Season 1 · Episode 8
Rabies Day Out
How does the Google no internet Dinosaur Game connect to Rabies? Haunt over the Raven by Edgar Allan Poe, classic Universal monster movies, psychological thriller and horror by Hitchcock, Kubrick, and Stephen King – including Cujo, and rabies and post exposure vaccine treatment.
In this episode
Edgar Allan Poe
Public domain
Rabies Virus
© F. Murphy, UTMB, public domainThe Tapping at the Chamber Door#
A storm knocks out the power, the internet dies, and you find yourself playing the little dinosaur game that appears when a browser has nothing to connect to. It is nearly Halloween. Somewhere in that ordinary evening is a path to one of the oldest and most terrifying diseases on Earth, because the road from a no-signal dinosaur to rabies runs through the literature of fear. Once upon a midnight dreary, as the most famous opening in American gothic has it, while the narrator nods nearly napping, something comes tapping at the chamber door. Edgar Allan Poe wrote that, and Poe died young and strangely, found delirious in borrowed clothes on a Baltimore street in 1849, and among the many theories about what killed him is rabies. That is fitting for a Halloween episode whose subject is the disease under the monsters. Rabies is older than the werewolf and the vampire stories that still echo its symptoms, and almost uniquely among those horrors, it is one we learned how to interrupt.
The Monster Behind the Monsters#
Trace the family tree of scary stories and Poe sits near the root. He gave us the modern horror tale and, in the same stroke, invented detective fiction. The gothic writers, Poe and Mary Shelley and Bram Stoker, fed directly into the great Universal monster movies of the 1920s through the 1940s, a run of films that gave Depression-era audiences a cheap hour of escape and gave us the silhouettes we still put on porches: Dracula, Frankenstein’s creature, the Mummy, and, most to the point, the Wolf Man. The lineage continues through Hitchcock and Kubrick and lands on Stephen King, the most adapted horror writer alive, whose early novel Cujo turns a beloved family Saint Bernard into a slavering killer that traps a mother and child in a broiling car. That dog is not possessed or supernatural. The dog has rabies.
Once you notice that, the same clinical picture keeps surfacing under older monsters: a familiar creature, a dog or a wolf or a person, that loses its mind, fears nothing, recoils from water, and passes its condition through a bite. The werewolf transformed by a bite, the vampire whose bite recruits new vampires, the loyal animal turned murderous, are folklore wearing symptoms that match a real virus. Rabies turns the bitten into biters. Horror writers were not inventing from nothing so much as remembering a pattern people had watched for centuries.
Madness in Latin#
The word rabies is Latin for madness, which is about as accurate as a disease name gets. It takes two broad forms, and the one we picture is furious rabies, with its hallmark cluster of agitation, erratic and aggressive behavior, drenching salivation, and the eerie symptom that gave the disease its old name of hydrophobia: a fear of water, caused by violent throat spasms so painful that the victim cannot swallow and may panic at the mere sight of liquid. Some patients react the same way to a puff of air. The animals show a strange tell, looking drunken and slow one moment and striking with shocking speed the next.
It is not a historical curiosity. The World Health Organization estimates that rabies still kills on the order of forty-four thousand people a year, the overwhelming majority in Africa and Asia, and roughly four in ten of the dead are children. Around the world, dogs are responsible for some ninety-nine percent of human cases; in the United States, where dog rabies is controlled, the usual sources are raccoons, skunks, foxes, and bats. Small animals like rats and mice almost never carry rabies and have not been known to pass it to people. And here is the fact that makes rabies the most frightening entry in this whole series: once symptoms appear, it is virtually one hundred percent fatal. In all of recorded history only about three dozen people are known to have survived symptomatic rabies, most with severe lasting damage. There is no monster in any movie with a kill rate like that.
The Slow Crawl to the Brain#
Under a microscope the virus looks the part, shaped like a blunt bullet. It belongs to the genus Lyssavirus. After a bite, the virus enters muscle and nerve endings, though which molecules it uses to attach are still debated, then slips into the nervous system and travels up the long fibers of the nerve cells toward the spinal cord and brain. It hijacks the cell’s own internal transport machinery and moves slowly, about two to four inches per day. When it reaches the brain and replicates there, clinical rabies begins. Then the virus travels back outward to the salivary glands, loading the mouth with infectious particles so that the host’s next bite delivers the disease to a new victim. The animal has been turned into a delivery system.
A schematic of that path. How long it takes varies, and which molecules the virus uses to enter a nerve are still argued, so no receptor is named. Once symptoms have begun, rabies is almost always fatal. This figure does not say what anyone should do after a bite.
