Is there a disease more sensationally gruesome, more thrillingly disturbing than rabies? The macabre virus, which has haunted the imaginations (and nightmares) of nearly every human culture for thousands of years, is the subject of a new nonfiction book by Wired journalist Bill Wasik and veterinarian Monica Murphy, a husband-and-wife team perfectly matched to tackle the cultural history of this most dreaded of zoonotic infections.
In Rabid: A Cultural History of the World's Most Diabolical Virus, Wasik and Murphy explore rabies' influence on such diverse subjects as immunology, 19th-century celebrity, religion, and, of course, zombies, werewolves, and vampires. It's also a history of the relationship between humans and dogs—with rabies standing in the way of full best-friendship status for centuries, and an account of our species' often (terribly) humorous attempts to prevent or conquer the disease, which until relatively recently had a 100% fatality rate in humans.
Rabid is also, I hesitate to admit, a fun read, rivaling a Stephen King novel for page-turning thrills. Except with this book, you'll come away with hundreds of creepy facts (Did you know that ancient map-makers from completely separate cultures used a dog's head to symbolize the edge of the known world—and thus the place of mysterious danger? That was probably because of rabies!) You also might find yourself seeing signs of rabies, or at least its paw-shaped footprint, practically everywhere.
I discussed Rabid with Bill Wasik and Monica Murphy over email, where, among other things, the two talked about how rabies predicted our current state of vaccination-hysteria, how their book is Twilight meets Marley & Me, and why you should never, ever, ever go near a bat.
How did you each first become interested in rabies?
BW: She got me interested in rabies.
MM: Wasn't any kid on any playground in the 1980s interested in rabies?
BW: Well, sure. But you got me re-interested in rabies.
MM: It's true. I never actually saw a rabid animal as a vet, but I used to tell you about it: how it hijacks animals to spread itself. For me, I think I got re-interested in veterinary school. Even though rabies is rare in the United States, it's thoroughly covered in vet school. One of the veterinarian's most solemn duties is to protect people and animals from rabies.
Why did you decide to write a book about rabies?
BW: One day, after one of these conversations, I had the thought that someone must have written a cultural history of rabies. I was especially hung up on the word rabid—this term for a fatal illness that over time took on a set of really extreme meanings: terrible hate but also, somehow, terrible love, too. I went looking for this book that must exist, thinking I'd buy it for Monica as a gift. But I quickly discovered that not only had no one written this book, but no one had ever even written any book about rabies for a general audience. You had a bunch of medical books, and that was basically it.
MM: So we decided, why not us?
BW: It seemed like a book that needed to exist. I mean, it's like a cross between a dog book and a vampire book: Twilight meets Marley and Me. We figure the giant royalty checks should start arriving any day now.
Can you explain what happens to a person when they become infected with rabies?
MM: Usually, of course, this happens through a bite wound. The virus in the animal's saliva enters through the wound and infects the nerve cells there. Then it slowly climbs its way up the nervous system toward the brain. If you're bitten on the face, it might reach the brain in a matter of days, but usually this journey will take weeks, months, or even upwards of a year. If you get vaccinated at any point before the virus arrives at the brain, you can clear it without any danger. But once it infects the brain, you have rabies, and it's nearly 100-percent fatal.
BW: After that things get grisly. The first symptom is actually sort of interesting: Supposedly you get this tingling sensation at the site of the wound. Like, you didn't have it before, all that time that rabies was crawling up to the brain. Usually the wound has even healed at this point. But once your brain is infected, you'll often start to feel something odd at the site: a tingling, an itch, a stabbing pain. It sounds almost supernatural, but apparently it's true.
MM: Soon, it manifests as a flu-like illness—a sort of general malaise. It gets worse from there. You start to become disoriented and deranged.
BW: Another classic symptom is a difficulty in swallowing, which winds up manifesting as a visceral revulsion to water or other drinks—hence the term "hydrophobia," which used to be the medical term for human rabies. Occasionally, patients also experience hypersexual behavior, with involuntary orgasms. (I read about one case report in Latin that said, "Semen at animam simul efflavit," i.e., "His seed and his life were lost simultaneously.")
MM: Over a short period of time, you swing back and forth between periods of hysterical aggression, on the one hand, and terrible lucidity on the other. So you're able to contemplate just how bad your situation is.
BW: And then it kills you.
MM: Yeah. Rabies ultimately shuts down the brainstem, at which point you either suffocate or your heart stops.
Rabid gives a fascinating history of supposed cures or methods of prevention for rabies over the centuries, most of which are hilariously ridiculous (a 19th-century Italian plan for mandatory canine bordellos comes to mind). What were your personal favorites for total absurdity?
BW: Pliny the Elder is pretty much a one-stop shop, to my mind. He's the one who suggested that you burn a hair from the dog that bit you and insert the ashes into the wound—which is the origin of the phrase, "hair of the dog." But he also rattled off this mindblowing series of other possible remedies. A maggot from a dead dog's body, or a linen cloth soaked with menstrual blood of a female dog. Chicken excrement, "if it is of a red color." Ashes from the tail of a shrew-mouse!
My favorite part of the book was the story of how Louis Pasteur, through tireless work and with great courage, finally figured out how to vaccinate against rabies and cure those who had been recently bitten. The chapter gave me goosebumps. Through his efforts to cure rabies, how did Pasteur change medicine forever?
MM: Pasteur's rabies vaccine was the very first "modern" vaccine, in that he and his collaborators weakened the disease-causing pathogen in the laboratory in order to induce an immune response and prevent infection. Before Pasteur, you'd only had Jenner's smallpox vaccine, which used a related virus found in cows—cowpox—that happened to induce immunity against the human strain. What Pasteur established, with the rabies vaccine, was a whole paradigm for developing vaccines that's essentially the basis for every vaccine created since. Today, we can "weaken" the pathogens at the genetic level, but the basic principle still applies.
