In September 2004, a 15 year old girl named Jenna Giese attended Sunday Mass with her mother at their church in the small town of Fond du Lac, Wisconsin. During the service, parishioners noticed a bat has become trapped inside the building, which had been completed in the 1860s. The bat was behaving strangely: it appeared disoriented, flying frantically from window to window but seemingly unable to figure out how to escape. Alarmed parishioners shooed it away with hymnals, and at the end of the service, an usher knocked it out of the air with a broom. Jenna, hoping to save a wayward animal and spare the other churchgoers from further distress, decided to pick up the bat to release it outside. She held it by the tips of its wings, evidently believing that doing so would prevent it from biting her. She was wrong, and as she exited the church with the bat, it bit her on the left index finger. Strangely, it refused to let go; she had to physically pull it off of her hand. She left the bat in a pine tree and returned to the church building, where she showed her mother the bite. Her mom wasn't alarmed, unaware that bats are a rabies vector. Jenna washed her hands with soap and water, then applied antiseptic to the bite.
Three weeks later, Jenna noticed tingling in her left hand and forearm, which she attributed to a minor sports injury. The next week, she became nauseated and extremely fatigued, then developed short-term memory loss and double vision. Her pediatrician referred her to a neurologist, who ordered a CT scan but reassured the Giese family that Jenna's symptoms were unrelated to the bat bite. The day after that appointment, Jenna presented to the emergency room with vomiting, nystagmus, left leg weakness, slurred speech, and tremors. Tests for West Nile virus, meningitis, and Lyme disease were negative, and Jenna was admitted to the local hospital for further testing. Her mother happened to mention the bat bite to her regular pediatrician, who was immediately suspicious. Jenna was transferred to the Children's Hospital of Wisconsin in a semiobtunded state, with tremor, ataxia, dysarthria, myoclonus, and bilateral cranial nerve VI palsies. On the second day of the hospital course, Jenna developed excessive salivation and impaired ability to swallow, requiring endotracheal intubation to protect her airway. Samples of cerebrospinal fluid, blood, skin, and saliva were taken for sendout to the CDC for diagnostic testing. The CSF and blood serum were positive for rabies specific antigens, although "attempts to isolate rabies virus, detect viral antigen, and amplify viral nucleic acid from two skin biopsies and nine saliva samples were unsuccessful".
Since Jenna was fully symptomatic at diagnosis, it was too late to administer the rabies vaccine/immunoglobin combination, and there was no hope that she would recover. With one exception, physicians advised the Gieses to take Jenna home to die. The lone dissenter was a young infectious disease specialist named Rodney Willoughby, who had just started at Children's of Wisconsin four months earlier. He proposed an "intense antiexcitotoxic strategy while the native immune response matured" combined with antiviral therapy. To that end, coma was induced with ketamine and midazolam in order to suppress brain activity. Ribavirin, an antiviral medication, and amantadine, a drug approved to treat dyskinesia associated with parkinsonism, were also administered because of limited evidence of efficacy in laboratory models of rabies infection.
Two weeks later, Jenna woke up, the first recorded survivor of symptomatic rabies infection. She required extensive physical, occupational, and speech therapy, but returned home in January 2005. She walks with a limp and sometimes has slight difficulty speaking clearly, but otherwise has made a complete recovery. She got her driver's license, graduated on time with her class in 2007, and completed a bachelor's degree in biology. She is married with 3 children under the age of 7, including twins. She and her husband are into sled dog racing. In a very bizarre twist, Jenna found a dead bat in the yard of the home she shared with with her husband. The carcass had obviously been chewed by the couple's 3 Siberian huskies. The results of rabies testing on the remains were positive. The Gieses' dogs were fully vaccinated, and after a mandatory 60 day quarantine period, they returned home. To put this in perspective, fewer than 1% of the millions of bats in the United States are infected with rabies. In less than a decade, Jenna Giese had a close encounter with two confirmed rabid bats.
There are actually 10 other patients worldwide who have survived rabies using the induced coma treatment, which is now known as the Milwaukee protocol. Dr. Rodney Willoughby is still practicing medicine at the Children's Hospital of Wisconsin. He attributes his successful treatment to "[getting] pretty lucky". Of course, many other patients treated with Milwaukee protocol have not survived, but one article I read suggested that the survival rate is around 25%.
There's a fantastic article in the New England Journal of Medicine
here, which covers Dr. Willoughby's treatment strategy in detail. The Milwaukee Journal Sentinel received a Pulitzer Prize in 2005 for their coverage of Giese's remarkable survival and recovery. Children's Hospital of Wisconsin released a nice human interest
article on Jenna's first Mother's Day in 2016.