rabid humans

rabidity in humans

Characteristics of rabies in humans are very similar to those in other mammals, differences reflecting our basic differences in physiology, behavior, and culture.  I pause here to remind everyone that only mammals, including humans, are susceptible to rabies infection.  Gators and geese and giant anacondas can be very aggressive, but they cannot be rabid!

Hydrophobia is the classic symptom of rabies infection in humans as it is in other mammals, occurring in the vast majority of victims and unique to rabies.  Victims may initially experience pain in the throat or difficulty swallowing.  Symptoms progress to the point that when attempting to swallow water, the victim experiences contraction of the diaphragm and other muscles associated with breathing including the sternocleidomastoids and scalenes.  These spasms may be followed by contraction of neck muscles and may be associated with retching, vomiting, coughing, and grimacing, and even extending to convulsions and hypoxia.  Initially a direct reaction to trying to swallow water, these spasms soon become associated with the sight, sound, or even mention of water.  Water splashed on the skin can produce similar reactions (“I’m melting, melting.  Oh, what a world….”)

Increased saliva is apparent, but humans do not salivate heavily like dogs and wolves preparing to ingest a meal.  Spitting may be the main sign of increased saliva in humans rather than actual foaming at the mouth.  Difficulty in swallowing would, of course, increase the saliva retained in the mouth so that hypersalivation per se would not be necessary to pass on the virus to victims.

Agitation, increased anxiety, and irritation can be among the earliest symptoms in humans, as in other mammals.  This may lead to violence including kicking and biting.  The only documented case of human to human transmission of rabies is that of a rabid 5-yr old biting his mother on the finger.  The paucity of documented human-to-human transmission has led some experts to state that humans are “dead-end victims”.  Certainly in modern, civilized society, biting is strongly sanctioned from a very early age.  Clearly, however, biting has ever been a threat.  The ancient Greek combat sport of pankration had only two restrictions - no biting and no eye-gouging.  This was apparently ignored by Spartans who were therefore banned from the ancient Olympics.  Similarly, a colorful exhortation at the beginning of any boxing match or similar combat sport is to have a ‘clean fight, no biting or gouging, or hitting below the belt’.  To have been specifically banned in the earliest rules of boxing, e.g., the London Prize Ring Rules of 1853, indicates that biting was not uncommon. And, Mike Tyson biting off a piece of Evander Holyfield’s ear vividly reminds us that biting is still a very prepotent human behavior, not one to be dismissed lightly.  Biting has regained popularity in the actions people should consider using when defending themselves against physical attacks.  The dangers of human bites, rabid or not, are well-documented – our mouths are a treasure trove of bacteria.  Still, human teeth are not designed to rend or even penetrate fresh flesh like those of other carnivores.  Skinning, cooking, and the use of utensils are important to our ability to eat other animals.  As transmission of the rabies virus requires its insertion through the skin, humans are particularly poorly suited for the task.  My Mom even joked that she was evolving into a more civilized being because her canines were so small.  Still, although humans are poorly suited for transmitting rabies, we should recognize that biting was not uncommon among our ancestors and that human-to-human transmission probably did occur, especially during fights that would have created open wounds in which virus-laden saliva could penetrate.  Characterizing us as dead-end victims as far as rabies is concerned is true, but not accurate.

Restlessness, including escape from closed rooms, and roaming are notable traits of rabid humans.  Periods of agitation and disorientation occur, separated by periods of lucidity.  Episodes of confusion with hallucinations and aggressive behavior may occur for short periods of time.  These may be brought on by sensory stimuli, but may occur spontaneously.

Aerophobia is also a common symptom of rabies infection in humans.  A fan test, that is blowing air on a potential victim to observe their reaction, is a quick way to increase the suspicion that a person has been turned.  Bright lights and loud sounds can also trigger fearful reactions, muscular spasms, or attack-like behavior.  General hyperesthesia is also common.         

