WEBVTT - Ep 130 Cocoliztli: We do love a salty dish

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<v Speaker 1>On the first day of August fifteen seventy six, Coco

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<v Speaker 1>Litsli began extremely strongly in Tekemachalco. It could not be resisted.

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<v Speaker 1>For this reason, many people died, young people, married people,

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<v Speaker 1>old people, men and women and children. In two or

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<v Speaker 1>three days. They died of hemorrhage. Blood emerged from their noses,

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<v Speaker 1>from the ears, from the eyes, from the anus, and

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<v Speaker 1>women bled between their legs. And for us men, blood

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<v Speaker 1>emerged from our members. Others died from diarrhea, which took

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<v Speaker 1>them suddenly. They died quickly from this awful Oh yeah,

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<v Speaker 1>it's this episode is loaded with quotes, Karen. That particular

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<v Speaker 1>quote was from an anonymous Nahua, author of the anal

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<v Speaker 1>state Techamachalco from the epidemic of Coco Leeseley in fifteen

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<v Speaker 1>seventy six. Okay, hi, I'm Aaron Welsh.

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<v Speaker 2>And I'm Erin Allman Updyke.

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<v Speaker 1>And this is this podcast will kill.

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<v Speaker 2>You And today we are doing a medical mystery.

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<v Speaker 1>We are. It's a first one in many episodes. It's

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<v Speaker 1>been the years, yeah, I think definitely over fifty episodes.

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<v Speaker 1>The last one was Sweating Sickness.

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<v Speaker 2>Sweating Sickness, yep yeah, no, no, dancing Pike.

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<v Speaker 1>I don't know. I don't know, could be either, It's

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<v Speaker 1>one of those. But yeah, this has been on our

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<v Speaker 1>list for a while, which I feel like we say

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<v Speaker 1>about every topic. But I'm really excited that we're covering

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<v Speaker 1>it because there is so much to get into. And wow,

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<v Speaker 1>like once I started pulling the string on this, I

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<v Speaker 1>just couldn't stop.

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<v Speaker 2>Like a sweater just came all the way unraveled.

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<v Speaker 1>Yep, I can't wait.

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<v Speaker 2>I am thrilled because so listeners, you may recall or

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<v Speaker 2>you may not, because again it's been a number of years.

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<v Speaker 2>We are going to do this episode in a different way,

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<v Speaker 2>and the way that Aaron and I have researched for

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<v Speaker 2>this episode is very different than.

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<v Speaker 1>Are you usual.

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<v Speaker 2>I know nothing about this story about Coco Elitesley at all,

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<v Speaker 2>but I have been given a list of contenders of

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<v Speaker 2>possible pathogens that may have caused this, and then we're

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<v Speaker 2>going to try and solve it, you know, in just

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<v Speaker 2>like the next hour and a half. Medical mystery that's

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<v Speaker 2>been going on for hundreds of years.

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<v Speaker 1>I mean, I hope that people aren't looking for full

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<v Speaker 1>resolution like I always do when I watch Unsolved mysteries,

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<v Speaker 1>and then at the end, I'm upset like that, what

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<v Speaker 1>a you solved in the name of the show. But

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<v Speaker 1>so brace yourselves. You'll know a lot more and maybe

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<v Speaker 1>be able to come to some conclusions yourself. But yeah,

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<v Speaker 1>this will be an unsolved mystery at the beginning, middle,

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<v Speaker 1>and end.

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<v Speaker 2>I can't wait. I'm really excited about it and to

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<v Speaker 2>get us started. I believe that it's quarantining time.

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<v Speaker 1>It certainly is. What are we drinking this week?

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<v Speaker 2>It's Anyone's Guess. That's the name of the name of it.

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<v Speaker 1>Thanks to John for that title. Appreciate it so creative

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<v Speaker 1>and in It's Anyone's guess. It's delicious, and it's got

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<v Speaker 1>a lot of ingredients, which is you know, I think

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<v Speaker 1>sometimes can be fun. It's got some dark rum, it's

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<v Speaker 1>got pineapple juice, orange juice, lemon juice and passion fruit juice,

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<v Speaker 1>tropical and lots of juices. Yeah, it's delicious.

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<v Speaker 2>We'll post a full recipe for that quarantine as well

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<v Speaker 2>as the non alcoholic and equally delicious plus Ebrita on

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<v Speaker 2>our website, This podcast weekili dot com and our social media.

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<v Speaker 1>We certainly will. On our website you can find all

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<v Speaker 1>sorts of things, such as transcripts, links to bookshop dot

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<v Speaker 1>org and goodreads lists. You can find music by Bloodmobile merch.

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<v Speaker 1>We've got some cool new merch coming out for you.

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<v Speaker 1>You know. There's more stuff sources for our episodes.

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<v Speaker 2>That's enough, right, it's a lot. There's a lot there.

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<v Speaker 2>Check it out O this podcast.

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<v Speaker 3>Weicill you dot com.

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<v Speaker 1>Can we get started? Please please?

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<v Speaker 2>I can't wait, all right, primed to take notes while

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<v Speaker 2>we talk. I'm so excited.

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<v Speaker 1>Let's just take a quick break and then we can

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<v Speaker 1>get right to it.

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<v Speaker 3>Okay.

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<v Speaker 1>In the year fifteen eighty four, seventy five years after

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<v Speaker 1>Hernando Cortes first arrived in what is now Mexico, Antonio

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<v Speaker 1>Sioux dad Reale and Frey Alonzo Ponce, both Spanish, traveled

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<v Speaker 1>through much of Mexico and wrote what they saw of

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<v Speaker 1>this once densely populated and vibrant land. Quote in times

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<v Speaker 1>past that town had a large population, according to the

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<v Speaker 1>older people, and now it just seems like ruins of houses,

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<v Speaker 1>and for the many fruit trees there are in the

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<v Speaker 1>surroundings among which the Indians usually have their towns, especially

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<v Speaker 1>being in the hot lands like it is, but with

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<v Speaker 1>the coco Litli. There was such a very large pestilence

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<v Speaker 1>and mortality in that land that everything was destroyed and

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<v Speaker 1>now there are scarcely two hundred inhabitants whoa yeah. And

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<v Speaker 1>while they name drop cocolitle specifically there, it was far

