Four Thousand Years of Concepts Relating to Rabies in Animals and Humans, Its Prevention and Its Cure Arnaud Tarantola To cite this version: Arnaud Tarantola. Four Thousand Years of Concepts Relating to Rabies in Animals and Humans, Its Prevention and Its Cure. Tropical Medicine and Infectious Disease, MDPI, 2017, 2 (4), pp.1-21. 10.3390/tropicalmed2020005. pasteur-01739365 HAL Id: pasteur-01739365 https://hal-pasteur.archives-ouvertes.fr/pasteur-01739365 Submitted on 21 Mar 2018 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. 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Distributed under a Creative Commons Attribution| 4.0 International License Tropical Medicine and Infectious Disease Review Four Thousand Years of Concepts Relating to Rabies in Animals and Humans, Its Prevention and Its Cure Arnaud Tarantola 1,2 1 Epidemiology & Public Health Unit, Institut Pasteur du Cambodge, BP983 Phnom Penh, Cambodia; [email protected] or [email protected]; Tel.: +687-50-78-88 2 Unité de Recherche et d’Expertise en Maladies Infectieuses (UREMI), Institut Pasteur de Nouvelle-Calédonie, 9800 Nouméa, New Caledonia Academic Editors: Charles Rupprecht and Bernhard Dietzschold Received: 20 February 2017; Accepted: 17 March 2017; Published: 24 March 2017 Abstract: The epitome of the One Health paradigm—and of its shortcomings—rabies has been known to humankind for at least 4000 years. We review the evolution through history of concepts leading to our current understanding of rabies in dogs and humans and its prevention, as transmitted by accessible and surviving written texts. The tools and concepts currently available to control rabies were developed at the end of the 19th Century, including the first live, attenuated vaccine ever developed for humans and the first post-exposure prophylaxis (PEP) regimen. No progress, however, has been made in etiological treatment, leaving clinicians who provide care to animals or patients with symptomatic rabies as powerless today as their colleagues in Mesopotamia, 40 centuries ago. Rabies remains to date the most lethal infectious disease known to humans. Widespread access to timely, effective, and affordable PEP in rural areas of developing countries is urgently needed. Keywords: rabies; vaccine; history; One Health; post-exposure prophylaxis; Galtier; Roux; Pasteur; Semple; dog Preamble Rabies is an ancient and much-feared disease. Over the centuries, many different authors—clinicians, veterinarians, surgeons, pharmacists but also writers, philosophers, and poets—have mentioned rabies in their writings. The sequence of research and surviving writings on rabies described below is far from exhaustive. Rather, it aims to identify the work of those who made remarkable contributions to the current stage of knowledge on dog-mediated rabies, its cause and its prevention, control or management. Sources that conducted research on rabies but proposed alternate views of causation now considered misleading (such as spontaneous generation) have purposefully been left aside. Furthermore, no further potential sources from Ancient China, India, pre-Columbian America, or Africa could be identified or accessed. 1. Rabies in Sumerian and Akkadian Civilizations Humans have lived alongside domesticated dogs for 14,000 years at least, with estimates reaching back to 32,000 years [1,2]. They have also long been familiar with their diseases, which became more prevalent as populations and their animals congregated in the cities that arose in Mesopotamia [3–6]. Two cuneiform tablets (Figure 1) discovered at Tell Abu¯ Harmal, Baghdad Governorate, Iraq in 1945 and 1947, recount the Laws of Eshnunna, a Sumerian and later Akkadian city-state located in present Tell Asmar, Iraq [7]. This city was most prominent during the Isin-Larsa period, ca. 1950–1850 BCE and the tablet is dated ca. 1770 BCE [8]. Distinct copies of another source date back to ca. 1930 BCE. These describe Sumerian rules and regulations attesting to the fact that a causal link between the bite of a rabid animal and a human death from rabies was well recognized almost 4000 years ago [9]: Trop. Med. Infect. Dis. 2017, 2, 5; doi:10.3390/tropicalmed2020005 www.mdpi.com/journal/tropicalmed Trop.Trop. Med. Med. Infect. Infect. Dis. Dis. 2017 2017, 2,, 25, 5 2 of2 21of 21 Trop.causalcausal Med. link Infect.link between between Dis. 2017 the, 2the,5 bite bite of of a a rabid rabid animalanimal and a human deathdeath from from rabies rabies was was well well recognized recognized2 of 21 almostalmost 4000 4000 years years ago ago [9]: [9]: “If“If a a dog dog becomesbecomes rabid andand thethe ward ward authority authority makes makes that that known known to itsto its owner,owner, butbut hehe does not watchwatch overover his his dog dog so so that that it itbites bites a mana man and and causescauses hishis death,death, the owner ofof the the dog dog shall shall pay pay forty forty shekels shekels of ofsilver; silver; if if it bites a slave and causes his death, he shall pay fifteen shekels of silver.” it bites a slave and causes his death, he shall pay fifteen shekels of silver.” (a) (b) (a) (b) Figure 1. Excerpts from the Sumerian Laws of Eshnunna, Northern Babylonia ca. 1930 BCE. (a) Tablets Figure 1. Excerpts from the Sumerian Laws of Eshnunna, Northern Babylonia ca. 1930 BCE. (a) Tablets Figureof the 1. Laws Excerpts of Eshnunna; from the Sumerian(b) One possible Laws of translation Eshnunna, of NorthernParagraphs Babylonia 56–57 of theca. 