WEBVTT - Ep 25 Put your hands together for: Gonorrhea! 0:00:00.400 --> 0:00:04.400 Okay, so this is a small disclaimer for this episode, 0:00:04.600 --> 0:00:07.880 since a lot of you either are kids, high kids, 0:00:08.200 --> 0:00:11.400 or you listen with your kids. Hi, parents and kids. 0:00:12.000 --> 0:00:15.400 We are discussing a sexually transmitted disease today, which means 0:00:15.400 --> 0:00:18.919 we're going to be talking about sex and genitals. So 0:00:19.120 --> 0:00:21.800 if you want to veto that for your five year 0:00:21.800 --> 0:00:26.840 old that's listening, put your earbuds in now. 0:00:28.200 --> 0:00:33.040 January eighteenth, seventeen sixty three. I this day began to 0:00:33.080 --> 0:00:37.000 feel an unaccountable alarm of unexpected evil, A little heat 0:00:37.159 --> 0:00:40.200 in the members of my body sacred to Cupid, very 0:00:40.320 --> 0:00:43.000 like a symptom of that distemper with which Venus when 0:00:43.120 --> 0:00:45.920 Cross takes it into her head to plague her votaries. 0:00:46.760 --> 0:00:49.360 But then I had run no risks, I had been 0:00:49.400 --> 0:00:52.199 with no woman but Louisa, and sure she could not 0:00:52.320 --> 0:00:55.720 have such a thing. Away then, with such idle fears, 0:00:55.800 --> 0:01:02.320 such groundless, uneasy apprehensions. January nine, eighteenth, the evening was 0:01:02.360 --> 0:01:06.080 passed most cheerfully when I got home, though then came 0:01:06.200 --> 0:01:13.440 sorrow to too. Plain was signor gonorrhea. Wait there's more. 0:01:22.000 --> 0:01:24.440 Thus ended my intrigue with the fair Luisa, which I 0:01:24.440 --> 0:01:27.520 flattered myself so much with and from which I expected 0:01:27.560 --> 0:01:31.479 at least a winter's safe copulation. It is indeed very hard. 0:01:31.959 --> 0:01:34.959 I cannot say, like young fellows who get themselves clapped 0:01:35.000 --> 0:01:37.680 in a body house, that I will take better care again, 0:01:37.880 --> 0:01:41.119 for I really did take care. However, since I am 0:01:41.200 --> 0:01:43.960 fairly trapped, let me make the best of it. I 0:01:44.040 --> 0:01:46.880 have not got it from imprudence. It is merely the 0:01:47.000 --> 0:02:32.520 chance of war. I mean, it goes on and on 0:02:32.600 --> 0:02:35.960 like there's a much more of it. That's just yeah, 0:02:36.000 --> 0:02:40.600 Oh my gracious, isn't it so good? 0:02:41.520 --> 0:02:42.160 What is that? 0:02:42.320 --> 0:02:46.720 What is that? Okay? So that is from James Boswell. 0:02:46.800 --> 0:02:52.280 So James Boswell was the He was the biographer of 0:02:52.480 --> 0:02:58.800 Samuel Johnson, who's a literary Okay, yeah, James Boswell throughout 0:02:58.840 --> 0:03:02.639 his life, throughout his journal entries at least became infected 0:03:02.680 --> 0:03:08.280 with GONERIEA at least nineteen separate times nineteen So this 0:03:08.360 --> 0:03:15.040 is merely one of them. I just he really you 0:03:15.040 --> 0:03:17.520 should take some time and just go and seek out 0:03:17.560 --> 0:03:18.800 the entirety read his. 0:03:19.520 --> 0:03:20.440 Whole journal entry. 0:03:20.560 --> 0:03:28.079 Yes, yes, man, Hello, Hello, I'm Aaron Welsh and I'm 0:03:28.200 --> 0:03:33.040 Erin Almond updyke and put your hands together for hands 0:03:33.080 --> 0:03:39.680 together for Goneriea, the subject of today's episode. 0:03:39.320 --> 0:03:45.480 Of this podcast Will Kill You. Welcome, Welcome, We're gonna 0:03:45.520 --> 0:03:46.720 have fun today, I can tell. 0:03:46.800 --> 0:03:52.200 Oh yeah, I mean if that journal entry is any indication, right, okay, 0:03:52.480 --> 0:03:56.400 So what are we drinking to talk about GONERIEA. 0:03:57.080 --> 0:03:59.560 We're drinking, of course, burning love. 0:04:00.600 --> 0:04:05.600 And it is burning because it does Jalipino simple syrup 0:04:06.560 --> 0:04:12.200 and tequila, lemon juice and a cucumber slice. 0:04:12.360 --> 0:04:13.440 Just for freshness. 0:04:13.600 --> 0:04:14.560 It's pretty delicious. 