Speaker 1: Welcome to Stuff You Missed in History Class, a production
Speaker 1: of I Heart Radio. Hello, and welcome to the podcast.
Speaker 1: I'm Tracy V. Wilson. Now I'm Holly Fry. Foxes are
Speaker 1: one of many wild animals that share cities and other
Speaker 1: places with human beings, and in April, one of them
Speaker 1: made headlines after biting at least nine people around the
Speaker 1: US capital. When this story crossed my Twitter feed, I'm
Speaker 1: became incredibly invested in whether everybody who got bitten by
Speaker 1: this fox had gotten their rabies shots. Afterward, news articles
Speaker 1: were not telling me the answer to this information. Some
Speaker 1: of them were talking about a specific reporter or a
Speaker 1: specific congress person, but I was like, no, everybody, everybody
Speaker 1: needs to get the raby shots because foxes can carry rabies.
Speaker 1: Rabies is virtually always is fatal once people develop symptoms,
Speaker 1: once anyone developed symptoms, but today's rabies profile access is
Speaker 1: almost a dent effective at preventing that from happening. It
Speaker 1: is I think the most effective vaccine that we have
Speaker 1: in existence. So then when news broke that yes, this
Speaker 1: fox did have rabies, it was like just a big flashing,
Speaker 1: screaming side in my brain, like raby shots raby shots.
Speaker 1: Raby shots, Please tell me everyone got their rabies shots.
Speaker 1: Of course, then that made me want to do a
Speaker 1: podcast on rabies and the vaccine that prevents it, something
Speaker 1: that somehow I thought we already had stuff on. We don't,
Speaker 1: or if we do, I failed to find it. The
Speaker 1: vast majority of our listeners live in places where Raby's
Speaker 1: deaths in humans are extremely rare. Some parts of the
Speaker 1: world are rabies free, and here in the United States
Speaker 1: there were only five human deaths from rabies, and that
Speaker 1: was the highest number of annual rabies deaths in the
Speaker 1: United States in a decade. There are also places, though,
Speaker 1: where rabies is still endemic, and globally about fifty six
Speaker 1: thousand people die from it every year. That is not
Speaker 1: like that's a small number compared to something like the
Speaker 1: current pandemic, but they're fifty six thousand totally preventable deaths,
Speaker 1: Like we have what we need to prevent this, So
Speaker 1: I wanted to talk about that heads up though there's
Speaker 1: a lot of animal experimentation in this episode and deaths. Obviously,
Speaker 1: rabies is caused by rabies list of virus, which probably
Speaker 1: originated in Old World bats. This virus has existed on
Speaker 1: every continent except Antarctica and Australia for millennia, and although
Speaker 1: Australia is Rabi's free, it's home to a closely related
Speaker 1: virus called bat lists of virus. But in spite of
Speaker 1: the viruses connection to Bat's humanity's connection to rabies has
Speaker 1: mainly been through dogs. That connection show is up in
Speaker 1: the first written reference we have of rabies, that's in
Speaker 1: the Eshnuna code from roughly two thousand b c e.
Speaker 1: Shnano was a city and what's now Iraq, and some
Speaker 1: of its laws have survived on a pair of broken
Speaker 1: tablets that were found at an archaeological site near Baghdad.
Speaker 1: Here's one of the laws quote. If a dog is mad,
Speaker 1: and the authorities have brought the fact to the knowledge
Speaker 1: of its owner, if he does not keep it in,
Speaker 1: and it bites a man and causes his death, then
Speaker 1: the owner shall pay two thirds of amina of silver.
Speaker 1: If it bites a slave and causes his death, he
Speaker 1: shall pay fifteen shekels of silver. The first written reference
Speaker 1: to rabies in China is from the Zoo tradition, sometimes
Speaker 1: called the Zoo Commentary. This is a commentary on the
Speaker 1: spring and Autumn Annals, which chronicles a period of Chinese
Speaker 1: history stretching from seven twenty two to four eighty one
Speaker 1: b C. One passage in the Two Tradition describes people
Speaker 1: of the capital city of Sung chasing a rabid dog.
Speaker 1: The dog ran into the home of a minister named
Speaker 1: wat Chin, and the people chased after it. Wat Chin
Speaker 1: was afraid and fled the city, and about the fourth
Speaker 1: century BC, Aristotle wrote this and his History of Animals
Speaker 1: quote dogs suffer from three diseases, rabies, quincy, and sore feet.
Speaker 1: Rabies drives the animal mad, and any animal whatever, accepting man,
Speaker 1: will take the disease if bitten by a dog so afflicted,
Speaker 1: the disease is fatal to the dog itself and to
Speaker 1: any animal it may bite man accepted. So this translation
Speaker 1: makes it sound like Aristotle was saying that humans don't
Speaker 1: get rabies, but it's also been interpreted as meaning that
Speaker 1: people don't always develop rabies when bitten by a rabid dog,
Speaker 1: and that is true, or that people don't always die
Speaker 1: from the disease if they contract it, which is almost
Speaker 1: never true. People will have known that rabies was essentially
Speaker 1: always fatal for thousands of years, though Roman court physicians
Speaker 1: Scribonious Largest described rabies as incurable in the first century CE.
Speaker 1: In addition to being lethal, rabies progresses in a way
Speaker 1: that can be really terrifying. The exact symptoms can vary,
Speaker 1: but there are two broad categories, both of which end
Speaker 1: in coma and death. Paralytic rabies involves lethargy, weakness, and paralysis,
Speaker 1: and furious rabies involves agitation, aggression, and hyperactivity. The word
Speaker 1: rabies reflects this latter type that comes from the Latin
Speaker 1: for to rage, which may have roots in a Sanskrit
Speaker 1: word meaning to do violence. Lissa virus has a similar root.
