1 00:00:02,440 --> 00:00:05,720 Speaker 1: Happy Saturday. Our episode on the Dick and Metal had 2 00:00:05,720 --> 00:00:08,760 Speaker 1: a brief mention of efforts to keep the UK free 3 00:00:08,760 --> 00:00:11,520 Speaker 1: of rabies, and we also just got an email from 4 00:00:11,560 --> 00:00:14,680 Speaker 1: listener Whitney on the subject of a mass rabies exposure 5 00:00:14,680 --> 00:00:17,720 Speaker 1: in the news, and we have been working on plans 6 00:00:17,720 --> 00:00:20,360 Speaker 1: for our trip to Morocco in November, which is a 7 00:00:20,360 --> 00:00:24,120 Speaker 1: country considered to be a high risk for dog rabies. Basically, 8 00:00:24,160 --> 00:00:26,599 Speaker 1: we're just thinking a lot about rabies right now, so 9 00:00:26,880 --> 00:00:29,800 Speaker 1: seemed like a good time to replay our May ninth, 10 00:00:29,840 --> 00:00:34,880 Speaker 1: twenty twenty two episode on the history of rabies. Enjoy 11 00:00:38,080 --> 00:00:41,000 Speaker 1: Welcome to Stuff You Missed in History Class, a production 12 00:00:41,159 --> 00:00:51,120 Speaker 1: of iHeartRadio. Hello, and welcome to the podcast. I'm Tracy V. 13 00:00:51,240 --> 00:00:55,440 Speaker 1: Wilson and I'm Holly Frye. Foxes are one of many 14 00:00:55,480 --> 00:00:59,720 Speaker 1: wild animals that share cities and other places with human beings, 15 00:01:00,040 --> 00:01:03,640 Speaker 1: and in April, one of them made headlines after biting 16 00:01:03,720 --> 00:01:08,200 Speaker 1: at least nine people around the US capital. When this 17 00:01:08,280 --> 00:01:12,480 Speaker 1: story crossed my Twitter feed, I became incredibly invested in 18 00:01:12,520 --> 00:01:15,440 Speaker 1: whether everybody who got bitten by this fox had gotten 19 00:01:15,480 --> 00:01:19,560 Speaker 1: their raby shots. Afterward, news articles were not telling me 20 00:01:19,600 --> 00:01:23,440 Speaker 1: the answer to this information some of them were talking 21 00:01:23,480 --> 00:01:27,440 Speaker 1: about a specific reporter or a specific congress person, but 22 00:01:27,480 --> 00:01:30,840 Speaker 1: I was like, no, everybody, everybody needs to get the 23 00:01:30,920 --> 00:01:36,240 Speaker 1: raby shots because foxes can carry rabies. Rabies is virtually 24 00:01:36,440 --> 00:01:40,600 Speaker 1: always fatal once people develop symptoms, once anyone develops symptoms, 25 00:01:40,600 --> 00:01:44,560 Speaker 1: but today's rabies profile axis is almost one hundred percent 26 00:01:44,600 --> 00:01:48,000 Speaker 1: effective at preventing that from happening. It is, I think, 27 00:01:48,040 --> 00:01:50,680 Speaker 1: the most effective vaccine that we have in existence. So 28 00:01:50,840 --> 00:01:54,520 Speaker 1: then when news broke that yes, this fox did have rabies, 29 00:01:55,120 --> 00:01:57,720 Speaker 1: it was like just a big flashing, screaming sign in 30 00:01:57,760 --> 00:02:02,520 Speaker 1: my brain, like raby shots, raby shots, Please tell me 31 00:02:02,560 --> 00:02:05,800 Speaker 1: everyone got their rabies shots. Of course, then that made 32 00:02:05,840 --> 00:02:07,880 Speaker 1: me want to do a podcast on rabies and the 33 00:02:07,960 --> 00:02:11,720 Speaker 1: vaccine that prevents it, something that somehow I thought we 34 00:02:11,800 --> 00:02:14,760 Speaker 1: already had stuff on. We don't, or if we do, 35 00:02:14,840 --> 00:02:18,359 Speaker 1: I failed to find it. The vast majority of our 36 00:02:18,400 --> 00:02:22,880 Speaker 1: listeners live in places where rabies deaths and humans are 37 00:02:23,120 --> 00:02:26,760 Speaker 1: extremely rare. Some parts of the world are rabies free, 38 00:02:27,040 --> 00:02:29,680 Speaker 1: and here in the United States there were only five 39 00:02:29,880 --> 00:02:34,040 Speaker 1: human deaths from rabies and twenty twenty one that was 40 00:02:34,080 --> 00:02:37,200 Speaker 1: the highest number of annual rabies deaths in the United 41 00:02:37,240 --> 00:02:40,239 Speaker 1: States in a decade. There are also places, though, where 42 00:02:40,320 --> 00:02:44,760 Speaker 1: rabies is still endemic, and globally about fifty six thousand 43 00:02:44,800 --> 00:02:47,240 Speaker 1: people die from it every year. That is a not 44 00:02:48,160 --> 00:02:51,320 Speaker 1: a like. That's a small number compared to something like 45 00:02:51,400 --> 00:02:56,680 Speaker 1: the current pandemic, but they're fifty six thousand totally preventable deaths, 46 00:02:56,880 --> 00:02:59,360 Speaker 1: like we have right what we need to prevent this, 47 00:03:00,000 --> 00:03:02,360 Speaker 1: so I want to talk about that adds up though 48 00:03:02,680 --> 00:03:08,400 Speaker 1: there's a lot of animal experimentation in this episode and deaths. Obviously, 49 00:03:09,200 --> 00:03:13,640 Speaker 1: Rabi's is caused by Rabi's lyssavirus, which probably originated in 50 00:03:13,760 --> 00:03:17,959 Speaker 1: Old World bats. This virus has existed on every continent 51 00:03:18,080 --> 00:03:22,639 Speaker 1: except Antarctica and Australia for millennia, and although Australia is 52 00:03:22,760 --> 00:03:26,640 Speaker 1: Raybi's free, it's home to a closely related virus called 53 00:03:26,840 --> 00:03:30,720 Speaker 1: bat Lissa virus. But in spite of the virus's connection 54 00:03:30,800 --> 00:03:35,240 Speaker 1: to bats, humanity's connection to Rabi's has mainly been through dogs. 55 00:03:35,800 --> 00:03:39,040 Speaker 1: That connection shows up in the first written reference we 56 00:03:39,160 --> 00:03:43,480 Speaker 1: have of rabies, that's in the Eshnuna code from roughly 57 00:03:43,520 --> 00:03:48,080 Speaker 1: two thousand BCE. Eshnuno was a city in what's now Iraq, 58 00:03:48,200 --> 00:03:50,840 Speaker 1: and some of its laws have survived on a pair 59 00:03:50,880 --> 00:03:54,200 Speaker 1: of broken tablets that were found at an archaeological site 60 00:03:54,280 --> 00:03:57,960 Speaker 1: near Baghdad. Here's one of the laws quote if a 61 00:03:58,080 --> 00:04:01,160 Speaker 1: dog is mad, and the authority have brought the fact 62 00:04:01,280 --> 00:04:03,760 Speaker 1: to the knowledge of its owner, if he does not 63 00:04:03,920 --> 00:04:06,200 Speaker 1: keep it in, and it bites a man and causes 64 00:04:06,240 --> 00:04:09,720 Speaker 1: his death, then the owner shall pay two thirds of 65 00:04:09,760 --> 00:04:12,840 Speaker 1: a mina of silver. If it bites a slave and 66 00:04:12,920 --> 00:04:16,320 Speaker 1: causes his death, he shall pay fifteen shekels of silver. 67 00:04:16,920 --> 00:04:20,479 Speaker 1: The first written reference to rabies in China is from 68 00:04:20,480 --> 00:04:24,919 Speaker 1: the Zuo tradition, sometimes called the Zoo Commentary. This is 69 00:04:24,960 --> 00:04:28,320 Speaker 1: a commentary on the Spring and Autumn Annals, which chronicles 70 00:04:28,320 --> 00:04:31,360 Speaker 1: a period of Chinese history stretching from seven twenty two 71 00:04:31,440 --> 00:04:35,520 Speaker 1: to four eighty one BC. One passage in the Tzuo 72 00:04:35,560 --> 00:04:39,599 Speaker 1: tradition describes people of the capital city of Sung chasing 73 00:04:39,600 --> 00:04:42,919 Speaker 1: a rabid dog. The dog ran into the home of 74 00:04:42,960 --> 00:04:46,360 Speaker 1: a minister named Huachen, and the people chased after it. 75 00:04:46,880 --> 00:04:50,520 Speaker 1: Quachen was afraid and fled the city. In about the 76 00:04:50,640 --> 00:04:55,480 Speaker 1: fourth century BCE, Aristotle wrote this in his History of Animals. 