Surviving rabies 100 years ago

Diane Wendt, associate curator in the Division of Medicine and Science, shares objects from the museum's collection that offers a glimpse at rabies vaccine history in the United States.

"Twenty-one raccoons, seven skunks, four foxes, a bat, a cat, and a cow." Although this sounds like the refrain of a children's song, it is instead the tally of rabies diagnoses this year in Fairfax County, Virginia. The list appeared in the paper on World Rabies Day, September 28, which coincides with the 118th anniversary of the death of Louis Pasteur, the famous French scientist who developed the first rabies vaccine in 1885. (Emile Roux, a lesser-known scientist who worked with Pasteur on the vaccine, should also be mentioned.)

 

The outside of a rabies vaccine outfit from the 1920s, produced by the H.K. Mulford Company. The box’s lid includes an inventory of the outfit’s contents and a notice advising that the treatment comprises a total of 21 doses.
The outside of a rabies vaccine outfit from the 1920s, produced by the H.K. Mulford Company. The box's lid includes an inventory of the contents and a notice advising that the treatment comprises a total of 21 doses.

In some parts of the world today, rabies is still responsible for the deaths of tens of thousands of people a year. The Fairfax County list unsurprisingly included no human victims, as incidents of rabies in people are rare in the United States, where treatment is widely available and our pets are usually well-vaccinated. However, we can tell from objects in the museum's collection that human rabies deaths in the United States were not always so rare.

 

The inside of the rabies vaccine outfit from above (see photographs below for full description of the contents)
The inside of the rabies vaccine outfit from above (see photographs below for full description of the contents)

Shortly after Pasteur successfully treated his first rabies patient in France, four boys from Newark, New Jersey, were bitten by a dog suspected of carrying the disease. A national campaign was launched to send the boys to Pasteur for treatment, and the story became a media sensation. It seemed that the entire nation was following the boys, who went to France for Pasteur's treatment and returned home as "heroes," even taking a subsequent tour of American cities.

 

Pasteur looks on as an early version of the rabies vaccine is administered in 1885. Image from Harper’s Weekly 29:1513 (December 19, 1885).
Pasteur looks on as an early version of the rabies vaccine is administered in 1885. Image from "Harper’s Weekly" (December 19, 1885).

This event helped launch the establishment of "Pasteur Institutes" in many American cities in order to provide rabies vaccines and treatment closer to home. Even so, many people would have to travel, and bear the time and expense of an extended stay, to receive the treatment that required several weeks of injections.

In 1911, Philadelphia drug company H. K. Mulford announced a new rabies treatment kit that could be shipped directly to doctors and was simple enough that "physicians who have had no previous experience may successfully apply it." The kit is a reminder that even the best medicine is of no consequence if it is not available and affordable.

 

The vaccine, syringe, needle, and plunger from the museum’s rabies vaccine kit
The vaccine, syringe, needle, and plunger from the museum's rabies vaccine kit

The treatment consisted of 25 injections of rabies vaccine: three on the first day, two on the second, two on the third, and one each day after for 18 days. Each dose was slightly stronger, or more virulent, than the preceding, so that the body could build up immunity. Because the vaccine had to be "fresh" to be effective it could not be stocked by druggists. Subsequent daily doses were shipped directly from Philadelphia in a special Caloris vacuum bottle (not unlike your coffee thermos).

 

The museum’s rabies vaccine kit, from the early 1920s, contains the following: three ampuls of rabies vaccine, doses one, two, and three; 26 syringes with physiological salt solution; 26 needles for the syringes; two metal piston rods and two metal finger rests for the syringes; one two-dram vial of tincture of iodine; two charts for recording cases; one letter of general instructions; two stamped return envelopes; one record-of-treatment blank; and one vial of sterile wires. The treatment at this time had been reduced to only 21 doses to be administered one a day for 21 days, and the Caloris vacuum bottle was replaced with a cardboard mailing tube.
The museum's rabies vaccine kit, from the early 1920s, contains the following: three ampules of rabies vaccine, doses one, two, and three; 26 syringes with physiological salt solution; 26 needles for the syringes; two metal piston rods and two metal finger rests for the syringes; one two-dram vial of tincture of iodine; two charts for recording cases; one letter of general instructions; two stamped return envelopes; one record-of-treatment blank; and one vial of sterile wires. The treatment at this time had been reduced to only 21 doses to be administered one a day for 21 days, and the Caloris vacuum bottle was replaced with a cardboard mailing tube.

Today the post-exposure treatment for rabies consists of four doses of vaccine given over a two-week period. The injections are usually given in the upper arm.

Diane Wendt is an associate curator in the Division of Medicine and Science at the National Museum of American History. She has previously blogged about influenza vaccines.

Special thanks to Rachel Anderson and the division's inventory team for the photography.

Posted at 7:00 am EDT in From the Collections