HISTORY

The first clear recognizable reference to rabies was from writings by Aristotle in circa 380 BC in which he described the symptoms and transmission of rabies in dogs. Despite centuries of observations on the transmission, symptoms, and a myriad of unsuccessful remedies, the disease remained invariably fatal until approximately 1885 when Louis Pasteur developed the first rabies vaccine in Paris. Unable to identify the intangible virus—indeed unaware at that time of even the difference between bacteria and viruses—he cultured it in the spinal cords of rabbits and, ultimately, injected it into Joseph Meister, a young boy severely attacked by a rabid dog on his way home from school. Given the severity of his wounds on his face, hands, and legs he undoubtedly would have died; however, he received a series of 13 injections, survived, and subsequently spent his life working as a guard at the Pasteur Institute.

EPIDEMIOLOGY

In 2001, the Centers for Disease Control and Prevention (CDC) reported that there were 7473 cases of rabies in animals in the United States but no human rabies infection. Hawaii has been the only state kept free of rabies infection in humans and animals. Ninety-three percent of cases were in wild animals. In the United States the largest reservoirs remain in raccoons followed by skunks, bats, foxes, and coyotes. Raccoon and fox reservoirs are mainly from the eastern states; bat and skunk cases were also found in parts of the south, Pacific Northwest, and California. Domestic animals only accounted for about 6.8% of rabies. Interestingly, cats are found to be infected with rabies almost double the infections of dogs.