why are rabies incurable
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Rabies is caused by a virus that likes to infect your nerve cells.
When the virus gets inside your skin, it travels to the closest nerve cell (or sometimes stays in a muscle cell), and starts using the cell’s own machinery to make more copies of itself. Your cells need that machinery to do their job and keep themselves alive, so infection often disables or kills them. Your immune system also spots that the cells are infected, and that causes inflammation.
Once it’s in a nerve cell, it uses it as a highway to get to your brain, and destroy cells in it. When the virus gets into your nerve cells, there is no preventing it from travelling up them to your brain. Most of the symptoms associated with rabies come from the brain not working properly, so you won’t show symptoms until your brain is already had a lot of damage, and you kind of need your brain in order to stay alive.
Importantly, rabies can be prevented even after an exposure. If you believe you have been exposed (bit or scratched by an unvaccinated mammal), go to your nearest emergency room.
By the time you show symptoms, it’s already spread to your brain and begun causing irreparable damage. It’s not impossible to treat, but it is very hard. Vaccine preventative is very affective though
Rabies is caused by a virus. And viruses are treated by helping out the body’s natural virus killing immune system. So without the immune system we can not fight the virus. Rabies attacks the nervous system, the brain. And due to the brain-blood barrier and a number of other things the immune system is not able to fight virus infections in the brain. So we can not really help it much at all. The best we can do is to vaccinate against rabies which helps the immune system fight the infection before it spreads to the brain. Even a vaccine given after someone is already infected will be fully effective at preventing the infection to spread to the brain.
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Rabies can hide from our defences. I think it uses specific parts of our own body (nerves/brain) that our immune system has trouble getting to, and it also has some chemical counter-measures to help avoid the immune response we do have in those areas.
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The virus travels very slowly through your nerves, and only hurts you when it reaches your brain.
The vaccine can act quickly, so if you get vaccined after being exposed, then your immune system can start to learn to fight it *before* the virus is half-way through destroying your brain, and hence defeat it.
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I am paraphrasing some parts of what I remember from this video: https://www.youtube.com/watch?v=4u5I8GYB79Y&ab_channel=Kurzgesagt%E2%80%93InaNutshell
Rabies (that’s the name of the disease, not a name for multiple diseases) is curable until you’re almost dead of it. It’s the same as the deadly kinds of E. coli, and many other diseases — there’s a treatment, but if you wait until the disease has already won the treatment stops working. It’s just that rabies starts causing noticeable symptoms when you’re almost dead and the disease has already won.
The treatment for rabies is a vaccine. Vaccines are normally preventative, but for diseases that spend a long time hiding and not making you sick before they cause problems it’s sometimes possible to make a vaccine that cures you (by teaching your immune system to force the pathogen out of hiding and kill it before it gets around to making you sick). The shingles vaccine is given after the chickenpox/shingles virus is already in your body, and there’s a company working on a new HPV vaccine that works the same way.
The first noticeable symptoms of rabies start when the virus is already in your brain, where your immune system has a hard time reaching, and has already started causing damage. At that point there’s no cure, partly because a lot of the damage has already been done and partly because we don’t have any medicines fast-acting enough to stop it. But there’s a long stretch of time before the first noticeable symptoms when the virus is silently living in your body and you can still be cured of it.
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There is a barrier that prevents icky stuff traveling in the bloodstream from entering your brain. This barrier means the brain is usually protected from such icky stuff. If something manages to cross that barrier, there’s no real way for your body to fight it.
Think of it like a super exclusive private dining room that you have to go through high security to get through. Once you’re inside, there’s no security, it’s just you and the dining room.
If you were to say, go full hog on the buffet, no one would be there to stop you. If you were to get really wasted, pooh and pee all over the walls, break the table, smash the chairs, etc., no one could get to you in time because of all the pesky security–it keeps out the good guys too!
Your brain is defenseless while the rabies virus goes full fat drunk guy at the VIP buffet on your delicious brain bits, and the fat guy doesn’t have the decency to pick up after himself, pooping and peeing all over the place while he’s there. He just keeps on munching until there’s nothing left, and you’re dead.
Rabies is bad because the fat drunk guy figured out a way to slowly sneak across that magical barrier without triggering an immune response. Imagine if he dressed up like a security guard, and the other guards just let him in.
By the time you have symptoms, the fat guy is already established a seat at the table, making a ruckus, and there is no one that can get by that magic barrier to kick him out.
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