77 00:04:55,560 --> 00:05:01,479 Speaker 1: Quote dogs suffer from three diseases, es, quincy, and sore feet. 78 00:05:02,279 --> 00:05:06,640 Speaker 1: Rabies drives the animal mad, and any animal whatever, excepting man, 79 00:05:06,720 --> 00:05:10,040 Speaker 1: will take the disease if bitten by a dog so afflicted, 80 00:05:10,680 --> 00:05:14,080 Speaker 1: the disease is fatal to the dog itself and to 81 00:05:14,240 --> 00:05:18,760 Speaker 1: any animal it may bite. Man accepted. So this translation 82 00:05:18,920 --> 00:05:22,200 Speaker 1: makes it sound like Aristotle was saying that humans don't 83 00:05:22,200 --> 00:05:25,400 Speaker 1: get rabies, but it's also been interpreted as meaning that 84 00:05:25,440 --> 00:05:29,040 Speaker 1: people don't always develop rabies when bitten by a rabid dog, 85 00:05:29,080 --> 00:05:32,320 Speaker 1: and that is true, or that people don't always die 86 00:05:32,360 --> 00:05:35,200 Speaker 1: from the disease if they contract it, which is almost 87 00:05:35,240 --> 00:05:38,880 Speaker 1: never true. People have known that rabies was essentially always 88 00:05:38,920 --> 00:05:43,520 Speaker 1: fatal for thousands of years, though Roman court physicians Scribonius 89 00:05:43,640 --> 00:05:47,960 Speaker 1: largest described rabies as incurable in the first century CE. 90 00:05:48,560 --> 00:05:52,600 Speaker 1: In addition to being lethal, rabies progresses in a way 91 00:05:52,640 --> 00:05:56,119 Speaker 1: that can be really terrifying. The exact symptoms can vary, 92 00:05:56,160 --> 00:05:59,680 Speaker 1: but there are two broad categories, both of which end 93 00:05:59,760 --> 00:06:06,680 Speaker 1: in coma and death. Paralytic rabies involves lethargy, weakness, and paralysis, 94 00:06:06,720 --> 00:06:12,960 Speaker 1: and furious rabies involves agitation, aggression, and hyperactivity. The word 95 00:06:13,200 --> 00:06:17,040 Speaker 1: rabies reflects this latter type that comes from the Latin 96 00:06:17,160 --> 00:06:20,240 Speaker 1: for two rage, which may have roots in a Sanskrit 97 00:06:20,279 --> 00:06:24,920 Speaker 1: word meaning to do violence. Lisavirus has a similar root. 98 00:06:25,000 --> 00:06:28,960 Speaker 1: It comes from a Greek word meaning frenzy or madness, 99 00:06:29,320 --> 00:06:32,120 Speaker 1: which was used to describe rabies as well as to 100 00:06:32,160 --> 00:06:37,000 Speaker 1: describe irrational rage. Rabi shows up a lot in popular culture, 101 00:06:37,160 --> 00:06:40,280 Speaker 1: and that goes back thousands of years as well, including 102 00:06:40,279 --> 00:06:43,080 Speaker 1: the use of rabies or rabid dogs as a metaphor 103 00:06:43,520 --> 00:06:47,560 Speaker 1: for being mad or uncontrollable. For example, in the Iliad, 104 00:06:47,600 --> 00:06:51,080 Speaker 1: which was written in about the eighth century BCE, Homer 105 00:06:51,160 --> 00:06:55,760 Speaker 1: describes Hector as a rabid dog. Rabies can also cause 106 00:06:55,839 --> 00:06:59,800 Speaker 1: paralysis and spasms in the throat that make it impossible 107 00:06:59,839 --> 00:07:04,120 Speaker 1: to swallow water. That's why it's also known as hydrophobia. 108 00:07:04,720 --> 00:07:08,599 Speaker 1: In the second century CE, Roman philosopher Celsus used the 109 00:07:08,600 --> 00:07:13,360 Speaker 1: word hydrophobia in his description of the disease. Celsus also 110 00:07:13,520 --> 00:07:19,120 Speaker 1: recognized that something was present in saliva that transmitted this illness, 111 00:07:19,200 --> 00:07:22,200 Speaker 1: and he recommended a range of techniques to draw this 112 00:07:22,440 --> 00:07:26,600 Speaker 1: substance out of wounds. Like the connection between Rabi's and 113 00:07:26,680 --> 00:07:30,720 Speaker 1: aggressive rage, the connection between rabies and hydrophobia made its 114 00:07:30,760 --> 00:07:34,640 Speaker 1: way into literature centuries ago. For example, in about the 115 00:07:34,720 --> 00:07:39,240 Speaker 1: year five hundred, Kayleius Aurelianus suggested that Homer's description of 116 00:07:39,320 --> 00:07:43,480 Speaker 1: Tantalus in the Odyssey might have been inspired by rabies, 117 00:07:43,560 --> 00:07:47,320 Speaker 1: since Tantalus is tormented by water that he cannot drink. 118 00:07:48,120 --> 00:07:52,480 Speaker 1: It's also possible that rabies influenced ancient Greek depictions of Cerberus, 119 00:07:52,520 --> 00:07:55,680 Speaker 1: the multi headed dog that guarded the underworld, and that 120 00:07:55,760 --> 00:07:59,240 Speaker 1: those depictions of a mad beast with poisoned frothing from 121 00:07:59,280 --> 00:08:03,800 Speaker 1: its jaws circled back to influence people's perceptions of rabies. 122 00:08:04,400 --> 00:08:08,000 Speaker 1: So through these and other written references, we know that 123 00:08:08,240 --> 00:08:13,560 Speaker 1: rabies had spread from wherever it originated, all through India, China, 124 00:08:13,680 --> 00:08:17,560 Speaker 1: the Middle East, Greece, Rome, and Egypt by about fifteen 125 00:08:17,680 --> 00:08:20,840 Speaker 1: hundred years ago, but we don't really know how wide 126 00:08:20,920 --> 00:08:23,560 Speaker 1: spread the disease was in any of these places, or 127 00:08:23,600 --> 00:08:26,920 Speaker 1: how many deaths it caused among humans and other animals. 128 00:08:27,600 --> 00:08:30,720 Speaker 1: That starts to change in the medieval period, when people 129 00:08:30,760 --> 00:08:35,800 Speaker 1: started documenting large outbreaks of the disease within specific animals. 130 00:08:36,120 --> 00:08:40,480 Speaker 1: These accounts primarily focused on outbreaks among dogs and other canids, 131 00:08:40,520 --> 00:08:44,760 Speaker 1: including wolves and foxes. For example, an outbreak of wolf 132 00:08:44,840 --> 00:08:49,679 Speaker 1: raybies struck Franconia in twelve seventy one. A massive outbreak 133 00:08:49,679 --> 00:08:52,800 Speaker 1: among red foxes spread over parts of Europe between fifteen 134 00:08:52,880 --> 00:08:56,320 Speaker 1: seventy one and fifteen eighty one, leading people to try 135 00:08:56,360 --> 00:09:00,520 Speaker 1: to stop the disease by culling them. Sometimes these outbreaks 136 00:09:00,600 --> 00:09:03,959 Speaker 1: could spread to other animals, including infecting people when they 137 00:09:03,960 --> 00:09:07,800 Speaker 1: were bitten. At this point, we haven't mentioned rabies in 138 00:09:07,880 --> 00:09:12,040 Speaker 1: the Americas, and that's because while rabies existed in the 139 00:09:12,120 --> 00:09:17,120 Speaker 1: Americas through all this, rabid dogs probably did not, based 140 00:09:17,160 --> 00:09:21,640 Speaker 1: on genetic studies of the virus itself. Before European colonization, 141 00:09:22,080 --> 00:09:27,240 Speaker 1: rabies in the America's primarily infected bats and skunks. There's 142 00:09:27,280 --> 00:09:30,880 Speaker 1: some evidence that indigenous peoples in ancient Central and South 143 00:09:30,880 --> 00:09:35,559 Speaker 1: America regarded both bat bites and snake bites as potentially 144 00:09:35,640 --> 00:09:40,000 Speaker 1: dangerous and treated bat bites with washing and cauterization with 145 00:09:40,120 --> 00:09:44,840 Speaker 1: hot coals to try to prevent disease. Spanish colonists were 146 00:09:44,840 --> 00:09:48,840 Speaker 1: reported being bitten by bats in the early fifteen hundreds, 147 00:09:48,840 --> 00:09:53,360 Speaker 1: and in fifteen fourteen, Fernandez de Oviedo wrote about several 148 00:09:53,440 --> 00:09:58,440 Speaker 1: soldiers dying after being bitten by vampire bats. Dog rabies 149 00:09:58,600 --> 00:10:02,280 Speaker 1: is one of many diseases that Europeans introduced to the Americas, 150 00:10:02,720 --> 00:10:05,760 Speaker 1: and after that introduction it spread to other animals and 151 00:10:05,800 --> 00:10:09,840 Speaker 1: became far more likely to infect people, but that process 152 00:10:09,920 --> 00:10:12,920 Speaker 1: did not happen nearly as quickly with rabies as it 153 00:10:12,960 --> 00:10:17,520 Speaker 1: did with diseases like smallpox. Rabies typically has an incubation 154 00:10:17,640 --> 00:10:20,320 Speaker 1: period of roughly three to eight weeks, although it can 155 00:10:20,400 --> 00:10:25,360 Speaker 1: occasionally be much longer. Once symptoms appear, rabies is virtually 156 00:10:25,520 --> 00:10:29,880 Speaker 1: always fatal within about ten days. When Europeans first started 157 00:10:29,920 --> 00:10:32,800 Speaker 1: sailing to the Americas, the voyage often took more than 158 00:10:32,840 --> 00:10:36,280 Speaker 1: two months, so any dogs or other animals that had 159 00:10:36,280 --> 00:10:40,720 Speaker 1: been infected before setting sail usually developed symptoms and died 160 00:10:40,840 --> 00:10:43,800 