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<v Speaker 1>from the only factor in the tremendous population losses and

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<v Speaker 1>cultural devastation experienced by indigenous populations in Mexico following first

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<v Speaker 1>contact with European colonizers in the sixteenth century. And if

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<v Speaker 1>you'll just allow me to get on a soapbox for

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<v Speaker 1>a little bit. Even though the focus of today's episode

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<v Speaker 1>is on just one of those factors, cocoliteslei, which we'll

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<v Speaker 1>spend a lot more time about, I don't want to

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<v Speaker 1>lose sight of that fact that this cultural and population

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<v Speaker 1>devastation was multifactorial. That we can't take this disease cocolitsli,

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<v Speaker 1>or these epidemics out of their historical context without considering

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<v Speaker 1>everything else that was going on at the time. Retrospective

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<v Speaker 1>diagnosis is a tricky enough business as it is, and

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<v Speaker 1>ignoring all of the social and political factors that played

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<v Speaker 1>a role in the spread of disease, it's only going

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<v Speaker 1>to further limit our ability to say anything about whether

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<v Speaker 1>Cokolitsli was rodent associated or waterborn. For way too long,

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<v Speaker 1>many historians have over emphasized the effects that pathogens alone

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<v Speaker 1>had on the population declines of indigenous peoples living in

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<v Speaker 1>the America's following European contact. The concept of quote unquote

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<v Speaker 1>virgin soil epidemics, as in the idea that these pathogens

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<v Speaker 1>that Europeans were more acquainted with and brought with them

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<v Speaker 1>to the New World, that these pathogens were more devastating

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<v Speaker 1>to immunologically naive populations. This concept has been overly used

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<v Speaker 1>in the construction of these like Eurocentric Jared diamond esque histories,

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<v Speaker 1>where the strong conquered the weak and took what was

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<v Speaker 1>rightfully theirs because nature i e. Pathogens determined that they

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<v Speaker 1>were the victors. Right.

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<v Speaker 2>No, oh, no no.

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<v Speaker 1>Focusing on the role that germs alone played in mass

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<v Speaker 1>mortality events in the Americas ignores the decisions that European

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<v Speaker 1>colonizers made to subjugate and oppress the indigenous populations, forced

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<v Speaker 1>labor overburdensome taxation, complete upheaval of everyday life, and repression

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<v Speaker 1>of traditional cultural practices. Germs weren't acting alone here in

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<v Speaker 1>more ways than one, Like, yes, there were devastating smallpox

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<v Speaker 1>epidemics that cannot be ignored, that cannot be debated, and yes,

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<v Speaker 1>there were also horrific measles outbreaks and influenza epidemics and

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<v Speaker 1>so one and so forth. But it's not like in

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<v Speaker 1>those like eighties action movies where the bad guys take

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<v Speaker 1>turns fighting the one good guy. It's like multiple pathogens

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<v Speaker 1>were all circulating at the same time, all the bad

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<v Speaker 1>guys were fighting all at once. And this isn't to

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<v Speaker 1>downplay the enormous mortality rates that we see during these epidemics,

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<v Speaker 1>upwards of sixty to eighty percent of the entire population

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<v Speaker 1>in some cases, but it's just to try to present

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<v Speaker 1>a more nuanced view you of where those numbers, those

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<v Speaker 1>mortality rates might be coming from. Death from disease absolutely

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<v Speaker 1>maybe increased by malnutrition or coinfection with another pathogen, or

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<v Speaker 1>weakened health from forced labor or fewer people to care

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<v Speaker 1>for the sick, like societal collapse. The layers of protection

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<v Speaker 1>from getting sick or dying from illness in many cases

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<v Speaker 1>had been entirely stripped away, and I think sometimes that

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<v Speaker 1>can get lost in looking at these epidemics from like

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<v Speaker 1>a purely biological microbiological epidemiological focus, I guess, and I

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<v Speaker 1>think this is especially important to remember when we're trying

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<v Speaker 1>to go through and guess which pathogen might be responsible

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<v Speaker 1>for Coco litesle and be like, wow, there's no known

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<v Speaker 1>pathogen that causes such high mortality rates. Like well, of course,

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<v Speaker 1>because it's not just one loan pathogen. But anyway, keeping

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<v Speaker 1>all that in mind, LAO, let's turn to Coco Leathsley.

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<v Speaker 1>What were the Coco Leitsli epidemics? In short, they were

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<v Speaker 1>a series of epidemics of undetermined cause that swept through

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<v Speaker 1>much of Mexico and the rest of meso America during

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<v Speaker 1>the sixteenth, seventeenth, eighteenth, and possibly even the nineteenth centuries. Huh.

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<v Speaker 1>At least thirteen distinct epidemics according to one paper I read.

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<v Speaker 1>But today I'm only going to be focusing on the

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<v Speaker 1>two most devastating Coco Leathsley epidemics, one that began in

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<v Speaker 1>fifteen forty five and the other in fifteen seventy six,

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<v Speaker 1>since they have the most documentation and had the most

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<v Speaker 1>apparently impact on the population. But to better understand how

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<v Speaker 1>these epidemics happened when they did and the impact they had.

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<v Speaker 1>Let's do a little bit stage setting. In fifteen nineteen,

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<v Speaker 1>the Spanish conquistador Hernando Cortes and his crew landed in Mexico,

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<v Speaker 1>where they claimed the land for the Spanish crown and

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<v Speaker 1>proceeded to travel inland until they reached toto che Lan,

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<v Speaker 1>the massive capital of the Aztec Empire, or specifically the

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<v Speaker 1>Mashka people. Aztec is kind of a political term I

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<v Speaker 1>learned that means really just the three tribes that controlled

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<v Speaker 1>a lot of Mexico at the time, and one of

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<v Speaker 1>these tribes, the most powerful, was the Meshika. Anyway, shortly

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<v Speaker 1>after arriving in to notche Chielan and being showered with

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<v Speaker 1>please go away gifts of silver and gold and textiles,

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<v Speaker 1>the Spanish then took the Meshika emperor of the city

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<v Speaker 1>as prisoner, Montezuma for a year until he was killed.

