Talk:Rabies

Active discussions
Rabies 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
Current status: Delisted good article

Tragedy in Germany: six transplants have rabiesEdit

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 FoxTrotEdit

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 (again)Edit

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? [2] 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)

RebukeEdit

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.[3] 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 (talkcontribs) 13:58, 17 January 2020 (UTC)

Image = rendering of a Rabies virus?Edit

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 wrongEdit

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 2020Edit

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)
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