Could rabies be treated through amputation?

As I understand it, the rabies virus propagates fairly slowly along peripheral nerves until it reached your brain. Then it kills you, horribly. But what if, say, a rabid animal bit my finger? If I didn’t have access to the vaccine, could I prevent a horrible death by just cutting off the finger? Or my hand? Or would this rather bloody-minded approach be entirely futile?

Yes, this would work.
The whole topic is rather complicated and fascinating, and I don’t have time right now to post my usual dissertation.

I refer you to the work of (among others) G M Baer who used volunteer mice to show that amputation is a workable approach.

“The pathogenesis of rabies was studied by inoculating mice in the rear footpad with virus from the salivary gland of a rabid bobcat; this virus was selected because it caused death one to three months after inoculation. This is similar to the incubation periods seen in man. Amputation of the inoculated feet within 18 days after inoculation was a life-saving procedure, indicating that the virus stays at or near the site of introduction for most of the long incubation period. Equine antiserum to rabies administered 24 hr after inoculation of virus failed to reduce mortality but resulted in singularly prolonged incubation periods.” *

There is much more to the story, and if I have time I will return to it. I believe Dean and Baer first published on this topic back in the early 60s, if you are interested enough to do your own research.

Briefly, rabies virus is not distributed by blood; when you get exposed in a soft tissue wound, it’s the attachment to local nerve endings and subsequent retrograde travel up the peripheral nerve axon (via axoplasmal transport) that gets you in trouble. In cultured nerves this can be as fast as 50-100 mm/day but in real-life humans, I’m not sure the rate is known.

Of course, if you have no access to post-exposure treatment, you may be in a situation where you also have no access to testing of the vector for rabies, so you might end up chopping off an extremity for nothing. But then, I realize you are not seeking medical advice. :wink:

Volunteer Mice?

OK, this reminds me of an episode of The Big Valley where they dumped gunpower on a fresh bite and cauterized it to kill the rabies virus. This makes sense to me, but just because it makes sense doesn’t mean it’s true. Any literature to back up the cautery approach?

Being born is considered the same as volunteering in the world of laboratory mice.

Band name?

Rabies, malaria, zombi-izm…anytime the body part is immediately amputated, the infection is prevented from spreading to the rest of the body.

Never mind the mice. Who volunteered to get the salivary gland from a rabid bobcat? :eek:

This is incorrect, and the Human Immunodeficiency virus or malaria serve as a good examples. Consider that, when the skin is broken with a wound, immediate access is gained to the vascular tree. Any pathogen which now becomes essentially injected into the blood stream is distributed within seconds hematogenously throughout the body.

Thus, were you to be exposed in a wound to HIV (consider a needleprick, for example), or to the malaria parasite, you would be considered to have been systemically exposed to the virus and local care (although recommended) would be minimally useful. This is because the HIV pathogen needs only to get past the skin barrier; once it’s into the bloodstream, local attention to the wound, or amputating (even within a minute or two) is of no value.

The rabies virus is remarkably different, as I mentioned in my original reply. It is not distributed by the blood to any pathogenic effect, and injection of rabies virus directly into the bloodstream is not all that serious an event. This is counter-intuitive but hematogenous spread of rabies is not thought to happen. What happens instead is that the virus parks in the local tissues (for days or weeks, perhaps) and if it gains access to the end (axon) of a nerve, its mechanism (and the only mechanism ever described, as far as I know) for distribution is to travel up that nerve’s axon, eventually gaining access to the spinal cord (for all peripheral nerves, anyway) and thence up the spinal cord to the brain. Once in the central nervous system the virus multiplies essentially unchecked and is almost uniformly fatal.

Amputating a limb in the scenario the OP describes is successful for rabies because of this mechanism. There are parallel similarities (clostridial gangrene, for instance) but they aren’t exactly the same; one gets systemically ill from gangrene because of hematogenous spread of the organism and the associated pathologies that happen locally, but the purpose of amputation in an instance like that is really to get rid of the overwhelming nidus of infection; it’s not to prevent hematogenous spread, and it is not, by itself (without antibiotics) necessarily curative (although it might be, since the body can handle a smaller amount of C Perfringens running around in the bloodstream).

For rabies, amputation of an extremity proximal to the point of retrograde intra-axonal travel of the virus is curative. For practical reasons, it’s not done as a therapeutic interaction, but this is not really the OP’s question.

There’s a nice cite (I believe the researcher was Henri Tsaing from the Pasteur Institute, who has a lot of publications on how rabies works) describing an experiment where a couple dozen skunks* (skunks are a natural vector for rabies in the wild) were injected intramuscularly in the leg to see how rabies spreads. When the skunks were killed at various stages, a nice ascending pattern of rabies in the peripheral nerves, spinal column ganglia and brain was documented.

I’m sort of offline right now, but will try to get back with some specific cites and more detail when I have the opportunity.

*Mangetout, I do not know if these were volunteer skunks or not, but I assume they were given the same opportunity as all lab animals to sign a waiver opting out of the experiment, and absent any signatures, were assumed to have volunteered their services.

This is the most badass thing I’ve heard all week. Well, maybe except for the “of laboratory mice” bit. I may have to steal it someday.

Need Answer Fast?

Both zombiism and lycanthropy are blood-borne and amputation would not work.

Even with rabies, assuming you amputated the finger/whatever in time, you’d probably still be strongly advised to get rabies shots when you reached civilization, unless you had thoughtfully brought along the head of the thing that bit you for testing (something that also likely would get you advanced to the front of the line at the Emergency Department).

Getting informed consent is the tricky part.

Researcher: “OK, Mickey, let’s go over the experiment again. We’re going to give you rabies on purpose. Then we cut off your foot. If you are real lucky, you might not die.”

Mouse: (suspiciously) “What’s the catch?”


Gee, Chief Pedant,that was exactly what I was going to write, but you beat me to it.

Seriously, fascinating information, thanks.

Thanks, Chief Pedant! Exactly the answer I was looking for - consider ignorance not only fought, but beaten so savagely that it now begs only for a painless death.

Very, very interesting. Thanks. God, I love the Dope!

According to Day of the Dead, amputation works against zombiism if you are quick enough.