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<v Speaker 1>And skipping over a whole lot of history here, that

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<v Speaker 1>really sort of kicked off the beginning of Spanish colonial

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<v Speaker 1>rule in Mexico. Like that is not even beginning to

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<v Speaker 1>get into that's not even surface level. There's so much

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<v Speaker 1>more history there. But basically things changed very quickly in

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<v Speaker 1>that Aztec Empire, from political organization to wealth distribution, cultural

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<v Speaker 1>practices to daily life. Agriculture shifted under Spanish rule as

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<v Speaker 1>domestic animals were introduced and the dominant crops switched from maize, squash, amorants, beans,

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<v Speaker 1>and peppers to wheat so that the Spanish could make

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<v Speaker 1>European style bread. Lakes were drained to prevent flooding or

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<v Speaker 1>to provide more arable land for farming. Taxation or tributes

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<v Speaker 1>grew enormously in demand, pretty much beyond anyone's means, and

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<v Speaker 1>as a result, nutrition really suffered, especially since there were

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<v Speaker 1>a series of droughts throughout the sixteenth century that we'll

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<v Speaker 1>talk maybe a little bit more about later on. Many

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<v Speaker 1>indigenous people were enslaved or forced to do labor, or

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<v Speaker 1>displaced from their homes and land. Even clothing changed, apparently

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<v Speaker 1>with an emphasis on European style clothing, along with fewer baths,

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<v Speaker 1>since it was the Spanish belief at the time that

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<v Speaker 1>bathing daily was bad for your health. Now, all of

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<v Speaker 1>these changes did not take place everywhere or at the

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<v Speaker 1>same time throughout Mesoamerica, but life certainly changed for everyone,

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<v Speaker 1>and I came across a paper about Coco Lethsley by

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<v Speaker 1>mar and Kirakoff from two thousand, where the authors wrote that,

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<v Speaker 1>quote certainly, the policies of the Spanish colonial regime were

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<v Speaker 1>harsh in many ways, but no more so than those

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<v Speaker 1>of the Aztec imperial regime had been end quote I

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<v Speaker 1>mean wrong, and I think to claim that is to

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<v Speaker 1>kind of undermine the drastic effects that the Spanish regime

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<v Speaker 1>had on life for indigenous peoples. So anyway, when Cortes

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<v Speaker 1>and his crew landed in fifteen nineteen, Mexico was home

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<v Speaker 1>to a population of around twenty two million people, and

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<v Speaker 1>the major city, ten Ochtreetlan had approximately two hundred and

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<v Speaker 1>fifty thousand to three hundred thousand occupants, which was five

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<v Speaker 1>times the size of London at the same time. Oh wow,

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<v Speaker 1>with an incredibly intricately connected society. But within the century,

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<v Speaker 1>millions upon millions of people would be dead from a

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<v Speaker 1>combination of disease and the major upheaval of Spanish rule.

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<v Speaker 1>And the first disease to make itself felt with smallpox,

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<v Speaker 1>which began to spread in fifteen twenty, only a year

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<v Speaker 1>after Cortes arrived. Eight million people died during the smallpox epidemic. Oh,

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<v Speaker 1>out of a population of twenty two million.

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<v Speaker 4>Yeah, that's.

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<v Speaker 1>Unfathomable.

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<v Speaker 4>Yep.

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<v Speaker 1>And again this was not just from smallpox alone, but

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<v Speaker 1>also from the general collapse of their society. Measles epidemic, typhus, influenza,

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<v Speaker 1>and other diseases all followed, described by witnesses as distinct diseases,

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<v Speaker 1>even though they may co occur. And although the fifteen

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<v Speaker 1>twenty smallpox epidemic has probably received more attention historically because

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<v Speaker 1>of how it affected the transition of power from Aztec

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<v Speaker 1>to Spanish rule, the Coco Leesle epidemics that followed were

0:16:41.800 --> 0:16:46.160
<v Speaker 1>no less terrifying or devastating. So finally getting to Coco

0:16:46.280 --> 0:16:51.280
<v Speaker 1>Ltsley in fifteen forty five, Coco Lethsley struck for seemingly

0:16:51.360 --> 0:16:55.400
<v Speaker 1>the first time. Over a dozen early Spanish and indigenous

0:16:55.400 --> 0:17:00.080
<v Speaker 1>contemporary accounts describe a deadly disease that swept through Mexico

0:17:00.400 --> 0:17:05.280
<v Speaker 1>and the rest of meso America. Bernardino des Sahagoon, Franciscan

0:17:05.320 --> 0:17:09.880
<v Speaker 1>scholar who witnessed this epidemic, wrote, quote, in the year

0:17:10.000 --> 0:17:14.120
<v Speaker 1>fifteen forty five, there was a huge and universal pestilence

0:17:14.280 --> 0:17:17.280
<v Speaker 1>where in all of New Spain most of the people

0:17:17.280 --> 0:17:20.520
<v Speaker 1>who lived there died. At the time of this pestilence.

0:17:20.560 --> 0:17:23.719
<v Speaker 1>I was in Mexico City, in the part of tlate Loco,

0:17:24.200 --> 0:17:27.160
<v Speaker 1>and I buried more than ten thousand bodies. And at

0:17:27.160 --> 0:17:29.879
<v Speaker 1>the end of the pestilence, I became ill and almost

0:17:29.960 --> 0:17:37.200
<v Speaker 1>died end quote hm. Importantly, Sahogoon also lived to see

0:17:37.200 --> 0:17:42.080
<v Speaker 1>the second epidemic of Cocolitsli in fifteen seventy six, which

0:17:42.119 --> 0:17:44.879
<v Speaker 1>he described as being very similar to the one in

0:17:44.920 --> 0:17:48.679
<v Speaker 1>fifteen forty five, and he ultimately died in a third

0:17:48.800 --> 0:17:51.440
<v Speaker 1>Cocolitsi epidemic in fifteen ninety.

0:17:51.880 --> 0:17:54.200
<v Speaker 3>Okay, okay, yeah.

0:17:54.600 --> 0:17:59.640
<v Speaker 1>The symptoms of the illness were described as quote acute

0:17:59.640 --> 0:18:04.480
<v Speaker 1>onset of fever, vertigo, and severe headache, followed by bleeding

0:18:04.520 --> 0:18:07.760
<v Speaker 1>from the nose, ears, and mouth. It was accompanied by

0:18:07.840 --> 0:18:12.159
<v Speaker 1>jaundice and severe abdominal pain and thoracic pain, as well

0:18:12.240 --> 0:18:15.679
<v Speaker 1>as acute neurological manifestations end quote.