Speaker 1: It comes from a Greek word meaning frenzy or madness,
Speaker 1: which was used to describe rabies as well as to
Speaker 1: describe irrational rage. Raby shows up a lot in popular
Speaker 1: cult sure, and that goes back thousands of years as well,
Speaker 1: including the use of rabies or rabid dogs as a
Speaker 1: metaphor for being mad or uncontrollable. For example, in the Iliad,
Speaker 1: which was written in about the eighth century b c. E.
Speaker 1: Homer describes Hector as a rabid dog. Rabies can also
Speaker 1: cause paralysis and spasms in the throat that make it
Speaker 1: impossible to swallow water. That's why it's also known as hydrophobia,
Speaker 1: and the second century CE Roman philosopher Celsus used the
Speaker 1: word hydrophobia in his description of the disease. Celsus also
Speaker 1: recognized that something was present in saliva that transmitted this illness,
Speaker 1: and he recommended a range of techniques to draw this
Speaker 1: substance out of wounds. Like the connection between rabies and
Speaker 1: aggressive rage, the connection between rabies and hydrophobia made its
Speaker 1: way into literature centuries ago. For example, in about the
Speaker 1: year five hundred, Klias A lean Is suggested that Homer's
Speaker 1: description of Tantalus in the Odyssey might have been inspired
Speaker 1: by rabies, since Tantalus is tormented by water that he
Speaker 1: cannot drink. It's also possible that rabies influenced ancient Greek
Speaker 1: depictions of Cerberus, the multi headed dog that guarded the underworld,
Speaker 1: and that those depictions of a mad beast with poison
Speaker 1: frothing from its jaws circled back to influence people's perceptions
Speaker 1: of rabies. So through these and other written references, we
Speaker 1: know that rabies had spread from wherever it originated, all
Speaker 1: through India, China, the Middle East, Greece, rome in Egypt
Speaker 1: by about fifteen hundred years ago, but we don't really
Speaker 1: know how widespread the disease was in any of these places,
Speaker 1: or how many deaths it caused among humans and other animals.
Speaker 1: That starts to change in the medieval period, when people
Speaker 1: started documenting large outbreaks of the disease within specific animals.
Speaker 1: These account it's primarily focused on outbreaks among dogs and
Speaker 1: other canids, including wolves and foxes. For example, an outbreak
Speaker 1: of wolf rabies struck Franconia in twelve seventy one. A
Speaker 1: massive outbreak among red foxes spread over parts of Europe
Speaker 1: between fifteen seventy one and fifteen eighty one, leading people
Speaker 1: to try to stop the disease by culling them. Sometimes
Speaker 1: these outbreaks could spread to other animals, including infecting people
Speaker 1: when they were bitten. At this point, we haven't mentioned
Speaker 1: rabies in the America's and that's because while rabies existed
Speaker 1: in the Americas through all this, rabid dogs probably did not.
Speaker 1: Based on genetic studies of the virus itself. Before European colonization,
Speaker 1: rabies and the America's primarily infected bats and skunks. There's
Speaker 1: some evidence that Indigenous peoples in ancient Central and South
Speaker 1: America regarded both bat bites and snake bites as potentially dangerous,
Speaker 1: treated bat bites with washing and cauterization with hot culls
Speaker 1: to try to prevent disease. Spanish colonists were reported being
Speaker 1: bitten by bats in the early fifteen hundreds, and in
Speaker 1: fifteen fourteen, Fernandez de Oviedo wrote about several soldiers dying
Speaker 1: after being bitten by vampire bats. Dog rabies is one
Speaker 1: of many diseases that Europeans introduced to the America's, and
Speaker 1: after that introduction, it spread to other animals and became
Speaker 1: far more likely to infect people, but that process did
Speaker 1: not happen nearly as quickly with rabies as it did
Speaker 1: with diseases like smallpox. Rabies typically has an incubation period
Speaker 1: of roughly three to eight weeks, although it can occasionally
Speaker 1: be much longer. Once symptoms appear, rabies is virtually always
Speaker 1: fatal within about ten days. When Europeans first started sailing
Speaker 1: to the America's, the voyage often took more than two months,
Speaker 1: so any dogs or other animals that had been infect
Speaker 1: did before setting sale usually developed symptoms and died or
Speaker 1: were killed while still at sea, so that meant introducing
Speaker 1: dog rabies to the America's required a voyage that was
Speaker 1: short enough for infected dogs to survive. It also required
Speaker 1: a large enough population of dogs and other mammals within
Speaker 1: a colony for the disease to keep circulating once it
Speaker 1: had been introduced. The first recorded outbreak of dog rabies
Speaker 1: in the Americas was reported in Mexico City in seventeen
Speaker 1: o nine, and by the end of the eighteenth century,
Speaker 1: dog rabies was widespread in most of the places in
Speaker 1: the Americas that Europeans had colonized. This in turn spread
Speaker 1: the disease to the continent's native animals, with some of
Speaker 1: those exposures leading to new strains of the virus that
Speaker 1: were adapted to specific species. We'll talk about how a
Speaker 1: vaccine was developed to prevent rabies after a sponsor break.
Speaker 1: By the eighteenth and nineteenth centuries, outbreaks of rabies were
Speaker 1: spread across a lot of the world and domesticated dogs
Speaker 1: and in wild animals. In North America, rabies became so
Speaker 1: widespread in skunks that they were nicknamed Phoebe cats like
Speaker 1: hydrophoby and phoebe tents were advertised as a way for
Speaker 1: cowboys to avoid being bitten by them in their sleep.
