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Rabid

A Cultural History of the World's Most Diabolical Virus

Bill Wasik - Author

Monica Murphy - Author

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ISBN 9780143123576 | 288 pages | 25 Jun 2013 | Penguin | 8.26 x 5.23in | 18 - AND UP
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An engrossing, lively history of a fearsome and misunderstood virus that binds man and dog
 
The most fatal virus known to science, rabies—a disease that spreads avidly from animals to humans—kills nearly one hundred percent of its victims once the infection takes root in the brain. In this critically acclaimed exploration, journalist Bill Wasik and veterinarian Monica Murphy chart four thousand years of the history, science, and cultural mythology of rabies. From Greek myths to zombie flicks, from the laboratory heroics of Louis Pasteur to the contemporary search for a lifesaving treatment, Rabid is a fresh and often wildly entertaining look at one of humankind’s oldest and most fearsome foes.



Introduction

Ours is a domesticated age. As civilization has advanced over the march of millennia, humans have assiduously stripped the animal kingdom of its armies, decommissioned its officers. Some erstwhile adversaries we have hunted to extinction, or nearly so. Others we confine to zoos, to child-friendly safari parks. The balance we shunt to the margins as we clear their land for ourselves—erecting our own sprawling habitats on the ruins of theirs, naming our cul-de-sacs for whatever wilderness we dozed to pave them.

Peer through news reports, though, and one can find pockets of resistance, as if some ancient animal essence were periodically reawakening. Consider the bobcat in Cottonwood, Arizona, that set out on a rampage one recent March evening, menacing a worker outside a Pizza Hut and then sauntering into a bar, sending patrons onto the pool table, mauling the one who dared to snap a picture on his phone. Or the furious otter in Vero Beach, Florida, at a waterfront golf community called Grand Harbor (a “gated enclave,” brags its website, “for those seeking the ultimate resort-at-home lifestyle”), that gnawed three residents, one of them while out on the links. Or the enraged beaver at the Loch Raven Reservoir, in the genteel exurban sprawl north of Baltimore, that cruelly interrupted the summertime reverie of four swimmers, a nightmare that ended only when the husband of one pulled the beaver from his wife’s upper thigh and smashed it with a rock.

Typically these creatures will shun the society of humans. But in an instant we can find them transformed into bewilderingly avid attackers, accosting us as we retrieve our mail or walk our dogs, sometimes even carrying out a home invasion. A particularly harrowing tale comes to us from the Adirondack hamlet of Lake George, N.Y. On an April evening just a few years ago, a young couple was walking from their car when they were set upon by a gray fox. The two managed to rush inside their home and close the door. But nearly a half hour later, when they opened the door again, the fox lay in wait; it sprinted toward the opening; only quick reflexes allowed the young man to close it just as the creature’s snout broached the threshold. When an animal control officer arrived, the fox attacked his SUV, repeatedly sinking its teeth into his tires. He shot at it multiple times from out his driver’s side window, but failed to hit his mark. Later, after the officer had finally run the fox over, he told a reporter that it was the single most aggressive foe he had encountered in nine years on the job. “This was a four- or five-pound animal attacking a 3,000-pound vehicle,” he said.

The sheer tenacity: that is the truly chilling element in all these tales. “What disturbs me,” remarked one Connecticut man to the local news, regarding the raccoon he had lately beaten to death with a hammer, “is I smashed his mouth off, I smashed his teeth in, but he still wanted to continue in the attack mode. I was actually terrified at the resilience of this animal.” In Pittsfield, Mass., on a sleepy street backing up to the Housatonic River, a fox attacked twice in an eight-hour span. In the first incident, one neighbor struck the fox multiple times with the lid to his barbecue smoker. Yet still the fox returned earlier the next morning, biting the girl next door; it took twenty minutes for the man and her sister to pry the fox off her leg, before the man could knock the fox unconscious and then choke it to extinction.