And, to the dismay of early, pious authors (or their editors), persistent priapism and recurrent ejaculation in men, and excessive libido in both genders has been reported.  Presumably, such symptoms are under-reported publicly, but can be found directly or alluded to in multiple reports.  For example, a woman “suddenly developed excessive sexual desire. This continued for three days. Her husband… had never noticed such behavior during nine years of married life.”  A few days later she developed the gold standard symptoms of rabies, and unfortunately succumbed.  Another report documents that recurrent ejaculation occurred in a patient at least eight hours before aerophobia was noted.  Reading between the lines of many early accounts, increased sexual behavior appears to be a common symptom of rabies infection.  Of particular note is that this increased sexual behavior can occur prior to other symptoms.  Thus, along with similar behaviors in other mammals, this ties in similar tendencies among reports of vampires (and werewolves, if they weren’t too busy giving their victims ferocious love nips…).  As the reader hopefully knows, nipping/biting is a common feature of frenzied sexual abandon.  Think only vampires and werewolves ‘vant to bite your neck’?  Think, no, feel, again!

Beavers in Belarus -- rabies is very alive

I have to interrupt the sequence of this blog to rail against additional victims of the rabies virus.  I’d like to think the report, with video, of a beaver attacking and killing a man is a hoax.  It is a sad and a horrific occurrence.  What it brings to the fore is that wild animals normally avoid open places during daylight – an unsheltered trail/road especially.  When one encounters an untamed animal out in the open, seemingly unaware or undisturbed by the presence of human beings, it’s a very good sign to avoid that animal.  It may appear cute or just interesting, but it almost certainly has rabies, and given the opportunity will attempt to pass the virus on.  Rabies may not create large epidemics, but it effectively manages to get passed on from one victim to another; this attack clearly shows how.

This latest incident is particularly sad because although the victim would likely have been exposed to rabies, we know that the rabies vaccine is very effective at capturing and ridding the body of the viral particles before they find the doorway into the central nervous system.  But, beavers have large, strong teeth and powerful jaw muscles that can rend trees to pieces.  They can easily rend human flesh.  In this case those teeth did the virus’s bidding too well, killing the victim before it could try to pass the virus on.

Sad also is the death of a soldier bitten while breaking up a fight between a dog, kept as a pet on his base, and another, feral, dog.  Eight months later he is dead. Why wasn't he immediately given the rabies vaccine!  Probably he was a bit embarrassed about allowing himself to be bitten, about breaking regulations and allowing a pet on base, about drawing attention to a dumb, little wound.  None of that matters; the virus doesn't give second chances.  He should have sought out and been given the rabies vaccine immediately and without any question!

Normally wild animals move away from humans.  When they don’t, the humans should move away!  People learn to avoid humans who exhibit the kind of explosive behavior the beaver displayed as well.  Unfortunately, these individuals don’t advertise their hair trigger volatility as clearly as a wild animal found rambling about in the open.  Or, we think we can change them with love and understanding, not realizing that these emotional time-bombs have little, if any, voluntary, conscious control over their behavior.  If only we could really help these people to reduce their volatility; allow them the time to be aware of their traits and to try to control themselves before they explode.  

Well, that’s the point of this blog, to say we can!  But, to do that, we must discover the root of how rabies manipulates our nervous system, how it turns us into human vampires and werewolves.  Then we will be able to treat the rampages.  We have the tools and the knowledge, we just need the will.

Rabidity in animals

Rabidity in animals

Of the symptoms of rabies infection in animals, hydrophobia, an aversion to water and especially the drinking of water, is a hallmark, and unique, sign.

Excessive salivation is frequently noted.  This is important because it is the saliva of the infected animal that contains the viral particles that must be passed on to a new victim, to turn them.

Nervousness and irritability are often noted; the infected animal exhibiting a posture and expression of alertness and anxiety.  Pupils are dilated; an indication of activation of the ‘fight or flight’ sympathetic nervous system.  

Infected animals are aggressive.  In response to the slightest provocation they may viciously and aggressively use teeth, claws, horns and hooves against animate and inanimate objects.  They may attack inanimate objects, such as the bars of a cage, with no apparent response to pain, to the point that they can break their teeth trying to bite through the bars.

Roaming is a strong characteristic, just walking and running.  Roaming is generally punctuated by multiple attacks on animals encountered.

