sexta-feira, 27 de maio de 2011
Rabies Survivor: Girl from USA
(MAY 26, 2011) It started with a stomachache. Eight-year-old Precious Reynolds, who lives in Willow Creek with her grandparents, three siblings and a cousin, had been complaining about tummy troubles, so her grandpa took her to the local clinic. Assuming she had the flu, her doctor advised the usual treatment — rest, fluids — and sent her home.
Soon, new symptoms began to appear. Around 3 in the morning on Saturday April 30, Precious woke her grandparents complaining that her neck and back were hurting. “I thought she might have just slept on it wrong, so I told her to go back and lay down,” her grandmother, Shirley Roby, told the Journal by phone Tuesday. Come daylight, however, Precious wasn’t any better, so her grandpa drove her over the hill to Mad River Hospital.
Doctors performed tests but, given her stomachache and muscle soreness, they, too, assumed Precious had the flu. Once again her grandpa brought her home. “At lunch time, I was fixing all the kids lunch, and [Precious] said she felt like she was gonna get sick to her stomach,” Roby recalled. “She got up from the table and her legs just collapsed on her. She looked at me surprised. She just wasn’t functioning right.”
The family helped Precious to the couch, and over the next few hours they kept offering her water. But every time Precious took a sip she would vomit it back up. By 8 p.m. she couldn’t talk and was barely moving. Around 10 p.m. Roby tried to prop Precious upright on the couch, but she immediately slumped over, “like she was paralyzed.” That’s when Roby knew something was seriously wrong. “I said, ‘This is no damn flu.’”
Indeed it wasn’t. The following morning, Precious was flown 200 miles south to the U.C. Davis Medical Center where, almost a week later, doctors determined that she’d been infected with rabies.
Human rabies cases have become exceedingly rare in the United States, thanks in large part to vaccinations of domestic animals. The most recent human case in California was nine years ago, according to the California Department of Public Health (CDPH). Precious’ case is the first from Humboldt County.
The viral disease affects the central nervous system and is typically transmitted to humans from the bite of a rabid animal (bats and skunks are most common, though any mammal can contract the disease). After infection, symptoms can appear in as little as nine days, or they can take a year or more to show up. At first these symptoms are typical of many illnesses — fever, headache, general malaise — but as the disease progresses it starts to cause neurological problems. These vary dramatically from case to case, but they can include insomnia, anxiety, confusion, fear of water, partial paralysis, difficulty swallowing, hallucinations and more. Once these symptoms appear, death from respiratory failure is usually imminent.
“Up until a few years ago we would have said quite definitively that rabies is 100 percent fatal,” said Dr. Curtis Fritz, a public health veterinarian with the CDPH. The first human ever to survive rabies without a vaccination was a Wisconsin teenager named Jeanna Giese. The 15-year-old made worldwide headlines in 2004 after doctors saved her life by medically inducing a coma to protect the brain while her body fought off the virus. This method, which came to be called the Milwaukee protocol, is exactly what doctors at U.C. Davis used to save Precious.
When she arrived at the hospital on May 1 she was already in critical condition, Roby said. According to Dr. Fritz, rabies is difficult to diagnose in living patients. Typically the disease is identified using a brain sample. “Obviously we can’t do that in a living patient,” Fritz said. Alternative measures involve looking for antibodies in the blood, cerebral-spinal fluid, saliva or corneal tissue (from the eyeball).
Though Precious had never mentioned being bitten by an animal, one of her doctors suspected rabies and called for the tests. (Later, Precious’ friends and siblings said they’d seen Precious playing with feral cats near her school.) The U.S. Centers for Disease Control confirmed the rabies diagnosis on May 6.
“She was fighting for her life right then and there,” Roby said. Even after the diagnosis, the doctors were pessimistic. They warned Roby and the rest of Precious’ family to expect the worst. “I was scared,” Roby admitted, her voice quivering. “I thought I was gonna lose her. I had never been around anything like this, but I knew she was a fighter.”
Literally, as a matter of fact; Precious loves athletics — wrestling in particular. Three years ago, Roby and her husband took guardianship of Precious, along with her sister and two brothers. The kids’ dad had warrants out for his arrest, and both parents were on drugs. As if that wasn’t enough, Precious has had a heart condition since birth — Supraventricular tachycardia, which sometimes makes her heart beat exceedingly fast, 260-280 times per minute. Yet through all this, Precious has remained outgoing and happy. “She’s one tough little cookie,” Roby said.
And so, despite the doctor’s warnings, Roby put her trust in her granddaughter’s resilient spirit. “Every day grandma would tell her, I’d say, ‘Precious, you got a bad bug inside of you.’ I’d say, ‘I want you to take him, throw him down, put him in a half-nelson, flip him over, get on his chest and smash him into that mat.’ I don’t know if that’s part of what brought her back or not, but we were fighting.”
Finally, doctors brought Precious out of her coma, and according to Roby, they’ve been simply amazed at the speed of her recovery. How do they explain it? “They can’t,” Roby said. “They said she has written a new chapter in the book.” Precious is now the seventh patient in the world to survive rabies, doctors told Roby, and nobody has progressed faster. Monday night she was moved from intensive care to pediatrics, and she’s speaking again — albeit in a whisper. Roby expects that her granddaughter will be ready to come home before too long.
The most important thing people can take away from this, Roby said, is to learn about the dangers associated with rabies so they don’t have to go through what Precious and her family have been through: Have your pets vaccinated, avoid contact with wildlife, and if you do get bit or scratched, treat the wound thoroughly and notify your doctor.