One victim in Putnam County, New York, survived her own interminable ordeal with a raccoon, which assaulted her at the end of her half-mile-long driveway. She held down the snarling beast while she tried to free her cellphone to call the house; eventually, her husband and son had to club the raccoon repeatedly with a tire iron before it died. (“I felt that nature had betrayed me,” she later told a reporter for the public-radio show This American Life.)Then there was the red fox in South Carolina that pursued a nine-year-old as he made his way to the school bus one morning. After an adult neighbor sheltered the boy in his house, the fox latched onto the good Samaritan’s foot. He flung the animal into his home office, where it flailed against the walls and windows before finally falling asleep on a dog bed.

Nearly any species can be afflicted. Arizona officials were recently called to the scene after a dog was attacked by a mad peccary, a pig-like creature whose residence in the southwest had until that point been considered largely peaceable. In Robbins, N.C., it was a skunk that beset the pet Pekinese of David Sanders, who was forced to watch the two creatures battle it out for the better part of an hour. (Sanders was unable to shoot the challenger, he explained, because all he had at hand was a shotgun.) In Decatur County, Ga., a donkey fell prey to the madness and bit its owner on the hand. In Imperial, Nebraska, the afflicted animal was literally a lamb, part of a child’s 4-H project gone terribly, almost Biblically awry. Some primeval force must truly be at work when the lamb can be made into a lion.

***

The agent of all these diabolical acts of possession is, of course, a virus. It is the most fatal virus in the world, a pathogen that kills 100 percent of its hosts in most species, including humans. Fittingly, the rabies virus is shaped like a bullet: a cylindrical shell of glycoproteins and lipids that carries, in its rounded tip, a malevolent payload of helical RNA. On entering a living thing, it eschews the bloodstream, the default route of most viruses but a path fraught with danger from immuno-protective sentries. Instead, like almost no other virus known to science, rabies sets its course through the nervous system, creeping upstream at one to two centimeters per day (on average) through the axoplasm, the transmission lines that conduct electrical impulses to and from the brain. Once inside the brain, the virus works slowly, diligently, fatally to warp the mind, suppressing the rational and stimulating the animal. Aggression rises to fever pitch; inhibitions melt away; salivation is ratcheted up. The infected creature now has only days to live, and these he will likely spend on the attack, foaming at the mouth, chasing and lunging and biting in the throes of madness—because the demon that possesses him seeks more hosts.

If this sounds like a horror movie, we should not be surprised, for it is a scenario bound up into our very concept of horror. Rabies is a scourge as old as human civilization, and the terror of its manifestation is a fundamental human fear, because it challenges the boundary of humanity itself. That is, it troubles the line where man ends and animal begins—for the rabid bite is the visible symbol of the animal infecting the human, of an illness in a creature metamorphosing demonstrably into that same illness in a person.

Today, we understand that more than half our new diseases (60 percent, by a recent tally in Nature) are “zoonotic,” i.e. originating in animal populations, and our widespread fear of the worst of these (swine flu, AIDS, West Nile, Ebola) has been colored by our knowledge of their bestial origins. It is hardly an exaggeration to say that nothing has made humans sicker than our association with animals. Not only our emerging diseases today but the major killers throughout the ages—smallpox, tuberculosis, malaria, influenza—evolved from similar diseases in animals. This is what Jared Diamond has called “the lethal gift of livestock,” a major shaper of human destiny; the very fact that the agricultural lifestyle won out over that of the hunter-gatherer is due in part, Diamond argues, because the former “breathed out nastier germs.” Through their close contact with livestock, early farmers built up immunity to illnesses that would readily kill unexposed populations, a dynamic that still holds for emerging infectious diseases today.

Yet until the early twentieth century, humans had no idea that so many of its illnesses derived from animals. During those years when the most catastrophic zoonosis in history struck—the fourteenth-century Black Death, or bubonic plague, which spreads to humans via fleas living on the backs of rats and other rodents—scholars blamed nearly everything else, from demonic forces and bad air to astronomical happenings and even human malefactors. For centuries, rabies was the only illness in which the animalistic transfer, or more like a transformation, was clear. No microscope was required to see the possession take place. A mad animal bit; a mad man appeared; each would die a terrible death. The madness could lurk within any beast, even in—especially in—the most domesticated and loyal of all, the dog.