Hyperactivity (and strong efforts to escape restrictions to movement such as cages), disorientation, and confusion are symptoms, extending to the observation that horses act as if they are blind.  In this confused state, rabid animals approach other animals they would normally avoid, humans for one.  A number of veterinarians report that rabid dogs or wolves commonly smell of skunk, indicating they have foolishly, and uncharacteristically, provoked a skunk.  Another fairly sure sign of rabies infection is a fox or coyote whose snout looks like a pin cushion, full of porcupine quills, indicative of an interaction they would normally avoid.  In addition, normally nocturnal animals, e.g. bats, are found in the open during daylight.

An infected animal will often withdraw from its companions, and go off roaming alone.  However, they may also seek comfort, such as a rabid pet kitten climbing up to lay in its owner’s lap, only to then bite the owner when it is petted.  It is reported that rabid bats emit a distress call resulting in other bats approaching the infected bat to comfort/protect it, only to become bitten themselves.  Whether these distress calls are simply signs of distress or a ruse to turn more victims is not possible to tell.  Either way, the result is that the rabid bat gains access to more victims.

Abnormal reactions to sensory stimuli are part and parcel of rabies infection in animals.  Aerophobia is often noted, denoting a fearful reaction to air movement.  Of particular interest is the common observation of photophobia, the apparent fear and avoidance of bright light.  General hyperesthesia, the fear or overreaction to sensory stimulation, including touch or noise in addition to those mentioned above, is found in most descriptions of rabid animals.  Sudden or annoying noises can provoke attacks by the rabid animal.

Finally, and importantly, priapism and increased libido are common descriptors of rabid animals.  They can be hypersexual in appearance and behavior.

Rabies is the model and the key to rage

Rabies is the model and the key to rage

The link connecting the animal counterparts of vampires and werewolves is exactly infection by the rabies virus.  This suggests that the behavior of rabid bats and wolves is very similar to characteristics of vampires and werewolves.  A seemingly straight-forward task is to list characteristics of a natural phenomenon, rabid animals, and determine how many are in common with both infected humans and with our legendary creatures.  Three factors will limit the information we can gather from naturally rabies-infected animals. 

The first limitation is the long and variable period of time from exposure from rabies to actual infection and concomitant behavioral effects.  In general, the pre-infection period lasts a few weeks to a month.  However, documented cases involving humans indicates that the period can be as long as a couple of years from exposure (bite, or organ transplant) to signs of infection and death.  And, prior to blatant infection with its overt characteristics, there are no known signs of impending disease.  Although bites by bats and wolves became associated with the subsequent occurrence of rabidity centuries ago, it is easy to understand how the long, unpredictable period between exposure and overt disease led our ancestors to associate rabidity with a more contemporary supernatural intervention rather than a long-forgotten bite.  In particular, the bite of a bat can be slight enough as to be overlooked and therefore no natural cause for disease may be evident when symptoms appear.  Only been the advent of modern forensic medical practice, with acceptance of, and tools to detect, bacteria and viruses, that searches diligently for just such a biological cause has been able to document rabies as an underlying mechanism .  Of course, discovering a biological cause is supposed to lead to prevention, medical treatment, and understanding of the disease.  With rabies, much of that is still only a dream.

Another limitation to the study of naturally occurring rabies infection is the brief amount of time from actual infection to death, two weeks at most.  This doesn't allow much time to observe behavioral and physiological symptoms, to put them through the battery of sophisticated tests that TV’s Dr. House would apply.  Worse, the infected animal/patient is trying to attack the observers (threatening to turn them) or is trying to escape, all while rapidly deteriorating toward death.

A third limitation is that the symptoms of rabies infections come in two flavors, furious or encephalitic rabies with its rage and attacks, and dumb or paralytic rabies primarily characterized by muscle weakness and ataxia.  These signs are not mutually exclusive, infected animals often exhibit signs of both, and muscle weakness is very often seen at the end-stage of both types.  Although we only know of one rabies virus, these different sequelae complicate that chance that one explanation, one disease, can suffice to account for what we know about it.  For our present purposes we will focus on furious rabies, always aware that we must combine the two forms under one explanation at some time.

