Talk:Rabies/Archive 2

Archive 1

Archive 2

Archive 3

Infants in rooms with bats

From the article, "Finding a bat in the room of a sleeping infant is regarded as an indication for post-exposure prophylaxis." I don't think this is precisely true. Shouldn't it be reworded to something like "Finding a bat in the room of an unattended infant is regarded as an indication for post-exposure prophylaxis." I suspect it should be applied to anyone of any age who finds a bat in their room when they wake up. --65.68.190.251 (talk) 19:06, 26 July 2010 (UTC)

Prognosis: Survival without vaccine, prophylaxis, or induced coma???

The current article reads: "There are only six known cases of a person surviving symptomatic rabies, and only one known case of survival in which the patient received no rabies-specific treatment either before or after illness onset.[8][37][38]" "Survival data using the Milwaukee protocol are available from the rabies registry.[39]"

This edit appears to be trying to say there is actually one recorded case of someone surviving symptomatic rabies without vaccine, post-exposure prophylaxis, or induced coma. If so, none of the cited articles support this proposition. In fact, the cited Scientific American article specifically contradicts it by stating that the Milwaukee case, where induced coma was first tried, was a unique instance of survival without vaccine, prophylaxis. (My previous edit designed to resolve this error was reverted by some tireless partisan of truth.) Unless there is a source that supports the claim that such an historic survival has been documented, this article should be edited accordingly.

Now if the current edit is really trying to agree with the SA article and is simply stating that the "Milwaukee protocol" is not a "rabies-specific treatment," then it is wrong in stating that such survivals are still unique as the next sentence of the article suggests. Such additional survivals using induced coma on previously untreated and vaccinated symptomatic cases have been documented, as the article states elsewhere.

That being fixed, the whole passage should be rewritten so that it is less ambiguous and confusing. As is, it is like an advertisement for Britannica. — Preceding unsigned comment added by 67.252.64.112 (talk) 05:35, 3 October 2011 (UTC)

Map (Rabies Free Countries Sourced 2010.svg)

France and Norway should be removed, there's rabies in French Guiana and Svalbard. Hawaii and Western New Guinea should also be removed, as they are not countries. Bgagaga (talk) 08:31, 12 January 2011 (UTC)

French Guiana is oversean by France, but is in an entirely different continent (South America). Just because France oversees it does not mean that what happens there also happens in France, especially when it comes to diseases and outbreaks. That's like saying that the Netherlands has rabies if Aruba does. That said, Austrailia should be taken off because there have been a few rare instances of confirmed rabies. But, I could only find 2-4 people with confirmed rabies, so the maker of the map probably considers it rare enough to not count it. Barbiegurl676 (talk) 08:14, 29 April 2011 (UTC)

French Guiana is part of France, so if it has rabies, France has rabies and should not be coloured green at all. Australia shouldn't be green either, one case is enough. A better idea would be to make a map of rabies free areas, not countries. Bgagaga (talk) 19:20, 7 June 2011 (UTC)

Many of the references on the map are out of date deadlinks, and need updating. I would suggest it is original research at this point and needs to be removed. 194.176.105.39 (talk) 08:55, 12 July 2011 (UTC)

Transmission

Someone has mentioned transmission via bites but not always, they failed to mention the other means though? what are they? —Preceding unsigned comment added by 190.212.64.35 (talk) 17:45, 17 April 2011 (UTC)

Hydrophobia?

Should it be mentioned that the disease is also commonly called 'hydrophobia', due to the water fear stage? — Preceding unsigned comment added by 71.201.144.231 (talk) 20:09, 5 August 2011 (UTC)

Historical treatment of rabies

Shouldn't a section about how rabies was treated historically be added? I would add something like the following, but I'm still not sure how to make footnotes in wiki:

In spite of the advent of Pasteur's rabies vaccine in 1885, people in the US were slow to make the transition from traditional folkloric remedies for rabies. In 1910, the Public Health Service and the US Surgeon General were still trying to convince people to stop using chicken breasts and "mad stones" to extract the rabies virus from wounds. (News article: "Expert repudiates mad dog fallacies," Times Picayune, 12 September 1910, pg. 1.) Mad stones were calcified hairballs taken from the stomachs of deer. It was believed that if a mad stone was soaked in milk and applied to a wound, the stone would adhere to the wound and draw out the rabies poison. It was thought that wounds not infected with rabies could be immediately identified because the mad stone would not adhere to such a wound. (News article: "Old Madstone from Alabama in collection." Dallas Morning News, 7 Jan 1940, Section IV, pg. 5.) As late as 1939 some people still looked to the mad stone as a cure for rabies: "Mad stone as rabies cure still holds confidence of many Kentuckians," Marietta Journal, 20 October 1939, pg. 1.) Jenzum (talk) 01:51, 8 September 2011 (UTC)

"Zombies"?

I read an article that mentioned scientist could be able to create an airborne rabies virus, and this would make "zombies" a possible threat.[1] Does anyone else think this is true or should be included? Juan.h.idea (talk) 19:23, 25 October 2011 (UTC)

Rabies

It is preventable from Animals that dont lay eggs. It starts off to 7 to 8 months. From this you will start having seizures, spazems, etc. — Preceding unsigned comment added by 68.112.16.249 (talk) 03:44, 20 February 2012 (UTC)

Pastuer.

At "^ Geison GL (April 1978). "Pastuer's work on rabies: Reexamining the ethical issues". Hastings Center Report 8 (2): 26–33. doi:10.2307/3560403. JSTOR 3560403. PMID 348641." there is a mistake, i have no clue how to edit the references, but it should say "Pasteur's work, not Pastuer's Work. thanks. 82.169.199.129 (talk) 13:45, 13 April 2012 (UTC)

Done Northutsire (talk) 20:04, 24 April 2012 (UTC)

Ancient history

Adamson (note 62 to the Wiki article, p. 140 of her article) says this: "In the ancient Near East the earliest mention of death from dog-bite is to be found in the laws of Eshnunna from Mesopotamia, dated c. 2200 B.C.8 No associated symptoms are mentioned, so that rabies cannot justifiably be incriminated as the cause of death." This flatly contradicts the statement in the article that "The first written record of rabies is in the Mesopotamian Codex of Eshnunna (ca. 1930 BC), which dictates that the owner of a dog showing symptoms of rabies should take preventive measure against bites. If another person was bitten by a rabid dog and later died, the owner was heavily fined.[63]". 63 is "Dunlop, Robert H; Williams, David J (1996). Veterinary Medicine: An Illustrated History. Mosby. ISBN 0-8016-3209-9." I haven't read Dunlop & Williams, but the confusion needs clearing up by someone who has.

Northutsire (talk) 20:24, 24 April 2012 (UTC)

Update the map

If rabid animals have recently been rediscovered in the UK (lead), the map of the word showing rabies prevalence by country should be updated to reflect this. Currently the UK is shown as a rabies-free zone. — Preceding unsigned comment added by 92.27.55.215 (talk) 07:22, 4 May 2012 (UTC)

The UK remains officially rabies free because the virus caught from a bat bite isn't true rabies, it's a related disease called European Bat Lyssavirus. It's also extremely rare, found in less than 1 in 10,000 bats tested. The recent case thats been all over the news is even less relevant - the woman was bitten and contracted rabies in Indian, she just happened to get back home to London before showing symptoms. Since rabies can't be passed between people (and everyone who had contact with her has been vaccinated anyway) this doesn't change the fact that the UK is rabies free. 82.68.159.246 (talk) 10:03, 28 May 2012 (UTC)

"Eradicated" vs. "Eliminated"

The Centers for Disease Control and Prevention reserves the word "eradicated" for a disease, like smallpox, that has been removed from the human population for a period of at least two years. The word "eliminated" is used to denote a disease that has been removed from a local population but not from the worldwide population. For rabies, the fact that Japan and Australia no longer have rabies means that the disease has been eliminated from those areas, but it is not yet eradicated. In fact, to date, only smallpox can be said to have been eradicated. — Preceding unsigned comment added by 158.111.4.51 (talk) 12:13, 31 May 2012 (UTC)

Rabies immunity

A report from the CDC today mentioned two Amazon villages that show immunity to rabies. The humans tested have antibodies to rabies, have been routinely exposed, but are disease free. I suspect further research is ongoing. http://www.cdc.gov/media/releases/2012/p0801_rabies_immune.html — Preceding unsigned comment added by Wzrd1 (talk • contribs) 00:03, 2 August 2012 (UTC)

Jeanna Giese

The item about Ms. Giese needs expansion: (1) why wasn't she able to receive the traditional vaccine? (2) was she allergic? (3) did she or her parents object on religious grounds? (4) The article states that she suffered "almost" no after effects. Okay, what "after effects" DID she suffer? It is important to answer these questions, as the anti-vaccination groups need to be provided with accurate information so that they will not mislead themselves or others on whether the vaccine is beneficial.John Paul Parks (talk) 17:02, 26 February 2013 (UTC)

Sentence does not make sense, or has grammatical errors.