As the unique mode of animal to human infection, rabies has always shaded into something more supernatural: into animal metamorphoses, into monstrous hybridities. When Greek myth beholds Lycaon, king of Arcadia, as he transforms into a slavering wolf, his countenance is “rabid,” his jaws “bespluttered with foam.” In fifteenth-century Spain, witch-hunters called saludadores were reputed, also, as healers of rabies, a convergence that makes eminent sense given the widely-held association between witches and demonic canine familiars. Between the fifteenth and eighteenth century, Europe gestated two enduring legends whose part-human, part-animal malefactors bite their victims, thereby passing along their own degraded conditions—namely, the werewolf and the vampire, both of whom haunt the Western imagination to the present day. As Susan Sontag pointed out, even as late as the nineteenth century, when viruses were becoming well understood and a rabies vaccine lay just around the corner, the true source of the rabies panics in France was not the fatality of the disease but rather the “fantasy”—though one might accurately say the fact—“that infection transformed people into maddened animals.”

Paradoxically, during the twentieth century, after Pasteur’s invention of a rabies vaccine provided a near-foolproof means of preventing its fatality in humans, our dark fascination with rabies seemed only to swell. The vaccine itself became as mythologized as the bug, such that even today, many Americans believe that treatment requires some twenty (or is it thirty?) shots, delivered with a footlong syringe into the stomach. (It’s four shots, for the record, and not particularly deep in the arm.) Even as vaccination of dogs in the United States was reducing the infection rate in that species down to negligible levels, a generation of children learned to scrutinize their pet pooches for the slightest signs of madness, largely thanks to the malign influence of Old Yeller, a Walt Disney film about a frontier-era boy who falls in love with a yellow dog that becomes rabid. Twenty-five years later, a novel called Cujo (and its subsequent film adaptation) taught a whole new generation to fear rabies, albeit a bit more forthrightly: no one finished the book or left the theater surprised by what became of that nice dog.

It’s almost as if the very anachronism of rabies, to the Western mind, has rendered it even more intriguing to us. Like the vampire, rabies carries with it the musty whiff of a centuries-old terror, even as it still terrifies us in the present day. Lately, TV comedians have taken to seizing on it for a laugh: two animated series created by Mike Judge, King of the Hill and Beavis and Butt-head, have both done episodes on rabies, as did the long-running medical comedy Scrubs. In the U.S. version of The Office, Michael Scott (the bumbling boss played by Steve Carell), tries to paper over the fact that he has hit an employee with her car by organizing a charity “race for the cure.” The disease he chooses is rabies. The boss soon becomes perplexed at how few donations are forthcoming:

Michael Scott: I was also hoping to hand the giant check to a rabies doctor. How’s that going?

Pam Beesly: Not well. A doctor won’t come out to collect a check for 700 dollars. Or 500 dollars, if we go with the giant check. And also, there is no such thing as a rabies doctor.

***

Contrary to what your television may have told you, there are most assuredly still rabies doctors, and humans still die in the tens of thousands from the disease (55,000, in the latest estimate)—just not usually in the United States, or in Western Europe. The dead hail overwhelmingly from Asia and Africa, from countries where vaccination is too expensive or too difficult to procure. And the course of their suffering is every bit as grim, and as inevitably fatal, as the course endured by victims throughout the millennia.

Indeed, other than the wide availability of painkillers, which can help stifle the final agonies of the disease, the sequence of horrors faced by a rabies patient today is hardly different from those experienced by the man who was probably the most eminent rabies victim in history: Charles Lennox, Fourth Duke of Richmond, who for the two years leading up to his death in 1819 served as Governor-General of Canada, the top post in what was then still a colonial government. The Duke was a famous lover of dogs; a portrait of Lennox as a boy shows the young nobleman reclining against a tree stump as an adoring spaniel paws at his finery. Ironically, it was not a dog but rather a fox, the ostensibly tame pet of a solider whose garrison the Duke had occasion to inspect in Quebec, whose jaws were to blame for his demise. When the fox tangled with his own dog—Blucher, so named in honor of Gebhard Leberecht von Blücher, the Prussian general who had recently bested Napoleon at Waterloo—Lennox stepped in to separate them. The mad fox seized this chance to insult the visiting head of state, chomping down hard on the base of his thumb.