0:04:14.600 --> 0:04:17.600 I gotta say it is delicious. I'm really enjoying it. 0:04:18.160 --> 0:04:20.440 And as always, we'll post the full recipe for this 0:04:20.560 --> 0:04:24.440 quarantine as well as our Placeyburrita, our non alcoholic version 0:04:24.880 --> 0:04:27.040 on all of our social medias. You can find us 0:04:27.080 --> 0:04:30.760 on Twitter at TPWKY, on Instagram and Facebook at this 0:04:30.800 --> 0:04:33.520 Podcast will Kill You, and on our website at this 0:04:33.600 --> 0:04:36.000 Podcast will Kill You dot com. 0:04:36.040 --> 0:04:38.520 And if you ever feel like reaching out to us, 0:04:38.800 --> 0:04:41.000 you can email us at this Podcast will Kill You 0:04:41.040 --> 0:04:43.599 at gmail dot com, or go to our website for 0:04:43.800 --> 0:04:45.719 an entry or a contact form. 0:04:46.480 --> 0:04:51.839 Yep. Cool, All right, let's do it right after this 0:04:51.960 --> 0:05:27.520 short break. All right, GONERIEA, gottareea. Let's get into it. 0:05:28.240 --> 0:05:32.400 So gonerhea is caused by a bacterium. It's called Nicia 0:05:32.760 --> 0:05:36.400 gonneriee goner rhea. Ee. I never know how to pronounce 0:05:36.520 --> 0:05:37.280 all those vowels. 0:05:37.279 --> 0:05:39.159 There are so many vowels at the end of that word. 0:05:39.560 --> 0:05:45.520 I know it's a lot. Niceria gonerie is closely related 0:05:45.560 --> 0:05:49.360 to another bacteria that some listeners and you, Aaron, will 0:05:49.400 --> 0:05:51.120 definitely have heard of. Do you remember what. 0:05:51.120 --> 0:05:53.160 It is, meningitis? 0:05:53.760 --> 0:05:59.760 Yes, Niceria meningititis, which causes meningitis. So all the Niceria 0:05:59.800 --> 0:06:03.640 are gram negative diplocoxie, which means that they stain pink 0:06:03.800 --> 0:06:06.080 when we use stains to look at them under a microscope, 0:06:06.279 --> 0:06:15.480 and they're just these two little balls gonna yeah, yeah, okay, 0:06:15.880 --> 0:06:18.680 So let's just I'm just gonna really we're gonna get 0:06:18.760 --> 0:06:21.360 right into this how all this goes. So we all 0:06:21.360 --> 0:06:23.039 know how goneria is transmitted. 0:06:23.240 --> 0:06:27.240 I think, right, well, maybe you should just do a 0:06:27.279 --> 0:06:28.520 refresher just in case. 0:06:29.040 --> 0:06:34.640 I mean, okay, So goneria is transmitted via sexual relations, 0:06:35.440 --> 0:06:37.920 so you can get it from all the kinds of 0:06:37.960 --> 0:06:44.760 sexual intercourse, vaginal, oral, anal and in any direction giving 0:06:45.200 --> 0:06:50.000 receiving doesn't matter. And for adults that's pretty much the 0:06:50.040 --> 0:06:52.640 only way that you're going to get goneriea is via 0:06:52.720 --> 0:06:58.279 sexual intercourse of some design, Okay, in neonates, so in 0:06:58.360 --> 0:07:02.359 tiny baby infants, it can be passed from mother to 0:07:02.600 --> 0:07:07.120 baby during delivery, during birth, during passage through the birth canal. 0:07:08.040 --> 0:07:11.280 So in general, in this country and in most other countries, 0:07:11.360 --> 0:07:15.920 we screen pregnant people for gonococcal infection. This is often 0:07:16.000 --> 0:07:21.000 called ganococcus or ganococcal infection or just gonerrhea, So I'll 0:07:21.040 --> 0:07:24.600 probably use all those words interchangeably, but yeah, infection in 0:07:24.640 --> 0:07:27.600 a newborn is actually pretty serious, and so you screen 0:07:27.680 --> 0:07:30.440 for it during pregnancy and then you treat it and 0:07:30.440 --> 0:07:35.679 that reduces the risk of neonatal infection. Cool, Okay, so cool. 0:07:36.200 --> 0:07:39.920 So what happens when you get exposed after a fun 0:07:40.040 --> 0:07:46.920 night to gonerhea? Basically, the bacterium which has been deposited 0:07:47.360 --> 0:07:51.880 into your body will adhere to your epithelial cells, okay, 0:07:52.240 --> 0:07:56.040 either along the vaginal canal or on the endocervix, or 0:07:56.320 --> 0:08:00.040 in the anal canal or I wrote penile canal, and 0:08:00.080 --> 0:08:06.360 then I realized that's just called