The following sentence does not make proper sense: "...this can result in hydrophobia, in which the patient has difficulty swallowing because the throat and jaw become slowly paralyzed, shows panic when presented with liquids to drink, and cannot quench its thirst"

At the very least the patient should not be referred to as 'it'. The word "its" if replaced by "his or her" would make better sense, but I note there is no obvious explanation for the panic, as this does not follow logically from a paralysis of the throat and jaw. — Preceding unsigned comment added by 82.71.186.167 (talk) 15:51, 24 May 2012 (UTC)

I cleaned it up a bit. — UncleBubba ^{( T @ C )} 18:29, 24 May 2012 (UTC)

Does not follow logically? If my throat and jaw became slowly paralyzed, and I began to have difficulty swallowing, I think I would panic. At least a little bit.John Paul Parks (talk) 17:05, 26 February 2013 (UTC)

Removed the un-credible source/fact.

Harris Gardiner of NY times later published an email apology about his article, which lacks any information about the sources of estimations for 20,000 death toll from dog bites in India. — Preceding unsigned comment added by 2620:0:10C9:1001:A800:1FF:FE00:19EB (talk) 10:51, 27 August 2012 (UTC)

I couldn't find any apology on the NYT web site, or from Google search, and NYT has not retracted the article. What's the source of your claim? -Zanhe (talk) 06:07, 31 August 2012 (UTC)

The introductory paragraph starts out with the following sentence. "Rabies (pronounced /ˈreɪbiːz/. From Latin: rabies, "madness") is a viral disease that causes acute encephalitis in warm-blooded animals." Considering that there are no cases of birds getting infected by the virus, isn't it more appropriate to change "warm-blooded animals" to "mammals"? — Preceding unsigned comment added by 76.126.241.233 (talk) 01:31, 3 January 2013 (UTC)

Although there are no cases of birds getting infected in the wild, they have been infected in experiments. Therefore, the sentence is correct, in that it caused acute encephalitis in birds. öBrambleberry of RiverClan 23:53, 23 March 2013 (UTC)

There appears to be a lot of confusion about this article's topic. Should this article be renamed to rabies in humans?

Judging by the content of this article, I can tell that there's some confusion among editors about the scope of this article. The article discusses the prevalence of rabies in both humans and non-human animals, but it doesn't make it clear whether this article is supposed to be about rabies in humans and other animals, or only about rabies in humans. If this article is intended to discuss rabies in humans specifically, I think it should be renamed to rabies in humans. It currently isn't clear how broad (or narrow) this article's scope is intended to be (in terms of the number of species that are being discussed), and its title should be modified to reflect the article's intended scope. Jarble (talk) 21:51, 28 March 2013 (UTC)

Also, there is already an article called rabies in animals. Is this article redundant, or does it somehow serve a separate purpose from the rabies article (which discusses rabies in both humans and non-human animals)? The image of a rabid dog at the top of this article also gives users the impression that this article is supposed to be about rabies in non-human animals. This adds to the confusion, since it's already unclear whether or not this article is intended to discuss humans exclusively. Jarble (talk) 21:58, 28 March 2013 (UTC)

Rabies also occurs much more frequently in non-human animals than in humans. This increases the likelihood that readers will be misled into believing that this article discusses rabies in non-human animals, when in fact it is intended to discuss rabies in humans exclusively. If this article were renamed rabies in humans, this source of confusion would be eliminated. Jarble (talk) 22:00, 28 March 2013 (UTC)

I have alerted WP:MED to this topic. Flyer22 (talk) 00:43, 29 March 2013 (UTC)

• Our articles on other zoonoses such as influenza, ebola, leptospirosis, glanders, and others are not named "xxxx in humans". I think this is an issue of editorial management of the lede. We know these diseases because they manifest in humans - their occurrence in animals is of interest largely because of human disease. -- Scray (talk) 01:22, 29 March 2013 (UTC)

It seems we have a choice: either 'Rabies' is an overview article that covers (possibly in summary style) the topics "rabies in humans" and "rabies in other animals" with rabies in animals as a daughter article; or 'Rabies' (in humans) is the primary topic for disambiguation between other rabies topics, in which case this article should only discuss rabies in humans and the hatnote to the Rabies (disambiguation) page needs to include rabies in animals. We just need to decide which of the two this article is.

@Scray: Because rabies in animals has far more impact in the public consciousness than leptospirosis, for example, the comparisons to naming for other zoonoses may be misleading. --RexxS (talk) 08:50, 29 March 2013 (UTC)

• Keep as is. We have a section at the end for "other animals" Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:40, 29 March 2013 (UTC)

Usually fatal

In the section on Prognosis it states:

In unvaccinated humans, rabies is usually fatal after neurological symptoms have developed

Correct me if I'm wrong, but given that there have only been a handful of recorded survivors, and these only due to the use of the Milwaukee protocol, isn't a stronger word than usually called for here? — Preceding unsigned comment added by 86.162.223.187 (talk) 17:31, 29 May 2013 (UTC)

 Done Done - good suggestion, supported by the cited source. -- Scray (talk) 18:12, 29 May 2013 (UTC)

To record it here on the talk page, Scray used "almost always" as the replacement wording. Flyer22 (talk) 18:18, 29 May 2013 (UTC)

Strategy of transmission: make the first host bite the next

I was just watching a documentary about Jeanna Giese and one of the doctors interviewed explained that the virus has evolved to drive one host to bite the next host. I came here to check this and found the article consistent with that. However, it doesn't seem to say so in such clear concise language. Why not? Are there any other viruses that take over the behavior of a host? If not, the article should say so. Chrisrus (talk) 03:48, 20 June 2013 (UTC)

Lots of content forks, how about some cleanup?

We have at a minimum the following articles directly related to rabies in the medical/scientific sense (see Category:Rabies for others).

• Rabies
• Rabies in animals
• Rabies testing
• Rabies transmission
• Rabies vaccine
  • Oral vaccination against rabies
• Rabies virus
• Prevalence of rabies
• Cryptic bat rabies
• Arctic rabies virus

It seems to me that some sense of consolidation is warranted. The two articles on vaccines should be merged, as oral simply a type of vaccine. Rabies transmission seems like an unnecessary content fork that mainly deals with a small subset of cases (especially regarding Transplantation), and should be merged into Rabies. Rabies testing is a stub that might be better off merged into Rabies. The three articles on virology are clearly distinct by strain. The benefit of merging is that medical content will be easier to monitor, and thus fringe or undue coverage more easily identified. What say you?
--Animalparty-- (talk) 00:15, 21 February 2014 (UTC)

Some of these are subpages rather than content forks. Agree that oral vaccination against rabies should be combined into rabies vaccine. The rest though are fine. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:18, 21 February 2014 (UTC)

Merged that one. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:23, 21 February 2014 (UTC)

This is really the worst article I've read on Wikipedia ever (someone fix this)

Every sentence in the first paragraph is source and the picture caption says "Person with Rabies"

Also, the maps wrong.