After a bite, the rabies virus binds quickly into the peripheral nerves but then makes its course with almost impossible sloth, requiring usually at least three weeks and often as long as three months to arrive at and penetrate the brain; on rare occasions a full year, or even five years, can elapse before the onset of symptoms. During this time the wound will heal over, and the victim may even forget about his scrape with a snarling beast. But healed or no, as the virus enters the brain the wound will usually seem to return, as if by magic, with some odd sensation occurring at the site. This sensation can take many forms: stabbing pain, or numbness; burning, or unnatural cold; tingling, or itching, or even a tremor. At roughly the same time, these soon-to-be-doomed patients typically display general signs of influenza, with a fever and perhaps a sore throat or some mild nausea. In the case of the Duke of Richmond, it began one day with shoulder pains and a sore throat, then progressed the following day to insomnia and fatigue.

All this is merely prelude to the illness itself, whose most notable symptom in humans—unique, as far as physicians know, to rabies among all diseases —is a terrifying condition called hydrophobia. As the term suggests, hydrophobia is a fear of water, though the word “fear” does not do justice to the eerie and fully physical manner in which it manifests. Present the hydrophobic patient with a cup of water and, though he desperately wants to drink it, his entire body rebels against the consummation of this act. The outstretched arm jerks away just as it is about to bring the cup to the parched lips. Other times the entire body convulses at the thought. Just beholding the water can make the diaphragm involuntarily contract, causing patients to gag and retch. On YouTube one can find video from a 2007 sufferer in Vietnam, showing the travails of a middle-aged construction worker is valiantly attempting to consume some dark beverage from a clear plastic cup. He brings the vessel two thirds of the distance to his lips before his hands begin to tremble uncontrollably. He stares at the fluid, mouth agape, his twitching hands sloshing it over the sides. Finally he forces himself to bring the tiniest sip into his mouth and, overcoming the revulsion in his gullet, to swallow it.

For the Duke of Richmond, though the chronology remains in some dispute, the hydrophobia seems to have struck first on the evening of August 26th, 1819. At dinner with his officers, he found that his glass of claret disagreed with him. “I don’t know how it is,” he is said to have remarked to Colonel Francis Cockburn, one of his retinue, “but I cannot relish my wine tonight as usual. I feel that if I were a dog I should be shot for a mad one!”

The next day, the Duke ate and drank almost nothing and remained in bed. By the evening, he found he could not drink at all. The following morning, a doctor prescribed a gargle, but this, too, had a “convulsive” affect on his throat. He could not even accept his customary shave, so repelled was he by the water in the basin. This day he dragged himself from his bed, because he was scheduled to tour the swamps around the Ontario town of Richmond, recently renamed as such in his honor. But his body rebelled as he stepped into the boat. In terror he jumped back to the shore. Taken to the closest house, he begged to be moved farther from land: the very sound of running water had become unbearable to him. He was moved to a barn and laid down on a deathbed of straw.

Fevers spike high during this final phase of the disease, as the body succumbs to its grip in other, literally visceral ways. The mouth salivates profusely. Tears stream from the eyes. Goosebumps break out on the skin. Cries of agony, as expressed through a spasming throat, can produce the impression of an almost animal bark. In the throes of their convulsions, patients have even been known to bite. At the height of an attack, they also hallucinate. The eminent French physician Armand Trousseau, who practiced in the middle part of the nineteenth century, noted that “the patient is seized with sudden terror; he turns abruptly round, fancying that somebody calls to him.” He cited a case of colleague, one Dr. Bergeron, whose rabies patient “heard the ringing of bells, and saw mice run about on his bed.”

Not uncommonly, male patients succumb to an even more lurid sort of abandon. The virus’s action on the limbic system of the brain can cause them to exhibit hypersexual behavior: increased desire, involuntary erections, and even orgasms, sometimes occurring at a rate of once per hour. If the Duke of Richmond evidenced this symptom, his companions were too gallant to set it down for posterity. But other case reports from history describe up to thirty ejaculations in a single day. The Roman physician Galen, in his own remarks on rabies, describes the case of an unfortunate porter who suffered such emissions for three full days leading up to his death. Commenting on this last case, the eighteenth-century Austrian physician Gerard van Sieten soberly noted, Semen et animam simul efflavit: His seed and his life were lost at the same time.