your your ethra, you're urethra, 0:08:07.320 --> 0:08:12.119 and it attaches to these epithelial cells. Using pilli, which 0:08:12.160 --> 0:08:16.040 are basically isn't that fun? I didn't know that until 0:08:16.040 --> 0:08:19.840 I started researching this. Yeah, so pilli are basically these long, 0:08:20.000 --> 0:08:23.880 stringy protein bits that bacteria have. They're kind of like 0:08:24.280 --> 0:08:27.080 you remember those sticky hands that you used to get 0:08:27.120 --> 0:08:29.360 from the twenty five cent machines. Oh yeah, you like 0:08:29.480 --> 0:08:31.080 throw them out and stick them on your wall, and 0:08:31.080 --> 0:08:33.040 then your mom gets mad at you because you ruin 0:08:33.080 --> 0:08:33.920 her white walls well. 0:08:33.840 --> 0:08:35.600 And then they get covered in fuzz and they don't 0:08:35.600 --> 0:08:37.960 stick anymore. Yes, just like that. 0:08:38.160 --> 0:08:40.000 But so you know, like if you throw that out 0:08:40.000 --> 0:08:41.880 and stick it and then you let it go, it 0:08:42.040 --> 0:08:45.240 like flings towards the wall, right, So that's kind of 0:08:45.280 --> 0:08:47.559 what these pill i do. They reach out, they grab 0:08:47.600 --> 0:08:50.360 onto the epithelial cells and then they contract and that 0:08:50.600 --> 0:08:53.600 sucks the bacteria up against the epithelial cells. 0:08:53.720 --> 0:08:54.520 That's so cool. 0:08:54.840 --> 0:08:57.720 It's very cool. And it's great if you're in something 0:08:57.840 --> 0:09:01.040 like a urethra or up against the cervix, because you're 0:09:01.040 --> 0:09:04.920 probably gonna have fluid rushing through those tubes and so 0:09:04.960 --> 0:09:06.560 you want to be able to stick on and grab 0:09:06.640 --> 0:09:09.480 on real type. Yeah, so ganeria is good at that, 0:09:10.120 --> 0:09:13.200 and once it sticks on it starts to replicate basically 0:09:13.280 --> 0:09:15.880 right then and there, it doesn't it's not a virus, 0:09:15.920 --> 0:09:17.800 so it doesn't have to infect your cells. It just 0:09:17.840 --> 0:09:23.160 grabs a hold and then starts replicating. Oh pretty fun. Yeah, 0:09:23.200 --> 0:09:26.320 and then once it colonizes, once it starts growing, it 0:09:26.440 --> 0:09:29.280 stimulates the release in your body of a whole bunch 0:09:29.320 --> 0:09:35.400 of pro inflammatory molecules. So this basically stimulates your immune response. 0:09:35.720 --> 0:09:38.880 So then a whole bunch of immune cells, especially neutrophils 0:09:39.040 --> 0:09:42.800 and macrophages, which are kind of the first line defense 0:09:42.840 --> 0:09:47.280 against bacteria. They come in and in normal bacterial or 0:09:47.320 --> 0:09:51.000 other bacterial infections, they'd be able to pagosatize, which means 0:09:51.160 --> 0:09:55.400 swallow up, essentially eat the bacteria and then help clear 0:09:55.440 --> 0:10:00.200 the infection. But Gonnerrhea are sneaky little suckers and they 0:10:00.240 --> 0:10:03.359 can actually survive inside of neutrophils. 0:10:03.600 --> 0:10:05.840 Oh that's amazing, I know. 0:10:06.400 --> 0:10:09.319 So when you look at like a swab from someone 0:10:09.320 --> 0:10:11.880 who has a goneriinfection, if you stain it, you'll actually 0:10:11.880 --> 0:10:15.280 see neutrophils just full of Gonnerhea bacteria. 0:10:15.440 --> 0:10:20.320 Oh my gosh, it's very cool. Like a trojan horse. Yeah, yeah, 0:10:20.360 --> 0:10:23.000 maybe sure. 0:10:25.920 --> 0:10:30.720 The neutrophils normally kill bacteria by using reactive oxygen species, 0:10:31.360 --> 0:10:35.199 but the niceria can actually what sort I'm looking for, 0:10:35.440 --> 0:10:38.440 neutralize those because they have an enzyme called catalase which 0:10:38.440 --> 0:10:41.880 helps to neutralize that. So they can just survive inside 0:10:41.960 --> 0:10:45.120 of the neutrophils, which I think is very cool. That's awesome, 0:10:45.400 --> 0:10:48.520 And because they're recruiting a bunch of neutrophils and macrophages, 0:10:49.160 --> 0:10:53.480 that is also what kind of results