Speaker 1: or were killed while still at sea. So that meant 161 00:10:43,840 --> 00:10:48,120 Speaker 1: introducing dog rabies to the Americas required a voyage that 162 00:10:48,320 --> 00:10:52,400 Speaker 1: was short enough for infected dogs to survive. It also 163 00:10:52,559 --> 00:10:56,520 Speaker 1: required a large enough population of dogs and other mammals 164 00:10:56,559 --> 00:11:00,199 Speaker 1: within a colony for the disease to keep circulating that 165 00:11:00,280 --> 00:11:05,160 Speaker 1: had been introduced. The first recorded outbreak of dog rabies 166 00:11:05,240 --> 00:11:08,600 Speaker 1: in the Americas was reported in Mexico City in seventeen 167 00:11:08,640 --> 00:11:11,160 Speaker 1: oh nine, and by the end of the eighteenth century, 168 00:11:11,240 --> 00:11:14,640 Speaker 1: dog rabies was widespread in most of the places in 169 00:11:14,679 --> 00:11:19,400 Speaker 1: the Americas that Europeans had colonized. This in turn spread 170 00:11:19,480 --> 00:11:23,120 Speaker 1: the disease to the continent's native animals, with some of 171 00:11:23,160 --> 00:11:26,200 Speaker 1: those exposures leading to new strains of the virus that 172 00:11:26,240 --> 00:11:30,160 Speaker 1: were adapted to specific species. We'll talk about how a 173 00:11:30,240 --> 00:11:33,840 Speaker 1: vaccine was developed to prevent rabies after a sponsor break. 174 00:11:43,160 --> 00:11:46,880 Speaker 1: By the eighteenth and nineteenth centuries, outbreaks of rabies were 175 00:11:46,920 --> 00:11:50,040 Speaker 1: spread across a lot of the world, in domesticated dogs 176 00:11:50,080 --> 00:11:54,000 Speaker 1: and in wild animals. In North America, rabies became so 177 00:11:54,120 --> 00:11:57,840 Speaker 1: widespread in skunks that they were nicknamed phobe Cats like 178 00:11:58,000 --> 00:12:01,840 Speaker 1: hydrophobe and phobe hens were advertised as a way for 179 00:12:01,960 --> 00:12:05,080 Speaker 1: cowboys to avoid being bitten by them in their sleep, 180 00:12:05,880 --> 00:12:09,200 Speaker 1: and eighteen oh three, an outbreak among wild foxes in 181 00:12:09,280 --> 00:12:14,480 Speaker 1: France spread to dogs, pigs, and people. Bites from rabid 182 00:12:14,600 --> 00:12:18,480 Speaker 1: wolves tended to be particularly lethal, in part because attacking 183 00:12:18,600 --> 00:12:23,440 Speaker 1: wolves often bit people's faces or necks, meaning the virus 184 00:12:23,559 --> 00:12:27,040 Speaker 1: was way closer to their brain, while rabid dogs usually 185 00:12:27,080 --> 00:12:30,480 Speaker 1: bit people's hands or arms. There was no cure for 186 00:12:30,600 --> 00:12:33,160 Speaker 1: rabies and no way to tell whether a person would 187 00:12:33,160 --> 00:12:36,520 Speaker 1: develop it after being bitten, and estimates of how many 188 00:12:36,520 --> 00:12:39,800 Speaker 1: people developed rabies after a bite stretch all the way 189 00:12:39,840 --> 00:12:43,640 Speaker 1: from five percent to fifty percent. Some of this is 190 00:12:44,080 --> 00:12:47,480 Speaker 1: just because of imprecise record keeping, but it's also connected 191 00:12:47,520 --> 00:12:51,360 Speaker 1: to how people responded to the disease. In many places, 192 00:12:51,400 --> 00:12:54,520 Speaker 1: there was a widespread assumption that any animal that bit 193 00:12:54,800 --> 00:12:58,440 Speaker 1: had rabies, and during outbreaks, people tended to hunt down 194 00:12:58,480 --> 00:13:01,400 Speaker 1: and kill animals that they thought might be spreading disease. 195 00:13:02,040 --> 00:13:04,360 Speaker 1: So a dog that bit someone in the midst of 196 00:13:04,440 --> 00:13:07,280 Speaker 1: all of this might be rabid, or it might just 197 00:13:07,360 --> 00:13:11,240 Speaker 1: be scared and cornered and trying to defend itself. Around 198 00:13:11,240 --> 00:13:15,200 Speaker 1: the world, people tried various herbs and medical preparations to 199 00:13:15,320 --> 00:13:18,959 Speaker 1: prevent or cure rabies, and because it was so lethal, 200 00:13:19,480 --> 00:13:23,880 Speaker 1: many of these also relied on the idea of divine intervention. 201 00:13:24,760 --> 00:13:28,520 Speaker 1: For example, Hubertus, also called Saint Hubert, is the patron 202 00:13:28,600 --> 00:13:32,680 Speaker 1: saint of hunting, and one of his reported miracles involved 203 00:13:32,800 --> 00:13:35,600 Speaker 1: curing somebody who had been bitten by a rabid dog. 204 00:13:36,280 --> 00:13:39,040 Speaker 1: So in much of Europe, people used a piece of 205 00:13:39,240 --> 00:13:44,360 Speaker 1: iron called Saint Hubert's key to cauterize bite wounds. As 206 00:13:44,400 --> 00:13:46,960 Speaker 1: part of this treatment, a priest would also make a 207 00:13:47,000 --> 00:13:51,320 Speaker 1: shallow cut over a person's forehead, place a black bandage 208 00:13:51,360 --> 00:13:54,240 Speaker 1: over that, and the person wore that bandage for nine days. 209 00:13:54,760 --> 00:13:57,480 Speaker 1: Some people even carried one of these keys around with 210 00:13:57,600 --> 00:14:01,160 Speaker 1: them for protection. Long before the development of the germ 211 00:14:01,200 --> 00:14:04,480 Speaker 1: theory of disease, people recognized that when someone was bitten 212 00:14:04,520 --> 00:14:08,440 Speaker 1: by a rabid animal, something in the animal's saliva was 213 00:14:08,480 --> 00:14:12,280 Speaker 1: going into the wound and potentially causing rabies. So some 214 00:14:12,400 --> 00:14:15,319 Speaker 1: of the other treatments for bites involved washing the wound, 215 00:14:15,720 --> 00:14:19,400 Speaker 1: applying caustic chemicals to it, or cauterizing it, whether it 216 00:14:19,440 --> 00:14:22,640 Speaker 1: was with a Saint Hubertus's key or with some other implement. 217 00:14:23,400 --> 00:14:27,160 Speaker 1: If these treatments were done immediately after a person was bitten, 218 00:14:27,600 --> 00:14:30,720 Speaker 1: they may have helped reduce the chance of developing rabies 219 00:14:30,720 --> 00:14:35,520 Speaker 1: by washing away the animals infected saliva. Thoroughly washing the 220 00:14:35,560 --> 00:14:39,520 Speaker 1: wound is still step one in rabies prevention today, but 221 00:14:39,680 --> 00:14:42,440 Speaker 1: none of this was enough to totally prevent the chance 222 00:14:42,480 --> 00:14:46,320 Speaker 1: of developing the fatal disease. People also tried to prevent 223 00:14:46,440 --> 00:14:50,120 Speaker 1: rabies by reducing the numbers of animals that could carry 224 00:14:50,120 --> 00:14:53,080 Speaker 1: it and transmit it to humans and to other animals. 225 00:14:53,560 --> 00:14:56,840 Speaker 1: For example, in eighteen sixty seven, the UK passed the 226 00:14:56,920 --> 00:15:01,800 Speaker 1: Metropolitan Streets Act. Among other things, this act empowered police 227 00:15:01,840 --> 00:15:05,360 Speaker 1: to collect and muzzle stray dogs, are dogs that were 228 00:15:05,360 --> 00:15:09,080 Speaker 1: determined to be dangerous. This reportedly led to a drop 229 00:15:09,120 --> 00:15:12,960 Speaker 1: in human cases of rabies in British cities. Also in 230 00:15:13,000 --> 00:15:17,200 Speaker 1: the eighteenth and nineteenth centuries, researchers were learning about rabies 231 00:15:17,240 --> 00:15:20,480 Speaker 1: and working on ways to prevent it spread. During the 232 00:15:20,560 --> 00:15:23,560 Speaker 1: earlier part of this time, researchers didn't yet know what 233 00:15:23,640 --> 00:15:27,160 Speaker 1: a virus was. But trying to talk around that got 234 00:15:27,240 --> 00:15:29,440 Speaker 1: really clunky. So we are still going to call it 235 00:15:29,560 --> 00:15:33,440 Speaker 1: a virus in our discussion today. Yeah, it was a 236 00:15:33,480 --> 00:15:36,200 Speaker 1: lot of incredibly stilted sentences before I was like, we're 237 00:15:36,240 --> 00:15:40,040 Speaker 1: just calling it a virus, regardless of whether that individual 238 00:15:40,080 --> 00:15:44,520 Speaker 1: researcher knew what a virus was. So in seventeen sixty nine, 239 00:15:44,760 --> 00:15:50,480 Speaker 1: Italian anatomist and pathologist John MORGANI observed that rabies traveled 240 00:15:50,560 --> 