Despite all the horrors of hydrophobia, arguably the most horrifying aspect is that fact that the attacks will usually subside, for a time, allowing patients periods of terrible lucidity: they are given the opportunity to fully contemplate what their condition portends. Before his death, the Duke dictated a lengthy letter to his eldest daughter, and also gave instructions that his beloved Blucher be handed over to her. “It will make her cry at first,” he said, “but turn him in when she is alone and shut the door.”

***

By now it should be apparent that this book is not for the squeamish or weak-kneed. Encounters with rabies have ever been thus. Louis Pasteur and his assistants, in order to develop their vaccine, had to corral dogs at the apex of their madness and extract deadly slaver from their snarling jaws. Axel Munthe, a Swedish physician, once saw Pasteur perform this trick with a glass tube held in his mouth, as two confederates with gloved hands pinned down a rabid bulldog. Some members of his team soon established a ghoulish failsafe for these procedures. “At the beginning of each session a loaded revolver was placed within their reach,” recalled Marie Cressac, the niece of Pasteur collaborator Emile Roux. “If a terrible accident were to happen to one of them, the more courageous of the two others would put a bullet in his head.”

We cannot claim so much bravado for this volume, on either our account or yours. A better analogy, perhaps, is the difficult process by which veterinarians submit suspect pets for rabies testing—another case study in how this diabolical disease causes nothing but agony for those who hope to behold it. Even today, vets do not use a blood test for rabies in animals; it’s not a pinprick and wait-and-see affair. Only a sampling from the animal’s brain will suffice. Therefore the animal must be killed, with its head removed and shipped off to authorities for study.

The first part of that process—capturing, and humanely dispatching, a deranged animal—is fairly standard stuff for your local vet. But carrying out a decapitation, even of a smallish creature, is much harder than they make it look in slasher pics. This is true not just for the obvious emotional reason: that in many cases, the vet had been trying to save the life of this beloved pet just hours beforehand. It’s also an ordeal in the purely practical sense. The carcass must be hauled onto a treatment table, which usually is reserved for care of the living, but which is the only surface equipped to handle the copious blood that might flow from a newly dead animal. The cadaver is laid out on its back, contorted face cocked skyward. With a scalpel the vet slices readily though the soft tissue around the animal’s neck: fur and skin, muscles and vessels, esophagus and trachea.

Now the vet is stuck with the problem of the spine, the very conduit through which the rabies virus may—or may not—have passed; like Schrödinger’s cat, the animal must be dead for this question to unravel. If the vet is lucky, her hospital has seen enough suspected rabies cases that it has thought to keep a hacksaw handy. In that case, she can take a brute-force path through bone, sawing straight through the tightly interlocked top vertebrae, the axis and atlas. If she is not so lucky, she will have only her scalpel to work with. A ten-minute job can thereby stretch out to forty-five, as she is forced to disarticulate those two top backbones, severing the tendons than bind them and separating one from the other: a decidedly grisly brainteaser.

To be honest, our tour through the four-thousand-year history of rabies has felt a little like that. Sometimes whole weeks got lost in a blur of blood and fur. Our explorations into the cultural meaning of rabies took us deep into the grisliest medical case reports, from ancient and modern times. Then they flung us out again, into the murky realm of myth, to dog-headed men and zombie mobs and the mass butchering of Cairo’s pigs. We’ve made pilgrimages to the Ardennes, to see the site of the holy rabies cure; to the Rue d’Ulm in Paris, to see the spot where Pasteur performed his heroics; and to the island of Bali, where we finally came to stare the devil in the face ourselves.

Now, after two years of sawing, we feel we have finally finished the job, and we are pleased to ship it off to you, the reader. Come to think of it: in the case of a fox, or cat, or even a toy-breed dog, the head might weigh just about the same as the book in your hands right now. Hold it in your outstretched palms, why don’t you, and close your eyes. Not so very heavy, is it? And yet from packages this small—as exurban homeowners sometimes learn, and as the Duke of Richmond discovered far too late—considerable mayhem can be unleashed.



