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Zombie infections: epidemiology, treatment, and prevention

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• Tara C Smith , associate professor 1
• 1 Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, Kent, OH 44242, USA
• tsmit176{at}kent.edu

Tara C Smith summarises the epidemiology and pathology of zombie infections and calls for research and funding to prevent a zombie apocalypse

Zombies—also known as walkers, Zed, Zs, biters, geeks, stiffs, roamers, Zeke, ghouls, rotters, Zoms, and runners—have become a dominant part of the medical landscape. Zombie expert Matt Mogk defines a zombie with three criteria: it is a reanimated human corpse; it is relentlessly aggressive; and it is biologically infected and infectious. 1 But Mogk notes that this definition has been altered by the recognition of “rage” zombies, which are infected but still alive. They are more closely related to vampires infected with the contagious bacterium Bacillus vampiris . 2 Here, I review zombie biology and epidemiology.

Descriptions of zombies date back to the 1500s. 3 Haitian zombies are probably the best described, often thought to be controlled by practitioners of voodoo. 4 They may have been created via a neurotoxin, typically described as tetrodotoxin, which puts the victim in a sleep-like state. 5 These voodoo or chemical zombies seem to be unrelated to the current wave of epidemics, which began with the first documented outbreak in 1968 (fig 1 ⇓ ). 6 The modern outbreaks are thought to be infectious in aetiology and transmissible by bite.

First documented US outbreak in 1968 6

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The Solanum virus is the most extensively studied infectious cause of reanimated zombies. 7 8 9 It has caused outbreaks around the world but does not have an identified reservoir in nature. 8 It has a 100% mortality rate, and zombification is certain in anyone exposed to an infected person. Solanum infection is universally fatal in all animals tested or observed, indicating that zoonotic transfer to humans is an unlikely origin. 8 One anecdotal report linked infection to the looting of underwater settlements in the Three Gorges Dam in China. 9 A child emerged, bitten, but his fishing partner did not surface at all. The dam was created by relocating over 1.24 million residents and flooding their former villages. 10 Zombie expert Max Brooks thinks that Solanum virus infection has occurred for thousands of years and is now emerging because of urbanisation and the interconnected nature of commerce and travel. 8 Whether this virus is the cause of the current outbreak in the United States has not been tested. 11 12

Although reanimated zombies have been documented for potentially millennia, 8 rage zombies seem to be a more recent phenomenon. These date back to at least 1973, when the weaponised Trixie virus was accidentally released in Pennsylvania. 13 This virus was also responsible for a 2010 outbreak in Iowa. 14 In both cases a military plane carrying the virus—a modified form of rhabdovirus—crashed into a small town’s water supply. Townsfolk were infected via ingestion of the virus and possible airborne spread. Infection caused the inhabitants to develop a murderous rage. The outbreak was quashed by a controversial military intervention and forced quarantine, but at a high cost of lives (fig 2 ⇓ ). Infected people may remain.

Military response to 2010 outbreak of rage zombies in Iowa 14

A 2002 epidemic of rage zombies decimated London, UK, leading to quarantine of the island of Britain. 15 This outbreak was traced back to the release of a genetically modified virus derived from Ebola that was tested in captive chimpanzees. 16 An animal rights activist was bitten while trying to liberate the chimpanzees from a laboratory in Cambridge. Because the incubation period of the virus is short (seconds), and the victims are quick and strong, the infection rapidly spread across the country, necessitating a complete border closure (fig 3 ⇓ ). Twenty eight weeks into the outbreak, after many of the zombies had died from starvation, a rare asymptomatic carrier of the virus was discovered, beginning a second wave of infections. 17

2002 outbreak of rage zombies in the UK 15

Symptoms and incubation period

Symptoms of infection tend to be fairly uniform, regardless of the nature of the pathogen, but the incubation period is highly variable, with time to development of symptoms ranging from seconds 15 16 17 to hours or days. 11 12 13 14 18 Infected people may clinically die and reanimate, 6 9 11 12 19 20 21 or they may remain alive but with the same aggressive tendencies and taste for human flesh as reanimated zombies. 13 14 15 16 17 Other symptoms may include a shambling gait, tendency to moan, loss of dexterity and prior personality traits, and the eventual rotting of flesh. In rare cases zombies may be highly intelligent, self aware, and lacking in the typical tendencies to bite and eat flesh. 13 14

Aetiology and transmission

What unites many outbreaks is transmission via bite. Other ways of becoming infected include insect vectors, 22 23 animal bites, 15 19 24 and a ubiquitous condition whereupon everyone reanimates as a zombie upon death. 11 12 22 24 Insect vectors seem to be rare, but include bedbugs in an island outbreak off the coast of South America 23 and mosquitoes as a vector of the modified Kellis-Amberlee virus. 22

Others types of pathogen have been reported. The causative agent of the zombie outbreak discovered retrospectively on the Titanic was a weaponised form of the bubonic plague bacterium, Yersinia pestis . 25 Cordyceps fungus has been documented as the cause of a diverse set of zombie phenotypes, 26 spread via bite or by spores released from dead hosts. A mutated strain of bovine spongiform encephalopathy—a prion infection—led to a US outbreak of zombiism. 18 In other cases, a combination of pathogens has been identified as necessary and sufficient to cause zombification. 20 21

Treatment and prevention

Because of the rapid onset of zombie outbreaks and their society destroying characteristics, prevention and treatment are largely unexplored. Severing the bitten area from the body has proved successful in some cases 11 12 but is not universally preventative, and it is sometimes impossible owing to bite location or the speed of viral incubation. 15 17 Vaccines have been difficult to study because of the associated cost and the inadequacy of many laboratories to provide proper containment of zombie pathogens or infected zombies, as well as the diversity of zombifying agents. Vaccine hesitancy may make it difficult to achieve society-wide uptake of a zombie vaccine. 27 Even if an effective treatment were developed, it may need to be taken perpetually to prevent the affected person from reverting to zombiism. 28 More research in this area is sorely needed.

Ethical considerations

Zombie outbreaks are expensive, difficult to control, and have deleterious effects on the stability of life. Quarantines often fail or are unable to accurately contain people who may be infected but not yet symptomatic, resulting in a de novo outbreak within the quarantine facility. 13 14 17 Resources often become depleted, and zombies can over-run cities or entire countries in days to weeks. 9 15 Complete containment of the zombie infection is rarely achieved. A notable exception may be the 2004 London outbreak, where the government stemmed the infection with a military response, and remaining zombies were used for labour and entertainment. 29

Several models of zombie infections have shown that in the event of a large scale outbreak (for example, zombie entry into a city of 500 000 or more) humans face extermination. 30 Chances of survival start out slightly higher in sparsely populated areas, but they eventually become overwhelmed. 8 31 The Centers for Disease Control and Prevention and others have published details of the preparations that should be made in the case of a pending zombie outbreak. 7 32 33 Unfortunately most countries remain grossly unprepared for a potential disaster of this nature.

The documented rise of multiple zombie pathogens should be a wake-up call to the international community that we need additional funding and cooperation among scientists and government officials to tackle the looming threat of apocalyptic disease. We need a frank discussion of the ethical and potential criminal problems associated with dealing with zombies. Will people be prosecuted for killing a zombie or a person who has been bitten but has not yet “turned”? Is mass quarantine of those who have been exposed to a zombie but not bitten legal? How would it be achieved?

The use of zombie pathogens as bioweapons is another critical area of investigation and policy planning. Deliberately engineered pathogens have been implicated in several zombie outbreaks, 13 14 20 24 although their release is almost always accidental or has unforeseen consequences. 15 16 Defensive work on zombie pathogens is necessary and must be carried out in well equipped and highly contained laboratories.

Some experts have argued that the rise in zombie infections is due to increased surveillance. 8 Brooks thinks otherwise, citing documentation of zombie outbreaks from antiquity to modern day as evidence of a true rise in incidents. He notes: “At this rate, attacks will only increase, culminating in one of two possibilities. The first is that world governments will have to acknowledge, both privately and publicly, the existence of the living dead, creating special organizations to deal with the threat. In this scenario, zombies will become an accepted part of daily life—marginalized, easily contained, perhaps even vaccinated against. A second, more ominous scenario would result in an all-out war between the living and the dead.” 8

For the sake of humanity we must ensure that such a war does not occur and that we work together as a unified global community to respond quickly to any and all new zombie threats.

Cite this as: BMJ 2015;351:h6423

Acknowledgments: I thank my Twitter followers and the Zombie Research Society, Omaha Chapter, for their suggestions and clarifications.

Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare. I am a member of the Advisory Board of the Zombie Research Society but receive no financial or other type of compensation.

• ↵ Mogk M.Everything you ever wanted to know about zombies. Gallery Books, 2011 .
• ↵ Matheson R. I am legend. Macmillan, 1954.
• ↵ Ackermann H-W, Gauthier J. The ways and nature of the zombi. J Am Folklore 1991 ; 104 : 466 -94. OpenUrl CrossRef
• ↵ Littlewood R, Douyon C. Clinical findings in three cases of zombification. Lancet 1997 ; 350 : 1094 -6. OpenUrl CrossRef PubMed
• ↵ Davis EW. The ethnobiology of the Haitian zombi. J Ethnopharmacol 1983 ; 9 : 85 -104. OpenUrl CrossRef PubMed Web of Science
• ↵ Romero G. Night of the living dead. 1968.
• ↵ Stanley D. The nurses’ role in the prevention of Solanum infection: dealing with a zombie epidemic. J Clin Nurs 2012 ; 21 : 1606 -13. OpenUrl CrossRef PubMed
• ↵ Brooks M. The zombie survival guide. Three Rivers Press, 2003.
• ↵ Brooks M. World war Z. Three Rivers Press, 2006.
• ↵ Yardley J. Chinese dam projects criticized for their human costs. New York Times 2007 Nov 19. www.nytimes.com/2007/11/19/world/asia/19dam.html .
• ↵ Darabont F. The walking dead. 2010.
• ↵ Kirkman R. The walking dead. Image Comics, 2003.
• ↵ Romero G. The crazies. 1973.
• ↵ Eisner B. The crazies. 2010.
• ↵ Boyle D. 28 days later. 2002.
• ↵ Niles S. 28 days later: the aftermath. Dey Street Books, 2007.
• ↵ Fresnadillo JC. 28 weeks later. 2007.
• ↵ Fleischer R. Zombieland. 2009.
• ↵ Maberry J. Rot and ruin. Simon and Schuster, 2011.
• ↵ Schlozman S. The zombie autopsies. Grand Central Publishing, 2011.
• ↵ Maberry J. Flesh and bone. Simon and Schuster, 2012.
• ↵ Grant M. Blackout. Orbit, 2012.
• ↵ Cummings P. The neuropathology of zombies. Sinister Press, 2001.
• ↵ Grant M. Feed. Orbit, 2010.
• ↵ Pauls C, Soloman M. Deck Z. Chronicle Books, 2012.
• ↵ Druckmann N, Straley B. The last of us. Sony Entertainment, 2013.
• ↵ MacDonald NE, SAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: definition, scope, and determinants. Vaccine 2015 ; 33 : 4161 -4. OpenUrl CrossRef PubMed
• ↵ Cruse C, Tucker R. The returned. 2015.
• ↵ Wright E. Shaun of the dead. 2004.
• ↵ Munz P, Hudea I, Imad J, Smith RJ. When zombies attack! Mathematical modelling of an outbreak of zombie infection. In: Tchuenche JM, Chiyaka C, eds. Infectious disease modelling research progress. Nova Science Publishers, 2009: 133-50.
• ↵ Alemi AA, Bierbaum M, Myers CR, Sethna JP. The statistical mechanics of zombies. Abstract S48.00008. American Physical Society March Meeting. San Antonio, Texas, 2-6 March 2015.
• ↵ Centers for Disease Control and Prevention. Zombie preparedness. www.cdc.gov/phpr/zombies.htm .
• ↵ Nasiruddin M, Halabi M, Dao A, Chen K, Brown B. Zombies—a pop culture resource for public health awareness. Emerg Infect Dis 2013 ; 19 : 809 -13. OpenUrl PubMed

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How Zombie Films Reveal the True Dangers of COVID-19

Like the living dead, a virus can overwhelm powerful states, ruin economies—and reveal our best and worst selves.