Speaker 1: In eighteen o three, and outbreak among wild foxes in
Speaker 1: France spread to dogs, pigs, and people. Bites from rabid
Speaker 1: wolves tended to be particularly lethal, in part because attacking
Speaker 1: wolves often bit people's faces or necks, meaning the virus
Speaker 1: was way closer to their brain, while rabid dogs usually
Speaker 1: bit people's hands or arms. There was no cure for
Speaker 1: rabies and no way to tell whether a person would
Speaker 1: develop it after being bitten, and estimates of how many
Speaker 1: people developed rabies after a bite stretch all the way
Speaker 1: from five percent to Some of this is just because
Speaker 1: of imprecise record keeping, but it's also connected to how
Speaker 1: people responded to the disease. In many places, there was
Speaker 1: a widespread assumption that any animal that bit had rabies,
Speaker 1: and during outbreaks, people tended to hunt down and kill
Speaker 1: animals that they thought might be spreading disease. So a
Speaker 1: dog that bits someone in the midst of all of
Speaker 1: this might be rabid, or it might just be scared
Speaker 1: and cornered and trying to defend itself. Around the world,
Speaker 1: people tried various herbs and medical preparations to prevent or
Speaker 1: cure rabies, and because it was so lethal, many of
Speaker 1: these were also relied on the idea of divine intervention.
Speaker 1: For example, Hubertus, also called St. Hubert Is the patron
Speaker 1: saint of hunting, and one of his reported miracles involved
Speaker 1: curing somebody who had been bitten by a rabid dog.
Speaker 1: So inch of Europe people used a piece of iron
Speaker 1: called St. Hubert's key to cauterize bite wounds. As part
Speaker 1: of this treatment, a priest would also make a shallow
Speaker 1: cut over a person's forehead, place a black bandage over that,
Speaker 1: and the person wore that bandage for nine days. Some
Speaker 1: people even carried one of these keys around with them
Speaker 1: for protection. Long before the development of the germ theory
Speaker 1: of disease, people recognize that when someone was bitten by
Speaker 1: a rabid animal, something in the animals saliva was going
Speaker 1: into the wound and potentially causing rabies. So some of
Speaker 1: the other treatments for bites involved washing the wound, applying
Speaker 1: caustic chemicals to it, or cauterizing in whether it was
Speaker 1: with a Saint Hubertists key or with some other implement.
Speaker 1: If these treatments were done immediately, after a person was bitten.
Speaker 1: They may have helped reduce the chance of developing rabies
Speaker 1: by washing away the animals infected saliva. Thoroughly washing the
Speaker 1: wound is still step one in rabies prevention today, but
Speaker 1: none of this was enough to totally prevent the chance
Speaker 1: of developing the fatal disease. People also tried to prevent
Speaker 1: rabies by reducing the numbers of animals that could carry
Speaker 1: it and transmit it to humans and to other animals.
Speaker 1: For example, in eighteen sixty seven, the UK passed the
Speaker 1: Metropolitan Streets Act. Among other things, this act empowered police
Speaker 1: to collect and muzzle stray dogs, are dogs that were
Speaker 1: determined to be dangerous. This reportedly led to a drop
Speaker 1: in human cases of rabies in British cities. Also in
Speaker 1: the eighteenth and nineteen centuries, researchers were learning about rabies
Speaker 1: and working on ways to prevent it spread. During the
Speaker 1: earlier part of this time, researchers didn't yet know what
Speaker 1: a virus was. But trying to talk around that got
Speaker 1: really clunky. So we are still going to call it
Speaker 1: a virus in our discussion today. Yeah, it was a
Speaker 1: lot of incredibly stilted sentences before I was like, we're
Speaker 1: just it a virus, regardless of whether that individual research
Speaker 1: or knew what a virus was. So in seventeen sixty nine,
Speaker 1: Italian anatomist and pathologist John Morganni observed that rabies traveled
Speaker 1: via the nerves rather than traveling through the bloodstream. He
Speaker 1: made this connection because some patients reported a feeling of
Speaker 1: pins and needles or other neurological disturbances around the site
Speaker 1: of their original bite wounds. Morgan was correct. Once it
Speaker 1: enters the body, the rabies virus moves along the nerves
Speaker 1: until it gets to the brain and the rest of
Speaker 1: the central nervous system. After it gets to the brain,
Speaker 1: the rabies virus makes its way to the salivary glands,
Speaker 1: where it can cause excessive salivation, and although eighteen century
Speaker 1: researchers didn't quite have that part figured out, they did
Speaker 1: know that the disease was spread through saliva. In seventeen
Speaker 1: ninety three, Scottish surgeon John Hunter speculated that it would
Speaker 1: be possible to use a lancet to intentionally introduce an
Speaker 1: infected animals saliva into another animal, but it's not clear
Speaker 1: whether he tried this in practice. We also don't know
Speaker 1: whether German naturalist George Gottfried Zinca was familiar with Hunter's work,
Speaker 1: but in eighteen o four he brushed saliva from a
Speaker 1: rabid dog onto a cut he had made in the
Speaker 1: leg of a healthy dog. This previously healthy dog contracted rabies.
Speaker 1: He did the same thing with other healthy mammals, demonstrating
Speaker 1: that it was possible for the bite of an infected
Speaker 1: dog to infect animals of other species. In eighteen twenty one,
Speaker 1: French neurophysiologist Francois Magendie reported that he had infected a
Speaker 1: previously healthy dog with saliva from a person who had
Speaker 1: contracted rabies. Victor Gautier was a professor at the National
Speaker 1: Veterinary School in Lyon, France, and he started experimenting with
Speaker 1: rabies in eighteen seventy nine. He found that it was
Speaker 1: possible to transmit rabies from a dog to a rabbit,
Speaker 1: and then from that rabbit to another rabbit. Rabbits were
Speaker 1: smaller and easier to keep than dogs, and they were
Speaker 1: less dangerous research subjects than rabbid dogs were. Gaultier also
Speaker 1: found that the rabbits had a shorter incubation period of
Speaker 1: about eighteen days rather than a month or more that
Speaker 1: you might see in a dog. Gaultier did various experiments
Speaker 1: with infected animals saliva, attempting to see whether he could
Speaker 1: find some way of using this infectious material to prevent rabies.