0:18:16.640 --> 0:18:19.200
<v Speaker 2>I'm I'm listening so intently.

0:18:20.520 --> 0:18:22.040
<v Speaker 1>I can hear you typing. I love it.

0:18:22.160 --> 0:18:22.359
<v Speaker 5>I know.

0:18:22.400 --> 0:18:24.919
<v Speaker 2>I'm sorry I doesn't pick up in the mic, but

0:18:24.960 --> 0:18:32.080
<v Speaker 2>I'm taking notes. Fever, verdio, headache, bleeding, okay, jaundice, okay, And.

0:18:32.040 --> 0:18:34.640
<v Speaker 1>We can go over all of this at the end.

0:18:34.880 --> 0:18:36.040
<v Speaker 1>Oh we will also.

0:18:36.440 --> 0:18:38.200
<v Speaker 2>Yeah.

0:18:38.200 --> 0:18:42.399
<v Speaker 1>In general, the duration of the disease was described as short,

0:18:42.600 --> 0:18:45.959
<v Speaker 1>about three to four days okay, and was said to

0:18:46.080 --> 0:18:50.639
<v Speaker 1>have mainly affected the indigenous population. However, sources vary on

0:18:50.640 --> 0:18:53.120
<v Speaker 1>that point, which is maybe something that we'll get into

0:18:53.200 --> 0:18:57.680
<v Speaker 1>later when going through the possible pathogens. Children and young

0:18:57.720 --> 0:19:01.399
<v Speaker 1>adults were said to be the most affected, although again

0:19:01.560 --> 0:19:05.720
<v Speaker 1>sort of sources are not entirely consistent on this point,

0:19:06.280 --> 0:19:09.639
<v Speaker 1>but this is supported by evidence from burial grounds in

0:19:09.680 --> 0:19:14.720
<v Speaker 1>southern Mexico where the Mishtek peoples lived, and these burial

0:19:14.760 --> 0:19:19.480
<v Speaker 1>grounds show that a young people were disproportionately buried and

0:19:19.720 --> 0:19:24.000
<v Speaker 1>b bodies were stacked vertically, suggesting that the deaths happen

0:19:24.119 --> 0:19:27.920
<v Speaker 1>too quickly for individual graves to be dug which is

0:19:27.960 --> 0:19:34.159
<v Speaker 1>the norm. So definitely like this is considered an epidemic graveyard.

0:19:34.440 --> 0:19:35.320
<v Speaker 2>Okay, okay.

0:19:36.000 --> 0:19:39.679
<v Speaker 1>And the bleeding seems like a key feature of this

0:19:39.840 --> 0:19:43.400
<v Speaker 1>disease since it shows up in many of the contemporary

0:19:43.440 --> 0:19:47.879
<v Speaker 1>illustrations of the epidemic. So one features a man in

0:19:47.920 --> 0:19:51.440
<v Speaker 1>a full body rash as blood or vomit flows from

0:19:51.480 --> 0:19:55.840
<v Speaker 1>his face, and others also feature bleeding from the face,

0:19:57.440 --> 0:20:01.720
<v Speaker 1>and written descriptions also mention in the blood quote a

0:20:01.800 --> 0:20:05.760
<v Speaker 1>pestilence in which blood poured from the nose end quote.

0:20:06.119 --> 0:20:10.840
<v Speaker 1>And someone who was writing about the fifteen forty five

0:20:10.960 --> 0:20:17.280
<v Speaker 1>Cocleaedsli epidemic like sixty years after it happened, wrote that

0:20:17.359 --> 0:20:21.120
<v Speaker 1>quote blood flowed from the mouth, eyes, nose, and anus

0:20:21.680 --> 0:20:25.000
<v Speaker 1>end quote of all people poor and noble alike, and

0:20:25.040 --> 0:20:29.119
<v Speaker 1>that the bodies were eaten by dogs and coyotes. Okay,

0:20:29.440 --> 0:20:32.240
<v Speaker 1>I think just like emphasizing the speed with which this

0:20:32.760 --> 0:20:38.399
<v Speaker 1>killed and how many people are killed. Another Franciscan friar

0:20:38.480 --> 0:20:42.000
<v Speaker 1>and eyewitness to both the fifteen forty five and fifteen

0:20:42.040 --> 0:20:47.359
<v Speaker 1>seventy six coco Leedes epidemics used the term pujamiento de sangre,

0:20:47.760 --> 0:20:53.960
<v Speaker 1>meaning abundant bleeding or full bloodiness, and said it was

0:20:54.080 --> 0:21:00.920
<v Speaker 1>characterized by blood fevers. Notably, though, this same author used

0:21:00.920 --> 0:21:05.200
<v Speaker 1>the Spanish word for Typhus Tabardillo for the fifteen seventy

0:21:05.280 --> 0:21:09.000
<v Speaker 1>six epidemic, and remember he saw both of them. But

0:21:09.240 --> 0:21:14.520
<v Speaker 1>in general, this fifteen forty five Cocolitsi epidemic was described

0:21:14.600 --> 0:21:19.760
<v Speaker 1>by most eyewitnesses as distinct from other European introduced diseases

0:21:19.840 --> 0:21:27.880
<v Speaker 1>including smallpox, measles epidemic, typhus, pertussis, and malaria. So in total,

0:21:28.600 --> 0:21:34.280
<v Speaker 1>an estimated five to fifteen million people died, said to

0:21:34.280 --> 0:21:37.040
<v Speaker 1>be about eighty percent of the indigenous population.

0:21:37.560 --> 0:21:40.560
<v Speaker 2>Is that in these two outbreaks combined or just in

0:21:40.600 --> 0:21:42.320
<v Speaker 2>the fifteen forty five outbreak.

0:21:42.040 --> 0:21:46.320
<v Speaker 1>Just fifteen forty five? Holy uh huh. Yeah, there's a

0:21:46.320 --> 0:21:48.560
<v Speaker 1>lot more detail on the fifteen seventy six one, so

0:21:48.600 --> 0:21:52.560
<v Speaker 1>we'll get into that one in a second. Oh my, yeah,

0:21:53.200 --> 0:21:57.760
<v Speaker 1>eighty percent is what most estimates say, eighty percent of

0:21:58.040 --> 0:22:00.000
<v Speaker 1>the indigenous population at the time.