Vampires and werewolves, even werecats, oh my…

Vampires and werewolves, even werecats, oh my…

As an aside of sorts, it seems surprising that werecats do not figure large in these legends and lore.  Large cats can attack and kill humans, certainly do kill large prey.  And cats are susceptible to infection by rabies.  Yet references, at least in European literature, to ravenous werecats are much less common compared with those regarding werewolves.  There are several factors that can account for this.  Attacks by cats, large and small, tend to be clean, often nearly bloodless, not in line with a lust for blood.  Killing, especially by large cats, is by asphyxiation, crushing the windpipe or by covering and closing off the prey’s snout.  House cats sever the spinal cord and/or windpipe, also resulting in death without bloodletting. In addition, felines tend to drag away and hide their kills, leaving no horrific trace for friends and relatives to find as in the case of wolf kills.  Moreover, the bite of a cat very likely ends in the victim’s death, not in injuries that could turn a survivor.  Cats inflict serious wounds through their claws, but because the transfer of rabies requires the introduction of virus-laden saliva into flesh and blood (as turning is said to require infection of the blood), survivors suffering scratches alone aren't going to acquire rabies; aren't going to be turned.  As frightening, as deadly, as wild cats can be, they don’t turn victims.  Not surprisingly then, werecats don’t figure large in our tales of blood-lust and rage in large part because they don’t produce rabid victims.

In addition, the paucity of ravenous werecats in European mythology is due to the fact that large cats, e.g. cave lions, were exterminated in Europe by 1000 AD, long before the printing press could make it easy to keep any such oral traditions alive.  Extant, much smaller, wild cats and their housecat relatives are more often depicted as witches eerily watching, but not attacking, humans. 

Ironically, in Westernized countries where pet dogs are routinely immunized against rabies, pet housecats have become the more common source of rabies exposure to humans, as they bite defensively when perturbed.

Vampires become the real deal

Vampires become the real deal

So, how is it these two fiends became so strongly associated?  The answer is that there are major traits of bats and wolves, vampires and werewolves that are strikingly similar.  Both are creatures of the night, bats almost exclusively.  Wolves can hunt both night and day, but their extremely sensitive night vision makes them especially successful at stalking prey in low light.  Human vision is suited for higher levels of light, where we can use our color vision to great advantage.  At night, we are the ones that are ‘blind as a bat’, while bats and wolves, vampires and werewolves, can sense us very well and appear to come out of nowhere to accost us. Both play heavily on our fear of the dark where wild things can sneak up on us. 

However, the greatest similarities between vampires and werewolves, beyond rage itself, are a thirst for blood, coupled with the ability to turn victims into new vampires or werewolves (respectively; only a very few, more recent – 17^th century - stories portray dead werewolves transforming into vampires).  A number of these characteristics are basic traits of wolves and other canidae.  Wolf-type and werewolf attacks are very bloody as they bite, chew, and rend flesh to fell their prey – bleeding out of the victim is common.  As Pavlov’s dogs remind us, canidae produce copious amounts of saliva in preparation for eating, literally foaming at the mouth, certainly also a vivid characteristic of werewolves.  Wolves gorge as much as they can at the site of the attack itself and then leave the bled-out carcass.  They may return later to feed further, but take few specific precautions to protect the carcass from other carnivores.  Evidence of their attacks is clear.   

On very much the other hand, Eurasian bats hunt only insects.  Normally they are just pesky nuisances to humans that are out at night.  However, when, and only when, infected with rabies, they will bite humans and the bite can draw blood.  This extraordinary change in their habits would have been enough to alarm people and to raise suspicions of witchcraft.  Only a few early versions of revenants portray them as lusting for blood to continue their unearthly life.  Since bats and revenants were associated in some ways (not quite dead yet…) and (rabid) bats bite humans, bats have always been associated, albeit weakly, with blood. However, when actual blood-sucking (well, blood-lapping) bats, the vampire bats of South and Central America, became known to Europeans in the mid-to-late 1500’s, the association of bats with a thirst for blood became an extraordinarily vivid reality.  The vision of vampire bats draining blood from apparently unaware (dazed, hypnotized…) victims confirmed the vampire’s blood-lust as real.  It also expanded the traits of humanesque vampires, affording them hypnotic powers that had not been a feature of earlier revenants or vampires, but are seen in many modern tales.