Three days before Halloween, people in Kyiv, Ukraine dress up as Zombies and participate in a ‘Zombie Walk.’ Courtesy of Efrem Lukatsky/ Associated Press .

by James Der Derian and Phillip Gara | April 5, 2020

On any given day at the University of Sydney in Australia, Chinese visitors spill out of tour buses to make their way up the hill to the main Quadrangle, an elegant Gothic Revival structure of sandstone, leaded glass windows, and whimsical gargoyles. Enamored with Harry Potter , the tourists hold smart phones aloft to capture images of the building their guides claim to have inspired Hogwarts School of Witchcraft and Wizardry . No one bothers to correct them.

Now the Quad is a ghost town, depopulated by the novel coronavirus, making it easy to spot the girl taking a selfie. She stands out in her solitude but also by her garb: black Doc Martens, black jeans, black t-shirt, accessorized by black N95 mask. When she turns there is a jolt of déjà vu, a psychic stutter-step like the glitch in the matrix that signals something bad is about to go down. On her shirt front is a meme that loops from WWII to “The Walking Dead” to the eternal now, of life and death in the time of coronavirus. It reads: “Keep Calm and Get Behind the Guy with the Crossbow.”

In a few short weeks, the happy tourists and playful necromancy of wizards and witches have been displaced by the necropolitics of the zombie , in which the power of death and life, the ultimate prerogative of the sovereign state, has been seriously challenged by the COVID-19 pandemic.

Zombies and SARS-CoV-2, the virus behind the COVID-19 disease, have a close if fitful relationship. Both zombies and the virus are the living dead, in the sense that they acquire vitality only after they find and infect a host . First encounters with them are marked by denial and complacency, which rapidly escalate into panic and fear of the other. Seeking individual security at the cost of the collective good, the most dangerous of enemies is created: our worst possible selves, ready to do whatever is necessary to survive.

The zombie clearly has something to teach us about the virus. The zombie film holds up a mirror to realities we’d prefer to bury, reflecting deep-rooted racism ( Night of the Living Dead ), superficial life-styles ( Dawn of the Dead ), environmental degradation ( World War Z ), and totalitarian eugenics ( Overlord ).

But in our post-truth era , in which story and world have become increasingly difficult to distinguish, the boundary between zombie zeitgeist and collective unconscious has become equally attenuated. This moment is captured in Jim Jarmusch’s 2019 film, The Dead Don’t Die , by the call-and-response between Officer Ronnie Peterson, played dead-pan by Adam Driver, and his partner, Cliff Robertson, played zombie-pan by Bill Murray. “This is all gonna’ end badly,” says Ronnie. “How can you be so sure?” asks Cliff. Because, says Ronnie, “I read the script.”

Characters in a zombie film know they are in an authored story. But do we? Have we lost our ability, our will, to ascertain fact from fiction? In the world of COVID-19, in the theater of security that pretends to be the real story, the fourth wall between author and audience—eroded by media disinformation, political confabulation and wishful thinking—has collapsed, and so too our best defense against the contagion : a credible script directed by competent leadership with sufficient resources to flatten the curve of the pandemic.

After denial and dithering by world leaders, most consistently President Trump—it’s “going to be fine” (February 10), “under control” (February 24), “going to disappear” (February 28), “going to go away” (March 12), and “opened up and just raring to go by Easter” (March 25)—we’ve been handed a series of script rewrites, ranging from ad hoc denial to aspirational planning to the ultimate power in politics, all-out war. President Macron of France fired the first salvo (“ We are at war ”), which was escalated by U.N. Secretary-General António Guterres (“ The world is at war with the virus ” ), traduced by U.S. President Trump with tropes first WWII (“ This is our big war ”) and then the Global War on Terror (“ nothing would be worse than declaring victory before the victory is won ”), and invoked for permanent state of emergency in Hungary (“ war-like state ”).

When the war of spectacle morphs into the spectacle of war, dangerous new specters emerge. In Carl von Clausewitz’s 1832 book, On War , the Prussian military strategist noted how “war gives to things exaggerated dimensions and unnatural appearance,” a warning taken up today by people like Dr. Anthony Fauci, who compares the current situation to “the fog of war.” To illustrate his point, Clausewitz likened war to the interactive nature of language, noting how war “has its own grammar, but not its own logic.” Clausewitz died long before geopolitical conflict gave way to a “ full-spectrum battlespace ,” in which language is weaponized as an instrument of an infowar let loose like a virus by those more self-interested in the control than the well-being of a population.

What does it mean, if language is a virus ( pace William Burroughs ) and the coronavirus is a language? For a start, we must decipher the mathematic and genetic grammars of SARS-CoV-2 to control the pandemic by quarantine and vaccine. We also need to understand the affective languages of war and disease, how dread, fear and panic force-multiply the effective impact of both, not only to sicken and kill but to crash economies, threaten civil liberties, and estrange whole populations.

Los Angeles

Driving on the vacant Los Angeles highways triggers a different kind of déjà vu to films like Children of Men or District 9 —with a tracking shot of COVID-19 freeway messages , ready.gov Zombieland -themed earthquake preparedness billboards, and countless homeless encampments. In March, ominous grindhouse opening scenes played out on TV—spring breaker super-spreaders, anti-science authoritarians, toilet paper hoarders, gun stockpilers , crashing circuit breakers, rippling layoffs, border rushes, xenophobia, vaccine panics , and sparse data on the spread . With reality finally settling in for President Trump—“I have seen things that I’ve never seen before. I mean I’ve seen them, but I’ve seen them on television and faraway lands, never in my country,”—the film has become all too real.

To those closely following the zombie genre or pandemic preparedness exercises for the past decade, the COVID-19 pandemic would not be a Black Swan or even an unmanageable crisis. Many elements of current events mimic the scenario that plays out in Max Brooks’ novel World War Z —about a zombie apocalypse that the author based on desktop models and field exercises prompted by the 2003 SARS outbreak. The book, in turn, has been used by the CDC , Naval War College , and the U.S. Army to update its own unconventional threat training exercises. From the Trump administration’s denial , unpreparedness , and self-destructive isolationism to the Chinese government’s Chernobyl-like initial censoring of reports on the COVID-19 outbreak, the similarities are uncanny. These avoidable missteps incubated a containable crisis and should be a sealed indictment for all the guilty parties who will try, once again, to hide behind the sorry excuse, ‘if we had only known then what we know now.’

In our film Project Z: The Final Global Event zombies helped us understand a wave of national security failures in the face of similar complex, globally interconnected events—from an illusory faith in high-tech warfare in Iraq to climate disasters, economic meltdowns, viral movements, cyberwar, and pandemics. A borderless zombie contagion revealed the gaps in our post-cold war defenses. Instead of good guys versus bad guys, a zombie threat—like the virus—forces us to contend with complex systems ,  feedback loops , quantum phase shifts , tipping points , and non-linear conflicts that confound predictive models .

Despite what should have been clear lessons from these experiences, recent events reveal just how fragile systems still are in the face of emerging forms of risk. The volatile panic on Wall Street—accelerated by high-speed trading and amplified by hazardous corporate management —teetered on the brink of a self-fulfilling, mutually self-destructive cascade, adding layers of crisis to the pandemic response. Similarly, retrograde national security prioritization—like the Trump administration’s disbanding of the National Security Council’s pandemic research directorate and trade war induced cut of the CDC’s China pandemic detection team —haunt us today.

While these new types of crisis expose hidden social vulnerabilities—like economic insecurity , poor healthcare infrastructure , fragile supply chains —they provide us with opportunities to become more resilient in the long term. In the shadow of COVID-19, we are seeing an enormous wave of innovation at a collective level. On Twitter, a chorus of epidemiologists , social scientists , statisticians , complexity researchers , and doctors on the front lines have stepped up to fill the void of an official response, and to push governments to respond to alarming viral growth rates. Who would have ever predicted that #flattenthecurve could become a trending hashtag? Or that the exponential impacts of small everyday safety precautions would become part of our cultural lexicon ?

In businesses across the world we’ve seen adaptation, with agile companies and p2p communities coming in to produce supplies where market forces and government planning has failed. As researchers race to create a vaccine in record time, new rapid response approaches like mRNA synthesis are emerging to combat fast-moving viral diseases. Perhaps we can draw hope in their similarity to defense preparedness exercises modeled on a zombie threat. Just as the CDC, NAVY and U.S. Army use zombie simulations to plan for viral security threats, these novel therapeutics use a synthetic virus expression to build needed antibodies.

The Interwar

Some might try to write off the trials of the past few months as just another “500-year flood.” Bewildered and failing in the face of a global epidemic, nationalist leaders will also try to fortify anti-globalization agendas, expanding surveillance and eroding democratic rights . But in our globally interconnected and tribally fragmented world, there will be more local incidents, networked accidents and emergent threats that cascade into planetary crises with no single-state solutions.

Thanks to early border closures and widespread testing, along with a solid healthcare system and deep-state capacity, it appears COVID-19 is about to peak in Sydney, while the growth curve is, alarmingly, just beginning in Los Angeles and sure to worsen in the mega-cities of the global south. The moment evokes the coming “ interpandemic period ” that epidemiologists use to strengthen preparedness before the next virus, as well as an “ interwar ” when the international community has a fleeting chance to realize a lasting peace rather than a temporary truce.

