Clinical findings in three cases of zombification

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

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)

Deadness as a Feeling Considered Through the Lens of The Walking Dead

Zombie films and shows have accelerated in popularity through the decades, and the genre is produced the world over. The Walking Dead, one such show, has been rated among the most popular cable network television programs since its inception. When watching a herd of zombie walkers, the viewer faces some important questions. In some ways, many can identify with the experience of the zombie, as it reflects the psychological state of inner deadness. The psychodynamic literature has a rich history describing this experience. A review of these ideas and the metaphor of the zombie help guide us in the treatment of our patients who do not experience themselves as truly living. The Walking Dead also provides a glimpse into the response of detachment to a viral pandemic, and how we might discover our best self during such times while helping our patients to do the same.

The undead in culture and science

The undead have a significant role in mythology, religion, folklore, and literature. In the 1800s, the word zombie was used to describe reanimated corpses in the Caribbean who often worked on plantations doing long, arduous field work. The movie White Zombie was released in 1932 and exploited this folklore, but it ignored the fact that zombies represent one outcome in Vodou religious beliefs regarding death and the migration of spirits following death. The interest in zombies eventually led to sociological and medical investigations into zombification. Wade Davis reported that powders used by malevolent priests (bokors) contained tetrodotoxin, which could cause the neurologic changes underlying the zombie phenotype. Recent clinical studies have indicated that synthetic cannabinoids and synthetic cathinones can cause bizarre zombie-like behavior. According to Haitian folklore, zombies can develop when bokors reanimate someone who suddenly died from an acute illness or who was purposely poisoned. Recent studies in molecular biology suggest that the sequence of programmed cell death can be reversed when the stressor is removed and that cells, tissues, and bodies (at least in Drosophila flies) can recover. These scientific studies would support the remote possibility that the near dead might recover under certain circumstances but have residual neuropsychological dysfunction. Alternatively, the bokors could maintain control of their victims using drugs with properties similar to those of synthetic cannabinoids. The concept of zombification needs to be considered in the context of culture, religion, and science.

The human body as an energetic hybrid? New perspectives for chronic disease treatment?

Inflammatory response is accompanied by changes in cellular energy metabolism. Proinflammatory mediators like plasma C-reactive protein, IL-6, plasminogen activator inhibitor-1, TNF-α or monocyte chemoattractant protein-1 released in the site of inflammation activates immune cells and increase energy consumption. Increased demand for energy creates local hypoxia and lead in consequence to mitochondrial dysfunction. Metabolism of cells is switched to anaerobic glycolysis. Mitochondria continuously generate free radicals that what result in imbalance that causes oxidative stress, which results in oxidative damage. Chronic energy imbalance promotes oxidative stress, aging, and neurodegeneration and is associated with numerous disorders like Alzheimer’s disease, multiple sclerosis, Parkinson’s disease or Huntington’s disease. It is also believed that oxidative stress and the formation of free radicals play an important role in the pathogenesis of rheumatoid diseases including especially rheumatoid arthritis. Pharmacological control of energy metabolism disturbances may be valuable therapeutic strategy of treatment of this disorders. In recent review we sum up knowledge related to energy disturbances and discuss phenomena such as zombies or hibernation which may indicate the potential targets for regulation of energy metabolism.

Traditional healing practices originating in Aruba, Bonaire, and Curaçao: A review of the literature on psychiatry and Brua

Brua is an Afro-Caribbean religion and healing tradition from the southern part of the former Netherlands Antilles. Like other Caribbean healing traditions, it plays a significant role in shaping how individuals experience and express disorders which Western health professionals consider to require psychiatric care. Because little has been published on Brua, and because patients from Aruba, Bonaire, and Curaçao are often reluctant to discuss their commitment to this tradition, they are often misdiagnosed and either over- or undertreated by biomedically trained health professionals. The present paper provides a review of the literature on Brua and its relation to psychiatry. A systematic search was carried out in PubMed, the Ovid database, Google Scholar, and the historical literature. Our search yielded 35 texts on Brua, including three peer-reviewed scientific papers and eight academic theses. From those texts Brua emerges as a holistic patchwork of creolized beliefs and practices which are considered to be both cause and remedy for a wide variety of ailments. Despite the fact that tension between the Brua discourse and Western-oriented psychiatric practice is significant, adherence to Brua does not seem to cause much patient delay in help-seeking. However, belief in Brua as a possible source of mental and physical complaints, as well as patients' frequent recourse to Brua practices, including the use of hallucinogens, may affect the diagnosis and treatment of mental disorders.