in the symptoms 0:10:53.880 --> 0:10:57.880 that we see. So if you get a genito urinary infection, 0:10:58.760 --> 0:11:01.960 let's talk about what kind of symptoms you'll actually have. 0:11:03.240 --> 0:11:05.320 First of all, most of the time you won't have 0:11:05.400 --> 0:11:09.760 any Most infections are straight up asymptomatic, which is part 0:11:09.760 --> 0:11:13.280 of why it can spread so easily, because anything that's 0:11:13.280 --> 0:11:17.320 spread by sexual contact in certain populations is going to 0:11:17.360 --> 0:11:20.640 be pretty easy to spread. And if it's asymptomatic, then 0:11:20.679 --> 0:11:23.480 it never gets detected or treated, so you just keep 0:11:24.000 --> 0:11:30.320 sharing the burning love. So for a genito urinary infection, 0:11:30.360 --> 0:11:33.520 if you get infected in the urethra, you're going to 0:11:33.559 --> 0:11:37.920 see dysurea, so that means painful urination because you've got 0:11:37.920 --> 0:11:41.400 basically inflammation going on along the lining of your urethra. 0:11:42.240 --> 0:11:45.400 And then you'll also get a discharge, and that discharge 0:11:45.440 --> 0:11:50.920 will be either white or yellow or greenish, okay, CoRIS 0:11:51.280 --> 0:11:56.040 and it's mostly neutrophils. It's mostly neutrophills, dead cells, and bacteria. 0:11:56.160 --> 0:11:59.199 And then even those neutrophils are often full of gonococcal 0:11:59.320 --> 0:12:00.280 bacteria as. 0:12:00.200 --> 0:12:04.319 Well, So all of the stuff that you are secreting 0:12:04.800 --> 0:12:09.120 is full of it's like packed with Gottrhea bacterial cells. 0:12:09.559 --> 0:12:13.160 Absolutely, yeah, yeah, so that discharge is super infectious. 0:12:13.280 --> 0:12:13.640 Okay. 0:12:14.440 --> 0:12:18.240 You also can get infection of the epidymus. So if 0:12:18.240 --> 0:12:21.880 it travels through their urethraat and back down into the epididymus, 0:12:21.920 --> 0:12:24.720 which is the tubes that surround the testis where the 0:12:24.760 --> 0:12:27.880 sperm actually have to travel through. Then you can get 0:12:27.920 --> 0:12:32.000 what's called epididymitis, which is infection inflammation of the epidymus, 0:12:32.040 --> 0:12:34.040 and that can be very very painful, So you can 0:12:34.040 --> 0:12:38.200 have testicular and scrotal pain on top of painful urination 0:12:38.480 --> 0:12:44.320 and urethral discharge. If you get an endocervical infection, so 0:12:44.400 --> 0:12:48.360 an infection of the vaginal canal and the cervix at 0:12:48.360 --> 0:12:52.679 the top there, it's even more likely to be asymptomatic. 0:12:53.280 --> 0:12:56.880 Than a urethral infection. Okay, if you do get symptoms, 0:12:56.960 --> 0:13:00.720 they're often mistaken for a bladder infection or aaginal infection 0:13:00.840 --> 0:13:03.920 like a yeast infection or a bacterial vaginosis or something. 0:13:04.200 --> 0:13:06.640 So you might have some dysyria, you might have some 0:13:06.720 --> 0:13:10.760 vaginal discharge or some bleeding in between periods. But more 0:13:10.840 --> 0:13:15.360 often there are no symptoms in people with an endocervical 0:13:15.440 --> 0:13:16.520 or a vaginal infection. 0:13:16.960 --> 0:13:19.040 And when you say more often, like can you give 0:13:19.040 --> 0:13:21.280 me a pee, put in number to the percentage of cases. 0:13:21.559 --> 0:13:23.480 I don't have a number. I was trying to find 0:13:23.520 --> 0:13:26.199 solid numbers. And it's just like most of the time 0:13:26.600 --> 0:13:30.200 in endocervical infections it's asymptomatic, and most of the time 0:13:30.240 --> 0:13:33.599 in your reath roll. In penile infections, it is symptomatic 0:13:33.800 --> 0:13:37.320 or it's more likely to be symptomatic, though in both 0:13:37.360 --> 0:13:41.760 cases it can be asymptomatic. The problem with endocervical infections 0:13:41.840 --> 0:13:45.200 is that they can spread. They're asymptomatic, so they're less 0:13:45.240 --> 0:13:48.280 likely to be detected, and they can spread from the 0:13:48.360 --> 0:13:52.760 endocervix to the uterus or the fallopian tubes, which causes 0:13:52.800 --> 0:13:57.600 what's called pelvic inflammatory disease. Or pid pid is a 0:13:57.760 --> 0:14:03.800 very serious disease. It can cause abdominal and pelvic pain, fever, abscesses. 