Sources: Fooks, Cliquet, Finke and colleagues, Nature Reviews Disease Primers (2017); Davis, Rall and Schnell, Annual Review of Virology (2015); World Health Organization, Rabies fact sheet.
That slow crawl up the nerves is what makes rabies so hard to stop once symptoms start, and what leaves a usable gap beforehand. Because the virus can take weeks, sometimes longer, to travel from a bite on the leg to the brain, there is a window. If the body’s defenses are ready before the virus arrives at the central nervous system, post-exposure vaccination can still work. Almost everything that saves people in this story depends on that gap of time.
The One Monster We Beat#
People have dreaded rabies for as long as there are records. There is a Mesopotamian legal code from around 1930 BC fining the owner of a dog that bit someone to death, and through the Middle Ages dogs were branded with a red-hot iron called St. Hubert’s Key, while desperate sufferers had their wounds cauterized in an attempt to burn the disease out. Nothing worked, and for almost all of human history a bite from a rabid animal could be a death sentence. Then, in 1885, Louis Pasteur changed it. Working with attenuated virus he had aged by drying out the spinal cords of infected rabbits, and famously not a physician himself, Pasteur treated a nine-year-old boy named Joseph Meister who had been bitten more than a dozen times by a rabid dog. Over about ten days the boy received a series of increasingly potent injections, and he lived. It was the birth of the Pasteur Institute and of an idea that still saves lives. Meister survived into adulthood and worked at the Institute for more than twenty years before his death in 1940.
What Pasteur discovered is that you can vaccinate someone after they have already been exposed, a strategy called post-exposure prophylaxis, and it works precisely because the virus moves so slowly. The modern version pairs an immediate dose of antibodies, which buy short-term protection, with a series of vaccine shots that train the body to make its own, and given promptly it is close to one hundred percent effective. The catch, which cannot be stressed enough, is that it has to happen before symptoms begin; once the virus reaches the brain, the window has closed. There are exceptions so rare they prove the rule, like the case of Jeanna Giese, a teenager who in 2004 became the first known unvaccinated person to survive symptomatic rabies after doctors placed her in an induced coma in a last-ditch experiment, an approach that has rarely worked since. Meanwhile, the most effective prevention happens before anyone is bitten at all: vaccinating the animals, including wild ones, sometimes by air-dropping millions of vaccine-laced baits over the woods.
From a midnight dinosaur game to a bullet-shaped Lyssavirus by way of Poe, the Wolf Man, and Cujo, the thread ends on a disease that still kills tens of thousands of people a year, about four in ten of them children, most of them in places with less access to post-exposure care. Unlike the monsters it helped inspire, rabies has a weakness: that slow nerve crawl. A person bitten in the dark can still get to a clinic before symptoms begin and walk back out. It took four thousand years of dread and Pasteur drying rabbit spines in a Paris lab, but the disease can be outrun a few inches of nerve at a time.
Corrections to the audio#
The episode audio states a number of things that are wrong. The corrections:
- At 03:57, Universal’s classic monster era did not end in the early 1940s. Its Frankenstein, Dracula and Wolf Man films ran to 1948 (AFI Catalog).
- At 04:40, The Black Cat came out in 1934, not 1935 (AFI Catalog).
- At 04:48, Lon Chaney Jr. was not in Universal’s three Poe films, which starred Bela Lugosi and, in two of them, Boris Karloff (Murders in the Rue Morgue, The Black Cat and The Raven, AFI Catalog). The Hunchback of Notre Dame (1923) and The Phantom of the Opera (1925) starred Lon Chaney, not Lon Chaney Jr., and came before the Poe films (The Hunchback of Notre Dame and The Phantom of the Opera, AFI Catalog).
- At 15:07 and 21:26, we say rabies kills about 17,000 people a year, half of them children. The World Health Organization puts the toll at tens of thousands of deaths a year (44,203 in its 2021 estimate), about 40% of them children under 15.
- At 15:19, the 55,000 to 60,000 deaths a year is not a figure from 30 years ago. About 59,000 a year is a 2015 estimate (Hampson and colleagues).
- At 16:23, the virus is said to move along nerves at less than half an inch to at most 15 inches a day. Retrograde transport in human nerves runs at roughly 50 to 100 millimeters, about two to four inches, a day (Scott and Nel).
- At 16:51, the Mesopotamian Laws of Eshnunna date to about 1930 BC, not 2300 BC (Tarantola).
- At 17:41, at the abbey of Saint-Hubert the red-hot St. Hubert’s Key was applied to dogs, not to the wounds of bitten people, whose foreheads were incised instead (Tarantola).