00:15:54,920 Speaker 1: via the nerves rather than traveling through the bloodstream. He 241 00:15:55,040 --> 00:15:58,320 Speaker 1: made this connection because some patients reported a feeling of 242 00:15:58,440 --> 00:16:02,600 Speaker 1: pins and needles or other neurological disturbances around the site 243 00:16:02,600 --> 00:16:07,000 Speaker 1: of their original bite wound. MORGANNYU was correct. Once it 244 00:16:07,280 --> 00:16:11,160 Speaker 1: enters the body. The rabies virus moves along the nerves 245 00:16:11,240 --> 00:16:13,040 Speaker 1: until it gets to the brain and the rest of 246 00:16:13,040 --> 00:16:16,120 Speaker 1: the central nervous system. After it gets to the brain, 247 00:16:16,280 --> 00:16:19,320 Speaker 1: the rabies virus makes its way to the salivary glands, 248 00:16:19,360 --> 00:16:23,880 Speaker 1: where it can cause excessive salivation. And although eighteenth century 249 00:16:23,920 --> 00:16:27,440 Speaker 1: researchers didn't quite have that part figured out, they did 250 00:16:27,560 --> 00:16:31,160 Speaker 1: know that the disease was spread through saliva. In seventeen 251 00:16:31,240 --> 00:16:35,040 Speaker 1: ninety three, Scottish surgeon John Hunter speculated that it would 252 00:16:35,040 --> 00:16:38,400 Speaker 1: be possible to use a lancet to intentionally introduce an 253 00:16:38,400 --> 00:16:42,960 Speaker 1: infected animal saliva into another animal, but it's not clear 254 00:16:43,000 --> 00:16:46,440 Speaker 1: whether he tried this in practice. We also don't know 255 00:16:46,480 --> 00:16:51,960 Speaker 1: whether German naturalist George Gottfried Zinka was familiar with Hunter's work, 256 00:16:52,040 --> 00:16:56,120 Speaker 1: but in eighteen oh four he brushed saliva from a 257 00:16:56,240 --> 00:16:59,120 Speaker 1: rabbit dog onto a cut he had made in the 258 00:16:59,200 --> 00:17:03,160 Speaker 1: leg of a health the dog. This previously healthy dog 259 00:17:03,360 --> 00:17:07,800 Speaker 1: contracted rabies. He did the same thing with other healthy mammals, 260 00:17:07,840 --> 00:17:10,480 Speaker 1: demonstrating that it was possible for the bite of an 261 00:17:10,480 --> 00:17:14,719 Speaker 1: infected dog to infect animals of other species. In eighteen 262 00:17:14,760 --> 00:17:20,160 Speaker 1: twenty one, French neurophysiologist Francois Magendi reported that he had 263 00:17:20,200 --> 00:17:24,720 Speaker 1: infected a previously healthy dog with saliva from a person 264 00:17:24,880 --> 00:17:29,199 Speaker 1: who had contracted rabies. Victor Gaultier was a professor at 265 00:17:29,200 --> 00:17:32,919 Speaker 1: the National Veterinary School in Lyon, France, and he started 266 00:17:33,000 --> 00:17:37,399 Speaker 1: experimenting with rabies in eighteen seventy nine. He found that 267 00:17:37,440 --> 00:17:39,960 Speaker 1: it was possible to transmit rabies from a dog to 268 00:17:40,080 --> 00:17:43,240 Speaker 1: a rabbit, and then from that rabbit to another rabbit. 269 00:17:44,160 --> 00:17:47,159 Speaker 1: Rabbits were smaller and easier to keep than dogs, and 270 00:17:47,200 --> 00:17:50,920 Speaker 1: they were less dangerous research subjects than rabbit dogs were. 271 00:17:51,800 --> 00:17:54,840 Speaker 1: Gaultier also found that the rabbits had a shorter incubation 272 00:17:55,000 --> 00:17:58,200 Speaker 1: period of about eighteen days rather than a month or 273 00:17:58,240 --> 00:18:01,040 Speaker 1: more that you might see in a dog. Gualtier did 274 00:18:01,160 --> 00:18:06,040 Speaker 1: various experiments with infected animal's saliva, attempting to see whether 275 00:18:06,119 --> 00:18:09,600 Speaker 1: he could find some way of using this infectious material 276 00:18:09,680 --> 00:18:13,600 Speaker 1: to prevent rabies. In eighteen eighty one, he injected rabies 277 00:18:13,680 --> 00:18:17,400 Speaker 1: virus into the jugular veins of sheep and they didn't 278 00:18:17,440 --> 00:18:20,280 Speaker 1: develop rabies, And then when he exposed one of them 279 00:18:20,320 --> 00:18:23,960 Speaker 1: to saliva from a rabid dog later on, it seemed 280 00:18:23,960 --> 00:18:27,320 Speaker 1: like it was immune to the disease. French chemist and 281 00:18:27,359 --> 00:18:31,159 Speaker 1: microbiologist Louis Pasteur started working on rabies at about this 282 00:18:31,280 --> 00:18:36,000 Speaker 1: same time, and he was inspired by Gautier's success. Pastor 283 00:18:36,119 --> 00:18:39,000 Speaker 1: already had an extensive background in this kind of work. 284 00:18:39,359 --> 00:18:43,000 Speaker 1: In the eighteen fifties, he had studied yeast and alcohol fermentation, 285 00:18:43,480 --> 00:18:47,920 Speaker 1: as well as the ability for microorganisms to contaminate fermenting beverages. 286 00:18:48,840 --> 00:18:51,880 Speaker 1: This had contributed to both the germ theory of disease 287 00:18:52,040 --> 00:18:56,119 Speaker 1: and the development of pasteurization. In the eighteen sixties, he 288 00:18:56,119 --> 00:18:59,760 Speaker 1: had identified a microorganism that was devastating the French silk 289 00:18:59,760 --> 00:19:03,240 Speaker 1: in day, and in the eighteen seventies he studied animal 290 00:19:03,280 --> 00:19:08,480 Speaker 1: diseases like anthrax and chicken cholera, including developing an anthrax vaccine. 291 00:19:09,160 --> 00:19:12,640 Speaker 1: While Pasteur had lots of experience in this kind of research, 292 00:19:12,760 --> 00:19:16,520 Speaker 1: he had pretty much no experience in medicine or the 293 00:19:16,520 --> 00:19:20,639 Speaker 1: clinical treatment of patience, so he relied on other people 294 00:19:20,720 --> 00:19:24,959 Speaker 1: for this knowledge, including French physician and bacteriologist Emil Roux. 295 00:19:25,840 --> 00:19:29,600 Speaker 1: A whole team of other scientists and doctors were involved 296 00:19:29,600 --> 00:19:34,000 Speaker 1: in this work as well, including Chiles Chamberlain, Emil Duclaux, 297 00:19:34,440 --> 00:19:39,119 Speaker 1: Luis Jullier, and Joseph Granche. This is definitely not a 298 00:19:39,200 --> 00:19:43,280 Speaker 1: solo effort, and Pasteur was not always excited about crediting 299 00:19:43,320 --> 00:19:46,760 Speaker 1: other people for their involvement in it. There are even 300 00:19:46,800 --> 00:19:50,679 Speaker 1: some historians who have accused him of stealing other people's ideas. 301 00:19:51,280 --> 00:19:55,520 Speaker 1: Much of Pastor's previous work had involved culturing bacteria and 302 00:19:55,560 --> 00:19:58,560 Speaker 1: working from those cultures, and he started out trying to 303 00:19:58,560 --> 00:20:01,760 Speaker 1: do the same thing with Rabi's. Since Rabi's is caused 304 00:20:01,760 --> 00:20:05,240 Speaker 1: by a virus rather than a bacterium, Pastor's efforts to 305 00:20:05,320 --> 00:20:10,000 Speaker 1: replicate his earlier process failed. He started working directly with 306 00:20:10,080 --> 00:20:13,119 Speaker 1: the saliva of infected animals and then moved on to 307 00:20:13,200 --> 00:20:16,560 Speaker 1: working with central nervous system matter. He found that if 308 00:20:16,560 --> 00:20:20,480 Speaker 1: he exposed a healthy rabbit to rabies, it developed rabies. 309 00:20:20,800 --> 00:20:24,320 Speaker 1: Then if he used that rabbit's central nervous system matter 310 00:20:24,400 --> 00:20:29,280 Speaker 1: to expose another rabbit, that second rabbit also developed rabies, 311 00:20:29,720 --> 00:20:32,960 Speaker 1: and the second rabbit's infection seemed to be more virulent 312 00:20:33,080 --> 00:20:36,040 Speaker 1: than the first. If he did this a third time, 313 00:20:36,200 --> 00:20:40,159 Speaker 1: the third rabbit's infection was also more virulent than the 314 00:20:40,240 --> 00:20:45,000 Speaker 1: seconds had been. He continued this serial passage of the 315 00:20:45,119 --> 00:20:48,119 Speaker 1: virus from rabbit to rabbit until he had a strain 316 00:20:48,200 --> 00:20:52,600 Speaker 1: of it that he described as fixed. It was consistent 317 00:20:52,760 --> 00:20:55,840 Speaker 1: and how virulent it was, and it had an incubation 318 00:20:56,040 --> 00:20:59,600 Speaker 1: period that was set at six or seven days. From there, 319 00:21:00,000 --> 00:21:03,120 Speaker 1: mastor Air dried the spinal cords of rabbits that had 320 00:21:03,200 --> 00:21:07,720 Speaker 1: died of that highly virulent fixed strain. The longer they dried, 321 00:21:07,800 --> 00:21:11,240 Speaker 1: the weaker the virus became. That's a process called attenuation. 