Long before bats became blood-thirsty, it was known that the bite of a (rabid) bat could turn a human or other mammal into a vampiric creature.  For bats, biting humans was a dramatic change from their normal behavior. The bite of a wolf was also well-known to result in the victim being turned.  As with bats, the association is specific for wolves infected with rabies.  Here the change in behavior is a bit more subtle, but more bloody.  Wolves do hunt humans and other mammals, but normally only when hungry.  When hunting for food they devour their victim – not much opportunity for the victim to be turned.  On the other hand, when rabid, wolves attack multiple victims without killing and eating them.  Under these conditions, victims could be left alive… to subsequently turn into rabid creatures themselves. And when rabid, wolves attack indiscriminately ignoring barriers such as fences that should warn them of dangers like humans.  Overall then, the primary association between bats and vampires, wolves and werewolves is their ability to turn victims into the likes of vampires and werewolves.  And, in both cases this is a direct result of rabies infection.  Blood-lust, at least bloody, is a primary feature of wolves and werewolves, but for vampires it seems more of an afterthought, not one noted in early descriptions.  But since Eurasian bats did bite mammals when rabid, it was a trait almost perfectly set in place just waiting for the conquistadores to confirm and embellish.

werewolves – no pesky nuisances here

werewolves – no pesky nuisances here

The origins of werewolves and their association with wolves are very different from those of revenants and vampires.  The first written account of a human becoming a werewolf may be in Ovid’s Metamorphoses (1 AD) in which the story is told of King Lycaon being transformed into a wolf by the king of the gods, Jupiter (Zeus, if ancient Greeks are telling the story).  Jupiter was disgusted that Lycaon served human meat for the god to eat (presumably Lycaon ate human flesh himself).  To emphasize that only animals, not civilized humans, ate human flesh, Jupiter transformed Lycaon into a werewolf.  As an animal, Lycaon could continue to feed on human flesh, but was utterly cut off from human company, from human society; was declared inhumane and non-human.  The image of a human being transformed into a wolf-like, uncivilized creature is a central theme of a werewolf. They are way more than pesky revenants, they are decidedly deadly. 

From Lycaon we also obtain the word and the concept of a lycanthrope or lycan, that is, a shape-shifter.  Shape-shifters are usually conceived as having the ability to change bodily forms at will.  It seems strange to me that Lycaon’s fate should be associated with shape-shifters since his transformation was neither self-induced, nor is there any indication he could ever change back into human form.  Even the lucky fellow chosen to become a werewolf at the festival of Jupiter Lycaon could only become human again if he did not eat human meat for nine years.  Fat chance.

Vampires, certainly revenants, are less often associated with shape-shifting, another difference between them and werewolves.  Some, especially Victorian, accounts of vampires have them shape-shift into bats.  Most recent stories give them tremendous speed and great strength letting them make huge leaps, but without wings (except, sometimes, for the old-timers, e.g. in “Únderworld”).  Perhaps the image of powerful vampires turning into scrawny little flying rats seems sissified, or turning into human-sized bats beyond the realm of modern credulity.

On the other hand, wolves and werewolves have no relationship with rebirth or returning from the dead, so central to the image of revenants.  They are strictly slingers of death, evil creatures in league with the devil.  To early shepherds wolves were terrifying enemies.  They were deadly threats to the unwary lone farmworker or traveler and to young damsels wearing red, hooded cloaks.  In spite of werewolves being human, they are straightforward extensions of wolves and wolf-like behavior.  This is very different from the fairly convoluted reasoning that originally linked bats to revenants and vampires. 

Nor do vampires cycle between being human and being a vampire as werewolves are forced to do when a full moon rises.  They may try to disguise themselves to walk among humans, but they are always vampires.  And, although they may sleep for long stretches of time, they wake up at will.  Overall then, vampires, as related directly to revenants, appear to be very distinct from werewolves.