And I quote,

Rodents are very rarely infected.[3] The rabies virus travels to the brain by following the peripheral nerves. The disease can also be diagnosed after the start of symptoms.[1]

What the **** are those three sentences doing next to each other? — Preceding unsigned comment added by 2601:8:1F00:483:6017:5723:CFE0:C261 (talk) 17:24, 21 August 2014 (UTC)

The lead is an overview of the article. The first bit deals with cause. The second bit with mechanism. The third bit with diagnosis. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:09, 21 August 2014 (UTC)

Upcoming edit

Hello all! My colleagues and I have identified several recent reviews with which to update this page. As already mentioned in this discussion page, this article needs a clean up so it can be brought up to standard. Our goal is to improve the clarity of the information by working on its structure and content. Our work should be complete in the next two months, and we welcome collaborators! Kimsamuel (talk) 14:42, 29 August 2014 (UTC)

Welcome. Make sure to read WP:MEDMOS. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:51, 29 August 2014 (UTC)

And WP:MEDRS. Flyer22 (talk) 19:54, 29 August 2014 (UTC)

I see that Jmh649 (Doc James) has given you a WP:Med template on your talk page. Flyer22 (talk) 19:57, 29 August 2014 (UTC)

Seminar

doi:10.1016/S0140-6736(13)62707-5 Lancet JFW | T@lk 22:39, 11 October 2014 (UTC)

Australia Free of Rabies

In the second paragraph, Australia is linked to a statistic of "less than 5% of cases are from dogs, with bats being the most common cause". However, later on, it's made clear Australia has "always" been free of Rabies. What am I missing? — Preceding unsigned comment added by 123.2.152.147 (talk) 01:14, 5 April 2014 (UTC)

Rabies is a type of lyssavirus. A related type of lyssavirus does occur in Australia but it currently only occurs in bats. The only humans known to of contracted this form of the virus in Australia (3 I believe & all have died), all contacted it by handling or working with bats. It is known as the Australian Bat Lyssavirus & does not appear to exist in any other animals. The only other known cases of Rabies (2 that I am aware of) were some time ago & the disease was contacted elsewhere overseas (one of these occurred some 12 months after a bite to a finger from an infected monkey in India) & hence not the native ABL version. Australia is generally considered free of Rabies since all of the bats in Australia are either small insect eating micro-bats or large fruit eating bats (generally refered to as flying foxes), none of which are known to directly attack either humans or other animals, even when infected (unlike infected dogs, wolves, foxes, cats, racoons, monkeys etc found elsewhere). You need to be either bitten or scratched by an infected bat to catch the disease. The greatest risk to the general public is attempting to rescue an injured bat or a small microbat that has flown into a confined space such as a room & can't readily find the way out (not helped by the broom waving human). You won't catch the disease by being attacked by a rabid animal in Australia ~~ — Preceding unsigned comment added by 101.170.213.54 (talk) 13:31, 15 October 2014 (UTC)

Rabies is caused by (top part, description of rabies, second paragraph)

This article could definitely be improved by separating the Americas, North & South. While it is true that bat bites cause most rabies in South America, nowhere near enough research on the topic has been done in Central America, and in North America, the disease's carriers are dependent on which region one happens to be talking about. For instance, here in Iowa, where I live, skunks are the #1 carrier of rabies, with raccoons being second, dogs third, and bats a very distant fourth. Less than half of one percent of bats in the Northern part of the country are infected with the disease Sources

The discussion is not who has rabies most often but what source is most common for human exposures.Doc James (talk · contribs · email) 01:25, 27 July 2015 (UTC)

prognosis

The article suggests rabies is almost always fatal. Yet other sources say it is universally fatal - in fact some say no one ever survived it, until Jeanna Giese.Royalcourtier (talk) 11:52, 30 July 2015 (UTC)

There has maybe been a couple of cases. So yes almost always fatal. Doc James (talk · contribs · email) 13:41, 30 July 2015 (UTC)

bats

"Awakening to find a bat in the room, or finding a bat in the room of a previously unattended child or mentally disabled or intoxicated person, is regarded as an indication for post-exposure prophylaxis (PEP)." What is this about? This reads more like witchcraft than a Wik discussion of a desiease or its treatment.64.53.191.77 (talk) 18:18, 15 June 2015 (UTC)

It is a legitimate indication for needing PEP. The population given is not capable of denying being in contact/bitten by the animal.--☾Loriendrew☽ ☏(ring-ring) 21:35, 15 June 2015 (UTC)

I agree that this whole part about bats, as it currently is at least, is rather poor. "Is regarded as an indication for"? Can't we just say something like "In the case of a person awakening to find a bat in the room, or finding a bat in the room of a previously unattended child or mentally disabled or intoxicated person, 'post-exposure' intervention and treatment is typically regarded by the medical-health community as warranted". At the very least we could say "... is regarded as a sign that post-exposure prophylaxis is required". The medical community struggles to speak simple English sometimes, though this 'struggle' is quite likely a function of the doctor's need to keep everyone else in a state of confusion, such that the doctor's supposed natural superiority and righteousness is underscored. — Preceding unsigned comment added by 156.34.25.166 (talk) 08:57, 15 September 2015 (UTC)

And what's the deal with "occult bat"? Just the pretentiousness of medical writing some times. — Preceding unsigned comment added by 156.34.25.166 (talk) 09:04, 15 September 2015 (UTC)

Your summary judgment of medical writing aside, did you read the reference? How about you just edit the paragraph to something you think is better?MartinezMD (talk) 01:21, 16 September 2015 (UTC)

Epedimiology Section Seems Self-Contradictory

In 2010, an estimated 26,000 people died from rabies, down from 54,000 in 1990.

An estimated 20,000 people die every year from rabies in India — more than a third of the global toll.

While there is, of course, some ambiguity, the first sentence implies ~26k deaths per year, while the second sentence implies ~60k deaths per year... — Preceding unsigned comment added by 75.101.109.53 (talk) 19:01, 10 April 2016 (UTC)

Estimates vary widely and deaths from rabies are thought to be underreported. The lead has a range of estimates from about mid 20K-60K (demonstrating a significant amount of uncertainty about the actual number of deaths). I hope that clarifies things for you. TylerDurden8823 (talk) 22:03, 10 April 2016 (UTC)

Three orders of magnitude difference is fairly small in the developing world :-) Doc James (talk · contribs · email) 14:36, 11 April 2016 (UTC)

The rabies vaccine is not as well-tolerated as a flu shot

The article currently includes this quote:

"The pain and side effects of modern cell-based vaccines are similar to flu shots."

I don't want to scare anyone, so I won't put a [citation needed] tag immediately, but I doubt you will find such a citation. Unless you interpret the word "similar" in very broad terms. There are two rabies vaccines in the US (for humans as of 2016), namely the HDCV and the PCEC vaccines. The FDA labels for each report "moderate" severity side effects in 60 to 80% of patients, and that's without any rabies immunoglobulin (which is called "immune globulin" by the FDA). The rate of fever, for instance, is much higher for both rabies vaccines than for modern flu shots. Fever is very rarely a nocebo effect, so I think it is safe to say it is actually being caused by the vaccine.

In summary, ask your doctor before getting pre-exposure prophylaxis for travel. This is one of the less-pleasant travel vaccines. Fluoborate (talk) 04:59, 17 August 2016 (UTC)

Testing Sites Box

I believe the article may benefit from the following:

United States	Rabies Virus Sample Agencies
National	CDC of USA
State	Texas DSHS
County	Los Angeles

Twillisjr (talk) 01:59, 21 September 2016 (UTC)

What does this mean? And it looks too US centric. Doc James (talk · contribs · email)

Apparent contradiction in maps

It's confusing to see Australia coloured green (rabies-free) and yet showing one death in the other map. What gives? --Slashme (talk) 12:24, 10 April 2017 (UTC)

Australia is free from "rabies virus" but has " Australian bat lyssavirus" Doc James (talk · contribs · email) 21:23, 10 April 2017 (UTC)

"A number of countries, including Australia, Canada, Japan, and the United States, and Western Europe, do not have rabies among dogs."

As seen here, here, here and here, an IP has repeatedly removed, and been repeatedly reverted on, this material. Thestar.com source should not be there, but what is the IP talking about regarding the WHO source? Also see this CDC source. The IP has since altered his approach, as seen here and here. Flyer22 Reborn (talk) 03:34, 5 April 2017 (UTC)

Doc James, now that you are back from your trip, do you have any thoughts on this matter? I take it that you are catching up on your watchlist and probably haven't gotten to this yet. Flyer22 Reborn (talk) 03:36, 10 April 2017 (UTC)

Thanks. Up to Apr 5th. Not sure what the IP is doing.