Our response is to read the message coded in the coronavirus and zombie film as a warning that must be heeded, irrespective of nation, party or religion. If we continue to degrade the ecosystem, heat up the planet, impinge on the wild habitus, impugn scientific knowledge, weaponize language, neglect failing infrastructure, ignore growing inequality and place our trust in leaders who have not earned it, we might well be writing the script for the final global event; in which case, the zombies are us.

Project Z: The Final Global Event is available to watch at OVID.TV .

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The CDC wants you to prepare for a zombie apocalypse. (Yes, you read that right.)

If zombies were to start roaming the streets – yes, we said zombies – the Centers for Disease Control and Prevention wants you to be prepared.

In the midst of providing guidelines on an unprecedented pandemic, the Center for Disease Control updated its tips to prepare for another extreme occurrence: A zombie apocalypse.

While the CDC says it began as a "tongue-in-cheek campaign," it actually is a practical guide for any emergency, like hurricanes, earthquakes or floods.

"You may laugh now, but when it happens you’ll be happy you read this," the CDC wrote on its website . "And hey, maybe you’ll even learn a thing or two about how to prepare for a real emergency."

So, what would happen if zombies were to start roaming the streets?

The CDC says it would conduct an investigation, as it would for any disease outbreak, and provide assistance to states. Until it could determine the cause of the outbreak and how it could be treated and stopped, the CDC listed guidelines to follow to be "safe than sorry." 

The first step is to prepare for zombies – or any disaster: Create an emergency kit with essentials to last a few days.

The kit should include a gallon of water per day for each person; nonperishable food items; medications; tools and supplies; sanitation and hygiene products; clothing and bedding; important documents and first aid supplies, the CDC says. 

Next, you should create an emergency plan when a zombie, or a hurricane, is outside your door.

This includes identifying the types of emergencies possible in your area – such as a tornado or an earthquake – to prepare for that situation and make a list of your emergency contacts. You should also pick a place to evacuate to and make an evacuation plan, which includes a designated meeting place for you and those you live with to regroup. 

This blog is especially relevant given the pandemic and last month's extreme winter weather in Texas  that caused 4 million people to go without power for days. Texans – and its power grid  – were unprepared for freezing temperatures and heavy snowfall, leaving many stranded and helpless without power and water. 

Related: Weeks after Mississippi winter storms, some residents still don't have water

The CDC blog, which was originally posted in 2011, received 1,450 comments, most of which praised the agency for its creative approach to disaster preparedness.

"It presents a disaster in a manner that I can actually entice my family into discussion; and it will provide some assistance for any potential disaster as well," wrote commenter Shelabella. 

"While I have yet to meet a zombie, I have been through a couple of power outages," another comment read. 

Disaster experts seem to agree about the effectiveness of this campaign. 

"I think it’s great," John Sellick, a professor in the Jacobs School of Medicine & Biomedical Sciences at the University at Buffalo, told Yahoo Life . "As we've seen with coronavirus, disaster preparedness is crucial."

Could Scientists Really Create a Zombie Virus

Scientists Talk About the Possibility of a Zombie Virus

By Ryan Bradley | Published Feb 24, 2011 7:22 PM EST

Maybe, but it’s not going to be easy. In West African and Haitian vodou, zombies are humans without a soul, their bodies nothing more than shells controlled by powerful sorcerers. In the 1968 film Night of the Living Dead, an army of shambling, slow-witted, cannibalistic corpses reanimated by radiation attack a group of rural Pennsylvanians. We are looking for something a little in between Haiti and Hollywood: an infectious agent, a zombie virus if you will, that renders its victims half-dead but still-living shells of their former selves.

See our gallery of real live zombies in nature.

An effective agent would target, and shut down, specific parts of the brain , says Steven C. Schlozman, an assistant professor of psychiatry at Harvard University and author of The Zombie Autopsies, a series of fictional excerpts from the notebooks of “the last scientist sent to the United Nations Sanctuary for the study of ANSD,” a zombie virus. Schlozman explained to PopSci that although the walking dead have some of their motor skills intact—walking, of course, but also the ripping and tearing necessary to devour human flesh—the frontal lobe, which is responsible for morality, planning, and inhibiting impulsive actions (like taking a bite out of someone), is nonexistent. The cerebellum, which controls coordination, is probably still there but not fully functional. This makes sense, since zombies in movies are usually easy to outrun or club with a baseball bat.

The most likely culprit for this partially deteriorated brain situation, according to Schlozman, is as simple as a protein. Specifically, a proteinaceous infectious particle, a prion. Not quite a virus, and not even a living thing, prions are nearly impossible to destroy, and there’s no known cure for the diseases they cause.

The first famous prion epidemic was discovered in the early 1950s in Papua New Guinea, when members of the Fore tribe were found to be afflicted with a strange tremble. Occasionally a diseased Fore would burst into uncontrollable laughter. The tribe called the sickness “kuru,” and by the early ’60s doctors had traced its source back to the tribe’s cannibalistic funeral practices, including brain-eating.

Prions gained notoriety in the 1990s as the infectious agents that brought us bovine spongiform encephalopathy, also known as mad cow disease. When a misshapen prion enters our system, as in mad cow, our mind develops holes like a sponge. Brain scans from those infected by prion-based diseases have been compared in appearance to a shotgun blast to the head.

Now, if we’re thinking like evil geniuses set on global destruction, the trick is going to be attaching a prion to a virus, because prion diseases are fairly easy to contain within a population. To make things truly apocalyptic, we need a virus that spreads quickly and will carry the prions to the frontal lobe and cerebellum. Targeting the infection to these areas is going to be difficult, but it’s essential for creating the shambling, dim-witted creature we expect.

Jay Fishman, director of transplant infectious diseases at Massachusetts General Hospital in Boston, proposes using a virus that causes encephalitis, an inflammation of the brain’s casing. Herpes would work, and so would West Nile, but attaching a prion to a virus is, Fishman adds, “a fairly unlikely” scenario. And then, after infection, we need to stop the prion takeover so that our zombies don’t go completely comatose, their minds rendered entirely useless. Schlozman suggests adding sodium bicarbonate to induce metabolic alkalosis, which raises the body’s pH and makes it difficult for proteins like prions to proliferate. With alkalosis, he says, “you’d have seizures, twitching, and just look awful like a zombie.”

Have a science question you’ve always wondered about? Email [email protected]

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Ryan Bradley is a freelance writer and editor based in Los Angeles. He’s been nominated for a National Magazine Award, won a Press Club award, and had his articles featured in The Best American Science and Nature Writing.

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50,000-year-old ‘zombie virus’ revived from ice could be a ‘public health threat,’ scientists warn

By Hannah Murdock

Scientists revived an ancient virus that was found buried in frozen ice, and the “zombie virus” could pose a potential public health threat.

Scientists from the French National Centre for Scientific Research found 13 ancient viruses frozen in Siberian permafrost, or permanently frozen ground, per The Weather Channel .

The oldest sample they discovered was a 48,500-year-old amoeba virus — dubbed Pandoravirus yedoma after Pandora’s box — that had been frozen under a Siberian lake, according to Science Alert .

What is a zombie virus?

The ancient amoeba virus unearthed by researchers is ominously being called a “zombie virus.”

The preliminary paper describes zombie viruses as “viruses that remained dormant since prehistorical times,” but have since been revived due to being unfrozen.

The amoeba virus, which had been dormant for nearly 50,000 years, was unthawed by the researchers, making it a zombie virus.

Are zombie viruses a public health threat?

According to the study, which has not been peer-reviewed yet, zombie viruses could become public health threats as climate change leads to permafrost melting and releasing viruses that have been frozen for thousands of years.

The researchers note that known viruses released from ancient permafrost could be combatted with antibiotics already at our disposal, but “the situation would be much more disastrous in the case of plant, animal, or human diseases caused by the revival of an ancient unknown virus.” 

“It is thus likely that ancient permafrost will release these unknown viruses upon thawing,” the study reads.

Just how infectious these zombie viruses would be when released is yet to be seen, but the risk of possible infections is “bound to increase in the context of global warming when permafrost thawing will keep accelerating,” the researchers wrote.

Volume 24, Number 9—September 2018

Another Dimension

Emerging infectious literatures and the zombie condition.

Cite This Article

The book club format has enabled expert and nonexpert exploration of infection and epidemiology as encountered in popular literature. This exploration reveals that fiction focusing on apocalyptic disease often uses the zombie as embodiment of infection, as well as an exemplar of current knowledge on emerging disease.

The Bad Bugs Book Club ( https://www2.mmu.ac.uk/engage/what-we-do/bad-bugs-bookclub/ ) was established in 2009 ( 1 ). This reading group meets every 2 months to discuss works of literary fiction from any genre that features infectious disease. The aim of these meetings is to engage scientists and nonscientists in discussions about epidemiology and infection and to consider what the texts tell us about our perception of science and its advances.

Book clubs, or reading groups, have increased in popularity since the late 1990s. Estimates in 2003 were of ≈50,000 book clubs in Britain and ≈500,000 in the United States ( 2 ). Some clubs are specialized groups whose members read restricted genres such as crime fiction, science fiction, or the classics. Fiction and nonfiction texts focusing on microbiology have been incorporated into the book club format, led primarily by academics for student education ( 3 – 5 ), but no evidence has been found in the literature for such groups for the general public.

Adults have been identified as 1 of 3 key underserved audiences in terms of engagement with science ( 6 ). The reading group format addresses this need and contrasts with unidirectional science communication activities from scientists (experts) to members of the public (nonexperts) ( 7 ) in that reading groups provide an opportunity for adults to contribute their knowledge, experience, and perceptions about the reading subject matter on a level platform.

Bad Bugs Book Club meetings take place in an informal environment (a bar) in the evening, typically comprising up to 8 participants, of whom around half have been members since 2009. New members are welcome; meetings are advertised online, as well as through an email group. At each meeting one book is discussed, selected by the group at the previous meeting. Discussions tend to be led by the group leader (J.V.), but all members can lead discussions, particularly for books that they have suggested. The meeting leader prepares questions before the meeting to guide discussion and publishes them online on the book club’s website after the meeting, but usually conversation does not require prompting. Meeting reports are also posted online, enabling themes to be identified across books and genres, as well as establishing a rich, freely accessible resource that has informed much of the content of this article.

Our findings, based on the reports accessible from the book club’s website, show that fiction content in epidemiologic narratives is often influenced by epidemiologic outbreaks—authors absorbing and recasting what have been called “outbreak narratives” ( 8 ) within plotlines—as well as by the pervading rhetoric of fear that surrounds pandemics in the media ( 9 ). We found that the representation of vampires and, particularly, zombies as agents of infection was frequent; these monsters appeared often as epidemiologic avatars ( 10 – 12 ). This article therefore examines the role of the zombie as a metaphor for infectious disease and the emergence of new literature describing apocalyptic disease as examples of the ways in which fiction can lead to a widespread discussion and understanding of pandemics. We use examples from books discussed in our book club meetings.