0:14:03.920 --> 0:14:07.280 It kind of is considered a more systemic infection and 0:14:07.400 --> 0:14:10.800 it can lead to infertility because it can really severely 0:14:10.880 --> 0:14:14.760 damage the filipian tubes and the uterus itself, and it 0:14:14.840 --> 0:14:17.600 also can cause scarring on the filippian tubes that can 0:14:17.679 --> 0:14:20.720 increase the risk for future ectopic pregnancy, which is when 0:14:20.760 --> 0:14:24.320 an embryo implants outside of the uterus, and that can 0:14:24.360 --> 0:14:29.600 be very dangerous in rare cases. Epididymitis can also lead 0:14:29.640 --> 0:14:33.040 to infertility, but it's more common that in people with 0:14:33.120 --> 0:14:36.720 a uterus or ovaries you end up with infertility as 0:14:36.840 --> 0:14:41.320 a complication of a gonococcal infection. You can also get 0:14:41.360 --> 0:14:48.040 rectal infection all holes here. It's usually asymptomatic, but you 0:14:48.160 --> 0:14:53.160 kind of do have the same symptoms discharge, anal itching, soreness, bleeding. 0:14:54.000 --> 0:14:58.080 You can also get a pharyngeal infection, an oral infection. 0:15:00.480 --> 0:15:03.280 So I have heard stories from people who work at 0:15:03.440 --> 0:15:06.560 the student health clinics of kids coming in they think 0:15:06.560 --> 0:15:09.359 they've got sore throat and it turns out it's gonnerrhea. 0:15:09.640 --> 0:15:14.720 Oh gosh, oh I got a kick out of it. 0:15:15.440 --> 0:15:17.920 So it causes the same symptoms as like sore throat. 0:15:18.320 --> 0:15:20.480 Yeah, it's basically just a sore throat. It's a pretty 0:15:20.520 --> 0:15:23.680 minor infection, and even in your throat, it's usually asymptomatic. 0:15:23.920 --> 0:15:25.760 Okay, So that's. 0:15:25.600 --> 0:15:29.800 Why gonerrhea is so easily spread is because in so 0:15:30.080 --> 0:15:38.000 many cases it's just completely asymptomatic. So yeah, but gonerhea, 0:15:38.200 --> 0:15:41.400 while it can cause these symptoms, and this type of 0:15:41.400 --> 0:15:44.400 infection just kind of right away right after it attaches 0:15:44.440 --> 0:15:49.040 and starts to colonize, it can also pass through that 0:15:49.120 --> 0:15:53.240 epithelial cell border, which is essentially your body's protection against bacteria. 0:15:53.280 --> 0:15:56.640 It's like first line defense. So it can make its 0:15:56.680 --> 0:16:00.000 way past that epithelial cell border and then make it 0:16:00.240 --> 0:16:04.440 into your bloodstream. And if, yeah, if nicia makes it 0:16:04.480 --> 0:16:07.560 into your bloodstream, it's very, very bad. It's called a 0:16:07.640 --> 0:16:13.080 disseminated ganococcal infection because it's disseminated amongst your whole body 0:16:13.120 --> 0:16:16.280 through your bloodstream, and it most often will then go 0:16:16.520 --> 0:16:20.400 to your joints and your synovial fluid around your joints 0:16:20.880 --> 0:16:25.720 and your skin, and it'll cause dermatitis and arthritis and 0:16:25.800 --> 0:16:29.320 in very rare cases. It can infect your meninges just 0:16:29.520 --> 0:16:33.400 like its cousin. I don't know, do you call bacteria 0:16:33.400 --> 0:16:38.480 in the same genus cousins relative, just like it's relative 0:16:38.880 --> 0:16:43.440 Niceria meningititis, which is a very common cause of meningitis. 0:16:43.720 --> 0:16:48.280 Niceria gono rhea can also cause meningitis if it infects 0:16:48.360 --> 0:16:52.400 your mininges, of your spinal cord or your brain. Wow. Yeah, 0:16:52.840 --> 0:16:58.040 so that's bad news bears. In neonatal infections, when an 0:16:58.080 --> 0:17:01.840 infant gets infected, it most commonly results in an ocular infection. 