Ref says "Canine rabies has been eliminated from western Europe, Canada, the United States of America (USA), Japan, Malaysia and a few Latin American countries; while Australia is free from carnivore rabies, and many Pacific island nations have always been free from rabies and related viruses." on page three.[2]

Doc James (talk · contribs · email) 03:49, 10 April 2017 (UTC)

The CDC; however, says "Rabies vaccination programs have eliminated domestic dogs as reservoirs of rabies in the United States, although we still see 80 – 100 dogs and >300 cats with rabies each year, usually infected by wildlife when these domesticated pets are not vaccinated against rabies."[3] Doc James (talk · contribs · email) 03:55, 10 April 2017 (UTC)

Have adjusted based on the CDC source you mentioned. Doc James (talk · contribs · email) 04:03, 10 April 2017 (UTC)

Okay, thanks. Flyer22 Reborn (talk) 04:05, 10 April 2017 (UTC)

I'll offer my view on it too. Generally the issue is the absolute statement that there isn't rabies in dogs in the US vs. the actuality that they aren't harboring canine rabies. The CDC site last lists 2014 data when there were 59 dogs reported in the US that had rabies. They likely get infected from things like getting into fights with rabid cats or raccoons, or feeding on cattle carcasses that are infected, but that those are different strains, and it is essentially imported into them as opposed to dogs being the source. MartinezMD (talk) 04:11, 10 April 2017 (UTC)

“While dogs may still become infected from raccoons, skunks or bats, they will not catch dog-specific rabies from another dog, the Atlanta-based U.S. Centers for Disease Control and Prevention said. We don't want to misconstrue that rabies has been eliminated -- dog rabies virus has been,"

1. https://www.cdc.gov/rabies/location/usa/surveillance/domestic_animals.html
2. http://www.reuters.com/article/us-rabies-usa-idUSN0741162020070907

MartinezMD, I see. Thanks for commenting. Flyer22 Reborn (talk) 04:17, 10 April 2017 (UTC)

Flyer22 Reborn you're welcome. I do think we need to make it clearer in the article. You can do it or I can if you prefer. MartinezMD (talk) 04:57, 10 April 2017 (UTC)

I have adjusted it further[4]. Your thoughts User:MartinezMD? Doc James (talk · contribs · email) 08:14, 10 April 2017 (UTC)

talk While it leaves accurate information, it cuts out the specific information about US and Canada from the source. I'd like to see a little more detail without making things too wordy, presuming that is your concern? MartinezMD (talk) 16:06, 10 April 2017 (UTC)

Yes let me add stuff to the body. Doc James (talk · contribs · email) 21:23, 10 April 2017 (UTC)

Added my final 2 cents to the article if there are no objections. MartinezMD (talk) 06:33, 11 April 2017 (UTC)

Looks good thanks :-) Doc James (talk · contribs · email) 17:43, 11 April 2017 (UTC)

Rabies

I had heard that rabid dogs could be seen to be visibly foaming at the mouth. If bitten at this stage, I understood there to be roughly a 24 hour time frame to seek extremely painful shots in the abdomen. This disease is fatal, I understand. I do not know much more than this. — Preceding unsigned comment added by Rip Van Winkle and Humpty Dumpty (talk • contribs) 07:30, 28 November 2016 (UTC)

Article discusses. Doc James (talk · contribs · email) 18:31, 28 November 2016 (UTC)

This info isn't true anyway. Rabies has a longer incubation period than 24 hours, rabies typically takes from 4 days- 1 month before clinical symptoms appear, the incubation period being affected by closeness of the bite to the brain, amount of viral particles introduced to the body, and the severity of the wound caused by the bite or scratch of the rabid animal. I've not read anything that says the amount of time that rabies takes to induce symptoms is as short as 24 hours.--Edittrack121 (talk) 09:29, 23 April 2017 (UTC)

Source

Lancet, 2014

Barbara (WVS) ✐ ✉ 20:20, 15 June 2017 (UTC)

Biting in humans

The article states that "bite and non-bite exposures inflicted by infected humans could theoretically transmit rabies, but no such cases have been documented, since infected humans are usually hospitalized and necessary precautions taken."

The following news article appears to contradict the claim that no cases of transmission from human bites are documented:

http://www.dailymail.co.uk/health/article-2449691/Dying-infant-rabies-infects-father-brother--BITING-them.html

I don't have the time presently to investigate the veracity of this source or the article, but hopefully someone can do so and remove/revise the claim if appropriate. BrandyLova (talk) 05:45, 18 June 2017 (UTC)

That is the Dailymail which is known for inventing stories. Doc James (talk · contribs · email) 18:34, 18 June 2017 (UTC)

Thank you for the advice, I'm not in the UK and wasn't aware of their reputation. I removed the tag. I'll leave this note in case anyone wants to try and find a more reliable reference for the alleged events. BrandyLova (talk) 19:18, 18 June 2017 (UTC)

Hydrophobia

To link to a dab page, where the only correct dab is back to the article from whence the link comes is pretty much a circular link, and not needed. The article contains a section on Hydrophobia, which is explains the use of the term far better than the dab.

Hydrophobia is not aquaphobia. Aquaphobia is psychological fear, akin to fear of heights, small spaces, spiders, etc. Hydrophobia is a specific physical syndrome related to the inability to handle oral liquids that can occur in this illness. However you want to edit it, linking to aquaphobia is wrong and promotes the misinterpretation by the general public. Please stop it. And please sign your comment. MartinezMD (talk) 15:47, 14 November 2017 (UTC)

Sorry I forgot to sign. And I did stop it. The redundant circular link to a dab page is unneeded, please stop it. Onel5969 ^{TT me} 15:50, 14 November 2017 (UTC)

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Survivors and the Milwaukee protocol

As it is right now, this article taken together with the Milwaukee protocol article seems to give confusing or even contradictory information on known human survivors of rabies and on the Milwaukee protocol. The leader states that "Only six people have survived a rabies infection after showing symptoms, and this was with extensive treatment known as the Milwaukee protocol." However, the latter of the two references given for this states that a patient in Texas survived in 2009 without being treated according to the Milwaukee protocol. The first reference is paywalled and I cannot access it.

In the section on treatment, there is a brief subsection on the Milwaukee protocol, and it includes the statement "The protocol is not an effective treatment for rabies and its use is not recommended." This statement is backed by a 2016 paper and appears sound.

But the Milwaukee protocol article, as it is, claims that the Milwaukee protocol has never been successfully used after the Giese case which was at least previously considered its first success. The papers, and there are more than one, on which the statement that the protocol has been discredited are also paywalled, so I cannot see if they back up such a strong claim, but the summaries at least do not. I do understand that if the protocol has been shown to be ineffective, then logically survivals cannot be attributed to it, but it's still contradictory or at least confusing, as I said.

It would be a good thing if all this was clarified, but that would require a somewhat better understanding of the matter than I have. (I'm just here to look it up; I don't know anything about the significance of cerebral vasospasm in rabies!) And further, if the Milwaukee protocol is now no longer considered effective, I wonder if it really merits its own article. It might be better just to discuss it in the treatment section of this article.

Rallette (talk) 08:12, 20 March 2018 (UTC)

So far as I can see the view is now that Giese's survival had nothing to do with the use of the Milwaukee protocol. We should probably be clearer about that here. Alexbrn (talk) 08:38, 20 March 2018 (UTC)

Actually, after googling about a bit, I'm beginning to wonder about the precise figure of six known survivors. It would appear there are more; this piece says recent (2015, 2016) reviews have counted 19 documented survivors since 1970, although that includes cases in which immunization had been attempted. Of course, it gets complicated. Maybe the leader should just say something like "Only few people are known to have survived rabies after developing symptoms. No effective treatment for symptomatic rabies exists." The possibility that survival is more common than has been thought seems to be the subject of some research, so maybe the question should have its own subsection in the article, or be more extensively dealt with under "Prognosis". That section would also benefit from a discussion of recovery. Apparently, Giese made a good recovery but some other survivors have been left with considerable permanent damage. Rallette (talk) 11:33, 20 March 2018 (UTC)

Possible country bias

Lack of sources to back the statement that "Unlike the other countries of Europe [Britain] is protected by being an island, and by strict quarantine procedures." Evidence suggests that other EU countries have similarly strict quarantine procedures. Indeed, the paragraph just before this statement says that Italy has been successful in eradicating rabies, so has Switzerland.