1930Laws BCE. of Eshnunna (a) Tablets of the Laws of Eshnunna; (b) One possible translation of Paragraphs 56–57 of the Laws of Eshnunna of (Athe iv Laws 20–24) of [10].Eshnunna; Another (b possible) One possible translation translation speaks of of a Paragraphsdog becoming 56–57 “furious” of the orLaws “vicious” of Eshnunna [8,9]. (A iv 20–24) [10]. Another possible translation speaks of a dog becoming “furious” or “vicious” [8,9]. Even (A Eveniv 20–24) 15 shekels [10]. Another was a considerable possible translation sum: The speaksHammurabi of a dog code becoming mentions “furious” the cost of or a “vicious”boat of sixty [8,9]. 15 shekels was a considerable sum: The Hammurabi code mentions the cost of a boat of sixty “gur” at Even"gur" 15 shekelsat two was a shekels.considerable (Sourc sum:e: Thehttp://legacy.fordham.edu/ Hammurabi code mentionshalsall/ancient/hamcode.asp). the cost of a boat of sixty two shekels. (Source: http://legacy.fordham.edu/halsall/ancient/hamcode.asp). Acknowledgement: "gur"Acknowledgement: at two shekels. Dr. Mark Weeden,(Source: Lecturer http://legacy.fordham.edu/ in Ancient Near Easternhalsall/ancient/hamcode.asp). Studies, School of Oriental Dr. Mark Weeden, Lecturer in Ancient Near Eastern Studies, School of Oriental and African Studies, Acknowledgement:and African Studies, Dr. London, Mark Weeden, UK. Lecturer in Ancient Near Eastern Studies, School of Oriental London, UK. and African Studies, London, UK. At least five old Mesopotamian “dog incantations” (ca. 1900–1600 BCE) such as the one below (FigureAt least 2) clearly fivefive old reflect Mesopotamian the notion of “dog rabies incantations” being caused (ca. by 1900–1600 something BCE)present BCE) such in the as thesaliva one of below the (Figureafflicted 2)2) clearlyanimal, reflectreflectakin to thethe notionpoison transmitted of rabies being by a causedsnakebite by or somethingsometh scorpioning sting present [9–12]. in Anthe herb saliva seems of the afflictedafflictedto have animal, been used akin after to the a poisondog bite transmitted and the biti byng a dog’ssnakebite movement or scorpion was restricted sting [[9–12].9–12 [12].]. An Dogs herb were seems to thoughthave been more used likely after to become a dogdog bitebite rabid andand when thethe a bitingbiti lunarng dog’seclipsedog’s movement movementoccurred at waswasyear’s restrictedrestricted end [9]. [[12].12]. Dogs were thought more likely to become rabid when aa lunar eclipseeclipse occurredoccurred atat year’syear’s end [[9].9]. "Its [seed] coagulates on its [dogs’] teeth. Where it has bitten it has left its [consequence].” "Its [seed] coagulates on its [dogs’] teeth. Where it has bitten it has left its [consequence].” (a) (b) Figure 2. “Dog incantation”, ca. 1900–1600 BCE (a) Tablet; (b) Translation, adapted from [11]. (a) (b) Finally, clay tablets (Figure 3) unearthed by H.V. Hilprecht in 1889 at the Nippur site (3rd Figure 2. “Dog incantation”, ca. 1900–1600 BCE (a) Tablet; (b) Translation, adapted from [11]. dynastyFigure of Ur 2. “DogIII, 21st- incantation”, 20th-century ca. 1900–1600 BCE) of BCE wh (aat) Tablet; is now (b) Translation,Nuffar in Iraq adapted display from [Akkadian11]. incantations,Finally, clay to tabletswhich healers(Figure resorted3) unearthed when bymedicine H.V. Hilprecht failed [9,13,14]. in 1889 This at the dialogue Nippur between site (3rd Marduk, the God of Healing, and his father Enki was recited by priests over (thus blessed) water dynastyFinally, of Ur clay III, tablets 21st- (Figure 20th-century3) unearthed BCE) by of H.V. wh Hilprechtat is now in 1889Nuffar at thein NippurIraq display site (3rd Akkadian dynasty of Ur III, 21st- 20th-century BCE) of what is now Nuffar in Iraq display Akkadian incantations, to which incantations, to which healers resorted when medicine failed [9,13,14]. This dialogue between Marduk,healers resorted the God when of Healing, medicine and failed his [father9,13,14 Enki]. This was dialogue recited between by priests Marduk, over (thus the God blessed) of Healing, water and his father Enki was recited by priests over (thus blessed) water which was then administered orally.