Speaker 1: In eighteen eighty one, he injected rabies virus into the
Speaker 1: jugular veins of sheep and they didn't develop rabies, and
Speaker 1: then when he exposed one of them to saliva from
Speaker 1: a rabbit dog later on, it seemed like it was
Speaker 1: immune to the disease. French chemist and microbiologist Louis Pasteur
Speaker 1: started working on rabies at about this same time, and
Speaker 1: he was inspired by Gaultier success. Pastor already an extensive
Speaker 1: background in this kind of work. In the eighteen fifties,
Speaker 1: he had studied yeast and alcohol fermentation, as well as
Speaker 1: the ability for micro organisms to contaminate fermenting beverages. This
Speaker 1: had contributed to both the germ theory of disease and
Speaker 1: the development of pasteurization. In the eighteen sixties, he had
Speaker 1: identified a micro organism that was devastating the French silk industry,
Speaker 1: and in the eighteen seventies he studied animal diseases like
Speaker 1: anthrax and chicken colera, including developing an anthrax vaccine. While
Speaker 1: Pasteur had lots of experience in this kind of research,
Speaker 1: he had pretty much no experience in medicine or the
Speaker 1: clinical treatment of patients, so he relied on other people
Speaker 1: for this knowledge, including French physician and bacteriologist Emile Roux.
Speaker 1: A whole team of other scientists and doctors were involved
Speaker 1: in this work as well, including Charles Chamberlin, Emile Duclox,
Speaker 1: Louis Dulier, and Joseph grane A. This is definitely not
Speaker 1: a solo effort, and Pasteur was not always excited about
Speaker 1: crediting other people for their involvement in it. There are
Speaker 1: even some historians who have accused him of stealing other
Speaker 1: people's ideas. Much of Pastor's previous work had involved culturing
Speaker 1: bacteria and working from those cultures, and he started out
Speaker 1: trying to do the same thing with rabies. Since rabies
Speaker 1: is caused by a virus rather than a bacterium, Pastor's
Speaker 1: efforts to replicate his earlier process failed. He started working
Speaker 1: directly with the saliva of infected animals and then moved
Speaker 1: on to working with central nervous system matter. He found
Speaker 1: that if he exposed a healthy rabbit to rabies, it
Speaker 1: developed rabies. Then if he used that rabbit's central nervous
Speaker 1: system matter to expose another rabbit, that second rabbit also
Speaker 1: developed rabies, and the second rabbits infection seemed to be
Speaker 1: more virulent than the first. If he did this a
Speaker 1: third time, the third rabbit's infection was also more virulent
Speaker 1: than the seconds had been. He continued this serial passage
Speaker 1: of the virus from rabbits to rabbit until he had
Speaker 1: a strain of it that he described as fixed. It
Speaker 1: was consistent and how virulent it was, and it had
Speaker 1: an incubation period that was set at six or seven days.
Speaker 1: From there, Pastor air dried the spinal cords of rabbits
Speaker 1: that had died of that highly virulent fixed strain. The
Speaker 1: longer they dried, the weaker the virus became. That's a
Speaker 1: process called attenuation. When he exposed other animals to a
Speaker 1: small amount of this attenuated virus, they seemed to develop
Speaker 1: a resistance to rabies rather than becoming ill. From there,
Speaker 1: Pastor started to wonder whether it was possible to make
Speaker 1: an animal more resistant to rabies after it had already
Speaker 1: been bitten. Preventing it from developing the disease. Having successfully
Speaker 1: tested out this idea in dogs, he tried at it
Speaker 1: on two people, but he didn't publish on either of
Speaker 1: these attempts, so they were not known about until much later.
Speaker 1: One of these was a man who had been bitten
Speaker 1: by a dog, and while this man survived, it's also
Speaker 1: likely that he had not actually been exposed to rabies.
Speaker 1: The other was an eleven year old girl who had
Speaker 1: been bitten in the face by a puppy, and she
Speaker 1: had already started developing rabies symptoms. She died the day
Speaker 1: after she was given the treatment. On July four, nine
Speaker 1: year old Joseph Meister was repeatedly bitten by a dog
Speaker 1: in Alsace. The dog was believed to be rabid, and
Speaker 1: two days later the child was brought to Pestor for help.
Speaker 1: Emil Ru had been heavily involved in Pestor's research up
Speaker 1: to this point, and he refused to be involved in
Speaker 1: the boy's treatment because of ethical concerns. Pastor expressed some
Speaker 1: reluctance as well, but Joseph Granche and Alfred Vopien of
Speaker 1: the Academy to Medicine encouraged him to try with granch
Speaker 1: admit us during the treatment. Since Pastor was not a doctor,
Speaker 1: Joseph was given a series of inoculations over the span
Speaker 1: of ten days, starting with a very weak preparation and
Speaker 1: working up through ones that were less and less attenuated.
Speaker 1: Three months later, he had no sign of rabies. Another
Speaker 1: attempt was started with another patient shortly after Joseph Meister
Speaker 1: was declared to be in the clear. That was Jean
Speaker 1: Baptiste Jupel, a fourteen year old shepherd who had been
Speaker 1: mauled while saving a group of younger boys from a dog.
Speaker 1: Pastor reported his results to the French Academy of Science
Speaker 1: on October eighteen eighty five, while Dupeel's treatment was still ongoing.