Statement seems to go back to an urban legend that Britain is protected by being an island, which is contradicted by the fact that Britain did have rabies cases in the 19th and 20th centuries. Ships are known to carry rats, so it's not the fact of being an island which has protected Britain, but rather strict quarantine and hygiene rules, which other countries have successfully implemented too. 213.246.196.82 (talk) Jerome 15:23, 22 November 2018

Our text uses the word "and" (" protected by being an island, and by strict quarantine procedures"), which would appear to counter your objections. Obviously being an island helps. Alexbrn (talk) 14:27, 22 November 2018 (UTC)

Milwaukee Protocol

Right now, the discussion of the Milwaukee protocol is divided up between Treatment and History. These two sections should be consolidated into a single discussion of the protocol. Particularly if a reader comes to the page and navigates immediately to the "History" section (as I did), this section is disjointed and lacks context without the background information provided in "Treatment." 104.153.224.169 (talk) 02:46, 26 November 2018 (UTC)

Can you suggest the actual text and where it should be placed? Ruslik_Zero 20:51, 26 November 2018 (UTC)

Contradiction in time range for effective treatment

At this time, under "Treatment", the first sentence reads: "Treatment after exposure can prevent the disease if administered promptly, generally within 10 days of infection." Under "Prognosis", the first sentence of the second paragraph reads: "Vaccination after exposure, PEP, is highly successful in preventing the disease if administered promptly, in general within 6 days of infection." These cite different sources: and respectively. I don't have access to the former via any kind of educational institution. It's also been succeeded by at least three new editions - the most recent I see available is 7th ed. Would someone with access to some version of Sherris Medical Microbiology or another academic source find a more authoritative or up-to-date citation to resolve this contradiction? Fzzr (talk) 02:47, 2 December 2018 (UTC)

References

Merger proposal of Rabies testing

I propose to merge Rabies testing into Rabies#Diagnosis. Both rabies testing and the Diagnosis section of Rabies cover the same topic, but it is better explained and referenced within the rabies page. DferDaisy (talk) 02:01, 20 January 2019 (UTC)

• Makes sense. Alexbrn (talk) 04:21, 20 January 2019 (UTC)
• Already more or less covered so simple redirected. Doc James (talk · contribs · email) 04:55, 20 January 2019 (UTC)

Second patient is saved by Dr mangesh waste in new Bombay hospital airoli Navi Mumbai name patient was M D Kadir

Second patient of rabies survived is M D kadir in new Bombay hospital airoli by Dr mangesh waste Mangeshsai (talk) 09:46, 22 February 2019 (UTC)

Hi. You will need to link to a reliable source to back that up. Hydromania (talk) 10:17, 22 February 2019 (UTC)

Worth getting to GA or FA....

Political aspect highlighted here Cas Liber (talk · contribs) 10:04, 3 March 2019 (UTC)

Possible inclusion of Rabiosexuality?

There are some sections of the internet where people are "rabiosexual" or attracted to those with rabies. Perhaps we should include such a section in this article pertaining to this strange subculture? — Preceding unsigned comment added by 2601:1C2:4D00:4432:646F:CC1C:69FF:934 (talk) 06:01, 21 June 2019 (UTC)

Sounds like WP:CB to me. A reliable source would be necessary. Alexbrn (talk) 06:08, 21 June 2019 (UTC)

I agree; and just loving the WP:CB shortcut. TJRC (talk) 06:15, 21 June 2019 (UTC)

Parody. Not real. [5] [6] Nomopbs (talk) 14:01, 21 June 2019 (UTC)

Milwaukee protocol (again)

As a result of recent edits:

• The Milwaukee protocol has been taken out of the "History" section and promoted to a (newly named) "Prognosis and treatment" section (it is no longer considered a treatment).
• We are using a case report which complicates the firm conclusion we have from a MEDRS that the protocol is ineffective.

I don't think either of these changes improve the article. Alexbrn (talk) 05:23, 18 November 2019 (UTC)

Was a warning message really needed for trying to fix an issue that needed merging? [7] The wholesale blanking of an entire section resulted in the loss of references which is also not improving the article. - Knowledgekid87 (talk) 05:24, 18 November 2019 (UTC)

Yes. Adding unreliable sources does not improve the article. Alexbrn (talk) 05:26, 18 November 2019 (UTC)

Onto the substance.... Wikipedia relies on a WP:NPOV (It is a core Wikipedia policy WP:5P), the fact is that it was used as a treatment with one person saved. It doesn't make sense to put the info under "History" either as the treatment was proven ineffective. As for sourcing, what remaining sources in particular do you have issue with? - Knowledgekid87 (talk) 05:29, 18 November 2019 (UTC)

You're buying into the hype, from the MEDRS source we know the protocol was not responsible for "saving" anybody, despite the advocacy of its inventor. This is a case report so falls afoul of WP:MEDRS, especially since it is being used to water down PMID 27730539, a review article. I don't think it quite right we now have a "Treatment" section when in general there is no treatment for Rabies. Alexbrn (talk) 05:38, 18 November 2019 (UTC)

From one source we know this? I'm saying we should present all sides of this debate as it provides a balanced point of view. Wikipedia isn't used for medical advice nor is it a medical book, its an encyclopedia. - Knowledgekid87 (talk) 05:44, 18 November 2019 (UTC)

Our health content must be based on reliable, third-party published secondary sources, and must accurately reflect current knowledge. We don't use unreliable primary sources to undercut reliable secondary ones. You contend the protocol has been "proven effective", but a strong MEDRS says it is ineffective. Which is Wikipedia bound to reflect? Alexbrn (talk) 05:52, 18 November 2019 (UTC)

Strong in whose opinion though? I could take the sourcing to WP:RSN for a consensual review. The source I added was from 2017 versus the other which dates to 2016. In effect both sources are saying the same thing.... that the treatment is ineffective. Rather than being blunt about it though, a mention is given on why it was proven ineffective. - Knowledgekid87 (talk) 05:56, 18 November 2019 (UTC)

One generally cannot "prove" something ineffective in medicine, you can only find if it is effective (or not). If you want to delve into the historical literature you'll see the protocol was tested on dozens of people and they all died (in one case it turned out the "survivor" never had rabies). It was nevertheless relentlessly promoted as a rabies treatment. If you want some orientation on medical sourcing maybe read WP:WHYMEDRS. If it's still not clear, we can get some input from WT:MED. We need to follow reliable sources. Alexbrn (talk) 06:01, 18 November 2019 (UTC)

Well if it was a scandal then it should be mentioned here as it involved people who were claiming to be medical professionals. I haven't looked up to see if any WP:RS expose the "survivor" as a fraud. This is something that people would have gotten sued or fired over. - Knowledgekid87 (talk) 06:05, 18 November 2019 (UTC)

Anyways I am off for the night, thank you for being civil here. I am leaning towards wanting to make a "controversy" section instead as this is what it sounds like. - Knowledgekid87 (talk) 06:10, 18 November 2019 (UTC)

I don't think any sources talk about "scandal" or "fraud". Mistaken assumptions maybe, but that's science. The speculation in the literature now is than the miniscule number of survivors are due to late vaccine administration or the effectiveness of modern intensive care regimes. As PMID 26639059 says:

Few reports of survivors exist in the literature, with the majority of survivors having received post-exposure prophylaxis with one or more doses of rabies vaccine. Documented survivors of rabies may, at least in part, represent advances in cardio-respiratory and other supports within modern critical care units and not be related to specific rabies directed therapies.

