2008 in Bali, an island full of dogs yet never known to have had a case of rabies, has the worst outbreak of rabies ever experienced in modern times. Over 150 people die and over 26,000 dogs are exterminated. After protests cease the indiscriminate, reactionary culling, the disease is only pushed back with an aggressive vaccination program. But the damage has been done physically and mentally to the majority Hindu and dog loving population of this small island.
It’s August or the dog days of summer, so when better to read a book on the history of rabies. Rabid: A Cultural History of the World’s most Diabolical Virus is a new book about probably the worst disease known to man. Rabies is a disease that has historically had a 100 percent rate of fatality and has left its mark in the culture by giving rise to the fear of transformation into monsters in the legends of werewolves, zombies and vampires. And although man and canine has coevolved in a mutually beneficial relationship, the specter of rabies has given the dog a dual nature of madness and evil as the most common vector of rabies to humans. This duality of the dog is an overlying theme of the book that sewn throughout.
The two authors of the book Bill Wasik, an editor of Wired magazine, and wife, Monica Murphy, a veterinarian and public health professional, have given us a great book that melds two of my loves together, history and science. It starts out with accounts of rabid dogs and the spurious cures for rabies form the ancient texts of China, Egypt and Greece. In Greece Pliny the Elder gives us the saying “hair of the dog” as part of his cure for rabies. There are also cures listed from the Middle Ages to modern times, including my favorite cure, rubbing a plucked chicken anus on the rabid bite in the hopes of it sucking out the disease. This spurious cure is from the 14th century hunting book, Master of the Game .
The most disturbing sections of the book involve the descriptions of the manifestation of the disease in humans. It starts with flu-like symptoms that become insomnia and fatigue. This is only the beginning as you start to have an irrational fear of water. Although you may be thirsty you cannot bring a cup of water to your mouth nor can you swallow your constantly streaming saliva (this seems to be a virus controlled behavior that wants to keep the virus laden spittle near your teeth for spreading it to others). Tears stream from the eyes, hallucinations, goose bumps, cries of agony that sound like barking and males suffer from priapism and hypersexuality. Eventually you die of a heart attack or just stop breathing. It is a horrible and completely disturbing monster of a disease.
There are two heroes of the story and the first is the Frenchman, Louis Pasteur. It was through his dogged adherence to the scientific method that led to the discovery of a vaccine for rabies even though he could never see the virus in his microscope. Pasteur and his assistants would take saliva samples from living, and raging, rabid dogs. These mad dogs would be secured with straps, but in case anyone was bit by the dog there was a pistol ready to shoot the victim in the head. Pasteur carefully created a series of inoculations, each one stronger than the first that could halt the slow moving virus from entering the brain and allow time for the body’s immune system to kill it. In July, 1885, the first human recipient of the vaccine, an Alsatian farm boy who was bit by a rabid dog, was cured, and Pasteur was celebrated worldwide.
The rabies virus moves extraordinarily slowly up the nervous system to the brain and sometimes symptoms don’t appear for months. Although the vaccine works before symptoms appear, after they appear nothing had been known to help and there was about a 100 percent fatality rate. That was until the second hero of the story, Dr. Rodney Willoughby, was confronted with a girl named Jeanna Giese that had developed the symptoms of rabies after being bitten by a bat in church. He combed through pages of literature and found a paper from the nineteen eighties that he thought held some promise. From the paper he realized that victims who died of rabies showed no brain trauma. The rabies virus was not destroying the brain it was causing an electrotoxicity that was making the brain kill the body. Willoughby decided to place the girl into a coma for seven days while giving give her antivirals, sedatives and ketamine, a medication that would suppress her brain activity but also had shown signs of anti-rabies properties when used in rats. After week they slowly began waking Jeanna. At first they were alarmed and thought that she was locked-in to her body (see the Diving Bell and the Butterfly) because there was only movement in her irises. Eventually she regained movement of her body but has needed years of therapy and is now ironically studying bats. This treatment has now been named the Milwaukee Protocol and has shown some success throughout the world.
The author concludes his book with actually witnessing a dog in the throes rabies-induced madness while on the Island of Bali. He finds it especially disconcerting in its blank-eyed expression and its seemingly absence of awareness. He also discusses new research in utilizing the rabies virus’ ability to easily penetrate the blood- brain barrier in drugs to combat encephalitis.
Overall the book is well written and interesting in its illumination of a virus that has haunted humanity and our canine companions for millennia.