On Respiratory Crisis and Other Respiratory Curiosities in the Aftermath of Encephalitis Lethargica: "Like Asthma".

Pandemics in the early 20th century (and now with SARS-CoV-2) have been dominated by respiratory viruses damaging lungs. Less is known about abnormal respiratory patterns from brain inflammation. One of the first descriptions of respiratory rhythm abnormalities was seen with an acute attack of epidemic encephalitis (encephalitis lethargica), and reports appeared soon after the original description in 1921. We reviewed these ill-remembered disorders of the respiration rate, respiratory patterns and respiratory "tics." Most commonly, dysregulations occurred during the phase when ocular signs appeared. The early symptoms were an unrelenting tachypnea without air hunger and an inspiratory hold (fixés en inspiration forcée). Initially regarded as "hysterical" in nature, the later bizarre disorders of respiration were considered equally serious with attacks of gasping, panting, puffing, inspiratory breath holding, coughs, giggles, sighing, grunting, and moaning. These respiratory disorders were seen exclusively as part of a parkinsonian syndrome. Most remarkably, these attacks could be provoked by oxygen administration.These respiratory abnormalities with encephalitis lethargica are not well remembered. One purpose of recalling these episodes is to call attention to central causes of respiratory illness even in pandemics with respiratory viruses.

Cinema's Terrifying Realities: Pandemics, Zombification, and SARS-COV-2.

Contagion is a function of the properties of the pathogen, social interactions, and personal relationships in the society it attacks. Filmmakers in the horror genre were inspired by the idea of rabies as a virus that could mutate into something more dangerous. Fictional epidemics of scavenging undead were often attributed to encephalitis caused by rabies or a mutated rabies virus. During the early months of the SARS-COV-2 pandemic, there was a spike in streaming of Contagion that portrays a viral infectious disease modeled after a bat virus that spreads at an alarming rate, unleashing a global public panic and a clueless governmental response. We wanted to trace how filmmakers used rabies pathology as source material for their plots. We searched internet film databases and reviewed fictional films that utilized this plot device. Many dystopic, rabies-induced pandemic scenarios - mostly from the zombie genre - reveal parallels to the COVID-19 pandemic. Many zombie films, despite their absurd premise, anticipated the realities of future pandemics.