The Zombie Research Society defines a zombie as “a relentlessly aggressive human or reanimated human corpse driven by a biologic infection” ( http://zombieresearchsociety.com/about-us ). This description neatly summarizes the current state of zombies, both narratively (in the stories told about them) and in terms of how they might become useful in our understanding of pandemics, contagion patterns, and prevention. One aim of the book club is to redress the balance between fear of infection and the importance of a working knowledge of microbiology, but zombies also provide a useful means for examining concerns about fast-spreading diseases in the first world, the “shock doctrine” used in the reporting of pandemics ( 13 ), emerging disease, and, more recently, the impact of antimicrobial resistance. Indeed, Bishop ( 14 ) proposes that “post-9/11 anxieties about potential terrorist attacks via anthrax, avian influenza, swine flu, and other forms of biologic warfare” may be responsible for this emergence and suggests that apocalyptic contagion narratives might outlive interest in the zombie.

The Zombie as Allegory of Infectious Disease Epidemiology

In fiction focusing on infectious disease, the invisible pathogen is an embodiment of the unknown, existing in intimate contact with us, yet beyond the boundaries of our senses. The infection is carried by its host and transmitted to another; its effects become apparent as symptoms develop. The pathogen as a microscopic Gothic presence can be represented metaphorically and macroscopically in the figure of the zombie, much as the ghost, the undead (the vampire), and the “weird creature” have traditionally acted as springboards for the exploration of the beyond and the numinous ( 15 – 17 ). In the zombie, internal damage to the host becomes externalized, and contagion patterns among populations are demonstrated as the zombie hordes rampage. With no subclinical manifestation, the zombie makes the apocalypse visible, enabling us to physically map the spread of infection. In other words, the zombie becomes an “allegory of infectious disease” and a “metaphor of ubiquitous contagion” ( 18 ). In their hordelike structure, zombies also operate metonymically, standing in for large swaths of the population (the infected), or viruses (the infection). The mathematics of zombie outbreaks has therefore also been explored as an education tool to represent contagion patterns and containment strategies ( 19 , 20 ).

In 1996, the influential horror survival video game Resident Evil was developed by Capcom (Capcom USA, San Francisco, CA, USA); this release was the first zombie game to rely on infection as the catalyst for the zombie state. Since then, and particularly after 2002, when a spate of infection zombie texts emerged (such as the Resident Evil movie series [2002 onward; directed by Paul W.S. Anderson], 28 Days Later [directed by Danny Boyle, 2002], and The Walking Dead comic series [2003–present] [ 21 ]), infection has tended to become the primary cause of the zombie condition itself. A blurring of the lines between the traditional zombie and the rabid human has shortened the distance between fantasy and reality ( 22 ). The zombie dominates the horror fiction landscape because it has adapted well to the real-life scenario of pandemic outbreaks as represented by and in the media. Like microorganisms themselves, zombies respond well to selection pressures.

Other parallels between the infection process and the infectious zombie text are apparent. In 2007’s 28 Weeks Later (directed by Juan Carlos Fresnadillo), a woman and son appear to be immune to infection but carry the Rage virus to susceptible populations. The novel I Am Legend ( 10 ) describes the scientific methods applied to isolate the cause of the undead plague, but ultimately it is the evolution of the agent of zombie infection that enables the survival of the host and the pathogen in the novel (although the monsters are infected with the “vampiris bacillus,” their behavior by night is zombie-like). Likewise, in The Girl with All the Gifts ( 23 ), airborne fungal spores ultimately bring about the extinction of the human race: the new world is populated by partially immune, but infected, children. Killing the host limits spread of infection and survival of the pathogen. In these novels, symbiosis is advantageous to both partners in the host–parasite relationship.

Tolerance of infection leads to recovery in the novel Warm Bodies ( 24 ); the immune response is stimulated when the host begins to interact socially with humans. Breathers: A Zombie’s Lament ( 25 ) is narrated by a zombie who regains his self-confidence through attendance at “Undead Anonymous” meetings and becomes a champion for zombie rights (with a taste for human flesh). In comparable texts in other media, such as the television series In the Flesh (written and produced by Dominic Mitchell, 2013–2014) and iZombie (directed by Rob Thomas, 2016–present), zombies are also likable main characters who suffer at the hands of a society that does not understand them. This cross-media development suggests that the zombie condition is evolving heterogeneously, sometimes (especially in melodrama and romance fiction) moving away from the image of the monstrous apocalyptic vector and into a more individually focused host–parasite relationship. The sentient zombie of Breathers or Warm Bodies can cohabit the same cultural space as the more traditional aggressors of Seth Grahame-Smith’s book Pride and Prejudice and Zombies ( 26 ) and Darren Shan’s Zom-B ( 27 ) series, and even zombie-like creatures, such as the rabid attackers of David Moody’s Hater ( 28 ). What unites all these zombies is a similar approach to the cause of their ontological status, namely, infection as the point of origin.

In contemporary zombie fiction, 3 different contagion outcomes predominate that parallel the pathogenesis of infection: success of the predator, mutualism, or a defeat of the predator. Our innate knowledge of real disease epidemiology is thus illustrated in much zombie literature by the behavior of the humans who are under threat. In the absence of any treatment strategy, options are restricted to quarantine (isolation of the infected, as in Cherie Priest’s Boneshaker [ 29 ]), immunization strategies (protection of the uninfected in Warm Bodies , Charlie Higson’s The Enemy [ 30 ], and Jonathan Maberry’s Rot and Ruin [ 31 ]), and control (extermination of the agent in Max Brooks’ World War Z [ 32 ]). As zombies become the manifestation of virulent infection, they do not just address our fear of pandemic disease and apocalypse; they also allow us to explore coping strategies.

Pathogens Influencing Zombie Epidemiology

Viruses are the perfect mechanistic microbiological comparison for the zombie, whose sole function is essentially to replicate/transmit the infection. Although some bacterial infections have had an impact on a global scale, viral pandemics are a greater threat: viruses replicate inefficiently, frequently creating different versions of themselves against which we have reduced or no immunological defense ( 33 ). The attributes of airborne transmission, high infection rate, and high virulence are the worst possible outcome for humanity because airborne transmission is extremely difficult to control or prevent, a high infection rate ensures high numbers of cases, and high virulence results in high rates of illness and death (as depicted in the 2011 infectious disease–themed movie Contagion, directed by Steven Soderbergh). In addition, the incubation period needs to be sufficiently long to enable others to become infected. These patterns have been followed in popular fictional narratives. For example, Ebola virus disease has varying infectivity and virulence: in the 1976 Zaire and Sudan outbreaks, infectivity was relatively low (contact with infected fluids was the route of infection), but fatality rates were high, approaching 90%, whereas in the 2014 outbreak, the fatality rate was 50% ( 34 ). Ebola epidemiology enabled dramatic scenarios in the book The Hot Zone ( 35 ) and the movie Outbreak (directed by Wolfgang Petersen, 1995). The zombie apocalypse draws from such scenarios, yet simultaneously eclipses them all in its scale.

The epidemiology of viral infection we have described may not always be directly applicable to the spread of the zombie condition (e.g., airborne infection happens only when the zombie origin is fungal), but noteworthy patterns do emerge. The novel World War Z (as opposed to the 2013 movie of the same name, directed by Marc Forster, which bears little resemblance to the novel) is a good example of how zombie fiction uses real epidemiologic scares to shape the ultimate viral zombie horror narrative. In microbiological terms, the book describes the emergence and spread of a pandemic whose infection and mortality rates are 100%, with an incubation period of a few days, whose symptoms make those infected extremely dangerous to society, and for which there is no treatment. Inactivation of infected persons by destruction of the brain becomes the only solution and prevention strategy. The infection is not airborne; rather, it is transmitted by biting or entry of infected tissue through injured skin and via transplants. Still, its other traits correlate with those of several true infectious agents, such as rabies virus, Creutzfeldt-Jakob prion disease, cytomegalovirus, herpes virus, and HIV ( 33 ). The zombie incubation period in the novel is also extended (“slow burns”) if a major blood vessel is missed during biting. This particular aspect of the virus is itself borrowed from rabies, in which a longer incubation period results from a bite to the leg rather than a bite to the neck. As with many influenza pandemics and severe acute respiratory syndrome, World War Z ’s pandemic begins in China. In this novel, there are other localized outbreaks, but the pandemic develops via misinformation and obfuscation—as occurred with the spread of severe acute respiratory syndrome from China. Politics plays a major part in the spread of the pandemic.

The zombie, an insentient creature with a tendency to swarm, has been used in several disciplines in recent years to shed light on the dynamics of economics, capitalism, and international politics and to channel fears connected to social alienation, especially as a result of digital and communication technologies and overpopulation ( 22 , 36 – 38 ). In contrast to the intellectual and allegorical use of the zombie in such disciplines, articles describing the epidemiologic properties and preventive measures in the event of a “zombie outbreak” have been presented in the scientific literature in a more ironic tone, nevertheless taking cues from emerging public interest in zombies. For example, BMJ has provided information on epidemiology, treatment, and prevention ( 39 ). However, the use of zombie epidemiology as an education tool requires careful planning; for instance, the CDC’s section on “zombie preparedness” ( http://www.cdc.gov/phpr/zombies.htm ) has been accused of “trivialization” of the preparedness topic ( 40 ).

At least 1 of the popular reimaginings of the late postmillennial zombie proposes that zombified humans may have a “new strain of prion disease.” In the novel Zombie Autopsies: Secret Notes from the Apocalypse ( 41 ), the private notes of a neurodevelopmental biologist written in a remote laboratory setting “where the world community could focus its efforts on the scientific study of ANSD [Ataxic Neurodegenerative Satiety Deficiency Syndrome]” describe the dissections of 3 zombie subjects before the author succumbs to the disease himself. This narrative is framed as the main section of a highly confidential memorandum from the United Nations outpost. Two working hypotheses on the nature of the pandemic are proposed. The first is that ANSD may be caused by an airborne engineered plague, a symbiosis that would result in 3 contagions operating through a single vector, specifically a combination of influenza and prion and a third unknown infectious agent. The second option is that humans may be faced “with something new… with distinct and adaptive properties. Something that hijacks the host.”