Speaker 1: Told about his success with Joseph Meister and the fact
Speaker 1: that he had successfully inoculated fifty dogs against rabies before
Speaker 1: trying this process on a human. We're gonna talk more
Speaker 1: about what happened with all of this after we paused
Speaker 1: for a quick sponsor break. As a word of Pastor's
Speaker 1: success that preventing rabies started to spread, people started flocking
Speaker 1: to him for treatment. By the start of eighteen eighties six,
Speaker 1: he had treated at least three hundred and fifty people.
Speaker 1: They came from all over Europe and from the United States.
Speaker 1: In early December of eighteen eighty five, a dog bit
Speaker 1: at least seven other dogs and six children in Newark,
Speaker 1: New Jersey. Word of Pastor's work had made it to
Speaker 1: the US, and a local doctor published an appeal for
Speaker 1: funds to send the boys to Paris for treatment. Four
Speaker 1: of the boys were sent to Paris by steamer. The
Speaker 1: other two were determined to not have sufficient injuries to
Speaker 1: need treatment. American news coverage of these boys tripped to
Speaker 1: Paris and then they returned to the United States turned
Speaker 1: rabies vaccine into just a media station, and three of
Speaker 1: the boys were displayed at the Globe Museum in the
Speaker 1: Bowery in New York after they all got home. Not
Speaker 1: everyone agreed with what Pastor and his team were doing.
Speaker 1: Anti vivisectionists objected to the use of animals in this research.
Speaker 1: And as we've said, not everyone who is bitten by
Speaker 1: a rabid animal contracts rabies, and not every animal who
Speaker 1: bites someone is rabid. Since there was still not a
Speaker 1: test for rabies, determining whether an animal had it usually
Speaker 1: involved just waiting to see if it died. But that
Speaker 1: wasn't really possible if it had already been killed, or
Speaker 1: if it just couldn't be found. You could also expose
Speaker 1: a healthy animal to the brain or saliva of an
Speaker 1: animal who had bitten someone, but by the time the
Speaker 1: healthy animal showed any symptoms, it was just likely to
Speaker 1: be too late for the human patient. So critics made
Speaker 1: the point that Pasteur was potentially exposing people to rabies
Speaker 1: for no reason, and his inoculation caused somebody who had
Speaker 1: been bitten by a non rabid dog to then develop
Speaker 1: rabies because of their treatment. Critics also noted that some
Speaker 1: of pasteurs patients did die. By November of eighteen eighty six,
Speaker 1: seventeen hundred patients had received rabies injections, and ten of
Speaker 1: them had died. The uncertainty combined with the deaths to
Speaker 1: spark a huge amount of debate within the medical community
Speaker 1: about whether what Pasteur was doing was ethical or even
Speaker 1: medically necessary. The Academy Demnsen held a meeting on the
Speaker 1: subject on January eleventh, eighteen eighty seven. Although Pastor's critics
Speaker 1: were vocal, his supporters, led by Dr Joseph Granche, successfully
Speaker 1: defended his work. The Institute Pasteur was established on June fourth,
Speaker 1: eighteen eighty seven, and it opened on November fourteenth of
Speaker 1: that year. It focused on disease research and on providing
Speaker 1: rabies vaccine. By eight more than twenty thousand people had
Speaker 1: been treated at the Pastier Institute after a possible rabies exposure,
Speaker 1: and only nine six of them had died, or less
Speaker 1: than half of a percent of patients. To be clear,
Speaker 1: there was a lot about this early version of the
Speaker 1: vaccine that was inherently unsafe. It was basically made from
Speaker 1: animal brain or spinal corn tissue. There could for sure
Speaker 1: be complications, but this was still a dramatic improvement over
Speaker 1: an untreatable fatal disease. Discoveries about the rabies virus continued
Speaker 1: after this point. In three, Italian pathologist al Deci Negri
Speaker 1: discovered round and oval regions in the brains of animals
Speaker 1: that had died of rabies, which he called negribodies. At
Speaker 1: the time he thought they were some kind of parasite,
Speaker 1: but they actually arise as part of the reproductive cycle
Speaker 1: of the virus. This paved the way for the first
Speaker 1: rabies tests. While there are new methods for detecting rabies
Speaker 1: in brain matter, Today, negribodies are still sometimes used when
Speaker 1: those methods are not available. The most reliable tests do
Speaker 1: still involve examining an animal's brain, which is why living
Speaker 1: animals have to be euthanized to be tested for rabies.
Speaker 1: Refinements in the vaccine were also in the works. Pastor's
Speaker 1: methods didn't always produce a consistently potent vaccine, and if
Speaker 1: it was too potent, it could cause somebody to contract rabies.
Speaker 1: In the early twentieth century, researchers started using phenol to
Speaker 1: kill the virus rather than attenuating it through air drying.
Speaker 1: Viruses were cultured in tissues in NY six, which led
Speaker 1: to tissue cultured vaccines rather than using brain matter to
Speaker 1: make them. Today's rabies vaccines are mostly cultured in human
Speaker 1: cells or in chick embryos or some other cellular matter.
Speaker 1: Although some of Pastor's colleagues speculated about whether it would
Speaker 1: be possible to mass vaccinate dogs or other animals and
Speaker 1: lower the spread of rabies to people, serious efforts to
Speaker 1: do that didn't start until decades later, but efforts like
Speaker 1: that have led to the successful eradication of rabies in
Speaker 1: some parts of the world. There are too many rabies
Speaker 1: free countries today for us to try to name them all,
Speaker 1: but they include many islands, including many Caribbean islands, the
Speaker 1: Canary Islands, the Falkland Islands, the Galapagos Islands, the UK, Iceland, Japan,
Speaker 1: and New Zealand. Several nations in continental Europe are also
Speaker 1: considered rabies free, including much of Western Europe. We should note, though,
Speaker 1: that rabies free often means rabies free and terrestrial animals.