- At 18:16, the year of Pasteur’s first human treatment is wrong. He treated Joseph Meister starting on July 6, 1885, not 1886 (Institut Pasteur).
- At 18:42, Pasteur’s preparation was not a killed vaccine. Meister received thirteen injections of a progressively more virulent rabid spinal cord preparation over ten days (Institut Pasteur).
- At 19:31, Joseph Meister was not 60 in 1940. He was born in 1876 and was nine when treated in July 1885, so he was 63 or 64 (Institut Pasteur).
- At 20:19, in modern post-exposure treatment the rabies immune globulin goes into and around the wound, and the four vaccine doses go into the upper arm (deltoid) on days 0, 3, 7 and 14 (Maine CDC summary of the ACIP regimen ).
- At 20:39, about 29 million people receive rabies vaccine each year, not 50 million (World Health Organization).
- At 21:06 and 21:30, about 34 people, not 15, are well documented as having survived rabies after symptoms began (Jackson).
Hosts
- Dr. Dustin Edwards
- Dr. Faith Cox
Chapters
Sources and Credits
- CreditWritten and performed by Dr. Dustin Edwards and Dr. Faith Cox (another site)
- MusicGraveyard Shift, Day of Chaos, and Distant Tension by Kevin MacLeod (another site)incompetech.comCC BY 4.0
- MusicToccata et Fugue by Johann Sebastian Bach (another site)Public domain
- MusicAlso Sprach Zarathustra by Richard Strauss, performed by Kevin MacLeod (another site)CC BY 3.0
- MusicThunder by Mike Koenig (another site)SoundBibleCC BY 3.0
- MusicGodzilla roar (another site)SoundBiblePublic domain
- ImageEdgar Allan Poe (circa 1849) (another site)Public domain
- ImageRabies virus (another site)Frederick MurphyUniversity of Texas Medical BranchPublic domain
- referenceDeath of Edgar Allan Poe (another site)WikipediaPoe was found delirious in Baltimore on Oct 3 and died Oct 7, 1849, at age 40; proposed causes include cooping, alcohol, rabies, and others; a 1996 Maryland Medical Journal analysis by cardiologist R. Michael Benitez argued for rabies.
- referenceThe (Still) Mysterious Death of Edgar Allan Poe (another site)Smithsonian MagazineBenitez's 1996 rabies diagnosis rested on delirium, hallucinations and swings in pulse and breathing; caveats include that Poe was reported drinking water and that no bite was recorded.
- referenceEdgar Allan Poe (the Poe Toaster) (another site)WikipediaFrom 1949 to 2009 an unknown 'Poe Toaster' left a bottle of cognac and three roses at Poe's grave each January 19; Poe pioneered the detective story and the American gothic tale.
- referenceLyssaviruses and the Fatal Encephalitic Disease Rabies (another site)PMC (Frontiers in Immunology)After a bite the virus travels up nerves to the brainstem and brain, where symptoms appear, then spreads to the salivary glands for transmission; dog strains classically cause hydrophobia and aerophobia.
- referenceRabies threatens as a preventable viral disease (pathogenesis) (another site)PMCRabies virus undergoes retrograde axonal transport from the bite up motor and sensory neurons to the spinal cord and brain, then centrifugal transport out to the salivary glands; an enveloped negative-sense RNA virus of genus Lyssavirus, family Rhabdoviridae.
- referenceRabies (Fact Sheet) (another site)World Health OrganizationTens of thousands of deaths annually (44,203 in the 2021 Global Health Estimates), about 40% in children under 15; dogs cause 99% of human cases; once clinical symptoms appear rabies is virtually 100% fatal, but deaths are preventable with prompt post-exposure prophylaxis.
- referenceBiting Back (Pasteur, Meister, and post-exposure prophylaxis) (another site)Science History InstituteIn 1885 Pasteur treated 9-year-old Joseph Meister, bitten 14 times by a rabid dog, who survived; modern post-bite treatment pairs rabies immune globulin with vaccine and exploits the virus's long incubation, with a success rate near 100%.
- referenceVaccine profiles: rabies (Pasteur, Meister, and Jeanna Giese) (another site)GaviPasteur passaged and then desiccated infected rabbit spinal cords to weaken the virus; in 2004 15-year-old Jeanna Giese of Milwaukee was hailed as the first survivor of symptomatic rabies after a medically induced coma; vaccinating 70% of dogs is the most effective prevention.
- referenceFour Thousand Years of Concepts Relating to Rabies in Animals and Humans, Its Prevention and Its Cure (another site)Arnaud TarantolaTropical Medicine and Infectious Disease (2017)The Laws of Eshnunna (ca. 1930 BCE) set a fine for the owner of a dog whose bite killed a person; at Saint-Hubert a white-hot Key of Saint Hubert was applied to dogs as prevention, while bitten people had their foreheads incised; cauterization of bite wounds remained widespread into the 19th century.
