History of Rabies
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Rabies, literally meaning “furious” in Latin, is commonly known throughout the ages for its terrifying effects on both humans and animals alike. Because the disease is fatal, people throughout the world have put greatest effort to find ways of controlling and preventing the disease. Natural remedies and protection amulets were used until Pasteur’s discovery of the vaccine. Based on those findings, people have altered techniques to make the vaccine. However, recently, there have been two particular cases concerning rabies. One woman survived the disease by an induced coma without receiving the vaccine. Another case a common organ donor infected with rabies killed all the recipients. These medical mysterious surprised many scientist even today.
Long before humans established their existence on Earth, microorganisms have always existed. Such is the case for a specific virus named rabies. People in the past could easily identify the presence of this tiny killer. Extending way back to about 2300 BC, people in ancient Babylon have acknowledged the presence of this terrifying disease. Furthermore, they even set up written laws, requiring owners to quarantine their rabid animals or risk being fined a certain amount of money if the animals attacked anyone (West 12-13). In the fifth century BC, a few famous Greek and Roman writers, such as Democritus, Aristotle, Hippocrates, Plutarch, Xenophon, Epimarcus, and Virgil, also mentioned rabies in their writings. However, during times where culture played a bigger influence than science, people typically documented the disease in an ambiguous and vague fashion. In Greek mythology, the god Aristaeus cancelled out the effects, while the goddess Artemis spread the disease to humans and animals alike, cursing them to a state of madness (Baer 1). Only until the first century AD that a Roman celebrated physician called Aulus Cornelius Celsus accurately described the disease (Rabies.com). He also stated “saliva was ‘venomous’ and the means of transmitting the disease” (West 13). In American culture, this disease has also made its mark on humanity because of the way one dies but also the way the person’s death affects everyone around them. In the two famous novels Their Eyes Were Watching God by Nora Hurston and Old Yeller by Frederick Gipson, the great emotional pain deeply scars the heroes of the stories. In Gipson’s novel, Old Yeller, a young boy’s beloved dog, is injured while saving his human family.
However, as soon as Old Yeller’s character dramatically changes for the worst, the boy has no choice but to kill his loving companion (Gipson). Hurston’s novel echoes the same sadness. While trying to save Janie in a storm, a rabid cattle bit Janie’s husband. Tragically, this heroine is forced to shoot her husband as soon as she realized her husband was no longer himself (Hurston).
Early in the time, when vaccines or cures for rabies had not been discovered, people relied on natural. For prevention, madstones (or moonstones) were carried as charms to ward off rabies. As George Baer had mentioned in the book The Natural History of Rabies, “The original amulets – apparently “hair balls” from the stomach of white deer (or their gallstones), gallstones of white cows, or any smooth white stones – were used by the American frontiersmen and early settlers” (11). People would occasionally dip stones into milk until the color became white. If bitten, the stones would then be placed on top of the wound for healing effects. Other means of curing a person included cauterization, meaning to use heat to destroy tissue exposed from the bite wound. Various herbs and natural resources were also recommended to purify the wound site, such as donkey’s milk, child’s urine, and ‘stones’ of a hedgehog (West 15). Additionally, doctors favored submerging their patients underwater, sometimes even almost drowning them. The reason for this treatment was because people infected with rabies tend to exhibit a distinctive symptom called hydrophobia, where intense feelings of thirst and fear of water rage on, driving the person mad. The doctors believed that confronting the patients with their fears and “baptizing” them in water would cleanse them of the disease (16). Since these treatments were not always successful, people resorted to combinations of these treatments. For example, Dr. Vaughan advised his patient on cautery of the wound, filling it with gunpowder, and lighting it. These actions would, supposedly, allow the virus to discharge from the body (17).
In the 1880s, the world-renowned French chemist and biologist, Louis Pasteur, discovered the science of microorganisms through investigations with the microscope. He found that when beer or wine ferments, milk turns sour, or meat decays, microorganisms were present. Beer factories asked him to join them in finding the best way in making the finest and longer lasting beer. Pasteur also had successes in smallpox and anthrax where after several cultures the organisms could no longer produce the disease. In 1857, the silk industry in southern France had run into a serious problem of a disease attacking the silk worms. Eventually, the scientists realized that it was the leaves the silkworms ate that contained the microorganisms killing the worms (“Louis”). Following up to this incident, Pasteur teamed up with Pierre Roux and Charles Chamberland to formulate a vaccine for the microscopic killer, rabies. This particular disease caught Pasteur’s attention, not only because of the excruciatingly painful effects of the disease, but also because of the number of deaths caused by the disease had become increasingly higher in France. Progress was lengthy because this disease only grew on living tissue and isolating the virus was difficult. After testing the saliva from infected animals, he realized that the disease mainly attacked the central nervous system, multiplying in the brain and spinal cord. Starting out with rabbits, Pasteur took pieces of an infected spinal cord and placed it into flasks to dry. He would dry these fragments for a certain amount of days, inject them in healthy animals, and observe the result. After a series of trials to see how many days it would take for the animal to not have any symptoms, Pasteur finally obtained an attenuated form of the virus. By July 6, 1885, fifty dogs withstood the virulent virus (West 123-124). However, the proof of this vaccine’s success did not occur until John Meister, a nine-year old boy who was bitten severely on his hands and legs by a rabid dog, came in pleading for the untested vaccine. Meister survived the horrible injuries and disease (Kaplan 105). Since then, there have been modifications of the disease. In 1908, Fermi used phenol to weaken the virus instead of relying on drying. In 1919, an Englishman in India, Semple, used phenol and a temperature of 37oC. This way either partially or completely killed the disease and reduced the chance the vaccine itself would kill the patient. Most people in the world today use the Semple vaccine. However, some people have an allergic reaction from the myelin used in the vaccine. In 1950, Dr. H. M. Powell and Dr. C. G. Culbertson used partially purified duck embryos infected with rabies. There are fewer allergic reactions to the duck-embryo but at times, there are also neurological complications. There are a total of fourteen injections. Another type of vaccine was tissue-cultured. According to Geoffrey West, these “highly purified and concentrated tissue-culture vaccines offer greatest prospects of success”. Hamster or pig kidney cells are common tissues to work with (126-129).