0:22:02.680 --> 0:22:06.480
<v Speaker 2>Yep, okay, I'm I'm I want to ask a million questions,

0:22:06.480 --> 0:22:08.080
<v Speaker 2>but I want I feel like you're going to answer them.

0:22:08.480 --> 0:22:12.440
<v Speaker 1>It's possible, but it's also possible that I won't at all.

0:22:14.440 --> 0:22:18.680
<v Speaker 1>But yeah, this this fifteen forty five epidemic lasted. It's

0:22:18.760 --> 0:22:21.600
<v Speaker 1>it's kind of unclear. It probably varied from region to region,

0:22:21.880 --> 0:22:25.440
<v Speaker 1>but it seems like I've read one and a half

0:22:25.520 --> 0:22:28.080
<v Speaker 1>years to four years as the total length of time,

0:22:28.400 --> 0:22:30.120
<v Speaker 1>more often four years.

0:22:30.560 --> 0:22:33.160
<v Speaker 2>And that's okay, So like from fifteen forty five till

0:22:33.200 --> 0:22:37.080
<v Speaker 2>fifteen forty nine, basically, yeah, so over that time period,

0:22:38.480 --> 0:22:43.280
<v Speaker 2>eighty percent of the population died presumably from this or

0:22:43.640 --> 0:22:46.520
<v Speaker 2>related to it, right for you know, there's co morbid

0:22:46.520 --> 0:22:47.320
<v Speaker 2>et cetera.

0:22:47.520 --> 0:22:51.320
<v Speaker 1>Co morbid and also just sort of like societal collapse,

0:22:51.440 --> 0:22:55.680
<v Speaker 1>like because this was such an intricately connected society. When

0:22:55.800 --> 0:22:59.520
<v Speaker 1>you don't have let's say, people who are sick can't

0:22:59.680 --> 0:23:03.959
<v Speaker 1>then harvest food, and then people who get sick who

0:23:04.040 --> 0:23:07.520
<v Speaker 1>can't turn that food into ingredients, and then people who

0:23:07.560 --> 0:23:10.240
<v Speaker 1>can't turn ingredients into meals, and then people who can't

0:23:10.359 --> 0:23:14.080
<v Speaker 1>you know, it's just like becomes this thing where if

0:23:14.119 --> 0:23:18.080
<v Speaker 1>you're sick, then who's caring for you? So I think

0:23:18.160 --> 0:23:22.760
<v Speaker 1>that's where we have to kind of remember where those

0:23:22.800 --> 0:23:25.120
<v Speaker 1>mortality numbers are coming from.

0:23:24.760 --> 0:23:28.120
<v Speaker 2>Right, because it's not necessarily all directly attributable to disease,

0:23:28.520 --> 0:23:33.760
<v Speaker 2>right exactly, and or to this one specific disease.

0:23:33.600 --> 0:23:37.520
<v Speaker 1>Right and you can't assume care, even like palliative or

0:23:37.560 --> 0:23:38.879
<v Speaker 1>supportive care or something.

0:23:39.119 --> 0:23:43.639
<v Speaker 2>Yeah, and then this but despite that, that is the

0:23:43.720 --> 0:23:46.640
<v Speaker 2>number that's attributed to this outbreak which took place over

0:23:46.840 --> 0:23:48.000
<v Speaker 2>four years.

0:23:48.560 --> 0:23:53.400
<v Speaker 1>It is what is the population losses during this epidemic?

0:23:53.560 --> 0:23:59.159
<v Speaker 2>Yes? And can I ask a question? Yeah, when it

0:23:59.359 --> 0:24:03.879
<v Speaker 2>like sporadic, like evenly distributed across those four years. Do

0:24:03.960 --> 0:24:06.800
<v Speaker 2>we know was it like mostly at the beginning or

0:24:06.800 --> 0:24:10.760
<v Speaker 2>mostly at the end. Was it like every spring for example,

0:24:11.000 --> 0:24:13.800
<v Speaker 2>or something like that, or is it just like it

0:24:13.840 --> 0:24:16.320
<v Speaker 2>was these four years? And that's the most resolution that

0:24:16.320 --> 0:24:16.720
<v Speaker 2>we have.

0:24:17.160 --> 0:24:20.359
<v Speaker 1>So for the fifteen forty five one, more or less,

0:24:20.400 --> 0:24:23.080
<v Speaker 1>that's the most resolution that we have. I think it

0:24:23.280 --> 0:24:27.680
<v Speaker 1>probably started out very strong, and it seems to have

0:24:27.720 --> 0:24:33.560
<v Speaker 1>sort of swept through towns very quickly and very dramatically.

0:24:35.080 --> 0:24:39.840
<v Speaker 1>But we do have more information in general for the

0:24:40.440 --> 0:24:46.440
<v Speaker 1>fifteen seventy six one. Okay, so let's get into that, okay, please.

0:24:47.040 --> 0:24:50.560
<v Speaker 1>But also I will say that the fifteen forty five

0:24:50.560 --> 0:24:52.680
<v Speaker 1>to one did start in August.

0:24:53.080 --> 0:24:57.840
<v Speaker 2>It started in August, Okay, Yeah, in Paris, in Mexico, Okay, Okay.

0:24:58.760 --> 0:25:02.520
<v Speaker 1>So there would be other appearances of cocolitesli in the

0:25:02.600 --> 0:25:06.760
<v Speaker 1>years following that fifteen forty five epidemic, but it really

0:25:06.800 --> 0:25:11.760
<v Speaker 1>came back with a vengeance in fifteen seventy six. Quote,

0:25:12.200 --> 0:25:15.680
<v Speaker 1>in the year fifteen seventy six, a great mortality and

0:25:15.760 --> 0:25:19.639
<v Speaker 1>pestilence that lasted for more than a year overcame the Indians.