- referenceHouse of Dracula (1945) (another site)AFI CatalogThe seventh Universal film to feature Frankenstein's Monster and the fourth with Dracula and the Wolf Man; all three appeared again in Universal's 1948 Abbott and Costello Meet Frankenstein.
- referencePoe Biography (another site)The Poe Museum"The Murders in the Rue Morgue" was the first modern detective story; Poe's contribution to horror is what makes him famous today, and he was one of the first to write psychological horror.
- referenceThe Living Authors with the Most Film Adaptations (another site)Emily TempleLiterary Hub (2017)Counting theatrical film adaptations, Stephen King leads living authors with 34.
- referenceCujo (another site)StephenKing.comPublished September 8, 1981; a Saint Bernard bitten by a rabid bat turns killer and traps a mother and her young son in their car.
- referenceRabies (etymology) (another site)Merriam-WebsterFrom Latin rabies, madness, from rabere, to rave.
- referenceDemise of the Milwaukee Protocol for Rabies (another site)Alan C. JacksonClinical Infectious Diseases (2025)There have been only about 34 well-documented survivors of clinical rabies, and most have serious neurological sequelae; there are no high-quality reports of Milwaukee protocol survivors beyond the 2004 index case, against at least 64 reported failures.
- referenceUsing Integrated Bite Case Management to estimate the burden of rabies and evaluate surveillance in Oriental Mindoro, Philippines (another site)Swedberg, Hampson and colleaguesOne Health & Implementation Research (2023)Uses a probability of 0.165 (range 0.124-0.206), taken from earlier work, that a rabid-animal exposure without post-exposure prophylaxis leads to rabies.
- referenceThe history of the first rabies vaccination in 1885 (another site)Institut PasteurJoseph Meister (1876-1940) was vaccinated every day for ten days; the treatment joined a laboratory scientist, Pasteur, with a clinician, Dr. Joseph Grancher, who gave the injections.
- referenceJoseph Meister, le premier guéri de la rage (another site)Pierre AnceryRetroNews (BnF)From 1918 Meister was the Institut Pasteur's concierge, a post he held until his death in 1940.
- referenceRecovery of a Patient from Clinical Rabies, Wisconsin, 2004 (another site)CDC, Morbidity and Mortality Weekly ReportA 15-year-old girl kept in a drug-induced coma became the first documented recovery from clinical rabies by a patient who had received neither pre- nor postexposure prophylaxis.
- referenceOral Rabies Vaccination (fact sheet) (another site)USDA APHIS Wildlife ServicesMore than 8 million oral rabies vaccine baits are distributed each year across 16 eastern states, mostly by air; fixed-wing aircraft disperse baits in rural areas.
- referenceMurders in the Rue Morgue (1932) (another site)AFI CatalogUniversal's Poe adaptation, released 21 February 1932, with Sidney Fox and Bela Lugosi.
- referenceThe Black Cat (1934) (another site)AFI CatalogUniversal's film based on Poe's short story, released 7 May 1934, with Karloff and Bela Lugosi.
- referenceThe Raven (1935) (another site)AFI CatalogUniversal film released 8 July 1935, with Karloff and Bela Lugosi.
- referenceThe Hunchback of Notre Dame (1923) (another site)AFI CatalogUniversal silent film released 6 September 1923, starring Lon Chaney.
- referenceThe Phantom of the Opera (1925) (another site)AFI CatalogUniversal film released 15 November 1925, starring Lon Chaney.
- referenceEstimating the global burden of endemic canine rabies (another site)Katie Hampson and colleaguesPLOS Neglected Tropical Diseases (2015)Estimates that canine rabies causes approximately 59,000 (95% CI 25,000-159,000) human deaths a year.
Transcript
Storm chatter and dinosaur costumes
Edgar Allan Poe and his mysterious graveside visitor
Universal Pictures and the classic monster movie era
Hitchcock, Kubrick, and the rise of psychological horror
Kubrick, The Shining, and Stephen King's Cujo
Dustin's late night rat bite scare
Furious rabies symptoms and real footage
How rabies spreads between animals and humans
How rabies virus travels through the nervous system
Ancient records and medieval rabies treatments
Pasteur, Roux, and the first rabies vaccine
Joseph Meister's later life and death
The modern post-exposure rabies vaccine
Jeanna Giese and the Milwaukee Protocol
Vaccinating wild animals with aerial bait drops
Hosts share their own horror movie scars