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Record W4408956709 · doi:10.1093/cid/ciaf157

Demise of the Milwaukee Protocol for Rabies

2025· article· en· W4408956709 on OpenAlexaff
Alan C. Jackson

Bibliographic record

VenueClinical Infectious Diseases · 2025
Typearticle
Languageen
FieldImmunology and Microbiology
TopicRabies epidemiology and control
Canadian institutionsUniversity of Calgary
Fundersnot available
KeywordsDemiseMedicineRabiesVirologyProtocol (science)PathologyLaw

Abstract

fetched live from OpenAlex

Human rabies has a very high fatality rate and there have only been about 34 well-documented survivors, defined as survival at 6 months after onset of clinical rabies. Many have had serious neurological sequelae. After a young patient survived rabies in Milwaukee in 2004, the approach dubbed the "Milwaukee protocol" has been aggressively promoted as an effective therapy. The protocol has included therapeutic (induced) coma, ketamine, ribavirin, and amantadine and details of the protocol have changed over time. Over the past 2 decades, no subsequent detailed reports have documented evidence of efficacy. There have been at least 64 cases with failure of the protocol. Likely critical care, which has been used for more than 50 years, is an important component of an aggressive approach. The time has now come to abandon the failed Milwaukee protocol for the therapy of rabies and consider new approaches based our current knowledge of rabies pathogenesis.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.007
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.354
Threshold uncertainty score0.816

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.007
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0000.000
Science and technology studies0.0000.001
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.037
GPT teacher head0.413
Teacher spread0.375 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations16
Published2025
Admission routes1
Has abstractyes

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