0:25:20.320 --> 0:25:23.440
<v Speaker 1>It was so big that it ruined and destroyed almost

0:25:23.440 --> 0:25:26.840
<v Speaker 1>the entire land. The place we know as New Spain

0:25:27.080 --> 0:25:30.000
<v Speaker 1>was left almost empty. It was a thing of great

0:25:30.040 --> 0:25:33.480
<v Speaker 1>bewilderment to see the people die. Many were dead and

0:25:33.600 --> 0:25:37.000
<v Speaker 1>others almost dead, and nobody had the health or strength

0:25:37.080 --> 0:25:40.040
<v Speaker 1>to help the diseased or bury the dead. In the

0:25:40.080 --> 0:25:43.280
<v Speaker 1>cities and large towns, big ditches were dug, and from

0:25:43.359 --> 0:25:46.720
<v Speaker 1>morning to sunset the priests did nothing else but bury

0:25:46.800 --> 0:25:49.600
<v Speaker 1>the dead bodies and throw them into the ditches without

0:25:49.640 --> 0:25:53.000
<v Speaker 1>any of the solemnity usually reserved for the dead, because

0:25:53.040 --> 0:25:56.520
<v Speaker 1>the time did not allow otherwise. At night they covered

0:25:56.560 --> 0:25:59.240
<v Speaker 1>the ditches with dirt. It lasted for one and a

0:25:59.320 --> 0:26:02.639
<v Speaker 1>half years and with great excess in the number of deaths.

0:26:03.480 --> 0:26:05.800
<v Speaker 3>End quote wow okay.

0:26:07.040 --> 0:26:11.080
<v Speaker 1>That is a quote from Freewan de Torkumata, who was

0:26:11.119 --> 0:26:15.480
<v Speaker 1>a Franciscan historian, and he was describing the epidemic in

0:26:15.560 --> 0:26:21.680
<v Speaker 1>Mexico City. The epidemic. This epidemic began in June in

0:26:21.720 --> 0:26:25.320
<v Speaker 1>central Mexico and quickly made its way across the land,

0:26:25.640 --> 0:26:28.800
<v Speaker 1>reaching as far north as parts of what is now

0:26:28.840 --> 0:26:32.880
<v Speaker 1>the Southern US and as far south as the Peruvian Andes.

0:26:33.480 --> 0:26:36.600
<v Speaker 1>But the vast majority of cases were concentrated in like

0:26:36.600 --> 0:26:41.040
<v Speaker 1>a four hundred mile radius in Mexico, where it spread

0:26:41.040 --> 0:26:43.760
<v Speaker 1>from the dry plains of the north to the densely

0:26:43.880 --> 0:26:49.359
<v Speaker 1>populated subtropical valleys of central Mexico, leaving almost no place

0:26:49.600 --> 0:26:55.320
<v Speaker 1>unscathed except for perhaps the coastal areas. According to some,

0:26:56.880 --> 0:27:00.960
<v Speaker 1>the spread seemed to slow by October fifteen seventy eight,

0:27:01.040 --> 0:27:05.119
<v Speaker 1>so it's like two years after, but then increased again

0:27:05.240 --> 0:27:09.399
<v Speaker 1>in August fifteen seventy nine, ending finally in the middle

0:27:09.440 --> 0:27:16.520
<v Speaker 1>of fifteen eighty one. The effect was truly devastating in Mexico.

0:27:16.880 --> 0:27:20.879
<v Speaker 1>More than two million people died during this epidemic, half

0:27:21.119 --> 0:27:25.600
<v Speaker 1>of the population fifty one point three six percent to

0:27:25.680 --> 0:27:30.320
<v Speaker 1>be precise. And we can be so precise because censuses

0:27:30.400 --> 0:27:33.600
<v Speaker 1>were conducted a few years before the epidemic and a

0:27:33.600 --> 0:27:34.359
<v Speaker 1>few years after.

0:27:35.640 --> 0:27:36.280
<v Speaker 2>Wow.

0:27:36.760 --> 0:27:42.000
<v Speaker 1>Yeah, this epidemic in general, like I mentioned, is much

0:27:42.040 --> 0:27:45.960
<v Speaker 1>better documented, So get ready for lots of quotes.

0:27:46.119 --> 0:27:46.520
<v Speaker 4>Okay.

0:27:47.400 --> 0:27:50.879
<v Speaker 1>The mortality rate was not consistent across all areas, so

0:27:51.040 --> 0:27:56.200
<v Speaker 1>one region southwest of Mexico City, Tepeyaka, lost eighty six

0:27:56.240 --> 0:28:00.600
<v Speaker 1>point six percent of its population of sixty thousand, while Chilula,

0:28:00.760 --> 0:28:04.200
<v Speaker 1>east of Mexico City lost only forty percent of its

0:28:04.240 --> 0:28:09.120
<v Speaker 1>fifteen thousand inhabitants. Only forty percent, right.

0:28:08.920 --> 0:28:10.679
<v Speaker 2>An unbelievable number.

0:28:11.000 --> 0:28:18.119
<v Speaker 1>Yeah yeah. One eyewitness described its erratic spread. Quote, it

0:28:18.160 --> 0:28:20.560
<v Speaker 1>appears as if it is a living thing, and that

0:28:20.600 --> 0:28:23.479
<v Speaker 1>it goes in search of towns so that none remain

0:28:24.160 --> 0:28:30.520
<v Speaker 1>end quote. The Bishop of Mishoa Khan wrote, quote, almost

0:28:30.600 --> 0:28:33.280
<v Speaker 1>half of the natives of this province have been taken.

0:28:33.880 --> 0:28:36.879
<v Speaker 1>When the pestilence enters a town for ten months or

0:28:36.920 --> 0:28:39.800
<v Speaker 1>a year, it jumps from barrio to barrio and from

0:28:39.840 --> 0:28:43.200
<v Speaker 1>house to house. And it was without order, even though

0:28:43.240 --> 0:28:46.800
<v Speaker 1>divine disposition would have had it well ordered, because it

0:28:46.880 --> 0:28:50.040
<v Speaker 1>struck one neighborhood and then jumped to another far away,

0:28:50.520 --> 0:28:53.760
<v Speaker 1>sparing the one closer by, and in the same home.