322 00:21:12,080 --> 00:21:15,199 Speaker 1: When he exposed other animals to a small amount of 323 00:21:15,200 --> 00:21:19,159 Speaker 1: this attenuated virus, they seemed to develop a resistance to 324 00:21:19,240 --> 00:21:23,679 Speaker 1: rabies rather than becoming ill. From there, Pastors started to 325 00:21:23,760 --> 00:21:26,600 Speaker 1: wonder whether it was possible to make an animal more 326 00:21:26,640 --> 00:21:30,680 Speaker 1: resistant to rabies after it had already been bitten, preventing 327 00:21:30,720 --> 00:21:34,840 Speaker 1: it from developing the disease. Having successfully tested out this 328 00:21:35,000 --> 00:21:38,040 Speaker 1: idea in dogs, he tried it on two people, but 329 00:21:38,160 --> 00:21:41,719 Speaker 1: he didn't publish on either of these attempts, so they 330 00:21:41,760 --> 00:21:45,040 Speaker 1: were not known about until much later. One of these 331 00:21:45,160 --> 00:21:47,040 Speaker 1: was a man who had been bitten by a dog, 332 00:21:47,160 --> 00:21:50,320 Speaker 1: and while this man survived, it's also likely that he 333 00:21:50,400 --> 00:21:53,720 Speaker 1: had not actually been exposed to rabies. The other was 334 00:21:53,720 --> 00:21:56,320 Speaker 1: an eleven year old girl who had been bitten in 335 00:21:56,400 --> 00:21:59,480 Speaker 1: the face by a puppy, and she had already started 336 00:21:59,520 --> 00:22:03,200 Speaker 1: developing rabies symptoms. She died the day after she was 337 00:22:03,240 --> 00:22:07,200 Speaker 1: given the treatment. On July fourth, eighteen eighty five, nine 338 00:22:07,280 --> 00:22:10,560 Speaker 1: year old Joseph Meister was repeatedly bitten by a dog 339 00:22:10,600 --> 00:22:14,199 Speaker 1: in Alces. The dog was believed to be rabid, and 340 00:22:14,240 --> 00:22:17,200 Speaker 1: two days later the child was brought to Pest for help. 341 00:22:17,880 --> 00:22:21,159 Speaker 1: Emil rou had been heavily involved in Pester's research up 342 00:22:21,160 --> 00:22:23,600 Speaker 1: to this point, and he refused to be involved in 343 00:22:23,640 --> 00:22:28,119 Speaker 1: the boy's treatment because of ethical concerns. Pastor expressed some 344 00:22:28,160 --> 00:22:32,159 Speaker 1: reluctance as well, but Joseph Groanche and Alfred Vaupien of 345 00:22:32,200 --> 00:22:36,280 Speaker 1: the Academy de Medcent encouraged him to try, with Granche 346 00:22:36,440 --> 00:22:40,719 Speaker 1: administering the treatment since Pastor was not a doctor, Joseph 347 00:22:40,840 --> 00:22:43,840 Speaker 1: was given a series of inoculations over the span of 348 00:22:43,960 --> 00:22:48,440 Speaker 1: ten days, starting with a very weak preparation and working 349 00:22:48,560 --> 00:22:52,560 Speaker 1: up through ones that were less and less attenuated. Three 350 00:22:52,600 --> 00:22:56,359 Speaker 1: months later, he had no sign of rabies. Another attempt 351 00:22:56,400 --> 00:22:59,440 Speaker 1: was started with another patient shortly after Joseph Meister was 352 00:22:59,480 --> 00:23:03,320 Speaker 1: declared to be in the clear. That was Jean Baptiste Jupelee, 353 00:23:03,359 --> 00:23:06,560 Speaker 1: a fourteen year old shepherd who had been mauled while 354 00:23:06,640 --> 00:23:10,560 Speaker 1: saving a group of younger boys from a dog. Pastor 355 00:23:10,680 --> 00:23:13,600 Speaker 1: reported his results to the French Academy of Science on 356 00:23:13,640 --> 00:23:17,639 Speaker 1: October twenty sixth, eighteen eighty five, while Jupeel's treatment was 357 00:23:17,680 --> 00:23:21,600 Speaker 1: still ongoing. Told about his success with Joseph Meister and 358 00:23:21,680 --> 00:23:25,639 Speaker 1: the fact that he had successfully inoculated fifty dogs against 359 00:23:25,760 --> 00:23:29,080 Speaker 1: rabies before trying this process on a human. We're going 360 00:23:29,160 --> 00:23:31,600 Speaker 1: to talk more about what happened with all of this 361 00:23:31,760 --> 00:23:43,439 Speaker 1: after we paused for a quick sponsor break. As a 362 00:23:43,440 --> 00:23:47,159 Speaker 1: word of Pastor's success at preventing rabies started to spread, 363 00:23:47,320 --> 00:23:51,080 Speaker 1: people started flocking to him for treatment. By the start 364 00:23:51,080 --> 00:23:53,960 Speaker 1: of eighteen eighty six, he had treated at least three 365 00:23:54,119 --> 00:23:58,080 Speaker 1: hundred and fifty people. They came from all over Europe 366 00:23:58,240 --> 00:24:01,760 Speaker 1: and from the United States. In early December of eighteen 367 00:24:01,800 --> 00:24:05,920 Speaker 1: eighty five, a dog bit at least seven other dogs 368 00:24:06,080 --> 00:24:10,600 Speaker 1: and six children in Newark, New Jersey. Word of Pastor's 369 00:24:10,720 --> 00:24:13,080 Speaker 1: work had made it to the US, and a local 370 00:24:13,160 --> 00:24:16,920 Speaker 1: doctor published an appeal for funds to send the boys 371 00:24:16,960 --> 00:24:20,840 Speaker 1: to Paris for treatment. Four of the boys were sent 372 00:24:20,880 --> 00:24:24,399 Speaker 1: to Paris by steamer. The other two were determined to 373 00:24:24,720 --> 00:24:29,600 Speaker 1: not have sufficient injuries to need treatment. American news coverage 374 00:24:29,600 --> 00:24:32,040 Speaker 1: of these boys tripped to Paris and then their return 375 00:24:32,119 --> 00:24:36,080 Speaker 1: to the United States turned rabies vaccine into just a 376 00:24:36,200 --> 00:24:40,840 Speaker 1: media sensation, and three of the boys were displayed at 377 00:24:40,880 --> 00:24:43,880 Speaker 1: the Globe Museum in the Bowery in New York after 378 00:24:43,920 --> 00:24:47,600 Speaker 1: they all got home. Not everyone agreed with what Pasture 379 00:24:47,680 --> 00:24:51,760 Speaker 1: and his team were doing. Anti vivisectionists objected to the 380 00:24:51,840 --> 00:24:54,680 Speaker 1: use of animals in this research, and as we've said, 381 00:24:54,760 --> 00:24:58,400 Speaker 1: not everyone who is bitten by a rabid animal contracts rabies, 382 00:24:58,880 --> 00:25:02,920 Speaker 1: and not every animal who bite someone is rabbid. Since 383 00:25:02,920 --> 00:25:06,000 Speaker 1: there was still not a test for rabies, determining whether 384 00:25:06,040 --> 00:25:08,920 Speaker 1: an animal had it usually involved just waiting to see 385 00:25:08,960 --> 00:25:12,240 Speaker 1: if it died, but that wasn't really possible if it 386 00:25:12,240 --> 00:25:14,880 Speaker 1: had already been killed, or if it just couldn't be found. 387 00:25:15,640 --> 00:25:18,359 Speaker 1: You could also expose a healthy animal to the brain 388 00:25:18,480 --> 00:25:21,439 Speaker 1: or saliva of an animal who had bitten someone, but 389 00:25:21,520 --> 00:25:24,199 Speaker 1: by the time the healthy animal showed any symptoms, it 390 00:25:24,320 --> 00:25:26,840 Speaker 1: was just likely to be too late for the human patient. 391 00:25:27,359 --> 00:25:31,600 Speaker 1: So critics made the point that Pasteur was potentially exposing 392 00:25:31,720 --> 00:25:36,320 Speaker 1: people to rabies for no reason, and that his inoculation 393 00:25:36,680 --> 00:25:40,040 Speaker 1: might cause somebody who had been bitten by a non 394 00:25:40,359 --> 00:25:44,240 Speaker 1: rabid dog to then develop rabies because of their treatment. 