Two different fictional worlds, in Charlie Higson’s The Enemy series (2009–2015) ( 30 ) and The Girl with All the Gifts ( 23 ), adopt and modify the “zombie fungus” Ophiocordyceps unilateralis as the apocalyptic zombie agent. In both cases, airborne fungal spores provide an inescapable source of infection, with the sporulation cycle being critical to the plot. Mira Grant’s novel Feed ( 42 ) is the first volume in a series following life in a postapocalyptic America where a third of the population has succumbed to the Kellis-Amberlee virus; zombies are a result of an ecoterrorism act that “released a half-tested ‘cure for the common cold’ into the atmosphere.” The novel’s dormant pathogen is based on Toxoplasma gondii , a pathogen that would not wipe out the entire susceptible population. In all these new novels, the aim is to provide a microbiologically accurate backdrop and story in which the population either succumbs to infection or learns to cope with a pathogen—for example, in Feed , through out-of-bounds contamination areas, complex decontamination routines, and constant screening.

Books like Zombie Autopsies shows how new infectious zombie texts act as virological repositories. The opposite is also true; since I Am Legend , several publications have attempted to use the symptoms of zombieism to explain the workings of specific pathogens and scientific principles. Many examples exist; a particularly notable one is Do Zombies Dream of Undead Sheep? A Neuroscientific View of the Zombie Brain ( 43 ), largely an introduction to neurology, in which consciousness deficit hypoactivity disorder (CDHD) is deemed to be the result of infection from external pathogens that hijack human systems, which could be caused by either Cordyceps -style fungi (as in The Girl with All the Gifts ), prion disease, or evolved brain tapeworms (parasites or protozoans). The zombie status is used here to explain viral attacks on the brain, as well as to describe how this organ generally operates. A book like Do Zombies Dream of Undead Sheep? shows both the tremendous reach of the zombie in the 21st century and how fiction may, in turn, end up delivering the very science it uses as inspiration.

Conclusion: Zombies and Emerging Infectious Literatures

New infectious zombie texts evince the main shifts in fictional representations of infection narratives; in them, symptoms and epidemiology are often based on real infections. We have termed the wider phenomenon within which the zombie narrative has manifested “emerging infectious literatures,” an echo of the term “emerging infectious diseases.” Generically, emerging infectious literatures are varied: some show clear horrific leanings, whereas others are more obviously defined as science fiction or thrillers. Influenza is a particularly malleable candidate for such narratives; the varying possible rates of transmission and virulence have been used to frame different postapocalyptic scenarios since the publication of Stephen King’s The Stand ( 44 ). For example, in Immunity ( 45 ), 4% of the population is lost in a matter of months, and screening is deployed to detect the infected, coupled with immunization of selected persons. In Station Eleven ( 46 ), a much more virulent strain almost wipes out humanity; survivors are few and required to construct new, small, civilizations. Yet another book, Not Forgetting the Whale ( 47 ), focuses on how an isolated Cornish community manages to avoid succumbing to an outbreak affecting the urban environment. Novels about the future impact of antimicrobial resistance are as yet few and far between, but no less interesting: A Fierce Radiance ( 48 ) describes the industrial production of antimicrobial drugs during World War II, the prioritization of combat troops to receive treatment, and the impact of antimicrobial drugs on public health, and The Deep Zone ( 49 ) is concerned with the discovery of new antimicrobial drugs in unusual environments (caves), couched in industrial and political espionage. More recently, short stories (for example, Infectious Futures , published by NESTA [ http://www.nesta.org.uk/search?search_api_views_fulltext=Infectious%20futures ]), comic books ( 50 ), and other public information efforts are attempting to raise awareness and change behavior. Perhaps Zika virus and Middle East respiratory syndrome will provide inspiration for the next epidemiologic antiheroes. Zombies will likely remain a returning concern for epidemiologically inclined writers.

To return to our initial premise, the book club format successfully allows discussion between experts and nonexperts about the overlaps between pandemic fact and fiction. Through these discussions, participants can focus on key messages about disease and infection that underpin the fiction narrative. Meeting reports and reading guides posted on the Bad Bugs Book Club website over the past 9 years provide evidence of the success of multiway discussion, and are a rich resource for others wishing to engage in similar activities. Book club discussions have enabled identification of different themes emerging from such texts, the most notable of which has, for us, been the zombie infection narrative. In the case of the novels discussed throughout this article, our meetings helped us come to grips with the contemporary significance, porosity, and ubiquity of the zombie as contemporary monster. The zombie has enabled the exploration of our behaviors when confronted with infection and served as an indication of how fiction reflects current knowledge about pandemics. In the same way that the changing virulence of pathogens has occurred throughout history, the zombie trope is flexible, something that has enabled its survival in 21st century literature. Emerging infectious diseases and their management likewise provide a rich lode for continuous exploration of the microbiological present and potential future in fiction.

Dr. Verran is a professor of microbiology at Manchester Metropolitan University, Manchester, UK. Her laboratory-based research focuses on the interactions occurring between microorganisms and inert surfaces, but she also investigates how art and literature can facilitate discussion and enhance understanding of infectious disease epidemiology among students and public audiences.

Dr. Aldana Reyes is a senior lecturer in English literature and film at Manchester Metropolitan University and a founding member of the Manchester Centre for Gothic Studies.

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DOI: 10.3201/eid2409.170658

Original Publication Date: July 31, 2018

1 The authors contributed equally to this article.

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January 6, 2017

Physics students explore feasibility of surviving zombie viral infection

by University of Leicester

A real-life zombie outbreak would leave the world's population in shambles, with less than 300 survivors remaining a mere one hundred days into the apocalypse, according to students from the University of Leicester.

Assuming that a zombie can find one person each day, with a 90 per cent chance of infecting victims with the zombie infection, the students from the University of Leicester Department of Physics and Astronomy suggest that by day one hundred there be just 273 remaining human survivors, outnumbered a million to one by zombies.

The students presented their findings in a series of short articles for the Journal of Physics Special Topics , a peer-reviewed student journal run by the University's Department of Physics and Astronomy. The student-run journal is designed to give students practical experience of writing, editing, publishing and reviewing scientific papers.

The student team investigated the spread of a hypothetical zombie virus using the SIR model – an epidemiological model that describes the spread of a disease throughout a population.

The model splits the population into three categories - those susceptible to the infection, those that are infected and those that have either died or recovered. The SIR model then considers the rates at which infections spread and die off as individuals in the population come into contact with each other.

As part of the formula, the students looked at S (the susceptible population), Z (the zombie population) and D (the dead population), suggesting that the average life-cycle of a zombie would be S to Z to D.

They also examined the time frame over which individuals in the population encounter one another.

The initial study did not factor in natural birth and death rates, since the hypothetical epidemic took place over 100 days, resulting in natural births and deaths being negligible compared to the impact of the zombie virus over a short time frame.

Without the ability for humankind to fight back against the undead hordes, the students' calculations suggest that if global populations were equally distributed in less than a year the human race might be wiped out.

However, in a more hopeful follow-up study, the students investigated the SIR model applied to a zombie epidemic and introduced new parameters, such as the rate in which zombies might be killed and people having children within the nightmare scenario. This made human survival more feasible.

The team factored in how over time survivors may also be less likely to become infected after having experience of avoiding or fending off zombies.

They found that it would be possible for the world's human population to survive the zombie epidemic under these conditions – and that eventually the zombie population would be wiped out and the human population would recover.

Course tutor, Dr Mervyn Roy, a lecturer in the University of Leicester's Department of Physics and Astronomy, said: "Every year we ask students to write short papers for the Journal of Physics Special Topics . It lets the students show off their creative side and apply some of physics they know to the weird, the wonderful, or the everyday."

Another Zombie Epidemic. Journal of Physics Special Topics . physics.le.ac.uk/journals/inde … article/view/965/683

Journal information: Journal of Physics Special Topics

Provided by University of Leicester

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Essay on Zombies

Students are often asked to write an essay on Zombies in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Zombies

Understanding zombies.

Zombies are fictional creatures often seen in movies and books. They’re typically depicted as dead humans who’ve come back to life, craving human flesh or brains.

Origin of Zombies

The concept of zombies originated from Haitian folklore. They were initially associated with magic and were said to be controlled by sorcerers.

Zombies in Pop Culture

Zombies became popular in western culture through movies like “Night of the Living Dead”. Now, they’re a common theme in horror genre, symbolizing fear and societal issues.

Zombies and Symbolism

Zombies often symbolize society’s fears or problems, making them more than just scary monsters in stories.

Also check:

• 10 Lines on Zombies

250 Words Essay on Zombies

Introduction to zombies.

Zombies, the walking dead, have long been a fixture in popular culture. These creatures, typically depicted as reanimated corpses or mindless human beings, are often associated with a global apocalypse caused by an infectious virus.

Zombie Origins: Historical and Cultural Context

The concept of zombies originated in Haitian folklore, where they were seen as bodies reanimated by magic or witchcraft. Over time, this concept evolved and was adapted by various cultures, each adding their unique interpretation.

Zombies in Popular Culture

Zombies have become a prevalent figure in films, literature, and video games. The portrayal of zombies in these mediums often reflects societal fears and anxieties. For instance, George Romero’s 1968 film “Night of the Living Dead” used zombies as a metaphor for the societal upheaval of the time.

Zombies: A Symbol of Fear

Zombies embody the fear of death and the unknown. They are often used as metaphors for societal issues like consumerism, pandemics, and political unrest. Their mindless nature and insatiable hunger make them a fitting symbol for the destructive potential of humanity.

Conclusion: The Enduring Appeal of Zombies

Zombies’ popularity in popular culture can be attributed to their ability to adapt and reflect our deepest fears. As long as these fears persist, zombies will continue to walk among us in our stories and myths, serving as a mirror to our collective anxieties.

500 Words Essay on Zombies

Introduction to the concept of zombies.

Zombies, the walking dead, have become a prevalent figure in popular culture, often depicted as reanimated corpses or virally infected human beings. They are primarily characterized by their mindless, ravenous behavior and their desire to consume human flesh or brains. This essay aims to explore the cultural significance of zombies, their historical roots, and their symbolic representation in society.

The Historical Roots of Zombies

The concept of zombies originates from Haitian folklore, where zombies were dead bodies reanimated through magical means by a sorcerer, known as a “bokor”. The zombie served the bokor, devoid of free will, reflecting the dehumanizing conditions of Haitian slavery. This narrative was later westernized, and George A. Romero’s 1968 film “Night of the Living Dead” is often credited with shaping the modern concept of zombies.

In contemporary culture, zombies have become a staple of horror and post-apocalyptic genres. They are featured in various forms of media, including films, television series, books, video games, and even music. This widespread fascination with zombies can be attributed to their flexibility as a narrative device. They can be used to explore themes of societal collapse, human survival, and existential dread.