The Milwaukee protocol however, is discredited and is at most a historical curio. I don't think there is any controversy as the science is settled. Alexbrn (talk) 06:16, 18 November 2019 (UTC)

(Ec) my two cents: 1) of course there is treatment for rabies, assumimg you're aware of it very early. Why would post expose vaccines not be considered a treatment? 2) yes the info was moved from history to prognosis. I think that makes sense. 3) I personally never liked the "it I am ineffective treatment and it's use is not recommended" as I believe he sourcing on that needs to be very strong with multiple sources. As of now my understanding is that one person survived possibly due to the protocol, with many medical professionals doubting the protocol's effectiveness. To write without qualification that it's use is not recommended would need sourcing which shows that there is consensus in the medical world as such. One source, no matter how strong, can't really support that, (unless it is saying exactly that, which by all means, correct me if I understood the source wrong). 4) the sources used to back up the word "controversial" don't actually use that word. Is it controversial or just disputed?

ps, doc James will probably be around soon to weigh in on this. Hydromania (talk) 06:19, 18 November 2019 (UTC)

Again, from PMID 26639059

Despite initial hope and enthusiasm for the Milwaukee protocol in the treatment of rabies, subsequent trials of this regimen have failed. Serious concerns over the current protocol recommendations are warranted in light of a weak scientific rationale. The recommendations for therapeutic coma, NMDA receptor antagonists, and the screening/prophylaxis/treatment of cerebral vasospasm are supported by little to no scientific evidence in the literature. The recommendations made by the protocol warrant serious reconsideration before any future use of this failed protocol.

and from PMID 27730539 (with my bold)

[...] this therapy, which has been dubbed the Milwaukee protocol, has been relentlessly promoted, and there have been numerous failures and no documented successes despite numerous repetitions of the basic approach with some variations. There have been many modifications of the protocol, but the scientific foundation of the protocol is very weak, and the approach should be abandoned because of a lack of efficacy and risks associated with the approach.

Alexbrn (talk) 06:29, 18 November 2019 (UTC)

Rebuke

Actually, digging deeper – and I'm not sure how deep we need to go into this – it does appear that the protocol's inventor was rebuked for over-egging research results, and it has been speculated that the single apparent success of the case was due to it being from a weak variant of bat rabies.[8] I can get decent sourcing for this if necessary, but I remain mystified why there is a push to have Wikipedia be equivocal about this when the sourcing seems 100% certain that the protocol does not work (and I have another source saying it's persistence has been damaging to legitimate rabies research). Alexbrn (talk) 09:55, 18 November 2019 (UTC)

The review states that the one surviving patient had antibodies to rabies before she arrived in hospital. So likely developed immunity some how... Doc James (talk · contribs · email) 13:33, 18 November 2019 (UTC)

What about this other case from 2011? https://abcnews.go.com/Health/california-girl-us-survive-rabies/story?id=13830407 — Preceding unsigned comment added by JediUnicorn (talk • contribs) 13:58, 17 January 2020 (UTC)

Image = rendering of a Rabies virus?

I have never seen such an over-top image being used in such an important article. It's pure Hollywood-esque WP:OR and should be removed. It's laughable that it has even been added to this page. But that's what happens when you block it people with half a brain from dipping in and editing out garbage. The so-called rendering of a Rabies Virus looks nothing like the real thing. Looks like no one has ever cared to check? 81.131.106.203 (talk) 14:09, 26 February 2020 (UTC)

Looks to me like a lot of the images on that search you provided. Which one of those is the "real thing"? --jpgordon^{𝄢𝄆 𝄐𝄇} 14:45, 26 February 2020 (UTC)

Figures seem wrong

https://www.cdc.gov/rabies/location/world/index.html — Preceding unsigned comment added by 109.240.3.81 (talk) 21:13, 26 February 2020 (UTC)

It doesn't give a year range, and deaths have varied a good bit. Article gives specifics "In 2010, an estimated 26,000 people died from rabies, down from 54,000 in 1990.[82]" So I don't see a conflict, unless you're referring to something else. MartinezMD (talk) 22:13, 26 February 2020 (UTC)

Semi-protected edit request on 24 May 2020

Remove or edit "Saliva production is greatly increased, and attempts to drink, or even the intention or suggestion of drinking, may cause excruciatingly painful spasms of the muscles in the throat and larynx. This can be attributed to the fact that the virus multiplies and assimilates in the salivary glands of the infected animal with the effect of further transmission through biting."

First sentence is accurate, follow up is wrong. Rabies, or any virus for that matter, doesn't multiply in a specific place so it can increase its rate of transmission or have a certain effect, it just does because through sheer chance it evolved to do that. The way the sentence is presented it makes it sound like whoever wrote it still believes in old evolution theory.

Also, hydrophobia is obviously related to the CNS not to the salivary glands, any attempt at explaining hydrophobia should be directed at that, not at the salivary glands, because obviously those aren't related to consciousness. 190.178.220.176 (talk) 06:54, 24 May 2020 (UTC)

Have reworded. – Thjarkur (talk) 10:20, 24 May 2020 (UTC)

Image use

The image Sauvages de la Croix, François Boissier de – Dissertation sur la nature et la cause de la Rage, 1777 – BEIC 3001126.jpg is used with no mention of either what it illustrates, nor why this particular edition of the work is relevant. It was first published in 1749 (compare title page of first edition). Unless there is some significance to the 1777 edition, using it may be misleading. I suggest to either remove the image (if found irrelevant, or if it is just one randomly picked work on rabies), or to replace the image by one from the first edition (it is in the public domain), change the image caption from a French to an English translation (the French translation is useful on the French Wikipedia, but not here), and add at least a sentence or two to that section of the article, describing the impact of that author and his work on the history of rabies. Renerpho (talk) 07:07, 6 December 2020 (UTC)

UK is not the only island in Europe

The sentence saying that "Unlike the other countries of Europe it is protected by being an island," is inaccurate. There are several other island countries that are more or less in Europe, including Malta (an island between Europe and Africa, but officially part of the EU), Cyprus (an island between Europe and Africa, but officially part of the EU, although part of the island is disputed between the country and Turkey), the Republic of Ireland (at least as much a part of Europe and the UK is), Iceland (this one is debatable because it's not in the EU and straddles the boundary between the North American and European plates, but it is part of the European market, the EFTA, and the EEA), etc. Also, the UK occupies several islands (see List of islands of the United Kingdom), not one.47.139.44.20 (talk) 19:41, 24 October 2020 (UTC)

Good catch. I reworded the sentence a little to be more accurate. MartinezMD (talk) 07:41, 6 December 2020 (UTC)

'at hospital' to 'in hospital'

The phrase in the following sentence under the 'After Onset' section should be changed from 'at hospital' to 'in hospital'. "She, however, already had antibodies against rabies when she initially arrived at hospital." A supporting source would be the 'Oxford Learner's Dictionaires', all examples for using the word 'hospital' in this way read either 'in hospital' or 'in the hospital'. <https://www.oxfordlearnersdictionaries.com/definition/english/hospital> GrammarCleric (talk) 18:00, 8 January 2021 (UTC)

 Done. AngryHarpy‍^talk 15:57, 9 January 2021 (UTC)

WP:VET

This is one of the most popular pages in Wikipedia:WikiProject Veterinary medicine's scope. Very few editors watch WT:VET's pages, which means that questions may not be answered in a timely manner. If you are an active editor and interested in animals or veterinary medicine, please put WT:VET on your watchlist. Thank you, WhatamIdoing (talk) 19:57, 11 January 2021 (UTC)

Semi-protected edit request on 3 February 2021

It's not fear of water, the nerves are violently stimulated by the virus making that even the sight of water will cause the entity to violently gulp in an involuntary attempt to drink the water. 212.88.251.103 (talk) 10:21, 3 February 2021 (UTC)

 Not done It's not clear what changes you want to be made, you can resubmit your edit request in a "change x to y" format. 54nd60x (talk) 11:23, 3 February 2021 (UTC)

Rabies Deaths Map is Wrong

I looked at the map of rabies deaths in 2012 and noticed some inaccuracies. For example, why are Australia and New Zealand in orange (meaning 2-4 deaths per thousand) when they've never even had rabies? If there's any way to fix maps do let me know and I'll fix the mistake they made. — Preceding unsigned comment added by KyokuTGM (talk • contribs) 03:41, 15 February 2021 (UTC)

Can you cite a reliable source (see WP:RS) for your "never even had rabies" claim? That's the best way to get the article changed. Cheers! — UncleBubba ^{( T @ C )} 16:50, 15 February 2021 (UTC)

Here is the link to the source proving that Australia has never had rabies cases. https://www.health.nsw.gov.au/infectious/factsheets/pages/rabies-australian-bat-lyssavirus-infection.aspx As you'll see there have been three deaths from Australian Bat Lyssa Virus - a closer related disease.2001:8003:680B:E01:E4D2:E967:9978:D38E (talk) 11:19, 8 March 2021 (UTC)

Semi-protected edit request on 19 February 2021

Ferretboy118 (talk) 00:03, 19 February 2021 (UTC) When i looked at the rabies article, i knew vomiting is a symptom in about half of cases of rabies Can i add vomiting to the rabies signs and symptoms?