0:17:02.480 --> 0:17:04.600 It'll get into their eyes as they pass through the 0:17:04.600 --> 0:17:08.520 birth canal, and this can cause blindness. It's really, really, 0:17:08.560 --> 0:17:12.400 really bad. Yeah, So that's why we screen pregnant women 0:17:12.480 --> 0:17:14.600 and most neonates when they come out, they give them 0:17:14.840 --> 0:17:19.439 erythromycin eye drops just in case. Yeah, so that's just 0:17:19.520 --> 0:17:23.320 to cover all the bases, because that would be terrible. 0:17:24.400 --> 0:17:27.280 It also can infect babies. It can go pass through 0:17:27.320 --> 0:17:29.960 their eyes and get because that's a mucous membrane where 0:17:29.960 --> 0:17:31.520 there's a lot of blood flow, it can get into 0:17:31.560 --> 0:17:35.680 their bloodstream and cause disseminated infection in babies as well, 0:17:35.960 --> 0:17:39.040 which can be life threatening, especially because babies have basically 0:17:39.040 --> 0:17:44.119 no immune system to help protect them. Also bad, Yeah, 0:17:44.160 --> 0:17:47.960 also bad. It's not a great disease. 0:17:48.600 --> 0:17:50.280 Nope, they never are. 0:17:50.840 --> 0:17:55.639 They never are. It is preventable, though, which is cool. 0:17:57.480 --> 0:18:01.720 Condoms work, right, so that's great. 0:18:03.880 --> 0:18:05.520 What about uh treatment? 0:18:05.600 --> 0:18:10.800 Treatment? Great question. It is still treatable today. So yeah, 0:18:10.960 --> 0:18:14.320 as of now, there is one recommended treatment, and that's 0:18:14.400 --> 0:18:17.280 recommended by the CDC and the WHO. If you get 0:18:17.320 --> 0:18:23.439 diagnosed with gonorrhea, you will get an injection of CEF triaxone, 0:18:23.520 --> 0:18:28.760 which is an extended spectrum cephalosporin antibiotic. You get an 0:18:28.800 --> 0:18:31.879 injection of that, and then you also get a single 0:18:31.960 --> 0:18:36.240 dose of a whole gram of azethromycin and you pop 0:18:36.280 --> 0:18:40.520 that oral and then that will take care of the gonerrhea. 0:18:41.119 --> 0:18:45.880 It also takes care of chlamydia because it's extremely common 0:18:46.000 --> 0:18:50.320 to have coinfection. I was trying to find one solid 0:18:50.400 --> 0:18:53.880 number on how common gonerrhea and chlamydia co infections are 0:18:53.960 --> 0:18:56.200 and I couldn't find one solid. But in some studies 0:18:56.200 --> 0:18:58.560 I found it was like up to forty percent of 0:18:58.600 --> 0:19:02.040 people who were diagnosed with gun we're also diagnosed with chlamydia. 0:19:02.840 --> 0:19:06.200 That's really interesting. Do they colonize the same areas. Is 0:19:06.240 --> 0:19:08.879 there competition or is it facilitation or what. 0:19:09.440 --> 0:19:12.119 That's a really good question. I don't know specifically. I 0:19:12.160 --> 0:19:15.320 don't know if it's just because it's they're transmitted in 0:19:15.359 --> 0:19:19.600 exactly the same way and have the exact same risk factors, 0:19:19.640 --> 0:19:21.119 so if you have one, it's really likely to have 0:19:21.200 --> 0:19:24.320 the other, yeah, Or if there's any kind of interactions 0:19:24.320 --> 0:19:27.040 that go on between the two bacteria, I'm not sure. 0:19:27.280 --> 0:19:27.680 Interesting. 0:19:27.720 --> 0:19:30.200 It's a great question though. Yeah, but it's super common 0:19:30.720 --> 0:19:36.360 as if thromycin will clear both a resistant gonereal infection 0:19:36.480 --> 0:19:39.200 that's resistant to the sef triaxone, but it will also 0:19:39.440 --> 0:19:42.879 additionally take care of the chlamydia. So that's why we 0:19:42.920 --> 0:19:46.639 give both. Okay, So if you've ever been diagnosed and 0:19:46.680 --> 0:19:48.600 been like, why do I need this giant horse pill 0:19:48.800 --> 0:19:51.520 and a shot in my butt? I assume they put 0:19:51.520 --> 0:19:55.919 it in your butt. I'm not positive though, that's why. Yeah, okay, 0:19:58.640 --> 0:20:02.240 So yeah, that's that's the bio. It's a pretty it's 0:20:02.240 --> 0:20:04.639 a pretty straightforward bacteria as far as they go. 0:20:04.760 --> 0:20:08.560 I feel like, yeah, it seems it goes there to 0:20:08.600 --> 0:20:10.480 do the job that it came there for. It does 0:20:10.520 --> 0:20:14.320 the job, and then you treat it. Yeah, fully hopefully. 