Husband and wife writers Bill Wasik and Monica Murphy deconstruct one of the most fearsome viruses ever known in Rabid:A Cultural History of the World's Most Diabolical Virus. Wasik and Murphy tell us what scares us about rabies and how it has worked its way into our culture.
Take us back to the origin of rabies. How did humans interact with the virus way back when? How did we behave when first encountering the virus?
We've had rabies for as long as we've had civilization. References to it survive in Sumerian texts dating back thousands of years—astrological explanations of it, incantations against it, the number of shekels you had to pay if your dog got it and killed someone. Even though genetic research indicates that rabies probably began in bats, it's always been associated with dogs. Indeed, it's always represented the dark side of the dog, the evil that lurks within man's supposed best friend.
Explain what happens to a body infected by rabies.
When a rabid animal bites a human, the virus infects the nerves at the site of the wound, then travels slowly up the nervous system toward the brain. If the victim gets vaccinated before the virusreaches its destination, the infection will be cleared with no symptoms. But once the virus reaches the brain, it's too late. Flu-like symptoms soon give way to high fevers, convulsions.Victims become disoriented, distressed, and sometimes violently aggressive. Often they have difficulty swallowing, which gives rise to a phenomenon called "hydrophobia," where they become physically repulsed at the sight of fluids. Eventually the virus shuts down the essential functions of the brain, and the patient dies of suffocation or heart failure. It's a truly terrible way to go.
How has our fear of rabies manifested itself in our culture?
It's a cultural link that you can find as far back as the Iliad. "Lyssa," the Greek term for rabies, is used by Homer and other ancient authors to denote a wild, animal rage. Indeed, the word "rage" itself derives from the French word for rabies, and that similarly starts to show up in medieval times as a literary metaphor for violent hate.
Since the 19th century, rabies has appeared more explicitly in literature, usually as a horrifying subplot—think about the rabid dog in To Kill a Mockingbird, or the death of Tea Cake in Their Eyes Were Watching God. By the 1970s and 1980s, there was a small market for rabies horror novels, both in England (where rabies was eradicated in 1902, but fear of imported disease persists) and in the United States (remember Cujo)?
How does the history of rabies compare to other "killer" viruses? How is it different?
Rabies always been relatively rare compared to other killer viruses. Even before there was a rabies vaccine, people died far more rarely from rabies than they did from smallpox, measles, and even influenza. (Not to mention from bacteria like cholera and tuberculosis, or from parasites like malaria.)
But in terms of popular fear, rabies has always loomed extremely large.This has been true in part because rabies was, and with rare exception remains, 100 percent fatal—the highest case-fatality rate of any known disease—andbecause it's such a terrible way to die. But it's also because rabies spreads observably from animals, and, perhaps more important, the symptoms themselves are animal-like in their mad fury. There's something intrinsically creepy about rabies. Part of why Louis Pasteur decided to develop the first modern human vaccine against rabies, instead of some other illness, is that it created so much hysteria in the general public.
Why are we at a stalemate with rabies?
Precisely because rabies isn't a huge killer of people, it doesn't rate as highly as other diseases in the budgets of philanthropic foundations orpublic-health agencies, even in countries (mostly in Asia and Africa) where death from rabies is still a significant problem. What seems to many people like an easy way to reduce rabies—massacring the animals that spread it—turns out to be ineffective and even counterproductive, since the population of feral (unvaccinated) animals will just rebound to fill the vacuum.
Instead, what reduces rabies is mass vaccination campaigns for animals, dogs in particular. But such campaigns require sustained political will, which is hard to muster in countries where other health problems seem more urgent.