• Do you have a reliable source that indicates that as a symptom? --Hammersoft (talk) 00:17, 19 February 2021 (UTC)
• Just looked it up: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255215/#:~:text=The%20first%20signs%20of%20rabies,%2C%20vomiting%2C%20depression%20and%20headache.

https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821 Should be added to the nonspecific symptoms

Added nausea and vomiting as symptoms, but did not include the suggested journal as a reference, as it’s listed as a predatory, non peer-reviewed journal. Added Johns Hopkins and Medical News today as reliable, independent sources. Ferkijel (talk) 19:29, 30 March 2021 (UTC)

Please change photo caption

"A female child about to receive PEP after being bitten by an animal" -> "A child about to receive PEP..."

It's absurd and very lazy to assume this child identifies as female.

Thank you. — Preceding unsigned comment added by 190.244.247.53 (talk • contribs) 17:23, 3 May 2021 (UTC)

It's not an assumption. The CDC source identifies her. It's absurd you just didn't read more. MartinezMD (talk) 17:29, 3 May 2021 (UTC)

Regarding the Milwaukee Protocol and Objectivity

I think it bears mentioning how frequently the information on this article regarding the Milwaukee Protocol (and the lesser-known Recife Protocol) has been updated, amended, added, and removed -- often without a full representation of the still-ongoing scientific debate as to its effectiveness. As the already-cited sources point out, many purported instances of survival cannot be 100% verified as having been cases of rabies in the first place — often due to a purported lack of neutralizing anti-rabies virus antibodies on later testing (as an aside,citations 39 and 41 of this currently cited source arguing against the protocol, which are cited in the source after these claims that survivors lacked neutralizing antibodies, are both impossible to locate in publicly available forms — it's impossible, therefore, to verify whether these sources do, in fact, state that this conspicuous lack of antibodies was noted). Additionally, those instances of survival that have been confirmed cases of rabies are often confounded by factors, such as administration of vaccines immunoglobin/presence of antibodies prior to exposure or in the course of post-exposure treatment, either as a prophylactic measure or alongside Milwaukee Protocol-esque post-onset treatment.

However, those sources also solely focus on cases reported in the USA, the UK, and in Canada between 2004 (when the Milwaukee Protocol was first introduced) and 2014. Considering one of these countries claims to have eliminated wild rabies, its inclusion in this data seems odd. Moreover, other, more recent sources note the difficulty in verifying case details, while also clearly stating that 11 cases of survival of suspected rabies following Milwaukee-style treatment protocols have been documented. I think it's hardly fair to say — as the current blurb about this subject does — that there have been no more cases of survival since the initial case from which the protocol takes its name. Putting aside the 2011 California case which some allege was never rabies to begin with, you have this case in which a 13-year-old boy from India survived without prophylactic post-exposure vaccination or immunoglobin, and also seemingly without any Milwaukee protocol-style intervention, despite the confirmed presence of rabies antigens. This would mean that there has been at least one more survivor since 2004 who did not receive any prophylactic pre-onset treatment. This would patently rule out the statement in the current section that there have been no further survivors.

Ultimately, I think more in-depth research into the body of available literature on these protocols is required, and the section on post-onset treatment should be updated to more accurately reflect that this is an ongoing area of scientific study that has hitherto produced mixed-quality evidence of efficacy. It is inherently un-Wikipedian, in my opinion, to have a section such as the current one that presents the Milwaukee protocol and regimens like it as forgone or abandoned avenues of post-exposure treatment. It would be wise, I think, to include some of the sources I linked above, and to rewrite the section in a way that reflects the current lack of a medical consensus regarding this protocol's effectiveness.Crossark (talk) 06:56, 20 March 2021 (UTC)

Semi-protected edit request on 21 March 2021

Hi Crossark, i think you are absolutely right about what you say! The article makes it seem, like it has been proven without doubt, that the treatment is ineffective. Also to me it is too unstructured.

Proposal: Change "After onset" to: At least two treatment schemes have been proposed to treat Rabies after the onset of disease, namely the Milwaukee Protocol and the Recife Protocol. The Milwaukee Protocol initially came into use in 2003, when it has been tested on Jeanna Giese. Subsequently, the teenager from Wisconsin became the first person known to have survived rabies without preventive treatments before symptom onset.[78][79] The basic idea is putting a person into a chemically induced coma and using antiviral medications to prevent fatal dysautonomia. However, the overall protocol is complex. The sixth version of the protocol last updated in 2018 consists of 17 pages with 22 steps of treatment, detailed monitoring and a timeline of expected complications. The Recife Protocol follows the same principle but differs in details like termination of sedation and supplementary medication. Some experts assed the Milwaukee Protocol as an ineffective treatment with concerns related to the costs and ethics.[77][81] Yet a study published in 2020 found 38 case reports for the Milwaukee Protocol and only one for the Recife Protocol with a total of 11 known survivors with varying sequelae.

References

I could not edit the original source, so it has to be reformatted before updating. Franzpuntila (talk) 16:37, 21 March 2021 (UTC)

Please do not request an edit until you have consensus for the change. Thanks. ScottishFinnishRadish (talk) 12:56, 23 March 2021 (UTC)

"and consensus should be obtained before requesting changes that are likely to be controversial" Why is this change likely to be controversial? It is more up to date, cites publicly available scientific sources and keeps most of the existing information. I removed the answered tag. Franzpuntila (talk) 19:02, 23 March 2021 (UTC)

References

To editors Franzpuntila, Crossark and ScottishFinnishRadish:  Not done for now: please establish a consensus for this alteration before using the {{edit semi-protected}} template. The answer to your question, Franzpuntila, lies in what Crossark noted above: [...] it bears mentioning how frequently the information on this article regarding the Milwaukee Protocol (and the lesser-known Recife Protocol) has been updated, amended, added, and removed [...]. This means that changes in the past to this issue have been ongoing and controversial. That is why a consensus must be garnered before the {{Edit semi-protected}} template is reactivated. It is not by any means a reflection of the nature of your arguments or sources. Thank you for your input! P.I. Ellsworth  ed. ^put'r there 19:47, 31 March 2021 (UTC)

Really, y'all...harping on an editor for "not obtaining consensus before requesting an edit" is kind of ridiculous. Just let the edit request become the proposal (which it appears it hath anyway). likewise, if consensus for a change through discussion has been reached, one of the editors involved should just make the edit - making the original proposer request an edit after consensus is ridiculous. we aren't a bureaucracy. Firejuggler86 (talk) 20:07, 3 April 2021 (UTC)

Sorry if you consider this "harping on an editor". Let me assure you that is not my intent. After reading the entire content in this section above, it seemed necessary to ask to see if consensus has changed. Guess it appeared to me to be ill-advised to add content to this article that had been added/removed/added/removed/added/removed in the past without getting a solid consensus first. We're all volunteers here and we're all hopefully here to improve this encyclopedia. If we harp or seem to harp, then that's why. After we get a good, solid consensus for this edit, then it will be easier to point future dissenters and reverters to the discussion below. Thank you for your opinion! P.I. Ellsworth  ed. ^put'r there 22:56, 5 April 2021 (UTC)

Hi, thank you for your input. I do not agree that the edit history of any page, makes changes to a more detailed, precise and up-to-date article with scientific sources controversial - especially when the status quo is outdated and biased. But if it is seen like this around here, let's make the best of it. I invite everyone interested in the article to suggest changes to my proposal, that I will happily incorporate if they provide better information. Also outside opinions are highly welcome.

Reopend. Franzpuntila (talk) 20:23, 19 May 2021 (UTC)

I would like to change the after-onset treatment to the proposal above. Happy to hear any input!