395 00:25:44,960 --> 00:25:49,200 Speaker 1: Critics also noted that some of Pasteur's patients did die. 396 00:25:49,480 --> 00:25:53,560 Speaker 1: By November of eighteen eighty six, seventeen hundred patients had 397 00:25:53,600 --> 00:25:58,480 Speaker 1: received rabies injections and ten of them had died. The uncertainty, 398 00:25:58,640 --> 00:26:02,040 Speaker 1: combined with the death to spark a huge amount of 399 00:26:02,040 --> 00:26:05,359 Speaker 1: debate within the medical community about whether what Pasteur was 400 00:26:05,440 --> 00:26:10,159 Speaker 1: doing was ethical or even medically necessary. The Academy de 401 00:26:10,240 --> 00:26:13,280 Speaker 1: Mensa held a meeting on the subject on January eleventh, 402 00:26:13,320 --> 00:26:18,640 Speaker 1: eighteen eighty seven. Although Pastor's critics were vocal, his supporters, 403 00:26:18,720 --> 00:26:23,119 Speaker 1: led by doctor Joseph Gronchet, successfully defended his work. The 404 00:26:23,359 --> 00:26:27,560 Speaker 1: Institute Pasteur was established on June fourth, eighteen eighty seven, 405 00:26:27,640 --> 00:26:30,960 Speaker 1: and it opened on November fourteenth of that year. It 406 00:26:31,040 --> 00:26:35,760 Speaker 1: focused on disease research and on providing rabies vaccine. By 407 00:26:35,800 --> 00:26:39,320 Speaker 1: eighteen ninety eight, more than twenty thousand people had been 408 00:26:39,359 --> 00:26:43,119 Speaker 1: treated at the Pasteur Institute after a possible rabies exposure, 409 00:26:43,160 --> 00:26:46,440 Speaker 1: and only ninety six of them had died, or less 410 00:26:46,480 --> 00:26:50,040 Speaker 1: than half of a percent of patients. To be clear, 411 00:26:50,080 --> 00:26:53,800 Speaker 1: there was a lot about this early version of the 412 00:26:53,920 --> 00:26:57,840 Speaker 1: vaccine that was inherently unsafe. It was basically made from 413 00:26:57,880 --> 00:27:02,679 Speaker 1: animal brain or spinal cordtish. There could for sure be complications, 414 00:27:03,320 --> 00:27:07,720 Speaker 1: but this was still a dramatic improvement over an untreatable 415 00:27:07,880 --> 00:27:13,359 Speaker 1: fatal disease. Discoveries about the rabies virus continued after this point. 416 00:27:13,960 --> 00:27:18,399 Speaker 1: In nineteen oh three, Italian pathologist Aldecci Negri discovered round 417 00:27:18,480 --> 00:27:21,199 Speaker 1: and oval regions in the brains of animals that had 418 00:27:21,280 --> 00:27:25,399 Speaker 1: died of rabies, which he called Negri bodies. At the time, 419 00:27:25,560 --> 00:27:28,040 Speaker 1: he thought they were some kind of parasite, but they 420 00:27:28,119 --> 00:27:31,520 Speaker 1: actually arise as part of the reproductive cycle of the virus. 421 00:27:32,320 --> 00:27:35,960 Speaker 1: This paved the way for the first rabies tests. While 422 00:27:35,960 --> 00:27:39,840 Speaker 1: there are newer methods for detecting rabies in brain matter today, 423 00:27:40,400 --> 00:27:44,480 Speaker 1: negribodies are still sometimes used when those methods are not available. 424 00:27:45,320 --> 00:27:49,800 Speaker 1: The most reliable tests do still involve examining an animal's brain, 425 00:27:49,880 --> 00:27:52,919 Speaker 1: which is why living animals have to be euthanized to 426 00:27:52,960 --> 00:27:57,119 Speaker 1: be tested for rabies. Refinements in the vaccine were also 427 00:27:57,280 --> 00:28:02,040 Speaker 1: in the works. Pastors' methods didn't always produce a consistently 428 00:28:02,119 --> 00:28:05,719 Speaker 1: potent vaccine, and if it was too potent, it could 429 00:28:05,840 --> 00:28:09,880 Speaker 1: cause somebody to contract rabies in the early twentieth century, 430 00:28:10,080 --> 00:28:14,040 Speaker 1: researchers started using phenol to kill the virus rather than 431 00:28:14,200 --> 00:28:19,000 Speaker 1: attenuating it through air drying. Viruses were cultured in tissues 432 00:28:19,040 --> 00:28:22,760 Speaker 1: in nineteen thirty six, which led to tissue cultured vaccines 433 00:28:23,760 --> 00:28:27,800 Speaker 1: rather than using brain matter to make them. Today's rabies 434 00:28:27,880 --> 00:28:31,200 Speaker 1: vaccines are mostly cultured in human cells or in chick 435 00:28:31,320 --> 00:28:36,679 Speaker 1: embryos or some other cellular matter. Although some of Pastor's 436 00:28:36,720 --> 00:28:39,920 Speaker 1: colleagues speculated about whether it would be possible to mass 437 00:28:40,000 --> 00:28:43,240 Speaker 1: vaccinate dogs or other animals and lower the spread of 438 00:28:43,320 --> 00:28:47,280 Speaker 1: rabies to people, serious efforts to do that didn't start 439 00:28:47,360 --> 00:28:51,120 Speaker 1: until decades later, but efforts like that have led to 440 00:28:51,160 --> 00:28:54,640 Speaker 1: the successful eradication of rabies in some parts of the world. 441 00:28:55,560 --> 00:28:58,800 Speaker 1: There are too many rabies free countries today for us 442 00:28:58,840 --> 00:29:01,480 Speaker 1: to try to name them all. They include many islands, 443 00:29:01,480 --> 00:29:06,040 Speaker 1: including many Caribbean islands, the Canary Islands, the Falkland Islands, 444 00:29:06,080 --> 00:29:11,200 Speaker 1: the Galapagos Islands, the UK, Iceland, Japan, and New Zealand. 445 00:29:12,040 --> 00:29:15,800 Speaker 1: Several nations in continental Europe are also considered rabies free, 446 00:29:15,960 --> 00:29:19,080 Speaker 1: including much of Western Europe. We should note, though, that 447 00:29:19,280 --> 00:29:25,520 Speaker 1: rabies free often means rabies free in terrestrial animals. There 448 00:29:25,560 --> 00:29:30,480 Speaker 1: can still be rabies or other lissaviruses in bats, specifically, 449 00:29:30,560 --> 00:29:34,080 Speaker 1: so even if you are somewhere that is considered rabies free, 450 00:29:34,640 --> 00:29:39,640 Speaker 1: being bitten by a bat still warrants medical attention. Just 451 00:29:39,680 --> 00:29:43,240 Speaker 1: in general. Don't touch bats with your bare hands. You 452 00:29:43,240 --> 00:29:45,880 Speaker 1: don't need to be afraid of bats. They're generally pretty 453 00:29:45,920 --> 00:29:47,480 Speaker 1: shy and they're not gonna mess with you if you 454 00:29:47,480 --> 00:29:49,480 Speaker 1: don't mess with them. But like, don't go grab one 455 00:29:49,520 --> 00:29:53,400 Speaker 1: with your hand, which is so hard because they're so cute. 456 00:29:53,440 --> 00:29:55,480 Speaker 1: Not for me because I see one. Like if I 457 00:29:55,520 --> 00:29:57,440 Speaker 1: see a bat somewhere that I don't expect to see 458 00:29:57,440 --> 00:29:59,800 Speaker 1: a bat, I'm like, that bat is definitely a problem. 459 00:30:00,080 --> 00:30:03,920 Speaker 1: I Am not going anywhere near it. I will tell 460 00:30:03,920 --> 00:30:07,040 Speaker 1: a bat story in our behind the scenes. Ok. As 461 00:30:07,080 --> 00:30:09,280 Speaker 1: we said at the top of the show, Rabies is 462 00:30:09,360 --> 00:30:12,000 Speaker 1: still endemic in some parts of the world, including parts 463 00:30:12,040 --> 00:30:16,160 Speaker 1: of Asia and Africa. About forty percent of human rabies 464 00:30:16,240 --> 00:30:19,360 Speaker 1: deaths occur each year in India, with the vast majority 465 00:30:19,400 --> 00:30:23,880 Speaker 1: of those exposures coming from dogs, and some serious outbreaks 466 00:30:23,920 --> 00:30:27,959 Speaker 1: among wild animals started long after the rabies vaccine was developed. 467 00:30:28,520 --> 00:30:32,320 Speaker 1: For example, rabies was identified in North American raccoons in 468 00:30:32,440 --> 00:30:35,600 Speaker 1: nineteen thirty six, and there is an ongoing epidemic of 469 00:30:35,720 --> 00:30:40,280 Speaker 1: rabies among raccoons all along the East Coast. There are 470 00:30:40,360 --> 00:30:43,520 Speaker 1: efforts to get these and other outbreaks in wild animals 471 00:30:43,640 --> 00:30:47,640 Speaker 1: under control, using things like oral rabies vaccine baits. Yeah, 472 00:30:47,640 --> 00:30:51,040 Speaker 1: there are also mass vaccination campaigns, a lot of work 473 00:30:51,080 --> 00:30:53,560 Speaker 1: on this. A lot of the deaths that occur around 474 00:30:53,560 --> 00:30:56,120 Speaker 1: the world happen in children who'd like just wanted to 475 00:30:56,160 --> 00:30:59,320 Speaker 1: pet a dog and got bitten, so it is very sad. 476 00:31:00,520 --> 00:31:04,480 Speaker 1: It's also possible for one animal to spark a huge 477 00:31:04,640 --> 00:31:09,560 Speaker 1: exposure scenario, even in places where rabies is relatively well controlled. 