says "The effectiveness of the Milwaukee Protocol and the lethality of rabies cannot be quantitatively estimated due to difficulties in obtaining information about the cases in which it was used". It might be worth going into a little bit of detail about this in the article. Bon courage (talk) 09:29, 30 November 2023 (UTC)[reply]
This article : https://www.medscape.com/viewarticle/712839_7?form=fpf too mentions several cases of survival after implementation of the Milwaukee protocol. Even assuming that "cases of survival cannot confidently be ascribed to the protocol", as you state, it doesn't mean that the Milwaukee protocol can confidently be rejected as the cause, either. Especially given that in its absence, there's no survival at all. In any case, the categorical assertion that "there has been no further case of survival" is incorrect, as, at worst, cases of survival are dubious, so I'm deleting this sentence from the article. 78.240.252.185 (talk) 22:57, 7 January 2024 (UTC)[reply]
The sentence has returned, obsolete or not. --2A02:908:898:9780:B130:E3F0:69CB:834 (talk) 21:30, 28 January 2024 (UTC)[reply]
I think the sentence should be removed, or at the very least, rephrased. It says, "While this treatment has been tried multiple times since, there have been no further cases of survival." As currently worded, it implies that only one person who has undergone the Milwaukee protocol has ever survived, and all other instances ended in death. From what I've been able to find, this is objectively false. There is at least one other case where a person has been put through the protocol and survived. [1][2]
That's not to say that additional clarification isn't warranted or that the general gist that the article is attempting to convey is necessarily wrong. To quote this [3] article, in Advances in Virus Research:
"The main component of the protocol is therapeutic coma, which was correctly predicted to lack efficacy in the accompanying editorial with the case report (Jackson, 2005)... The protocol lacks a firm scientific rationale (Zeiler & Jackson, 2016) and at least 53 failures have now been documented... plus an additional six cases... (Willoughby & Epstein, 2019). Claimed successes of the Milwaukee protocol include patients who have died and who likely did not have rabies, and others who received rabies vaccine prior to the onset of illness similar to many patients who survived without the protocol... There have been 10 successes reported from India with critical care since 2015, but without other components of the protocol. Hence, critical care is probably the only effective component of the protocol and has been previously recommended for aggressive therapy of rabies patients (Jackson et al., 2003)." TalkingMarlin (talk) 15:55, 23 February 2024 (UTC)[reply]
As I said above, as I recall our cited review goes into some detail on why any cases of survival cannot confidently be ascribed to the Protocol, and indeed the Brazilian review linked above says "The effectiveness of the Milwaukee Protocol and the lethality of rabies cannot be quantitatively estimated due to difficulties in obtaining information about the cases in which it was used". The Jackson chapters says "critical care is probably the only effective component of the protocol" (i.e. not the protocol). The last thing we want is hopium from newspapers, too. Bon courage (talk) 16:10, 23 February 2024 (UTC)[reply]
I'm not disagreeing with anything you're saying here. However, as phrased, what you've detailed is not exactly what the article says. I'm proposing that this sentence is removed or reworded:
"While this treatment has been tried multiple times since, there have been no further cases of survival."
As currently worded, this sentence would be interpreted as, "No one who has undergone the Milwaukee protocol since then has survived", rather than, "No cases of rabies survival can be confidently attributed to the Milwaukee protocol". There's an important distinction here. The former is false, whereas the latter appears (to me) to be true. There appear to be survivors who have been treated with the protocol, even if the protocol is not what led to their survival. TalkingMarlin (talk) 18:22, 23 February 2024 (UTC)[reply]

"She, however, already had antibodies against rabies when she initially arrived at hospital."