Natural products from ethnodirected studies: revisiting the ethnobiology of the zombie poison

Wade Davis's study of Haitian “zombification” in the 1980s was a landmark in ethnobiological research. His research was an attempt to trace the origins of reports of “undead” Haitians, focusing on the preparation of the zombification poison. Starting with this influential ethnopharmacological research, this study examines advances in the pharmacology of natural products, focusing especially on those of animal-derived products. Ethnopharmacological, pharmacological, and chemical aspects are considered. We also update information on the animal species that reportedly constitute the zombie poison. Several components of the zombie powder are not unique to Haiti and are used as remedies in traditional medicine worldwide. This paper emphasizes the medicinal potential of products from zootherapy. These biological products are promising sources for the development of new drugs.

Culture et santé mentale en Haïti : une revue de littérature

Cet article passe en revue et résume l’ensemble de la littérature sur la santé mentale et les services de santé mentale en Haïti. Ce compte rendu a été rédigé à la suite du tremblement de terre qui a frappé Haïti en janvier 2010. Nous avons effectué des recherches dans Medline, Google Scholar et d’autres bases de données disponibles en vue de recueillir la littérature scientifique pertinente sur la santé mentale en Haïti. La consultation d’ouvrages de référence et de la littérature grise sur Haïti a complété les recherches. La première partie décrit les principales données historiques, économiques, sociologiques et anthropologiques qui permettent de comprendre sommairement Haïti et sa population. La démographie, la structure familiale, l’économie haïtienne et la religion y sont abordées. La deuxième partie est axée sur la santé mentale et les services de santé mentale. L’épidémiologie élémentaire des maladies mentales, les croyances au sujet des maladies mentales, les modèles explicatifs, les idiomes de détresse, les comportements de recherche d’aide, la configuration des services de santé mentale et l’étude des relations entre la religion et la santé mentale y sont examinés.

Functionalists and zombis: Sorcery as spandrel and social rescue

At one level, anthropologists remain functionalists in that they generally see acts and institutions as contributing to a greater social whole only through which they make sense. Thus, sorcery accusations have been traditionally interpreted in terms of maintaining social harmony and cohesion. In the case of Haitian zombification, the zombi seems a locally misidentified victim who is frequently mentally ill. As a hapless non-agent, the zombi cannot initiate the sorcery accusations, so how do we understand the recognition and rescue of the zombi, either in terms of social function or social action?

Neurotoxic marine poisoning

Marine poisoning results from the ingestion of marine animals that contain toxic substances and causes substantial illness in coastal regions. Three main clinical syndromes of marine poisoning have important neurological symptoms-ciguatera, tetrodotoxin poisoning, and paralytic shellfish poisoning. Ciguatera is the commonest syndrome of marine poisoning and is characterised by moderate to severe gastrointestinal effects (vomiting, diarrhoea, and abdominal cramps) and neurological effects (myalgia, paraesthesia, cold allodynia, and ataxia), but is rarely lethal. Tetrodotoxin poisoning and paralytic shellfish poisoning are less common but have a higher fatality rate than ciguatera. Mild gastrointestinal effects and a descending paralysis are characteristic of these types of poisoning. In severe poisoning, paralysis rapidly progresses to respiratory failure. Diagnosis of all types of marine poisoning is made from the circumstances of ingestion (type of fish and location) and the clinical effects. Because there are no antidotes, supportive care, including mechanical ventilation in patients with severe paralysis, is the mainstay of treatment.

Puffer fish poisoning: a potentially life-threatening condition

Puffer fish poisoning has been documented rarely in Australia. It results from ingesting tetrodoxtoxin found in the liver, ovaries, intestines and skin of the fish. Over a recent 16-month period, 11 cases of puffer fish poisoning were reported to the NSW Poisons Information Centre. Symptoms of poisoning may include paralysis, respiratory failure, numbness, paraesthesia, nausea and ataxia. Health professionals should be aware of the condition so as to institute early and appropriate management.

Trauma and the Kanun: two responses to loss in Albania and Kosova

Social anthropology has proposed that social institutions and psychological reactions may at times be alternative ways of dealing with similar situations; and that at a high level of generality, they may be conceived of as variants of similar (psycho-social) phenomena. Response to sudden bereavement in Albanian Kosova may follow two routes: the customary law arguing stoicism but retribution, and the psychological idiom of 'trauma' recently introduced by Western European aid agencies. Similarities and differences between what at first appear two quite distinct responses are outlined.