Jaipur: Since 2023, SMS Medical College has been placing unvaccinated rabies patients into drug-induced comas under the Milwaukee protocol, an experimental regimen that produced the world’s only documented survivor in 2004. In Jaipur, the outcome has been starkly different— not a single patient has lived.The protocol relies on ketamine, ribavirin, and other drugs to temporarily suppress brain activity, buying time for the immune system to mount a defence against the virus once it reaches the central nervous system. Yet, even though SMS hospital treats 24 to 30 confirmed rabies cases every year, its infectious diseases department has recorded a 100% mortality rate under the regimen.“Rabies remains one of the deadliest infections known to medicine, and no proven cure exists once clinical symptoms appear,” admits Dr Sunil Mahawar, nodal officer for infectious diseases department at SMS Hospital. “We continue to use the Milwaukee protocol because, in 2004, one unvaccinated girl in Milwaukee survived. That solitary case gives us the faintest hope, even if none of our patients have pulled through so far.”Patients exhibiting classic symptoms — hydrophobia, aerophobia, excruciating nerve pain, convulsions, and eventual coma — are shifted to isolated wards designed to minimise light, sound, and other triggers that aggravate the disease. Doctors then induce therapeutic coma, hoping to shield the brain long enough for immunity to develop. At SMS, that hope has repeatedly been extinguished.With rabies still universally fatal once its symptoms manifest, the continued application of the Milwaukee protocol is a desperate, last-ditch gamble, one that has, for now, only delivered heartbreak.
SMS Hosp’s Milwaukee protocol for rabies treatment a non-starter | Jaipur News