Speaker 1: There can still be rabies or other lists of viruses
Speaker 1: in bats, specifically, so even if you are somewhere that
Speaker 1: is considered rabies free, being bitten by a bat still
Speaker 1: warrants medical attention. Just in general, don't touch baths with
Speaker 1: your bare hands. You don't need to be afraid of bats.
Speaker 1: They're generally pretty shy and they're not gonna mess with
Speaker 1: you if you don't mess with that. But like, don't
Speaker 1: go grab one with your hands, which is so hard
Speaker 1: because they're so cute, not for me because I see one.
Speaker 1: Like if I see a bat somewhere that I don't
Speaker 1: expect to see a bat, I'm like that bat is
Speaker 1: definitely a problem. I'm not going anywhere near it. I
Speaker 1: will tell a bat story and are behind the scenes.
Speaker 1: As we said at the top of the show, rabies
Speaker 1: is still endemic in some parts of the world, including
Speaker 1: parts of Asia and Africa. About of human rabies deaths
Speaker 1: occur each year in India, with the vast majority of
Speaker 1: those exposures coming from dogs, and some serious outbreaks among
Speaker 1: wild animals started long after the raby's vaccine was developed.
Speaker 1: For example, rabies was identified in North American raccoons in
Speaker 1: nineteen thirty six, and there is an ongoing epidemic of
Speaker 1: rabies among rec coons all along the East Coast. There
Speaker 1: are efforts to get these and other outbreaks in wild
Speaker 1: animals under control, using things like oral rabies vaccine baits. Yeah,
Speaker 1: they're also mass vaccination campaigns. A lot of work on this.
Speaker 1: A lot of the deaths that occur around the world
Speaker 1: happen in children who just wanted to pet a dog
Speaker 1: and got bitten, so it is very sad. It's also
Speaker 1: possible for one animal to spark a huge exposure scenario
Speaker 1: even in places where rabies is relatively well controlled. For example,
Speaker 1: on October a family bought a kitten from a pet
Speaker 1: store in New Hampshire and then about three weeks later,
Speaker 1: this kitten developed seizures and died. After its death, it
Speaker 1: was determined to have had rabies. This kitten had been
Speaker 1: examined by a veterinarian and had a certificate of health
Speaker 1: before it was sold, but the pet store didn't have
Speaker 1: clear records of when animals had arrived there or been sold,
Speaker 1: so in the end, six hundred sixty five people received
Speaker 1: post exposure prophylaxis or PEP for rabies. These were people
Speaker 1: who had come into contact with that kitten, or who
Speaker 1: had bought other animals that had probably had contact with
Speaker 1: the kitten at the store, or people who had contact
Speaker 1: with those animals, people who worked at the store, people
Speaker 1: who visited the store and handled the animals. Really just
Speaker 1: on and on. The probable initial source for this whole
Speaker 1: thing was a raccoon that may have come into contact
Speaker 1: with three feral kittens that were then captured and sold
Speaker 1: at the store. As a side note, you may have
Speaker 1: heard that Raby's prophylaxis is a horrifying series of incredibly
Speaker 1: painful shots directly into the stomach with a gigantic and
Speaker 1: terrifying needle. It is not Older versions of Raby's PEP
Speaker 1: did involve a long series of fourteen to twenty one
Speaker 1: shots usually given in the abdomen. But that's just because
Speaker 1: the abdomen offered a lot more surface area to work with,
Speaker 1: not because the injections went into the stomach through a
Speaker 1: huge needle. Still, I mean to be clear, that is
Speaker 1: a lot of shots into a tender area, and the
Speaker 1: vaccine that was in use at the time could have
Speaker 1: a range of unpleasant side effects. Yeah, I would not
Speaker 1: want to get fourteen to twenty one shots all around
Speaker 1: my abdominat it. It was not a gigantically long needle
Speaker 1: going into people's actual stomachs. It's also not what is
Speaker 1: in use today. The current recommendation is that a person
Speaker 1: gets one dose of human rabies immune globulin and one
Speaker 1: dose of rabies vaccine shortly after the bite. The immune
Speaker 1: globulin is typically injected near the bite location, and then
Speaker 1: the vaccine typically goes into the deltoid region of the arm,
Speaker 1: where lots of other vaccines go. Then the person gets
Speaker 1: three more doses of vaccine that are spread out in
Speaker 1: the days that follow, again as injections into the shoulder area.
Speaker 1: Also using a vaccine that is like cultured and tissues
Speaker 1: and a lot safer than what was being used in
Speaker 1: the past. This process can be a little bit different
Speaker 1: for children or if a person is um you know, compromised,
Speaker 1: or if a person has been previously vaccinated for rabies.
Speaker 1: That's something that's typically only done based on a person's
Speaker 1: risk for being exposed to rabies. As another side note,
Speaker 1: we have been really really focused on bites here because
Speaker 1: the overwhelming majority of rabies exposures come from bites or
Speaker 1: possibly scratches. There are some other ways to contract the disease,
Speaker 1: but they're extraordinarily rare, like through the eyes or mucous membranes.