Symbolic Representation of Zombies

Zombies often serve as a metaphor for societal fears and anxieties. In the context of consumer culture, zombies can represent mindless consumption or conformity. For example, in George A. Romero’s “Dawn of the Dead,” the shopping mall setting serves as a critique of consumerism, with the zombies symbolizing mindless consumers.

On a broader scale, zombies can embody societal fears of pandemics and disease. The transformation process into a zombie often involves infection, which can be seen as a reflection of our fears regarding uncontrollable disease spread. This metaphor has become particularly poignant in the context of the recent COVID-19 pandemic.

The enduring appeal of zombies in popular culture can be attributed to their adaptability as a narrative device and their ability to embody societal fears and anxieties. They serve as a mirror, reflecting our deepest fears and darkest aspects of human nature. As long as these fears and anxieties persist, zombies will continue to walk among us, in our stories and on our screens.

That’s it! I hope the essay helped you.

If you’re looking for more, here are essays on other interesting topics:

• Essay on Zero Hunger
• Essay on YouTube
• Essay on Youth Violence

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Scientists Revive 48,500-Year-Old Virus, Setting World Record

As temperatures rise because of climate change, melting permafrost could cause dormant diseases to re-emerge, researchers warn

Margaret Osborne

Daily Correspondent

As climate change accelerates the melting of ice in the Arctic, carbon dioxide emissions , habitat loss and rising sea levels aren’t the only threats humans face. Scientists have shown that ancient “zombie viruses” frozen for thousands of years can reawaken with rising temperatures. 

In a paper posted on the preprint server bioRxiv  in November, scientists detail how they revived several of these viruses from the Siberian permafrost. The oldest is a 48,500-year-old pandoravirus, which set a world record for the age of a restored virus, co-author Jean-Michel Claverie , a genomicist at Aix-Marseille University in France, tells New Scientist ’s Michael Le Page. 

All viruses the team uncovered infect only amoebas and therefore are not direct threats to public health. But they were still alive and able to replicate—an indication that dormant viruses dangerous to humans could also be revived from lurking in the ice. 

“If the authors are indeed isolating live viruses from ancient permafrost, it is likely that the even smaller, simpler mammalian viruses would also survive frozen for eons,” Eric Delwart , a molecular virologist from the University of California, San Francisco, who was not involved in the research, tells New Scientist .  

In fact, a deadly outbreak attributed to melting permafrost has already happened. In 2016, a heatwave in Russia thawed a 75-year-old frozen reindeer carcass infected with anthrax. As the disease spread, dozens of people were hospitalized, one child was killed and thousands of reindeer fell ill. Researchers are warning this may become more common. 

“The public health risk is coming from the accelerated release of previously frozen viruses combined with increased human exposure, since global warming is also making Arctic areas much more accessible to industrial development,” Claverie tells Newsweek ’s Pandora Dewan. However, Delwart tells  New Scientist  it's more likely that a zombie virus would circulate in wild or domestic animal populations than create a pandemic-scale outbreak in humans.

Claverie and his colleagues have previously uncovered zombie viruses. Back in 2014, they revived a 30,000-year-old pandoravirus . In their new paper, they describe 13 new viruses isolated from nine samples, including seven samples from permafrost.  

Permafrost covers about 24 percent of landmass surfaces in the Northern Hemisphere, and it makes up almost half of the organic carbon stored in Earth’s soil, per the Arctic Institute . Just 3 degrees Celsius of warming could melt 30 to 85 percent of the top permafrost layers in the Arctic. Exactly which microbes this melting could resurface is unknown. Just a single gram of Arctic permafrost can contain hundreds to thousands of microbe groups . 

“We really don’t know what’s buried up there,” Birgitta Evengård , a microbiologist at Umeå University in Sweden, told NPR ’s Michaeleen Doucleff after the anthrax outbreak in 2016. “This is Pandora's box.”

Rebecca Katz , a global health expert at Georgetown University who was not involved in the research, tells New Scientist the dangers should be taken seriously. 

“It makes sense to understand all of the potential pathways for emergence so we can be as prepared as possible,” she tells the publication. “Ancient viruses being released by the thawing permafrost is a very real threat.”

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Margaret Osborne | | READ MORE

Margaret Osborne is a freelance journalist based in the southwestern U.S. Her work has appeared in the  Sag Harbor Express  and has aired on  WSHU Public Radio.

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Updates on Rabies virus disease: is evolution toward “Zombie virus” a tangible threat?

Giuseppe lippi.

1 Section of Clinical Biochemistry, University of Verona, Verona, Italy

Gianfranco Cervellin

2 Academy of Emergency Medicine and Care, Pavia, Italy

Human rabies disease is caused by Rabies Lyssavirus, a virus belonging to Rhabdoviridae family. The more frequent means of contagion is through bites of infected mammals (especially dogs, but also bats, skunks, foxes, raccoons and wolves) which, lacerating the skin, directly inoculate virus-laden saliva into the underlying tissues. Immediately after inoculation, the Rabies virus enters neural axons and migrates along peripheral nerves towards the central nervous system, where it preferentially localizes and injuries neurons of brainstem, thalamus, basal ganglia and spinal cord. After an initial prodromic period, the infection evolves towards two distinct clinical entities, encompassing encephalitic (i.e., “furious”; ~70-80% of cases) and paralytic (i.e., “dumb”; ~20-30% of cases) rabies disease. The former subtype is characterized by fever, hyperactivity, hydrophobia, hypersalivation, deteriorated consciousness, phobic or inspiratory spasms, autonomic stimulation, irritability, up to aggressive behaviours. The current worldwide incidence and mortality of rabies disease are estimated at 0.175×100,000 and 0.153×100,000, respectively. The incidence is higher in Africa and South-East Asia, nearly double in men than in women, with a higher peak in childhood. Mortality remains as high as ~90%. Since patients with encephalitic rabies remind the traditional image of “Zombies”, we need to think out-of-the-box, in that apocalyptic epidemics of mutated Rabies virus may be seen as an imaginable menace for mankind. This would be theoretically possible by either natural or artificial virus engineering, producing viral strains characterized by facilitated human-to-human transmission, faster incubation, enhanced neurotoxicity and predisposition towards developing highly aggressive behaviours. ( www.actabiomedica.it )

The Rabies virus

Rabies disease is mostly sustained in humans by Rabies Lyssavirus, a virus belonging to the large family of Rhabdoviridae, comprised within the Mononegavirale order ( 1 ). It is conventionally assumed that the original virus shall have evolved in Old World bats, which then shifted to carnivores and spread globally, more or less resambling what has more recently happened with coronavirus disease 2019 (COVID-19). The virus is characterized by a bullet-shaped structure, sizing approximately 75×200 nm, and is substantially divided in two parts, encompassing a structural (i.e., the viral envelope) and a functional (i.e., the ribonucleoprotein; RNP) unit. The ~12 kd RNA of the virus contains five major genes, encoding five corresponding viral proteins ( 1 ). Briefly, (i) the N gene encodes the nucleoprotein encapsulating both viral and unsegmented negative-stranded RNA, (ii) the P gene encodes a phosphoprotein involved in transcription and replication activities, as well as in mediating interplay with cellular proteins during neural transportation (see below), (iii) the M gene encodes a matrix protein, (iv) the G gene encodes a transmembrane glycoprotein, which mediates binding during initial infection and seems to be the major antigenic domain responsible for generation of neutralizing antibodies and, finally, (v) the L gene encodes a RNA polymerase ( 1 ). The viral capsid is typically surrounded by host cell-originating plasma membrane, strictly interacting with the matrix protein and the transmembrane glycoprotein. Overall, Rabies viruses are divided into two major phylogroups, accounting for a total number of up to 14 different genotypes ( 2 ). Among these, genotype 1 seems to be the most prevalent, and also that causing the largest number of human infections ( 3 ).

Physiopathology of Rabies virus infection

Although all the precise mechanisms involved in the physiopathology of Rabies virus infection have not been thoughtfully discovered and defined so far, several important aspects can be summarized. The more frequent means of Rabies virus transmission in humans is through bites of infected mammals which, lacerating the skin, directly inoculate virus-laden saliva into underlying tissues. Dogs are the most frequent vehicles of infection in poor countries, whilst virus inoculation by other mammals such as bats, skunks, foxes, raccoons and even wolves has been reported in developed countries ( 4 ). The risk of virus inoculation through bites is highly variable (i.e., between 5-80%), depending on bite severity, animal species, virus concentration, amount of saliva inoculation and so forth, but remains consistently higher than after simple scratchs (i.e., 0.1-1.0%) ( 1 ). In particular, a recent study reported that the risk of virus inoculation by animal bite exposure is the highest for skunks, followed by bats, cats and dogs ( 5 ). In general, bites involving the face, neck or hands expose the patient to the highest risk of contagion, especially when the lesion is accompanied by profuse bleeding ( 1 ). Since Rabies virus is actively present in many human biological fluids, especially cerebrospinal fluid (CSF), saliva, urine and tears, as well as at the nape of neck containing hair follicles ( 6 ), an accidental and involuntary human-to-human transmission is theoretically possible ( 7 , 8 ), as also revealed by publication of a number of paradigmatic case reports ( 9 - 12 ). Nonetheless, cases of rabies contamination through direct contact with blood of infected humans have not been described so far, whereby the virus seems to follow a prevalent intra-neuronal localization, and a clear viraemia is hence probably absent in mammals ( 13 ). Moreover, the Rabies virus can be very rapidly inactivated by sunlight (i.e., ultraviolet rays) and heat exposure, so that its chances of survival outside the host are extremely limited. It seems reasonable to conclude that the cumulative risk of human-to-human infection appears definitely low, except in the case of direct inoculation of human saliva (e.g., through voluntary or involuntary bite) of infected individuals ( 13 ).

Immediately after inoculation, the virus enters neural axons of sensory and motor nerves with an endosomal transport pathway, and then migrates along peripheral nerves (through fast axonal transport system) towards the CNS, with a speed estimated at approximately 8-20 mm/day ( 4 ). According to this velocity of propagation, the incubation period of rabies disease depends on the site of inoculation, whereby in patients who have been infected at distant sites (i.e., arms or legs) the virus would need longer time to reach the CNS than in those bitten on face or neck. Although no clear receptor mechanism has been elucidated so far, it seems that nicotinic acetylcholine receptor (nAchR) and neural cell adhesion molecule (NCAM) may play a role in concentrating virus particles at the neuromuscular junction and providing a more efficient transportation within the intracellular space. Once the intact virions have reached the CNS (thus producing pathognomonic cytoplasmic inclusions, known as “Negri bodies”), viral replication starts by transcription of viral genome by P-L polymerase and further assembly of new viruses, especially in dorsal-root ganglia and anterior-horn cells. The virus then propagates throughout the CNS, principally through plasma-membrane budding, cell-to-cell direct infection or trans-synaptic dissemination, with preferential localization in brainstem, thalamus, basal ganglia and spinal cord ( 3 ). Importantly, major damages to the limbic system are those responsible for onsets of the typical emotional and motivational symptoms characterizing patients with viral encephalopathy ( 2 ). The cumulative neurotoxicity is perhaps the result of a combination of direct cell damage due to virus replication, as well as to development of immune response and autoimmune reactions against infected neurons. Importantly, the huge cytokines production that accompanies CNS infection generates a strong impact on hippocampus and other limbic-system functions, thus impairing electrical cortical activity, hypothalamo-pituitary-adrenal axis and serotonin metabolism ( 4 ). Later in the course of disease, Rabies virus returns to the periphery by means of intra-axonal transport, with enhanced tropism for salivary and lacrimal glands ( 14 ).

