Editing Rabies (section)

==={{anchor|Jeanna Giese}}After onset===
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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 was tested on Jeanna Giese. Subsequently, the teenager from Wisconsin became the first person known to have survived rabies without preventive treatments before symptom onset. The basic idea is to put a person into a chemically induced coma and to use 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.<ref>{{Cite web |title=Milwaukee Protocol, version 6 (updated November 2018) |url=https://www.mcw.edu/-/media/MCW/Departments/Pediatrics/Infectious-Diseases/Milwaukee_protocol.pdf?la=en}}</ref> The Recife Protocol follows the same principle but differs in details like termination of sedation and supplementary medication.<ref name="ncbi">{{Cite journal |title=Comparing clinical protocols for the treatment of human rabies: the Milwaukee protocol and the Brazilian protocol (Recife) |year=2020|pmc=7670764|last1=Ledesma|first1=L. A.|last2=Lemos|first2=E. R.|last3=Horta|first3=M. A.|journal=Revista da Sociedade Brasileira de Medicina Tropical|volume=53|pages=e20200352|doi=10.1590/0037-8682-0352-2020|pmid=33174958}}</ref> Some experts assessed the Milwaukee Protocol as an ineffective treatment with concerns related to the costs and ethics. 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.<ref name="ncbi" />