I will then reopen the edit request within three weeks from now. Franzpuntila (talk) 22:08, 1 April 2021 (UTC)

• Support the change – Franzpuntila's proposal appears to be a well-sourced and neutral-sounding update, so unless someone points out problems with it, I'd say go ahead. Dicklyon (talk) 05:16, 2 April 2021 (UTC)
• Support - Satisfied with its sourcing. Idealigic (talk) 21:18, 27 April 2021 (UTC)

To editor Franzpuntila: (et al.)  done, and thank you very much for your patience! P.I. Ellsworth  ed. ^put'r there 17:33, 20 May 2021 (UTC)

Semi-protected edit request on 21 May 2021

Cricopharyngeal spasm should be the hyperlink for violent movements I believe according to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4372763/ Banana Of Hell (talk) 14:57, 21 May 2021 (UTC)

 Not done: It's not just throat spasms, there are other spasms and violent movements. ScottishFinnishRadish (talk) 15:09, 21 May 2021 (UTC)

Semi-protected edit request on 14 June 2021

"It then travels along the afferent nerves toward the central nervous system."

Should be

"It then travels along the efferent (motor) nerves toward the central nervous system."

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842493/#S2title , which says

"It is thought that RABV entry into primary motor neurons is followed by retrograde axonal transport, replication and assembly in the neuronal cell body, and then transport to and budding from another synapse to start a new round of infection and resultant neuron-to-neuron spread." (emphasis mine)

For more confirmation see the other facts in the article: 1. Rabies uses anterograde transport, which means that to get to the CNS it must be traveling up neurons carrying signals away from the brain (i.e. efferent neurons) and 2. Rabies uses motor (i.e. efferent) neurons to replicate and reach the CNS.

The linked source for the original fact does mention "afferent" at page 258 https://books.google.com/books?id=p8rMezRaD4oC&newbks=0&printsec=frontcover&pg=PA290&hl=en&source=newbks_fb#v=onepage&q=afferent&f=false But not in the way it is used in this article: the source mentions that one variation of the virus did infect afferent sensory neurons (among other areas) when the virus was injected into the eye but it does not say that this is the usual mechanism of transport from infection site to CNS (e.g. looking at Figure 3 we can see that the other variant travels along efferent nerves). In Figure 1 on page 247 the book clearly shows the virus reaching the CNS via motor neurons (#3, #4, #5). However I think that the fact about the variant is still interesting as it shows that the pathway to the brain is not strictly via efferent neurons. Cameronfr (talk) 00:21, 15 June 2021 (UTC)

I agree. Will make the change. MartinezMD (talk) 00:47, 15 June 2021 (UTC)

Semi-protected edit request on 12 July 2021

Please change these sentences in the introduction:

Rabies causes about 56,000 deaths worldwide per year.[4] More than 95% of human deaths from rabies occur in Africa and Asia.[1] About 40% of deaths occur in children under the age of 15.[14] 

to

Rabies causes about 56,000 deaths worldwide per year,[4] about 40% of which are in children under the age of 15.[14]  More than 95% of human deaths from rabies occur in Africa and Asia.[1]

74.98.192.38 (talk) 20:09, 12 July 2021 (UTC)

 Done Morneo06 (talk) 21:47, 12 July 2021 (UTC)

Rabies Survivors

The article says that there were 14 rabies survivors, but the first scientific source cited says four, not fourteen, and the second one, while it says 13 (presumably plus the case described as 14), gives a citation for an article that doesn't actually support that number. [This paper] gives "seven", but as noted in the paper, two of those succumbed within 2-4 years after "recovering" from the disease. I added a Citation Needed tag. Titanium Dragon (talk) 00:03, 23 August 2021 (UTC)

Semi-protected edit request on 29 September 2021

In the section Treatment > After Onset, there is a small grammatical mistake / typo.

It reads:

" The protocol has be criticised in the journal Asian Biomedicine,"

I think it should be changed to:

" The protocol has been criticised in the journal Asian Biomedicine," Stuartws777 (talk) 20:04, 29 September 2021 (UTC)

 Done Thank you, - FlightTime (open channel) 20:51, 29 September 2021 (UTC)

Chicago rabies case

Unreliable source, but an RS may eventually confirm. [9] Sizeofint (talk) 18:28, 4 October 2021 (UTC)

Proposed merge of Rabies transmission into Rabies

No real point in keeping Rabies transmission as a standalone article. It is poorly sourced and redundant with Rabies § Transmission. Maybe a few sentences could be lifted and copied here but not much else. JBchrch talk 02:51, 2 October 2021 (UTC)

• Support. Didn't know that article existed and agree with your points. MartinezMD (talk) 03:16, 2 October 2021 (UTC)
• Support – Agree it is redundant to have a separate article regarding transmission. DferDaisy (talk) 15:16, 2 October 2021 (UTC)
• Comment. Alright, I'm gonna move forward with this one. Not much is salvageable from the Rabies transmission except one WP:MEDRS source [10] that I'm going to try to integrate to this article. JBchrch talk 18:41, 9 October 2021 (UTC)

Disputed: Number of survivors

Someone added the citation needed tag to the statement "14 people have survived rabies". The correct format is to add the disputed tag instead. I have quoted the person's comment verbatim:

First scientific source says four survivors, not fourteen; second one gives a number but the source it cited for the number gives a different one.

I don't think I am qualified to discuss this, so I won't.Kylesenior (talk) 04:50, 12 October 2021 (UTC)

This source accounts for twelve. Then this source documents the 13th case. The source you're talking about documents the fourteenth case. You are correct the authors cite the paper that reports twelve cases. The publication dates for the papers documenting the 13th and 14th cases are only one month apart. I would guess the authors of the latter paper were aware of the 13th case, but that paper hadn't been published yet for them to cite so they cited the next best thing. Sizeofint (talk) 03:43, 16 October 2021 (UTC)

Section that is poorly worded.

Vaccination after exposure, PEP, is highly successful in preventing rabies.[73] In unvaccinated humans, it is almost always fatal after neurological symptoms have developed.[89]

What is "almost always fatal"? The disease? Or the vaccination? I dont have enough medical knowledge to correct this myself. — Preceding unsigned comment added by 2001:8003:E422:3C01:EDCD:204E:BD1A:AB81 (talk) 06:09, 18 October 2021 (UTC)

The infection. I've clarified it by specifying rabies. MartinezMD (talk) 16:16, 18 October 2021 (UTC)

Semi-protected edit request on 12 November 2021

On the Prognosis section, change the vaccination link to Rabies vaccine, keeping the current link text. 2804:7F0:B1C3:406D:1294:4AE5:85BB:AE00 (talk) 06:11, 12 November 2021 (UTC)

Rabies vaccine is already linked twice in the article. A third link is not necessary. MartinezMD (talk) 06:53, 12 November 2021 (UTC)

Semi-protected edit request on 22 November 2021

Editing the prognosis of the disease Donny Van Beek (talk) 18:35, 22 November 2021 (UTC) Editing the prognosis of the disease

 Not done: requests for decreases to the page protection level should be directed to the protecting admin or to Wikipedia:Requests for page protection if the protecting admin is not active or has declined the request. - FlightTime (open channel) 18:37, 22 November 2021 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 1 October 2018 and 12 December 2018. Further details are available on the course page. Student editor(s): Gikdavis.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 07:40, 17 January 2022 (UTC)

One of the sources does not provide evidence to support the claim.

Was reading this part of the article: "Any mammal infected with the virus may demonstrate hydrophobia." The source was [23] https://web.archive.org/web/20140914174652/http://www.nhs.uk/Conditions/Rabies/Pages/Symptoms.aspx However, nowhere on the source does it say that any mammal infected with rabies may demonstrate hydrophobia. It only mentions human hydrophobia. Multiple sources I've seen state that hydrophobia is not experienced in dogs. Can someone remove this statement from the page, or back it up with a source that verifies the claim?

— Preceding unsigned comment added by OneSmallStepForMan (talk • contribs) 13:17, 15 February 2022 (UTC)

Done: I agree that the source does not back up that sentence, so I have tagged it as "fails verification" for now. I am quite sure that hydrophobia is in fact observed in rabid dogs, but haven't taken the time to research tonight. If you care to share your sources on that front they can be evaluated. Retswerb (talk) 08:57, 19 February 2022 (UTC)