Pathology and clinics of Rabies virus infection

The so-called prodromal stage typically initiates when the virus propagates from peripheral nerves to dorsal-root ganglia (i.e., triggering neuropathic pain), up to the CNS. Along with prickling or itching sensation at the site of the original bite, the initial symptoms appear relatively non-specific, mimicking an influenza syndrome, and thus encompassing fever, general weakness and headache ( 1 ). After this initial period, whose length is somewhat variable (i.e., between 2-10 days), the infection can then evolve towards two distinct clinical entities, encompassing encephalitic (i.e., “furious”; ~70-80% of cases) and paralytic (i.e., “dumb”; ~20-30% of cases) rabies ( 4 ).

The former subtype (i.e., encephalitic) of rabies is also the most severe, whereby the vast majority of these patients die within 1 week of onset, and display fever, hyperactivity aggravated by thirst, fear, light, noise and other external stimuli. Within 24 hours from the onset of the first symptoms the patients also develop hydrophobia, hypersalivation, fluctuating consciousness, hallucinations, phobic or inspiratory spasms (often accompanied by fearful facial expressions), along with signs of autonomic stimulation. Importantly, the impaired serotonin neurotransmission due to injured brainstem cells is frequently accompanied by marked agitation and irritability, and can occasionally evolve toward aggressive behaviours ( 15 ). Throughout this period, patients shall be preferably isolated and sedated, to prevent that they may involuntarily injury, or even contaminate, relatives and/or the healthcare staff ( 16 ). The mental status varies, characterized by almost normal periods alternated with severe agitation or depression, up to consciousness deterioration and coma. Seizures are not very frequent, but can occasionally develop in pre-terminal stage. Hematemesis may be present in nearly half of the patients few hours before death, which can also occur for respiratory, cardiac and circulatory arrest during severe spasm episodes ( 4 ). Taken together, these signs and symptoms would contribute to associate a rabid patient with the traditional image of a “Zombie”, as originally depicted by George A. Romero in his notorious 1968 movie “The Night of the Living Dead” ( 17 ), where humans were transformed into aggressive, flesh-eating cannibals after being exposed to radiations of space probe which exploded in the atmosphere while coming back from Venus.

The paralytic, and less frequent form of rabies, is mostly characterized by weakness due to peripheral nerve dysfunction attributable to the combined effect of an autoimmune reaction against the infected cells and activation of immune response against the viruses within the axons ( 4 ). Unlike the encephalitic subtype, where brain stem, cerebrum and limbic system are especially affected, this form mainly involves medulla and spinal cord ( 18 ). This mostly leads to appearance of symptoms like muscular paralysis and facial diparesis. The CNS involvement develops later in the course of disease, evolves towards coma and is then usually followed by death ( 4 ).

Epidemiology of rabies

The most updated statistics on rabies epidemiology can be garnered from the database of the Global Burden of Disease (GBD) Study 2017 ( 19 ), which is currently considered the most comprehensive worldwide repository of health-related information ( 20 ). The trends of incidence and mortality of this condition over the past 3 decades are reported in figure 1 , which clearly shows that both these epidemiologic measures have considerably declined, by approximately 80%, between the years 1990-2017. In 2017 (i.e., the last accessible year in the GBD database), rabies disease has an estimated incidence and mortality of 0.175×100,000 and 0.153×100,000, respectively (i.e., ~13200 cases and ~11500 deaths around the world). Notably, the mortality rate has also contextually declined during the past 30 years, from 96% to 87%, thus mirroring the combination of improved diagnosis and better therapeutic care.

Epidemiology of Rabies virus disease during the past three decades.

The geographic distribution of rabies disease in the year 2017 is shown in figure 2 . The worldwide area with the highest incidence and mortality is Africa, followed by South-East Asia, Eastern Mediterranean and Western Pacific, whilst the values of both these epidemiologic measures is <0.01×100,000 in Europe and Americas. The highest burden of rabies disease cases described in Africa (i.e., 0.40×100,000) and South-East Asia (0.34×100,000) is clearly dependent on insufficient infrastructure for preventing, diagnosing and rapidly establishing post-exposure prophylaxis, as well as on ubiquity of wild and domestic animals, which enormously magnifies the risk of human contagion ( 2 ). Notably, the incidence of rabies disease in Romania (which is - incidentally - the ancestral vampires’ homeland) is over 2-fold higher than in the rest of Europe (i.e., 0.011×100,000 vs. 0.005×100,000). The distinctive geographical localization of rabies disease mirrors that of the socio demographic index (SDI), since the incidence in countries with low SDI (0.445×100,000) is nearly 4-fold higher than in medium SDI countries (0.102×100,000), being approximately 300-fold higher than in high SDI countries (0.002×100,000).

Geographical distribution of Rabies virus disease.

The age and sex distribution of rabies disease is then summarized in figure 3 , showing that the overall incidence is nearly double in men than in women (i.e., 0.22×100,000 vs. 0.13×100,000). The epidemiology in men is characterized by an almost triphasic curve, with peaks of incidence in the childhood (i.e., between 0-14 years), in the middle age (i.e., between 40-54 years) and in the elderly (i.e., after 75 years of age), whilst the epidemiology in women seems more homogenous, with an initial peak in childhood, a further decline between 10-29 years and a final (virtually stable) increase throughout adulthood.

Sex- and age-related epidemiology of Rabies virus disease.

Could Rabies virus become a “Zombie virus”?

The term “rabies” most likely derives from the old Indian root word “ rabh ”, which stands for “making violence” ( 21 ). It is hence not surprising that the most devastating phenotype of encephalitic (“furious”) rabies disease is that of an individual displaying hypersalivation, hydrophobia, paranoia, hyperactivity, hyperirritability and abnormal aggressiveness ( 4 ). Interesting evidence has recently been published by a team of scientists from the University of Alaska Fairbanks ( 22 ), who demonstrated that a specific sequence within the Rabies virus glycoprotein, which has partial homology with snake toxins, is capable to inhibit the nAchR in the CNS, thus modifying animal behaviours and triggering high excitability and hostility.

The hypothesis of viral infection as primary cause of a “Zombie” transformation (i.e., “zombification”) is not new, since it has already been proposed in both the “Resident Evil” movie series and by “Walking Dead” comics, nearly 20 years ago ( 23 ). In the former case, the so-called “Tyrant Virus” (also known as “T-Virus”) was originally developed by the imaginary pharmaceutical company “Umbrella Corporation” in the late 1970s, with the primary scope of eradicating some genetic diseases. Nevertheless, the innate characteristics of the T-Virus persuaded some scientists to promote its conversion into a biological weapon, whereby the pathogen would have been capable to almost irreversibly damage the CSF (especially neurons in frontal lobe, somatosensory cortex and hypothalamus), thus generating a dramatic decline in intelligence and motor functions in the host, but preserving many elementary function, reducing pain responsiveness and amplifying psychotic rage, persistent hunger, and increased aggressiveness (i.e., “zombification”) ( 17 ).

Some intriguing cases of “pseudo-zombification” have also been reported in the scientific literature, mostly occurring in Haiti (where the original term “Zombie” was coined), as result of tetrodotoxin and/or Datura stramonium intake ( 24 ), or more recently in the US, after mass intoxication with synthetic cannabinoids such as AMB-FUBINACA ( 25 ). The risk of a “Zombie emergency” has also been seriously contemplated by the US Centers for Disease Control and Prevention (CDC), issuing an official manual entitled “Preparedness 101: Zombie Pandemic” ( 26 ) ( Fig. 5 ), which aims to prepare healthcare and civil resources to handle epidemic threats, among which Zombie infestation is perhaps the most paradigmatic example. This document has then been followed by another guide, endorsed by the US Government, and specifically called “Counter-Zombie Dominance” ( 27 ). This second document contains the thoughtful description of how a military strategy shall be established for defending the nation against an imaginable Zombie alert, thus encompassing detailed information on biological characteristics of “enemy force”, on available means for preventing pathogen transmission, as well as on conceivable strategies that shall be planned for preventing collapse of civilized society ( 27 ). Therefore, some discernible questions would follow. Specifically, how much human rabies disease overlaps with “zombification”? And, would it be possible that a mutated Rabies virus epidemics (or pandemic) will transform mankind into Zombies?

The Centers for Disease Control and Prevention (CDC) manual “Preparedness 101: Zombie Pandemic”.

The first important aspect is defining the risk of human-to-human transmission, the mainstay of the imaginary Zombie contagion ( 28 ). It has been previously highlighted that bloodborne transmission is very unlikely for rabies disease, whereby viraemia does not seemingly occur with this type of infection. The survival of Rabies virus outside the host is also frankly poor, so that the most probable means of human-to-human transmission would need direct inoculation of the pathogen through bites from infected people ( 13 ). Rabies virus detection in saliva of infected humans has been reported as being the highest 2-3 days after the onset of symptoms, remains apparently stable for 2-7 days afterwards, and then apparently declines ( 29 ). Throughout the contagious window, it shall hence be assumed that patients with overt rabies disease would be so aggressive against their own kind to feel the uncontrollable instinct to bite them. Although there is only sporadic evidence of rabid patients biting other humans (e.g., a 41-year-old woman died of rabies disease after being bitten by her 5-year-old son, who in turn had developed the pathology after being bitten by a rabid dog) ( 9 ), this possibility cannot be straightforwardly excluded. The real incidence of human bites is largely underestimated due to under-reporting, and also because affected people tend to avoid medical care. Nevertheless, current evidence suggests that mammalian bites would account for almost 1% of all emergency department visits, up to 20% of which are attributable to human bites (i.e., 0.2% of all emergency department admission) ( 30 ). Therefore, the suggestion that extremely aggressive rabid patients would suffer from an incontrollable instinct to bite other humans, and thus transmitting the infection, remains actual. Interestingly, the Advisory Committee on Immunization Practices of the CDC suggests that post-exposure prophylaxis shall be planned for all people with mucous membranes or non-intact skin exposure to potentially infectious body fluids from rabid patients ( 31 ), thus implicitly confirming that the risk of human-to-human transmission of rabies disease is not irrelevant.