“A searing narrative.”
—The New York Times
 
“In this keen and exceptionally well-written book, rife with surprises, narrative suspense and a steady flow of expansive insights, ‘the world’s most diabolical virus’ conquers the unsuspecting reader’s imaginative nervous system. . . . A smart, unsettling, and strangely stirring piece of work.”
—San Francisco Chronicle
 
“Fascinating. . . . Wasik and Murphy chronicle more than two millennia of myths and discoveries about rabies and the animals that transmit it, including dogs, bats and raccoons.”
—The Wall Street Journal
 
Rabid delivers the drama of Louis Pasteur’s courageous work developing the rabies vaccine at the same time it details the disease’s place in our cultural history, taking us from Homer to the Bronte sisters to Zora Neale Hurston to Richard Matheson. . . . All along the book’s prose and pace shine—the book is as fast as the virus is slow.”
—The Seattle Times
 
“A very readable, fascinating account of a terrifying disease….Wasik and Murphy grippingly trace the cultural history of the disease. . . . Rabid reminds us that the disease is a chilling, persistent reminder of our own animal connections, and of the simple fact that humans don’t call all of the shots.”
—The Boston Globe
 
“Compelling. . . . Murphy and Wasik give life, context and understanding to the terrifying disease. Like the virus itself, this fascinating book moves quickly, exploring both the marginalized status and deadly nature of the virus. And as the authors trace the influence of rabies through history, Rabid becomes nearly impossible to put down.”
—New Scientist
 
“An elegant exploration of the science behind one of the most horrible way to die.”
—Chris Anderson, author of The Long Tail
 
“This book is not for the squeamish. Yet those who are fascinated by how viruses attack the body, by the history of vaccination and by physicians’ efforts to save the most desperately ill patients will want to read it. There is also a happy ending: scientists are working to harness rabies as a potent drug delivery vehicle.”
—Scientific American
 
“[Wasik and Murphy] offer an in-depth look at a disease so insidious that it even turns our best friends—dogs—against us. The pair convincingly link the history of rabies…with the history of man’s fear of nature and the unknown, and our own latent capacity for beastliness.”
—The Daily Beast
 
“Thrilling, smart, and devilishly entertaining, Rabid is one of those books that changes your sense of history—and reminds us how much our human story has been shaped by the viruses that live among us.”
—Steven Johnson, author of The Ghost Map
 
“Rabies has always been as much metaphor as disease, making it an excellent subject for cultural history. . . . As Wasik and Murphy document . . . the horror of rabies has been with us since the beginning of human civilization.”
—Bookforum
 
“Funny and spry. . . . It’s a rare pleasure to read a nonfiction book by authors who research like academics but write like journalists.”
—Alice Gregory, n+1
 
 “Readable, fascinating, informative, and occasionally gruesome, this is highly recommended for anyone interested in medical history or the cultural history of disease.”
Library Journal (starred review)
 
“Take Bill Wasik, one of our most perceptive journalistic storytellers, have him join forces with Monica Murphy, scholar of public health, and you end up with this erudite, true-life creep show of a book. It turns out that the rabies virus is a good bit more fascinating and at least as frightening as any of those blood-thirsty monsters that have stalked our fairy tales, multiplexes, and dreams.”
—Donovan Hohn, author of Moby Duck
 
“Ambitious and smart.”
—Publisher’s Weekly
 
“Terrible virus, fascinating history in Rabid.”
—NPR
 
“As entertaining as they are on rabies in culture, the authors also eruditely report on medicine and public health issues through history, from ancient Assyria to Bali to Manhattan in the last five years, showing that while the disease may be contained, it may never be fully conquered. Surprisingly fun reading about a fascinating malady.”
—Kirkus Reviews
 
“The ultimate weird dad book.”
—Very Short List
 
“The rabies virus is a microscopic particle of genes and proteins. And yet it has cast a fearful shadow over all of human history. Bill Wasik and Monica Murphy have produced an eerily elegant meditation on disease and madness, dogs and vampires. It's as infectious as its subject.”
—Carl Zimmer, NPR contributor and author of Parasite Rex
 
 “A fun read, rivaling a Stephen King novel for page-turning thrills.”
—The Awl



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