0:28:53.880 --> 0:28:57.160
<v Speaker 1>It took some and spared others, only to return four

0:28:57.240 --> 0:29:00.480
<v Speaker 1>or six months later to claim the healthy. This was

0:29:00.520 --> 0:29:06.840
<v Speaker 1>observed by all end quote hmmm. He added that quote,

0:29:07.400 --> 0:29:10.240
<v Speaker 1>these poor indios are half what they were in number,

0:29:10.360 --> 0:29:13.520
<v Speaker 1>and the half that return are wasted, weary, and miserable

0:29:13.920 --> 0:29:17.320
<v Speaker 1>because everyone has either succumbed to the pestilence or escaped it.

0:29:17.760 --> 0:29:21.120
<v Speaker 1>And even today the sorrowful ones who survived are still

0:29:21.160 --> 0:29:26.800
<v Speaker 1>preoccupied with their loved ones who continue to suffer. End quote.

0:29:27.040 --> 0:29:30.080
<v Speaker 1>So the Spanish, who seem to be less affected by

0:29:30.120 --> 0:29:36.920
<v Speaker 1>the disease, although ASTERISK did keenly feel its impacts in

0:29:37.080 --> 0:29:42.960
<v Speaker 1>other ways, namely economical. The accountant of the Royal Treasury

0:29:43.000 --> 0:29:46.760
<v Speaker 1>of New Spain wrote, quote, the illness and death of

0:29:46.800 --> 0:29:49.760
<v Speaker 1>the natives have been so great that they have been

0:29:49.880 --> 0:29:54.440
<v Speaker 1>completely diminished, so much so that in many pueblos in

0:29:54.480 --> 0:29:58.440
<v Speaker 1>this great land, fewer than half the population remains, and

0:29:58.520 --> 0:30:01.840
<v Speaker 1>in others less than a third, And so our profits

0:30:01.880 --> 0:30:05.040
<v Speaker 1>are less than they were. The absence of natives in

0:30:05.080 --> 0:30:08.440
<v Speaker 1>these lands is so great that it seems unfathomable that

0:30:08.480 --> 0:30:11.680
<v Speaker 1>they could have been brought to this point. The profits

0:30:11.760 --> 0:30:15.280
<v Speaker 1>are far less, and our expense is ever greater because

0:30:15.320 --> 0:30:19.160
<v Speaker 1>of the tremendous hardship, and the whole land is in misery,

0:30:19.280 --> 0:30:21.520
<v Speaker 1>affliction and need end.

0:30:21.560 --> 0:30:27.680
<v Speaker 5>Quote that quote, like, you're a tremendous hardship because your

0:30:27.680 --> 0:30:33.120
<v Speaker 5>profits are down. That's yeah, gross, I know this tremendous hardship.

0:30:33.160 --> 0:30:38.640
<v Speaker 5>If I need care for people, my goodness, and this

0:30:38.720 --> 0:30:40.000
<v Speaker 5>is truly.

0:30:41.240 --> 0:30:45.680
<v Speaker 1>Astounding, right, yeah, I mean, I know, I just keep

0:30:45.680 --> 0:30:47.280
<v Speaker 1>saying it. Over and over again. But it's just like

0:30:47.360 --> 0:30:50.760
<v Speaker 1>it's unfathomable, and it's there's so much here, and I

0:30:50.800 --> 0:30:54.560
<v Speaker 1>think it's it's also fascinating how number one, how well

0:30:54.600 --> 0:30:59.920
<v Speaker 1>this is documented too, how much more is still being

0:31:00.120 --> 0:31:04.960
<v Speaker 1>uncovered because for a long time, the main accounts that

0:31:05.000 --> 0:31:09.640
<v Speaker 1>were used were from were written by Spanish colonizers. And

0:31:09.720 --> 0:31:13.840
<v Speaker 1>only more recently do we have people the Nahua people

0:31:14.640 --> 0:31:18.760
<v Speaker 1>who's who also wrote down histories like those are being

0:31:19.560 --> 0:31:22.959
<v Speaker 1>translated and then taken into account in these retellings, and

0:31:23.040 --> 0:31:30.840
<v Speaker 1>so it's interesting, very interesting. Yeah. Yeah, but cocolitesle, this

0:31:31.040 --> 0:31:36.720
<v Speaker 1>epidemic especially threatened Spanish rule and colonial order because of

0:31:37.040 --> 0:31:42.000
<v Speaker 1>sheer population loss, not just economically but also culturally, fewer

0:31:42.040 --> 0:31:46.800
<v Speaker 1>people to convert to the new religion and to rule over.

0:31:48.280 --> 0:31:51.400
<v Speaker 1>And so okay, at this point we've established that this

0:31:51.480 --> 0:31:56.160
<v Speaker 1>is a pretty deadly disease. Now let's go through how

0:31:56.280 --> 0:32:02.480
<v Speaker 1>this one was described. Yeah. Again, the Nahwat word cocolitesli

0:32:02.800 --> 0:32:08.440
<v Speaker 1>or hue cocolitsli was used to mean pestilence or great pestilence,

0:32:09.000 --> 0:32:14.760
<v Speaker 1>and the Spanish also used malpestillencia, pestilencia universal bad or

0:32:14.840 --> 0:32:19.120
<v Speaker 1>universal pestilence. It was discussed as distinct from the other

0:32:19.280 --> 0:32:23.440
<v Speaker 1>known epidemic diseases, and was generally seen as something new,

0:32:23.560 --> 0:32:29.400
<v Speaker 1>something unfamiliar. Some reports describe young people being disproportionately affected,

0:32:29.560 --> 0:32:33.959
<v Speaker 1>while others say it attacked all ages. No animal deaths,

0:32:34.280 --> 0:32:38.880
<v Speaker 1>domestic or wild were mentioned. When it comes to symptoms,

0:32:39.200 --> 0:32:43.280
<v Speaker 1>there's actually a medical description by doctor Fernando Hernandez, who

0:32:43.400 --> 0:32:47.400
<v Speaker 1>is the physician in chief of New Spain. It's very long,

0:32:47.880 --> 0:32:50.200
<v Speaker 1>so brace yourself, but I think you're going to find

0:32:50.240 --> 0:32:52.000
<v Speaker 1>it very interesting.

0:32:52.360 --> 0:32:56.360
<v Speaker 2>And yes, I'm going to try and memorize it.