Speaker 1: If someone is exposed to aerosolized rabies virus in some way,
Speaker 1: or because rabies can closely resemble various types of encephalitis,
Speaker 1: it is sometimes missed as a diagnosis when doctors don't
Speaker 1: know that the person was bitten by an animal. This
Speaker 1: has led to an extremely small a number of rabies
Speaker 1: transmissions through organ transplants, although the risk of this is
Speaker 1: extremely remote. After their first report of it happening, many
Speaker 1: organ procurement organizations started including screening questions to try to
Speaker 1: rule out this possibility. Circling back around to rabies and
Speaker 1: pop culture, This was actually a plot line on the
Speaker 1: TV show Scrubs. Its sounds truly horrifying, but also like
Speaker 1: the disease process that rabies causes, like in the umbrella
Speaker 1: of encephalitis, And if a doctor doesn't know that a
Speaker 1: person was bitten by an animal or picked up a
Speaker 1: bat or whatever, like it's most doctors have never seen
Speaker 1: a case of rabies in their career, and it's not
Speaker 1: the thing that first comes to mind. In two thousand four,
Speaker 1: fifteen year old Gina Geezy and her medical team made
Speaker 1: headlines after she became the first person known to survive
Speaker 1: rabies after starting to develop symptoms. She had picked up
Speaker 1: and been bitten by a bat, and although her wound
Speaker 1: was cleaned with hydrogen per beside, she wasn't taken in
Speaker 1: for further treatment. She started developing symptoms about a month later,
Speaker 1: and then about six days into her illness reported having
Speaker 1: been bitten by the bat. Doctors placed ge Zy in
Speaker 1: a medically induced coma and gave her anti viral drugs
Speaker 1: and other treatments. These treatments continued until tess suggested that
Speaker 1: her body was fighting off the virus, and at that
Speaker 1: point she was brought out of the coma. She survived
Speaker 1: this experience, and news outlets have continued to report on
Speaker 1: her life into the year one. At the time, this
Speaker 1: seemed like a hopeful sign that what came to be
Speaker 1: known as the Milwaukee Protocol would make it possible to
Speaker 1: cure people after they started showing symptoms of rabies, but
Speaker 1: efforts to replicate that success have been largely unsuccessful. One
Speaker 1: paper in the Journal of the Brazilian Society of Tropical
Speaker 1: Medicine traced thirty eight published uses of the Milwaukee Protocol,
Speaker 1: including one use of a similar protocol called the Recipe
Speaker 1: proto Call. Only eleven of those patients survived, with all
Speaker 1: but five of them having moderate to severe complications afterward.
Speaker 1: This is certainly an improvement over a disease with an
Speaker 1: essentially fatality rate, but these numbers may be deceptively optimistic.
Speaker 1: Three of the people who were described as having survived
Speaker 1: did make it through the most critical part of the illness,
Speaker 1: but they still died. At least one of the patients
Speaker 1: may not have actually had rabies, and there's been no
Speaker 1: coordinated method for tracking when this protocol has or hasn't
Speaker 1: been attempted. It's likely that anyone who tried it and
Speaker 1: succeeded would publish their results. But it's also possible that
Speaker 1: people who tried it and failed have not yet. There
Speaker 1: are some papers like Opinion Commentary written by teams of
Speaker 1: doctors that are like this does not work and we
Speaker 1: need to stop focusing our effort on it, and others
Speaker 1: that are a little bit more like this may need
Speaker 1: some other refining before it could work. Aside from all that, though,
Speaker 1: all the patients described in these publications spent at least
Speaker 1: a month in the hospital with extensive care throughout their stay,
Speaker 1: so it's extremely unlikely that this protocol could really be
Speaker 1: put into use in the places where human deaths from
Speaker 1: rabies are the most prevalent. These places tend to be
Speaker 1: rural and poor without a lot of health care infrastructure.
Speaker 1: Places where people don't have access to Raby's profile axis
Speaker 1: are likely to also be places where people don't have
Speaker 1: access to a hospital that could support this kind of treatment. Also,
Speaker 1: it's extremely clear at this point that coordinated programs of
Speaker 1: public education and dog vaccinations and sometimes vaccinations in particular
Speaker 1: wild animals, can lower the number of human Raby's deaths enormously,
Speaker 1: and places that don't have the resources to support those
Speaker 1: kinds of programs and initiatives are really likely not to
Speaker 1: have the resources to support hundreds or thousands of people
Speaker 1: with long term hospital stays and medically induced comas. It's like,
Speaker 1: even if this worked, it would really be working for
Speaker 1: the wealthiest countries in the world and not the places
Speaker 1: where treatment is most needed. So all of that said,
Speaker 1: the global cost of rabies is roughly eight point six
Speaker 1: billion dollars per year, and more than fifteen million people
Speaker 1: per year received rabies PEP. This protocol can be really expensive.
Speaker 1: In the United States, it can cost between twelve hundred
Speaker 1: and sixty hundred dollars. Yeah, that's like one estimate that
Speaker 1: I can saw that I saw. I saw something that
Speaker 1: were even higher than that. September twenty eight every year
Speaker 1: is World Raby's Day. That's also the anniversary of the
Speaker 1: death of Louis Pasteur. Well, that's a basic history of rabies. Rabies.
Speaker 1: My my hope is that in the future will at
Speaker 1: least get to the point where the places in the
Speaker 1: world that have lots of free roaming dogs also have
Speaker 1: those dogs vaccinated, because that's really where like so much
Speaker 1: feeding back into the greater environment and so much feeding
Speaker 1: into humans cases of rabies, Like it's all interconnected with
Speaker 1: the dogs. Yeah. I think we mentioned it at the
Speaker 1: top of our episode on the history of veterinary medicine
Speaker 1: that one of the vets at my practice participates in
Speaker 1: a program where she goes to countries where the dog
Speaker 1: population is not well vaccinated and tries to just do
Speaker 1: as many vaccinations as they can in a short period
Speaker 1: of time. Yeah, they had gone some mallowe I think.
