Historical Perspective of Rabies in Europe and the Mediterranean Basin (review)

Although rabies has always been a rare disease in humans, it has exercised a powerful hold on the imagination and for centuries occupied an apparently disproportionate place in the medical literature. Yet its history has received relatively little attention, apart from work on Pasteur and his associates. This publication from the World Organisation for Animal Health is a welcome addition to an understudied field.

The articles published here are a tribute to the enthusiasm for international collaboration that marked the career of its principal editor, the late Arthur King; they represent the work of sixty-six contributors from Europe, North Africa, and parts of the Middle East. The result is in many ways a remarkable compendium, though for readers of the Bulletin, two caveats are in order. First, this is a work by and for nonhistorians. Its historical-comparative approach was designed in large part to identify best practices that could be applied in rabies control; the stated audience consists of scientists, veterinarians, and policymakers. The authors come from similar backgrounds; King himself was a virologist and principal scientific officer of the Central Veterinary Laboratory in Weybridge (U.K.). Their methods are not those of academic historical scholarship. Second, although there is much useful information here, the organizational scheme and the lack of an index make it unfortunately difficult to access.

The twenty-five chapters can be loosely grouped under three rubrics. The book opens with two broad historical overviews. The first, on the ancient world, discusses the writings of a series of classical authors; the second, on the period from Antiquity to the nineteenth century, proceeds by region. Another twelve chapters deal with geographic areas, covering no fewer than fifty-six countries. Each provides at least some historical background, generally following a three-part periodization: before Pasteur and Negri, from the Pastorian era to the mid-twentieth century, and after World War II.

The remaining eleven chapters have a topical focus, though they also address variations over time and space. Three concern technical aspects of epidemiology and virology: rabies virus variants and molecular epidemiology in Europe, Europe as a source of rabies for the rest of the world, and epidemiological models. Four discuss animal vectors and reservoir species: European bats, dogs in the Mediterranean region, and European foxes, with a separate chapter on computer analysis of the fox rabies epidemic. Two chapters deal with broad topics in public health: rabies control in Europe, past and present, and international cooperation and the role of international organizations in the campaign against rabies. A single chapter is devoted to human rabies and another to larger cultural issues ("Folklore, Perceptions, Science, and Rabies"). Inevitably, there is much overlap among the contributions. Less inevitably, the editors do not provide a synthetic introduction or conclusion.

Armed with sufficient patience, however, the determined reader will nonetheless be rewarded with insights into the epidemiology of rabies, control of the disease in various species, and genetic variations in the lyssavirus genus. A particularly significant story is the emergence in the mid-twentieth century of a rabies epizootic primarily affecting foxes, which originated around the Russian-Polish border. It has been largely contained in Western Europe through oral immunization using vaccine-containing baits, starting with a campaign in Switzerland in 1978.

The reader in search of a survey history of rabies should still turn first to Jean Théodoridès's Histoire de la rage: cave canem (1986), especially for its account of medical theory and therapeutics in the period from Antiquity through the early twentieth century. Unfortunately, there is no English translation. For more recent developments, however, especially in epidemiology, Historical Perspectives is a useful resource.