478 00:31:10,200 --> 00:31:13,600 Speaker 1: For example, on October fifth, nineteen ninety four, a family 479 00:31:13,640 --> 00:31:16,200 Speaker 1: bought a kitten from a pet store in New Hampshire, 480 00:31:16,240 --> 00:31:19,200 Speaker 1: and then about three weeks later, this kitten developed seizures 481 00:31:19,240 --> 00:31:22,800 Speaker 1: and died. After its death, it was determined to have 482 00:31:22,880 --> 00:31:27,240 Speaker 1: had rabies. This kitten had been examined by a veterinarian 483 00:31:27,400 --> 00:31:30,000 Speaker 1: and had a certificate of health before it was sold, 484 00:31:30,080 --> 00:31:34,160 Speaker 1: but the pet store didn't have clear records of when 485 00:31:34,400 --> 00:31:39,200 Speaker 1: animals had arrived there or been sold, so in the end, 486 00:31:39,520 --> 00:31:44,320 Speaker 1: six hundred and sixty five people received post exposure prophylaxis 487 00:31:44,440 --> 00:31:47,760 Speaker 1: or PEP for rabies. These were people who had come 488 00:31:47,800 --> 00:31:51,520 Speaker 1: into contact with that kitten, or who had bought other 489 00:31:51,640 --> 00:31:54,520 Speaker 1: animals that had probably had contact with the kitten at 490 00:31:54,560 --> 00:31:58,880 Speaker 1: the store, or people who had contact with those animals, 491 00:31:59,240 --> 00:32:01,960 Speaker 1: people who worked at the store, people who visited the 492 00:32:02,000 --> 00:32:05,600 Speaker 1: store and handled the animals. Really just on and on. 493 00:32:05,760 --> 00:32:09,440 Speaker 1: The probable initial source for this whole thing was a 494 00:32:09,600 --> 00:32:13,000 Speaker 1: raccoon that may have come into contact with three feral 495 00:32:13,080 --> 00:32:15,720 Speaker 1: kittens that were then captured and sold at the store. 496 00:32:16,200 --> 00:32:18,760 Speaker 1: As a side note, you may have heard that Raby's 497 00:32:18,760 --> 00:32:23,640 Speaker 1: prophylaxis is a horrifying series of incredibly painful shots directly 498 00:32:23,680 --> 00:32:27,360 Speaker 1: into the stomach with a gigantic and terrifying needle. It 499 00:32:27,520 --> 00:32:31,640 Speaker 1: is not. Older versions of Raby's PEP did involve a 500 00:32:31,680 --> 00:32:35,520 Speaker 1: long series of fourteen to twenty one shots, usually given 501 00:32:35,520 --> 00:32:38,640 Speaker 1: in the abdomen, but that's just because the abdomen offered 502 00:32:38,640 --> 00:32:41,520 Speaker 1: a lot more surface area to work with, not because 503 00:32:41,560 --> 00:32:45,720 Speaker 1: the injections went into the stomach through a huge needle. Still, 504 00:32:45,840 --> 00:32:47,320 Speaker 1: I mean to be clear, that is a lot of 505 00:32:47,360 --> 00:32:50,000 Speaker 1: shots into a tender area, and the vaccine that was 506 00:32:50,040 --> 00:32:52,440 Speaker 1: in use at the time could have a range of 507 00:32:52,560 --> 00:32:56,320 Speaker 1: unpleasant side effects. Yeah, I would not want to get 508 00:32:57,120 --> 00:33:00,360 Speaker 1: fourteen to twenty one shots all around my abdominati think 509 00:33:00,480 --> 00:33:04,960 Speaker 1: like it was not a gigantically long needle going into 510 00:33:05,040 --> 00:33:09,440 Speaker 1: people's actual stomachs. It's also not what is in use today. 511 00:33:10,360 --> 00:33:14,120 Speaker 1: The current recommendation is that a person gets one dose 512 00:33:14,200 --> 00:33:18,080 Speaker 1: of human rabies immune globulin and one dose of rabies 513 00:33:18,160 --> 00:33:22,440 Speaker 1: vaccine shortly after the bite. The immune globulin is typically 514 00:33:22,480 --> 00:33:26,120 Speaker 1: injected near the bite location, and then the vaccine typically 515 00:33:26,200 --> 00:33:29,120 Speaker 1: goes into the deltoid region of the arm, where lots 516 00:33:29,160 --> 00:33:32,680 Speaker 1: of other vaccines go. Then the person gets three more 517 00:33:32,840 --> 00:33:36,000 Speaker 1: doses of vaccine that are spread out in the days 518 00:33:36,040 --> 00:33:40,160 Speaker 1: that follow, again as injections into the shoulder area. Also 519 00:33:40,280 --> 00:33:43,040 Speaker 1: using a vaccine that is like cultured in tissues and 520 00:33:43,080 --> 00:33:46,680 Speaker 1: a lot safer than what was being used in the past. 521 00:33:47,240 --> 00:33:49,760 Speaker 1: This process can be a little bit different for children, 522 00:33:49,920 --> 00:33:52,640 Speaker 1: or if a person is immuno compromised, or if a 523 00:33:52,640 --> 00:33:57,360 Speaker 1: person has been previously vaccinated for rabies. That's something that's 524 00:33:57,400 --> 00:34:00,560 Speaker 1: typically only done based on a person's risk for being 525 00:34:00,600 --> 00:34:04,320 Speaker 1: exposed to rabies. As another side note, we have been 526 00:34:04,480 --> 00:34:08,280 Speaker 1: really really focused on bites here because the overwhelming majority 527 00:34:08,320 --> 00:34:12,879 Speaker 1: of rabies exposures come from bites or possibly scratches. There 528 00:34:12,960 --> 00:34:15,359 Speaker 1: are some other ways to contract the disease, but they're 529 00:34:15,400 --> 00:34:19,200 Speaker 1: extraordinarily rare, like through the eyes or mucous membranes. If 530 00:34:19,200 --> 00:34:22,959 Speaker 1: someone is exposed to aerosolized rabies virus in some way, 531 00:34:23,719 --> 00:34:27,800 Speaker 1: or because rabies can closely resemble various types of encephalitis, 532 00:34:28,200 --> 00:34:31,399 Speaker 1: it is sometimes missed as a diagnosis when doctors don't 533 00:34:31,440 --> 00:34:34,719 Speaker 1: know that the person was bitten by an animal. This 534 00:34:34,840 --> 00:34:38,440 Speaker 1: has led to an extremely small number of rabies transmissions 535 00:34:38,520 --> 00:34:43,400 Speaker 1: through organ transplants, although the risk of this is extremely remote. 536 00:34:43,680 --> 00:34:47,160 Speaker 1: After their first report of it happening, many organ procurement 537 00:34:47,280 --> 00:34:50,839 Speaker 1: organizations started including screening questions to try to rule out 538 00:34:50,840 --> 00:34:55,120 Speaker 1: this possibility. Circling back around to rabies in pop culture, 539 00:34:55,200 --> 00:34:57,840 Speaker 1: this was actually a plot line on the TV show Scrubs. 540 00:34:58,360 --> 00:35:03,520 Speaker 1: Its sounds truly horrifying, but also like the disease process 541 00:35:03,560 --> 00:35:06,840 Speaker 1: that rabies causes, like in the umbrella of encephalitis, and 542 00:35:06,880 --> 00:35:09,320 Speaker 1: if a doctor doesn't know that a person was bitten 543 00:35:09,360 --> 00:35:11,680 Speaker 1: by an animal or picked up a bat or whatever, 544 00:35:11,960 --> 00:35:15,239 Speaker 1: like it's most doctors have never seen a case of 545 00:35:15,320 --> 00:35:17,440 Speaker 1: rabies in their career, and it's not the thing that 546 00:35:17,440 --> 00:35:21,360 Speaker 1: first comes to mind. In two thousand and four, fifteen 547 00:35:21,440 --> 00:35:25,040 Speaker 1: year old Gena Geezy and her medical team made headlines 548 00:35:25,120 --> 00:35:28,400 Speaker 1: after she became the first person known to survive rabies 549 00:35:28,400 --> 00:35:31,920 Speaker 1: after starting to develop symptoms. She had picked up and 550 00:35:32,000 --> 00:35:35,239 Speaker 1: been bitten by a bat, and although her wound was 551 00:35:35,320 --> 00:35:38,920 Speaker 1: cleaned with hydrogen peroxide, she wasn't taken in for further treatment. 552 00:35:39,520 --> 00:35:42,319 Speaker 1: She started developing symptoms about a month later, and then, 553 00:35:42,360 --> 00:35:45,880 Speaker 1: about six days into her illness, reported having been bitten 554 00:35:45,960 --> 00:35:49,720 Speaker 1: by the bat. Doctors placed Geezy in a medically induced 555 00:35:49,760 --> 00:35:53,080 Speaker 1: coma and gave her anti viral drugs and other treatments. 