0:20:14.560 --> 0:20:19.040 Yeah, so how did we get here? Eron, where did 0:20:19.119 --> 0:20:21.240 this bacteria come from? 0:20:21.720 --> 0:20:22.160 Okay? 0:20:22.880 --> 0:20:25.640 And oh my gosh, tell me how it got its name? 0:20:25.880 --> 0:20:31.400 I can't wait. Okay, right after this break. 0:21:02.800 --> 0:21:07.200 Ganorrhea is an oldie, and we've got the Holy Trinity 0:21:07.240 --> 0:21:11.560 of ancient Egypt, the Bible, and Hippocrates to back that up. 0:21:12.200 --> 0:21:13.680 The Holy Trinity, I like that. 0:21:15.440 --> 0:21:18.919 There's a papyrus from thirty five hundred BCE and ancient 0:21:18.960 --> 0:21:23.600 Egypt that recommends some certain plant extracts for painful urination. 0:21:24.480 --> 0:21:27.520 There's a passage in Leviticus in the Old Testament that 0:21:27.560 --> 0:21:31.280 declares that men with runny penises are unclean, not in 0:21:31.320 --> 0:21:34.480 those words, but more or less in those words. And 0:21:34.720 --> 0:21:39.399 Hippocrates describes genital ulceration and how it is sectually transmitted. 0:21:40.400 --> 0:21:45.119 We've also got Abubakar Muhammad ebn Zakaria al Razi, so 0:21:46.240 --> 0:21:50.800 again yeah, yeah, he's everywhere. And even Senna, so Avicenna 0:21:50.880 --> 0:21:55.119 also is the okay Latinised name. They seem to describe 0:21:55.320 --> 0:22:00.200 urethrilled discharge and urine retention, both which are characteristics of ganarrhea. 0:22:00.640 --> 0:22:03.439 Now any I mean, any one of these could be 0:22:03.640 --> 0:22:08.080 referring to many other sexually transmitted infections. But goneria is 0:22:08.119 --> 0:22:14.000 definitely old, as is its name, which was given by 0:22:14.000 --> 0:22:20.440 the Greek physician Galen in the second century CE, so likes, 0:22:21.080 --> 0:22:23.600 it's a long time ago. For a long time it 0:22:23.640 --> 0:22:28.080 was tied in with syphilis and so and it had. 0:22:28.280 --> 0:22:30.639 It went by many different names in different places and 0:22:30.680 --> 0:22:32.840 so on, so it's interesting that this one was the 0:22:32.840 --> 0:22:36.240 one to make it through the whole way. But Goneriea 0:22:36.280 --> 0:22:40.320 is from Ghanos for seed and row for flow, so 0:22:40.400 --> 0:22:42.000 it's just sort of flow seed flow. 0:22:42.440 --> 0:22:43.720 Yeah, it's kind of yucky. 0:22:44.280 --> 0:22:49.320 I mean. By at least the tenth and eleventh centuries, 0:22:49.359 --> 0:22:52.639 goneria seemed to be pretty prevalent, or at least prevalent 0:22:52.760 --> 0:22:55.280 enough to lead to the creation of laws that were 0:22:55.400 --> 0:22:59.080 to prevent any activity that spread the disease of burning pea. 0:23:00.240 --> 0:23:03.760 It also may have had a hand in secularizing medicine 0:23:03.760 --> 0:23:07.200 in some places, because physicians were ordered to treat everyone 0:23:07.240 --> 0:23:09.720 whip the disease without being able to refuse based on 0:23:09.800 --> 0:23:14.320 moral objections. Oh interesting, So yeah, along with like leprosy 0:23:14.400 --> 0:23:19.600 and some other sort of stigmatized diseases. But even so, 0:23:20.240 --> 0:23:22.960 no one really paid much attention to gonarrhea alone for 0:23:23.000 --> 0:23:26.320 another few hundred years. But before I get into that, 0:23:27.320 --> 0:23:28.480 where did it come from? 0:23:28.800 --> 0:23:29.119 Yeah? 0:23:29.160 --> 0:23:32.080 And I couldn't find a ton of good info on 0:23:32.119 --> 0:23:35.560 its evolutionary origins, but according to one of my sources, 0:23:36.000 --> 0:23:40.400 there are two possibilities, and neither of which is particularly exciting. 