Speaker 1: And Malawi's target is like se of the dog population vaccinated,
Speaker 1: which would do a lot to reduce the number of
Speaker 1: human deaths, but still would like there would still be
Speaker 1: a reservoir of circulating rabies among dog populations. There are
Speaker 1: a lot of sad parts to that, but one of
Speaker 1: the saddest parts is like a lot of the a
Speaker 1: lot of the people who die of rabies are like
Speaker 1: just a kid that wanted to pet a dog. So anyway, uh,
Speaker 1: I haven't a listener mail it's about animals, um, it's
Speaker 1: not about rabies. It's from Kaylee, And it followed our
Speaker 1: episodes on Shackleton. Kaylee rode in and said, Hi, Holly
Speaker 1: and Tracy, I'm a huge fan of yours. I've been
Speaker 1: listening to your podcast for years. I finally have something
Speaker 1: to write to you about. I just listened to the
Speaker 1: Endurance episodes. I can't wait for your behind the scenes
Speaker 1: episodes about it. I'm a children's librarian in Maine, and
Speaker 1: it's my job to try to read as many books
Speaker 1: in our children's collection in order to give recommendations. Well,
Speaker 1: a twenty nineteen book called Fearless Felines thirty True Tales
Speaker 1: of Courageous Cats came across my desk a few months back,
Speaker 1: and as an avid cat lover, I opened up the
Speaker 1: book and immediately started reading. The first story I happened
Speaker 1: to see was about Mrs Chippy, the explorer cat aboard
Speaker 1: the Endurance. According to this children's book and other research,
Speaker 1: I found, Mrs Chippy would climb in the rigging and
Speaker 1: walker along the narrow ship rails, even in bad weather.
Speaker 1: There was one episode where Mrs Chippy jumped through the
Speaker 1: porthole and the crew had to rescue him after he
Speaker 1: spent ten minutes in the water. When I read the
Speaker 1: part about the ship getting stuck in shackleton, making tough
Speaker 1: decisions and this meant no more Mrs Chippy, I absolutely
Speaker 1: lost it and hit in the library basement, bawling my
Speaker 1: eyes out. As a highly sensitive person, sometimes I wonder
Speaker 1: if I can make it as a children's librarian from
Speaker 1: all the books I've read that have caused tears. Fast
Speaker 1: forward to more recent weeks than I was driving to
Speaker 1: work and listening to NPR and the story of the
Speaker 1: Endurance wreckage being discovered came on. A descendant of Shackleton
Speaker 1: was talking about how their great grandfather was a hero
Speaker 1: and brave and all I could do was hell but
Speaker 1: he killed Mrs Chippy at the radio, listening to your
Speaker 1: episodes about Shackleton and the Endurance gave me another perspective.
Speaker 1: Though Shackleton clearly cared about his crew, from their health
Speaker 1: to the morale. Their situation was dire, and I'm glad
Speaker 1: Mrs Chippy, along with the puppies and dogs, didn't starve
Speaker 1: to death. You probably found this in your research. But
Speaker 1: mc nish, the carpenter on the Endurance, held a grudge
Speaker 1: against Shackleton after the whole Mrs Shippy Ordeal McNish died
Speaker 1: penniless and was buried in an unmarked grave. In nineteen thirty.
Speaker 1: The New Zealand Antarctic Society gave him a headstone in
Speaker 1: nineteen fifty nine, and then in two thousand four, a
Speaker 1: life size bronze statue of Mrs Chippy was built on
Speaker 1: his grave. Visiting his grave and the Mrs Chippy memorial
Speaker 1: is now on my bucket list and if I make it,
Speaker 1: I'll be sure to send a picture. But in the meantime,
Speaker 1: here's a picture of my cat family I rescued last summer.
Speaker 1: Past regards from a librarian considering joining Peter Cayley, thank
Speaker 1: you so much for this email. You are not the
Speaker 1: only person who commented in some way about being angry
Speaker 1: at Shackleton about Mrs Chippy. Like when we put the
Speaker 1: episode on our on our social media, there were various
Speaker 1: comments that said things like he killed Mrs Chippy, he's
Speaker 1: a monster of and it uh, it reminded me a
Speaker 1: little bit um. Some years ago, we were having a
Speaker 1: conversation about potential future episode topics and suggestions on our
Speaker 1: Facebook page or somewhere, and there were a lot of
Speaker 1: people who were asking for LM. Montgomery, who wrote Ann
Speaker 1: of Green Gables, who was definitely on my to do
Speaker 1: list for an episode. And there was one particular person
Speaker 1: who had been apparently traumatized by a scene in one
Speaker 1: of the later books that involves a cat being killed,
Speaker 1: and then was like commenting in reply to every single
Speaker 1: person who suggested that topic with like how horrible the
Speaker 1: cat death was, And I was like you, clearly, this
Speaker 1: is something that really upset you as a child. But
Speaker 1: attitudes about animals were very different at the time, and
Speaker 1: like what people thought of as the humane way to
Speaker 1: treat animals not the same as we think of now
Speaker 1: when we think of pets as family members. A very
Speaker 1: different situation, and I understand how upsetting it can be.
Speaker 1: But like Kaylee, I'm glad that the animals who were
Speaker 1: with Shackleton, although we could have a whole argument about
Speaker 1: whether they should have been there in the first place,
Speaker 1: glad that they did not face some of the dire
Speaker 1: situations of of hunger and cold and all of that
Speaker 1: that the that the men faced. Um, so thank you
Speaker 1: for this email and the picture. And the story is
Speaker 1: about Mrs Chippy. I didn't put a lot about Mrs
Speaker 1: Chippy in the episode itself because I didn't want to
Speaker 1: make the end of Mrs Chippy even sadder than it
Speaker 1: already was. Like part of me didn't even want to
Speaker 1: put the name Mrs Chippy in there, but some how
Speaker 1: that made it harder. Um, so thank you for giving
Speaker 1: me the chance to share some Mrs Chippy stories. You
Speaker 1: would like to write to us about this or any
Speaker 1: other podcasts for a history podcast at iHeart radio dot com.
Speaker 1: And we're all over social media at MS in history
Speaker 1: That's Real Fight or Facebook, Twitter, Pinterest, and Instagram. And
Speaker 1: you can subscribe to our show on the iHeart Radio
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