Despite finding the vaccine for rabies, one peculiar case showed that there may be other ways of ridding oneself of the disease. Jeanne Giese, a fifteen-year old girl, is the first person known to have survived rabies without ever receiving the vaccine. On September 2004, a bat she found in the St. Patrick’s Church bit her left index finger. About thirty-seven days later, Giese was admitted to the Children’s Hospital of Wisconsin for tremors and unstable walking. With suspicions of rabies, the doctors consulted with the parents, suggesting a never tested strategy to destroy the viral entity. Giese’s parents agreed, and the doctors put the girl into induced coma with ketamine and midazolam. During the next seven days, doctors gave her Phenobarbital (a sedative) and antiviral drugs (ribavirin and amantadine), waiting for the immune system response. Giese was then brought out of the coma, and after thirty-one days, she no longer had the virus. With some rehabilitation therapy for the nerve damage, she was released from the hospital on January 1, 2005. Giese was able to resume a normal life. Doctors cannot explain the miraculous recovery. The theory was that the coma would help her survive until the immune system fought off the virus in her body. But more than six additional attempts to save patients in the same method had always failed. This still remains a medical mystery (Willoughby).
Another strange, recent incident proves that rabies could infect people not only through bites, and more testing is needed for this infectious disease. The case concerned three organ recipients diagnosed with rabies from the common donor. The organ donor was an Arkansas man who visited two Texas hospitals for “severe mental status and a low-grade fever”. After neurological imaging, doctors found the source of the pain was from a subarachnoid hemorrhage (MMWR). Eventually, two days later, his condition worsened, leading to his death. After some screening and testing, the man passed the regulations for organ donation. With his family’s consent, the man’s lungs, kidneys, and liver were recovered. On May 4, 2004, the kidneys and liver were transplanted to three patients at Baylor University Medical Center in Texas. A patient that received the transplanted lungs at an Alabama hospital died from complications. The liver recipient had the liver disease. The other female and male needed the kidneys because of the renal disease. In the beginning, all three patients recovered and were released from the hospital. It turned out the situation was much more serious and about twenty-five days later, each patient returned to the hospital. Within the next twenty-four hours, the three died of neurological symptoms. Since the cause of death was unknown, samples were sent to the lab for analysis and sure enough, the tissues were infected with rabies. Later, they found a fourth recipient at the hospital had received part of an artery from the same Arkansas man, and died in the same pattern. This case is not completely new. Previously, in five other countries, eight cases of rabies in the transplanted eye corneas. However, this case is more shocking because this is the first case of solid organs infecting recipients with rabies (Kuehn).
Throughout the times, more and more information has been acquired about this fatal disease. From olden-day superstitious cures to truly-working vaccines, medicine has greatly improved. But there is so much more to be learned. The last case above proves that rabies can kill in ways people would not have predicted before. Medical scientists will need to find more possible methods of curing viruses and include more precautions in organ donation regulations. Pasteur’s work has only begun a course of much more discoveries yet to unfold.
Baer, George M. The Natural History of Rabies. Ed. George M Baer. 2nd ed. Boca Raton: CRC Press, 1991.
Gipson, Frederick Johnson. Old Yeller. 1956. New York City: HarperCollins, 1990.
Hurston, Zora Neale. Their Eyes Were Watching God. 1937. New York City: HarperCollins, 1998.
Kaplan, Colin, et al. Rabies the Facts. Ed. Colin Kaplan. Oxford: Oxford UP, 1977.
Kuehn, Bridget M. “CDC: Rabies Transmitted through Organ Donation.” Journals of the American Veterinary Medical Association (Aug. 2004). 24 July 2007
“Louis Pasteur.” Zephyrus Interactive Education. 8 June 2007. 25 July 2007
MMWR Dispatch. “Investigation of Rabies Infections in Organ Donor and Transplant Recipients.” Morbidity and Mortality Weekly 53.26 (July 2004): 586-589. 24 July 2007
Rabies.com. 24 July 2007
West, Geoffrey P. Rabies in Animals and Man. Ed. Newton Abbot. Great Britain: David & Charles Limited, 1972.
Willoughby, Rodney E, Jr, et al. “Survival after Treatment of Rabies with Induction of Coma.” Survival after Treatment of Rabies with Induction of Coma 24 ser. 352.2508-2514 (June 2005). The New England Journal of Medicine. 22 July 2007