Fun fact of the day: rabies can come as a big surprise to people because they don’t recall being bitten by an animal.

Fun fact of the day: the majority of rabies diagnoses in the United States come as a big surprise to people because they don’t recall being bitten by an animal.

Rabies is a viral infection classically spread when an infected animal bites an uninfected animal; the virus spreads along the nerves and reaches the brain, where it causes bizarre behaviour, paranoia, rage, the famous foaming at the mouth, and (potentially) eventually death. Rabies is an important illness in medieval fantasy. It’s been a part of human culture and probably human myth for about as long as either one has existed. Whereas most people don’t necessarily have a very clear idea of what cancer or a heart attack actually are and certainly don’t tend to have a very clear of idea of how most neurological disorders work, rabies is one of those disorders that most people develop a mental picture of at a young age. Werewolf mythology likely has some grounding in ancient cases of rabies, as might the stories behind many other monsters.

Modern rabies isn’t quite the same as classic rabies, however, because the most common mode of transmission has changed. Through scientific advancement and public education, we’ve done a good job of reducing the incidence of, say, rabid dogs attacking and infecting children. The classic image of rabies that we teach our kids by and large remains that of the rabid dog, the rabid raccoon, or the rabid squirrel. These are functional things to teach, because they give kids a reason not to approach strange animals (which likely aren’t rabid but can certainly present other dangers, especially if parents are unnecessarily germophobic). In reality, however, according to the best national data, the single most common cause of rabies in the 21^st century is actually bat bites.

The really funny thing about bats is that it’s really, really easy to be unaware that one has bitten you. It’s hard not to notice a German Shepherd hanging off of your arm, but you can sleep right through a bat bite.

Occult rabies – “occult” in the sense of being unseen, as opposed to being from magical causes – is a potentially very entertaining disease to spring on a group of PCs. A party of adventurers that spends a night sleeping in the woods could easily fail to notice bats swooping in and biting a few people if the character on watch fails a Perception or Spot check. The storyteller rolls a few Fortitude saves – or deliberately fudges the rolls in the name of comedy – and over the next four weeks characters start slowly taking Intelligence, Wisdom, and Charisma damage and don’t know why. Good role-players, who might play up their slowly eroding social skills, could potentially have a lot of fun with this situation while they try to figure out the cause and solution to the problem. Of course, once they solve the puzzle, a simple remove disease spell is enough to cure the illness, but even so, it will take them some time to heal their ability score damage, and even a few days of low wisdom for a cleric or low charisma for a bard can completely change a game’s dynamic. 

More than four years ago, Dr. Eris Lis, M.D., began writing a series of brilliant and informative posts on RPGs through the eyes of a medical professional, and this is the one that appeared here on September 20, 2015. Lis is a physician, gamer, and author of the Skirmisher Publishing LLC OGL sourcebook Insults & Injuries, which is also available for the Pathfinder RPG system.