Intended for healthcare professionals

Feature Christmas 2015: Infection Control

Zombie infections: epidemiology, treatment, and prevention

BMJ 2015; 351 doi: (Published 14 December 2015) Cite this as: BMJ 2015;351:h6423
  1. Tara C Smith, associate professor1
  1. 1Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, Kent, OH 44242, USA
  1. tsmit176{at}

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 19686

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 …

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