556 00:35:53,680 --> 00:35:57,160 Speaker 1: These treatments continued until tests suggested that her body was 557 00:35:57,200 --> 00:35:59,600 Speaker 1: fighting off the virus, and at that point she was 558 00:35:59,600 --> 00:36:03,200 Speaker 1: brought up of the coma. She survived this experience, and 559 00:36:03,280 --> 00:36:06,280 Speaker 1: news outlets have continued to report on her life into 560 00:36:06,280 --> 00:36:09,480 Speaker 1: the year twenty twenty one. At the time, this seemed 561 00:36:09,520 --> 00:36:12,160 Speaker 1: like a hopeful sign that what came to be known 562 00:36:12,200 --> 00:36:15,680 Speaker 1: as the Milwaukee Protocol would make it possible to cure 563 00:36:15,719 --> 00:36:19,880 Speaker 1: people after they started showing symptoms of rabies, but efforts 564 00:36:19,920 --> 00:36:25,000 Speaker 1: to replicate that success have been largely unsuccessful. One paper 565 00:36:25,080 --> 00:36:28,360 Speaker 1: in the Journal of the Brazilian Society of Tropical Medicine 566 00:36:28,400 --> 00:36:32,920 Speaker 1: traced thirty eight published uses of the Milwaukee protocol, including 567 00:36:33,480 --> 00:36:37,080 Speaker 1: one use of a similar protocol called the Recifi protocol. 568 00:36:37,760 --> 00:36:41,320 Speaker 1: Only eleven of those patients survived, with all but five 569 00:36:41,440 --> 00:36:46,160 Speaker 1: of them having moderate to severe complications afterward. This is 570 00:36:46,239 --> 00:36:49,359 Speaker 1: certainly an improvement over a disease with an essentially one 571 00:36:49,480 --> 00:36:54,200 Speaker 1: hundred percent fatality rate, but these numbers may be deceptively optimistic. 572 00:36:54,680 --> 00:36:57,560 Speaker 1: Three of the people who were described as having survived 573 00:36:57,840 --> 00:37:00,440 Speaker 1: did make it through the most critical part of the illness, 574 00:37:00,480 --> 00:37:03,600 Speaker 1: but they still died. At least one of the patients 575 00:37:03,719 --> 00:37:06,840 Speaker 1: may not have actually had rabies, and there's been no 576 00:37:07,000 --> 00:37:10,640 Speaker 1: coordinated method for tracking when this protocol has or hasn't 577 00:37:10,680 --> 00:37:14,200 Speaker 1: been attempted. It's likely that anyone who tried it and 578 00:37:14,239 --> 00:37:18,040 Speaker 1: succeeded would publish their results, but it's also possible that 579 00:37:18,080 --> 00:37:21,359 Speaker 1: people who tried it and failed have not yet. There 580 00:37:21,400 --> 00:37:25,880 Speaker 1: are some papers like Opinion Commentary written by teams of 581 00:37:25,960 --> 00:37:28,200 Speaker 1: doctors that are like this does not work and we 582 00:37:28,280 --> 00:37:31,440 Speaker 1: need to stop focusing our effort on it, and others 583 00:37:31,480 --> 00:37:34,000 Speaker 1: that are a little bit more like this may need 584 00:37:34,200 --> 00:37:39,400 Speaker 1: some other refining before it could work. Aside from all that, though, 585 00:37:40,000 --> 00:37:43,080 Speaker 1: all the patients described in these publications spent at least 586 00:37:43,120 --> 00:37:46,800 Speaker 1: a month in the hospital with extensive care throughout their stay, 587 00:37:47,000 --> 00:37:51,319 Speaker 1: so it's extremely unlikely that this protocol could really be 588 00:37:51,400 --> 00:37:54,239 Speaker 1: put into use in the places where human deaths from 589 00:37:54,320 --> 00:37:57,600 Speaker 1: rabies are the most prevalent. These places tend to be 590 00:37:57,719 --> 00:38:01,080 Speaker 1: rural and poor without a lot of health care infrastructure. 591 00:38:01,719 --> 00:38:05,800 Speaker 1: Places where people don't have access to rabies profile axis 592 00:38:05,920 --> 00:38:08,920 Speaker 1: are likely to also be places where people don't have 593 00:38:09,080 --> 00:38:13,799 Speaker 1: access to a hospital that could support this kind of treatment. Also, 594 00:38:13,880 --> 00:38:17,640 Speaker 1: it's extremely clear at this point that coordinated programs of 595 00:38:17,719 --> 00:38:23,280 Speaker 1: public education and dog vaccinations and sometimes vaccinations in particular 596 00:38:23,360 --> 00:38:28,759 Speaker 1: wild animals, can lower the number of human rabies deaths enormously, 597 00:38:29,640 --> 00:38:32,719 Speaker 1: and places that don't have the resources to support those 598 00:38:32,800 --> 00:38:36,520 Speaker 1: kinds of programs and initiatives are really likely not to 599 00:38:36,600 --> 00:38:40,320 Speaker 1: have the resources to support hundreds or thousands of people 600 00:38:40,840 --> 00:38:45,319 Speaker 1: with long term hospital stays and medically induced comas. It's 601 00:38:45,400 --> 00:38:48,800 Speaker 1: like even if this worked, it would really be working 602 00:38:48,840 --> 00:38:52,000 Speaker 1: for the wealthiest countries in the world and not the 603 00:38:52,040 --> 00:38:56,800 Speaker 1: places where treatment is most needed. So all of that said, 604 00:38:57,160 --> 00:39:00,560 Speaker 1: the global cost of rabies is roughly eight point six 605 00:39:00,640 --> 00:39:04,400 Speaker 1: billion dollars per year, and more than fifteen million people 606 00:39:04,440 --> 00:39:08,560 Speaker 1: per year receive Raby's PEP. This protocol can be really expensive. 607 00:39:08,680 --> 00:39:11,360 Speaker 1: In the United States, it can cost between twelve hundred 608 00:39:11,440 --> 00:39:15,280 Speaker 1: and sixty five hundred dollars. Yeah, that's like one estimate 609 00:39:15,320 --> 00:39:17,200 Speaker 1: that I can sew that I saw. I saw some 610 00:39:17,320 --> 00:39:20,520 Speaker 1: that were even higher than that. September twenty eighth of 611 00:39:20,560 --> 00:39:23,879 Speaker 1: every year is World Raby's Day. That's also the anniversary 612 00:39:23,920 --> 00:39:27,480 Speaker 1: of the death of Louis Pasteur. Well, that's a basic 613 00:39:27,560 --> 00:39:32,960 Speaker 1: history of rabies, raybees. My hope is that in the 614 00:39:33,000 --> 00:39:37,520 Speaker 1: future will at least get to the point where the 615 00:39:37,560 --> 00:39:41,560 Speaker 1: places in the world that have lots of free roaming 616 00:39:41,760 --> 00:39:48,840 Speaker 1: dogs also have those dogs vaccinated, because that's really where 617 00:39:49,480 --> 00:39:52,919 Speaker 1: like so much feeding back into the greater environment and 618 00:39:53,000 --> 00:39:55,920 Speaker 1: so much feeding into human cases of rabies, Like it's 619 00:39:55,960 --> 00:40:00,359 Speaker 1: all interconnected with the dogs. Yeah. I think we mention 620 00:40:00,440 --> 00:40:03,240 Speaker 1: it at the top of our episode on the history 621 00:40:03,239 --> 00:40:05,880 Speaker 1: of Veterinary Medicine that one of the vets at my 622 00:40:06,080 --> 00:40:09,640 Speaker 1: practice participates in a program where she goes to countries 623 00:40:09,680 --> 00:40:13,680 Speaker 1: where the dog population is not well vaccinated and tries 624 00:40:13,719 --> 00:40:17,200 Speaker 1: to just do as many vaccinations as they can in 625 00:40:17,239 --> 00:40:20,600 Speaker 1: a short period of time. Yeah, they had gone to Malawi, 626 00:40:20,719 --> 00:40:23,920 Speaker 1: I think, and Malawi's target is like seventy percent of 627 00:40:24,000 --> 00:40:27,400 Speaker 1: the dog population vaccinated, which would do a lot to 628 00:40:27,480 --> 00:40:30,040 Speaker 1: reduce the number of human deaths, but still would like 629 00:40:30,120 --> 00:40:33,760 Speaker 1: there would still be a reservoir of circulating rabies among 630 00:40:33,800 --> 00:40:36,960 Speaker 1: dog populations. There are a lot of sad parts to that, 631 00:40:37,000 --> 00:40:38,879 Speaker 1: but one of the saddest parts is like a lot 632 00:40:38,880 --> 00:40:40,880 Speaker 1: of a lot of the people who die of rabies 633 00:40:41,000 --> 00:40:43,680 Speaker 1: or like just a kid that wanted to pet a dog. Yeah, 634 00:40:49,040 --> 00:40:52,040 Speaker 1: thanks so much for joining us on this Saturday. If 635 00:40:52,080 --> 00:40:54,200 Speaker 1: you'd like to send us a note, our email addresses 636 00:40:54,400 --> 00:40:58,960 Speaker 1: History Podcast at iHeartRadio dot com, and you can subscribe 637 00:40:59,000 --> 00:41:01,879 Speaker 1: to the show on the ihea radio app, Apple Podcasts, 638 00:41:02,040 --> 00:41:04,120 Speaker 1: or wherever you listen to your favorite shows.