The comparison of the current image of a Zombie with that of a rabid patient is a second import aspect that needs to be accurately scrutinized. As already emphasized, conventional Zombies, as depicted in comics and movies ( 23 ), share some similar behaviours with patients infected by Rabies virus. Both undergo a variable degree of consciousness deterioration, which tends to be almost identical in the last stages of rabies disease. Both individuals display also fearful facial expressions, increased hyperirritability and aggressiveness, which can be both substantially accentuated by external stimuli (thirst, fear, light and noise) in rabid patients ( Figure 4 ), and may ultimately evolve toward violent and ferocious behaviours.

Clinical similarities between encephalic rabies disease and imaginary “zombification”.

That said, it is now widely acknowledged that many viruses are characterized by naturally occurring high mutation rates, which induce constant changes as reliable means for escaping host defences or facilitating their transmission to other susceptible hosts. Rabies virus makes no exception to this rule, as recently described by Wang et al ( 32 ), who found a vast array (up to 100) of antigenic variants of this pathogen in a wide range of animal hosts and geographic locations. Notably, even single amino acid mutations in the proteins of Rabies virus can considerably alter its biological characteristics, for example increasing its pathogenicity and viral spread in humans, thus making the mutated virus a tangible menace for the entire mankind ( 33 ). Beside the natural evolution of Rabies virus, an equal threat may come from the science of genetic engineering, which would reproduce the theatrical scenario depicted in the movies of the Resident Evil saga ( 23 ), and more recently advocated also for COVID-19. By means of genetic engineering, scientists have already developed innovative biological weapons, which would appear more powerful and destructive than their natural counterparts ( 34 ). The outbreak of severe acute respiratory syndrome (SARS) in 2003, in China, is perhaps the most paradigmatic example ( 35 ), whereby many biological features of the pathogen have led some eminent scientists to conclude that the SARS virus might have been produced under laboratory conditions ( 36 ). Would a mutated Rabies virus, bearing one or more mutations such as those described by Hueffer et al ( 22 ), and hence characterized by facilitated human-to-human transmission, faster incubation, enhanced neurotoxicity and predisposing towards aggressive highly behaviours, become the most lethal biological agent that humans have ever faced?

Conclusions

The Rabies virus, like the vast majority of other pathological microorganisms, attempts to perpetuate itself with general and reservoir host-specific mechanisms, which ultimately confer a considerable epidemiological plasticity. The pace and phenotype of rabies infection are mostly written in the virus genome, whilst transmission is strongly favoured by aggressive behaviours (i.e., a biting inclination) of rabid hosts ( 37 ). Despite incidence and mortality of rabies disease have both markedly declined during the past three decades ( Fig. 1 ), and irrespective of whether the genetic code of Rabies virus can be naturally (i.e., by ecological opportunities and viral adaptation) or artificially (i.e., by genetic engineering) modified, we need to think “out-of-the-box”, in that the generation of a “Zombie virus” cannot be firmly excluded according to the currently available biological evidence ( 38 ). Wavefront velocity of rabies disease propagation has been calculated in wild animals (e.g., foxes, skunks, raccoons and vampire bats) at around 10-40 km per year ( 37 ). However, in densely populated towns, where natural landscape barriers would be minimal, the human-to-human contagion may increase by several orders of magnitude, thus easily assuming apocalyptic proportions and creating a new generation of pseudo-human creatures, who have completely unleashed their already existing part of zombie within ( 39 ). In keeping with this conjecture, an interesting simulation of an imaginary Zombie outbreak reveals that most of the US population would turn into Zombies within one week from appearance of the first case, whilst only some remotes zones in Montana and Nevada would remain infestation-free one month afterwards ( 40 ).

In conclusion, what has become rather clear so far is that rabies disease is entirely preventable, while encephalomyelitis has never been described in people who had received pre-exposure vaccination or post-exposure booster ( 41 ). Therefore, although the transformation of Rabies virus into a “Zombie virus” will always remain a tangible threat surrounding human future ( Fig. 1 ), further efforts shall be made for disseminating a culture of widespread knowledge, prevention and surveillance against this and other potentially devastating viruses ( 42 ).

Conflict of interest:

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article.

March 22, 2024

What to Know about Measles Outbreaks in the U.S.

A growing number of measles cases in the U.S. has experts worried about how a decline in routine vaccinations could bring back preventable illnesses

By Riis Williams

Measles, also known as Rubeola, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus.

Mediscan/Alamy Stock Photo

Pediatric infectious disease doctor Paul Offit isn’t vaccinated against measles. Like many of his peers, he caught the virus as a child in the 1950s, roughly a decade before a vaccine was created. At that time the highly contagious and potentially fatal disease sickened an estimated three million to four million Americans each year . Offit has been immune ever since and likely will be for life.

For those who haven’t undergone the full-body rash, swollen eyeballs and plethora of other unpleasant symptoms of measles in order to earn a lifelong defense against the disease, the vaccine is key. After widespread adoption of the two-shot vaccine regimen in the 1990s, disease transmission decreased so much that the U.S. declared measles eliminated from the country in 2000 .

But this year the U.S. Centers for Disease Control and Prevention has reported 58 measles cases in outbreaks across 17 states —a case number equal to the total measles infections reported in all of 2023. As of last week, the states with documented measles cases in 2024 are Arizona, California, Florida, Georgia, Illinois, Indiana, Louisiana, Maryland, Michigan, Minnesota, Missouri, New Jersey, New York, Ohio, Pennsylvania, Virginia and Washington. The CDC has not reported any deaths, and several outbreaks are still considered active. A n outbreak in Chicago that has involved at least 15 cases—several of which were among people staying in a migrant shelter in the neighborhood of Pilsen—has triggered a strong joint response from the city’s department of public health, the CDC and other local health centers to isolate infected individuals and vaccinate people who are susceptible to the disease.

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Florida also reported measles infections among several students at an elementary school near Miami last month. The outbreak garnered significant media attention after the state’s surgeon general Joseph Ladapo said in a public statement that unvaccinated children could continue to attend school despite potential for exposure . The Florida Department of Health said that no measles infections have been reported from the school since February 16 , although it has not publicized the exact number of cases in the outbreak. The department did not respond to Scientific American’s request for comment.

Some measles transmission each year is expected despite the nation’s herd immunity , which is achieved when the majority of a population—in this case, 95 percent—is immune to a disease. But the high number of infections so early in 2024 has some public health experts concerned about what this bodes for the rest of the year and how vaccine misinformation and disinformation—exacerbated by COVID—may be affecting vaccination rates. “During the pandemic there were obviously a number of people who didn’t like that they were being mandated to receive COVID vaccines, and now that mindset’s spilled over into the [measles] vaccine,” says Offit, who is director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. “But people can forget that measles is exponentially more contagious than COVID..., and it’s a nightmare.”

Measles is an airborne respiratory disease that spreads when a sick person breathes, coughs, sneezes and touches surfaces. Symptoms usually begin 10 to 14 days after an initial exposure. They include a red, splotchy rash that originates on the face and neck, fever, puffy and watery eyes and common-cold-like features. Anyone can catch measles, but children—particularly those two years old or younger with a still-developing immune system—are the most susceptible. There is no specific treatment for measles, and in some cases the disease can cause ear infections, diarrhea, pneumonia and encephalitis (swelling of the brain that can lead to a permanent disability); occasionally it can result in death.

Credit: Amanda Montañez; Source: Centers for Disease Control and Prevention ( data )

In the early 1900s the U.S. was reporting an average of 6,000 measles-related deaths each year. By mid-century, developments in medical treatments helped reduce complications and deaths. And people’s natural antibodies, which can be passed from mothers to their babies and provide short-term protection, made infant infections less common. Still, nearly everyone contracted measles by the time they turned 15. Approximately 48,000 people were hospitalized annually, and 400 to 500 died.

“As someone who had a natural measles infection, I can tell you that it’s seriously no fun,” Offit says. “Now they ask old people like me to come down to the emergency room to look at people with fever and a rash because I’ve seen so much of it, and I can tell them within 30 seconds whether or not it’s measles.”

Biochemist John Enders and physician Thomas Peebles created the first measles vaccine, approved in 1963, after successfully extracting and isolating the virus from an infected 13-year-old boy. Microbiologist Maurice Hilleman refined the shot in 1968, and it was distributed across the U.S. This version of the vaccine, called MMR, also protects people against two other infectious diseases, mumps and rubella, and is the shot most commonly used today.

The MMR shot is 93 percent effective at preventing measles, and its use drastically reduced infections. But a notable number of outbreaks were still occurring as of 1989, so at that time, U.S. public health organizations began recommending that people receive one dose of the vaccine around their first birthday and a second dose when they are four to six years old, which provides 97 percent effective protection for a lifetime.

In the early 2000s, however, MMR vaccination rates in the U.S. dipped after British physician Andrew Wakefield published a scientific study claiming that the vaccine could cause autism. His research was debunked after further review but not before it incited fear and skepticism across the U.S. and in other countries. “It’s really hard to unring a bell,” Offit says. “Once people are scared of something, it’s tricky to ease them, and so a bunch of measles started showing up again around 2004 and 2005.”

MMR vaccination rates have been steadily rising since then, and today most public and private schools require children be vaccinated before enrolling. But measles cases are once again popping up around the country, and Offit worries that a surge in antivaccine sentiment that began during the COVID pandemic may be partially responsible.

The most common reasons parents might opt their child out of MMR and other vaccine requirements are for religious or medical accommodations, although some states allow parents to cite personal beliefs as their basis for exemption. According to a CDC report published last November , vaccine exemption rates among kindergartners rose nationally to 3 percent during the 2022–2023 school year—a 0.4 percent jump from the previous year—and in 10 states, more than 5 percent of them had exemptions. Coverage can vary greatly across counties and municipalities, too, says Jerne Shapiro, an instructional assistant professor of epidemiology at University of Florida, and within them, every private institution can also have its own specific criteria for vaccinations.

Measles outbreaks can also start when people who are infected come to the U.S. from abroad. If sick travelers come in contact with unvaccinated or immunocompromised Americans, secondary measles cases can emerge, Shapiro says. One person with measles infects, on average, 12 to 18 others , Offit adds.

With measles outbreaks likely increasing, Offit and Shapiro both urge Americans—especially spring break travelers—to check their MMR vaccination status and seek vaccine and outbreak information only from physicians and government-certified sources, including the CDC, World Health Organization and the National Institutes of Health. “There is so much misinformation about vaccines in general,” Shapiro says. “But this vaccine has been administered for decades and decades. Most of us are fortunate enough not to know what most vaccine-preventable diseases look like, and sometimes we can take that for granted.”