Were you surprised to learn that the irrational objection to vaccination, even in the face of evidence, was happening even in Pasteur's time?
MM: Even before Pasteur! When Jenner invented the smallpox vaccine, antivaccinists started organizing against its implementation almost immediately. Then as now, they'd pull together pseudoscience and anecdotal fearmongering to chip away at public support.
BW: There's something about the whole vaccine idea that seems unnatural—it's weirdly monstrous and Promethean, the idea of giving an animal virus to a human, or tinkering with a human virus and infecting people with it on purpose. And those sorts of revulsions were ascendant in the 19th century: witness the birth of the Frankenstein story, and the other monster tales of the era. In a way, the antivaccine impulse has some parallels to the overheated fear of rabies, which never killed huge numbers of people—not compared to other diseases, at least—but always terrified people out of proportion to its mortality rate. The animal nature of it gave rabies (and still gives it) a monstrous aspect.
MM: But of course, vaccines have proven to be one of mankind's greatest inventions. You're the monster if you don't vaccinate.
BW: For sure.
The book does a great job of tracing our popular fascination with vampires, zombies (particularly of the "fast" variety), werewolves, and other changed-human monsters to our collective fear of rabies. Do you think if rabies is finally eradicated, those beaten-to-death tropes (in my opinion) might finally go away?
BW: No, I don't think so. I mean, we don't really fear rabies as much as we used to, but those tropes haven't weakened at all, right?
MM: If anything (as we argued in the Wall Street Journal last weekend), our vampires and zombies have gotten more rabid over the centuries.
BW: Why is that? I don't know for sure, but I have to think that both the fear of rabies and the fear of "rabid" undead both come down to their animal essence—the idea of an animal nature inside us, the notion that humans might be transformed into senseless, aggressive, subhuman beings, in the same way that rabies transforms the creatures it infects. I actually wonder if our distance from animal aggression today—i.e., the fact that we don't have any predators out there, even hypothetically—has helped to make the zombie and vampire myths even more primal and rabies-like. If you look at how rabies appeared for the Sumerians, or for the ancient Greeks, or even for Europeans in the 18th century, there's a sense that the ferocious, slavering animal has a place in the order of things, which is very different from today. We never encounter aggressive, biting beasts except at the multiplex.
Rabid mentions cats only four times, always in an offhand way. I know the book is focused on dogs, who have been the most notorious spreaders of rabies to humans and who are inextricably linked to rabies in the human imagination. But do you guys just hate cats or what?
MM: Actually, in the United States, where most owners know to vaccinate dogs, cats are more likely than dogs to be infected with rabies.
BW: But to your question, you're right: In history, rabies has always been seen as a disease of the dog, and so that fact tended to focus the book on dogs. Absolutely no offense to the cat people.
MM: Well, and rabies actually evolved with dogs. Dogs have their own strain of the virus, which is still responsible for 99 percent of the worldwide deaths from rabies. Cats don't, which means that cat populations don't harbor or spread the virus as effectively as dogs or certain wildlife species do.
BW: In general, though, if you like a particular animal, you shouldn't want it to appear in our book. In a history of rabies, nothing ends well for the animals.
Did you run into any particular challenges writing a book as a husband/wife team that you'd like to share?
BW: It worked out great.
MM: I agree.
BW:: But that's a question we got asked a lot. When we told other writers that we were writing a book together, they were like, "Uh, how's that going…?" If they were with their spouse or partner, they'd often look at each other with a weird expression.
MM: It helped, I think, that our egos were invested in different aspects of the project. For me, I really wanted it to get the science right, but also to explain it in a way that lay readers could understand.
BW: I was more focused on the history and the surprising cultural connections. I knew Monica would help me with the science, so I could concentrate on making it fun. And creepy.
Given that over 50,000 people in Asia and Africa die of rabies every year, what do you think governments (including our own) could do to help eradicate the disease?
MM: In parts of the world where rabies is common, governments need to invest more in the vaccination of dogs. Often they make the mistake of thinking they can kill dogs instead and achieve the same result. But that doesn't work: culling just creates an ecological vacuum that draws in (and breeds) more dogs, and during the establishment of this new population, rabies is actually more likely to spread. The only program that works is widespread vaccination of dogs, ideally coupled with spaying and neutering. That way the human population has a stable community of immune dogs surrounding it.
BW: As for the United States, there's not much more we can do. We've eradicated the canine strain of rabies.
MM: I don't know—I'm pretty excited about wildlife vaccination! In the 1990s, there was a successful series of bait drops for coyotes that managed to keep dog rabies out of Texas. And in urban areas, like Philadelphia's Fairmont Park and New York's Central Park, they've used trap-vaccinate-release programs to shut down outbreaks of raccoon rabies. It's a strategy that more health departments will be able to use to keep rabies away from large population centers
What's the most important advice you'd give someone reading this who wants to avoid death by rabies?
MM: Vaccinate your pets.
BW: Assuming you're in the United States, watch out for bats.
MM: Most people don't know that bats can bite you without you feeling it or seeing a mark. If you wake up in a room with a bat, you might be at risk. (And if you find a bat in the room of a small child or an incapacitated person, you should definitely call a doctor for advice.)
BW: In general, err on the side of getting vaccinated, especially if you get bit by something while you're traveling in Asia or Africa. Even if it's something weird, like a monkey or a mongoose.
MM: The vaccine isn't as terrible as you think! Lots of people believe that it's 20 shots in the stomach, or something like that. In reality it's just a series of four shots in the arm.
BW: Dying from rabies, on the other hand, is really terrible.