0:23:40.520 --> 0:23:43.680 But one is that it came from an a virulent 0:23:43.760 --> 0:23:47.480 strain in the vaginal and rectl mucosa which mutated into 0:23:47.520 --> 0:23:50.600 a virulent strain. Okay. Another was that it came from 0:23:50.600 --> 0:23:53.680 the naso pharynx and mutated into a virulent strain via 0:23:53.880 --> 0:23:58.080 oral sex. So yeah, I don't know when this occurred 0:23:58.160 --> 0:24:00.000 or where, but it would have required a decent pipe 0:24:00.080 --> 0:24:03.800 ulation density to be sustained and then spread throughout medieval times, 0:24:04.359 --> 0:24:07.560 though not as big of a population as something like measles. 0:24:08.160 --> 0:24:10.919 And that's because the long duration of infectivity and the 0:24:10.920 --> 0:24:14.560 possibility of sort of these latent infections. 0:24:14.840 --> 0:24:19.320 Yeah, probably helped symptomatic Yeah yeah, Okay. 0:24:20.359 --> 0:24:23.399 Around the fifteen hundreds is when it began to be 0:24:23.440 --> 0:24:28.040 called the clap, which it's colloquial, one of its colloquial names. 0:24:28.440 --> 0:24:30.919 I had no idea that it was gonorrhea that was 0:24:30.920 --> 0:24:33.000 called the clap oh. 0:24:32.880 --> 0:24:35.040 Yeah, well, because I think a lot of people think 0:24:35.080 --> 0:24:37.159 it's uh, chlamydia because. 0:24:36.920 --> 0:24:39.480 C yeah, that's what makes sense, chlamydia. 0:24:39.600 --> 0:24:45.800 Yay, yeah, okay, So why did Why was it called 0:24:45.800 --> 0:24:49.359 the clap There are a couple of hypotheses, One which 0:24:49.400 --> 0:24:52.040 is the most likely one is that it refers to 0:24:53.320 --> 0:24:56.919 less clapiers c L A p I e r s 0:24:58.000 --> 0:25:01.320 clapiers there we go, which is the French word for 0:25:01.400 --> 0:25:08.080 brothels reallyble source of infection, that's what they were called. Yeah, 0:25:08.320 --> 0:25:10.960 I never knew that. Another I read somewhere is that 0:25:11.000 --> 0:25:15.919 it causes a clapping sensation when you pee. And the 0:25:15.920 --> 0:25:18.760 most horrifying one I found was that it refers to 0:25:18.880 --> 0:25:21.800 a common treatment for gannere infections in men, where you 0:25:21.840 --> 0:25:25.320 were supposed to clap the penis hard to get the 0:25:25.320 --> 0:25:29.080 pea flowing again, maybe using your hands, maybe using a 0:25:29.080 --> 0:25:37.280 book and a hard surface, Oh no, yikes. Yeah. But 0:25:37.400 --> 0:25:40.760 for much of its history, ganerrhea was overshadowed by syphilis, 0:25:40.920 --> 0:25:44.040 which we will definitely be doing an episode on some time. 0:25:44.240 --> 0:25:47.080 Absolutely, syphilis is major. 0:25:46.840 --> 0:25:51.800 It's huge, Yeah, But syphilis had settled down enough around 0:25:51.880 --> 0:25:54.800 the fifteen sixteenth century for people to start taking note 0:25:55.119 --> 0:25:59.679 of this other disease and describing it. And one of 0:25:59.720 --> 0:26:02.879 the tracing this early history, of course, relates to that 0:26:02.920 --> 0:26:06.280 where goneria and syphilis were assumed to be the same disease, 0:26:06.400 --> 0:26:10.120 with goneria to be more the mild precursor to full 0:26:10.160 --> 0:26:11.880 blown pocks of syphilis. 0:26:11.920 --> 0:26:12.520 That makes sense. 0:26:12.920 --> 0:26:15.680 One guy in the seventeen hundreds decided to settle this 0:26:16.000 --> 0:26:19.160 once and for all. He wanted to prove that they 0:26:19.200 --> 0:26:22.960 were the same, and that gonorrhea was the secreting form 0:26:23.000 --> 0:26:27.159 and syphilis was the skin form. So he took the 0:26:27.240 --> 0:26:32.000 postular discharge from an infected person and then smeared it 0:26:32.119 --> 0:26:41.280 onto himself, onto his yeah, onto his genus. Unfortunately, he 0:26:41.320 --> 0:26:48.160 came down with syphilis, so he didn't really prove anything, 0:26:49.440 --> 0:26:51.600 but I guess so, yeah. 0:26:51.400 --> 0:26:57.320 He he swabbed somebody's like ulcer or something and then 0:26:57.560 --> 0:26:58.200 or what did he. 0:26:58.600 --> 0:27:01.720 What it seemed like is that he took the discharge. 0:27:01.800 --> 0:27:06.159 So the direct quote was pustular discharge. Okay, So I 0:27:06.160 --> 0:27:10.600 don't know if it was from the like, from the urethra, 0:27:10.760 --> 0:27:15.320