In my opinion, this sentence implies that a possible reason that Jeanna Giese survived is that she had pre-existing antibodies to rabies before her infection. However, I believe that this is a misreading of the source. The review linked states that Jeanna had neutralizing antibodies against rabies upon presentation at the hospital, but the review also states that the presence of neutralizing antibodies against rabies in a patient with no previous rabies vaccinations is diagnostic for rabies infection. The source also lists known survivors of rabies and whether they received any pre-exposure or post-exposure vaccinations, and Jeanna is listed as receiving no vaccination either before or after her infection. I believe that this sentence is misleading and should be removed. Sappholococcus (talk) 05:23, 12 October 2023 (UTC)[reply]

Well it's what the source says about Giese, so Wikipedia is right to mirror it. We could add (per the same source) that's it's unknown why she had a fairly good outcome. Bon courage (talk) 05:36, 12 October 2023 (UTC)[reply]
The source says she had antibodies against rabies when she arrived at the hospital, but (from my reading of the source) she had antibodies because she had an active rabies infection. The antibodies were proof that she was infected with rabies and would be present in almost anyone with an active rabies infection, not only Giese or people with an unusually good outcome. I think the way the sentence is phrased implies that the antibodies she had when presenting at the hospital were or could be protective, which I think is a misreading of the source (obviously antibodies have the potential to be protective, but they weren't unique to Giese or even unusual; people who die of rabies also have rabies antibodies by the time they have rabies symptoms). Sappholococcus (talk) 18:37, 12 October 2023 (UTC)[reply]
Yes, the source cited says "One possibility, mentioned by the authors, is that she may have been infected by an attenuated variant of bat rabies virus, perhaps one never yet isolated, and that the specific therapeutic agents she received may have played an insignificant or only a minor role in the outcome." So maybe the best solution is simply to remove the sentence. Bon courage (talk) 19:22, 12 October 2023 (UTC)[reply]

Protection

Why is this article semi-protected, exactly? 78.240.252.185 (talk) 23:02, 7 January 2024 (UTC)[reply]

There was some ongoing really stoooopid vandalism. Maybe the idiots have moved on. I've unprotected. --jpgordon𝄢𝄆𝄐𝄇 03:59, 8 January 2024 (UTC)[reply]
The torrent of vandalism and unhelpful editing resumed after the protection was removed. The page has been re-protected. MaterialsPsych (talk) 22:52, 20 February 2024 (UTC)[reply]
Thanks. --jpgordon𝄢𝄆𝄐𝄇 23:02, 20 February 2024 (UTC)[reply]

Semi-protected edit request on 25 February 2024

Please add this article tag until the indicated video, discussed in the Talk section with this same hour's timestamp, is hidden from view. (If the legal matter raised for Commons to adjudicate in that Talk section is decided toward the end that the video is compliant, it can of course be returned. But as long as the video remains in view, and the legal matter raised has not been addressed, this template message should call attention to the issue.)

24.14.18.35 (talk) 23:04, 25 February 2024 (UTC)[reply]

Semi-protected edit request on 25 February 2024

Since it appears that even Talk in this article is protected, I have to ask that the following edit be made to the recently submitted new Talk section, regarding potential legal and ethical issues involving the 46 sec video currently appearing (just submitted, in this timestamped hour).

Correction: The link written into that newly submitted Talk section on the legal-ethical issues, the square bracketed link to a source of license and copyright information in that new Talk section, should be the following specific link, and not the one to PLOSOne originally posted. It makes no great difference, but it is best to be correct about such things.

https://journals.plos.org/plosmedicine/s/licenses-and-copyright 24.14.18.35 (talk) 23:12, 25 February 2024 (UTC)[reply]

Just a note here; not responding to the request: This talk page is not in fact protected. You can check this at https://en.wikipedia.org/w/index.php?title=Talk:Rabies&action=info. I don't know what obstacle you ran into trying to edit your earlier request, but it was not page protection. --Trovatore (talk) 22:25, 26 February 2024 (UTC)[reply]
 Done I have edited the link as you requested. I will have a more substantial response to your original request shortly. Anon126 (notify me of responses! / talk / contribs) 04:24, 27 February 2024 (UTC)[reply]
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