0:32:56.520 --> 0:33:03.280
<v Speaker 1>Yeah. Quote. The fevers were contagious, burning, and continuous, all

0:33:03.320 --> 0:33:07.760
<v Speaker 1>of them pestilential, in most part lethal. The tongue was

0:33:07.880 --> 0:33:15.160
<v Speaker 1>dry and black, enormous thirst urine of the colors sea, green, vegetable, green,

0:33:15.360 --> 0:33:19.160
<v Speaker 1>and black, sometimes passing from the greenish color to the pale.

0:33:19.960 --> 0:33:24.720
<v Speaker 1>Pulse was frequent, fast, small, and weak, sometimes even null.

0:33:25.440 --> 0:33:29.360
<v Speaker 1>The eyes and the whole body were yellow. This stage

0:33:29.520 --> 0:33:34.160
<v Speaker 1>was followed by delirium and seizures. Then hard and painful

0:33:34.240 --> 0:33:38.320
<v Speaker 1>nodules appeared behind one or both ears, along with heartache,

0:33:38.560 --> 0:33:44.360
<v Speaker 1>chest pain, abdominal pain, tremor, great anxiety, and dysentery. The

0:33:44.400 --> 0:33:47.280
<v Speaker 1>blood that flowed when cutting a vein had a green

0:33:47.440 --> 0:33:52.320
<v Speaker 1>color or was very pale, dry and without serocity. In

0:33:52.360 --> 0:33:58.640
<v Speaker 1>some cases, gangreen and Sphacilus aka necrosis invaded their lips,

0:33:58.720 --> 0:34:03.120
<v Speaker 1>pudental regions and other regions of the body with putrefact members,

0:34:03.680 --> 0:34:07.040
<v Speaker 1>blood flowed from the ears, and in many cases blood

0:34:07.200 --> 0:34:11.520
<v Speaker 1>truly gushed from the nose. Of those with recurring disease,

0:34:11.800 --> 0:34:15.400
<v Speaker 1>almost none was saved. Many were saved if the flux

0:34:15.440 --> 0:34:17.840
<v Speaker 1>of blood through the nose was stopped in time. The

0:34:17.920 --> 0:34:21.879
<v Speaker 1>rest died. Those attacked by dysentery were usually saved if

0:34:21.920 --> 0:34:26.200
<v Speaker 1>they complied with the medication. The abscesses behind the ears

0:34:26.280 --> 0:34:29.920
<v Speaker 1>were not lethal if somehow their size was reduced, either

0:34:29.960 --> 0:34:34.480
<v Speaker 1>by spontaneous maturation or given exit by perforation with catteries.

0:34:34.880 --> 0:34:37.399
<v Speaker 1>The liquid part of the blood flowed or the puss

0:34:37.560 --> 0:34:40.880
<v Speaker 1>was eliminated, and with it the cause of disease was

0:34:40.920 --> 0:34:44.520
<v Speaker 1>also eliminated, as was the case of those with abundant

0:34:44.560 --> 0:34:48.680
<v Speaker 1>and pale urine. At autopsy, the liver was greatly enlarged.

0:34:49.160 --> 0:34:52.799
<v Speaker 1>The heart was black, first draining a yellowish liquid and

0:34:52.840 --> 0:34:56.520
<v Speaker 1>then black blood. The spleen and lungs were black and

0:34:56.560 --> 0:35:01.160
<v Speaker 1>semi putrefacted. The bile was observed in its container, the

0:35:01.239 --> 0:35:05.040
<v Speaker 1>abdomen dry, The rest of the body anywhere it was

0:35:05.160 --> 0:35:10.160
<v Speaker 1>cut was extremely pale. This epidemic attacked mainly young people

0:35:10.239 --> 0:35:13.320
<v Speaker 1>and seldom the elder ones. If old people were affected,

0:35:13.360 --> 0:35:16.520
<v Speaker 1>they were able to overcome the disease and save their lives.

0:35:17.120 --> 0:35:20.480
<v Speaker 1>The epidemic started in June fifteen seventy six and is

0:35:20.560 --> 0:35:23.320
<v Speaker 1>not over in December when I am writing these lines.

0:35:24.160 --> 0:35:27.920
<v Speaker 1>Very few with abdominal distension were saved. At the beginning,

0:35:28.120 --> 0:35:31.879
<v Speaker 1>the blood was expelled by some without severe disease, then

0:35:32.000 --> 0:35:38.720
<v Speaker 1>by very few. Vital energy was consumed quickly. End quote

0:35:39.200 --> 0:35:40.160
<v Speaker 1>A lot to unpack.

0:35:40.160 --> 0:35:43.680
<v Speaker 2>There was there a time frame in that description that

0:35:43.719 --> 0:35:44.240
<v Speaker 2>I missed.

0:35:45.000 --> 0:35:48.800
<v Speaker 1>There was not, but again in general, three to four days,

0:35:48.920 --> 0:35:49.319
<v Speaker 1>three to.

0:35:49.320 --> 0:35:52.760
<v Speaker 3>Five wow, okay okay, okay yeah.

0:35:53.160 --> 0:35:57.680
<v Speaker 1>Other symptoms that I saw mentioned or key observations by

0:35:57.719 --> 0:36:01.759
<v Speaker 1>other eyewitnesses include the fact that it was puss that

0:36:01.760 --> 0:36:05.400
<v Speaker 1>would drain out of those swollen lymph nodes if cut,

0:36:06.280 --> 0:36:11.279
<v Speaker 1>and that bloodshot eyes were common and insatiable. Thirst was

0:36:11.360 --> 0:36:16.680
<v Speaker 1>also mentioned. Lung hemorrhage was seen at autopsy, but again

0:36:17.120 --> 0:36:21.680
<v Speaker 1>bleeding does seem to be a main feature and the

0:36:21.719 --> 0:36:26.399
<v Speaker 1>phrase blood emerged from our noses, and variations on that

0:36:26.719 --> 0:36:33.200
<v Speaker 1>appeared many times throughout accounts of this epidemic. Epidemics of

0:36:33.320 --> 0:36:37.520
<v Speaker 1>coco Elitzley continued, possibly until as recently as the early

0:36:37.760 --> 0:36:41.440
<v Speaker 1>nineteenth century, although the name used in these later epidemics

0:36:41.600 --> 0:36:48.040
<v Speaker 1>was mala zowat netlike rash, and it's unclear if the

0:36:48.080 --> 0:36:51.759
<v Speaker 1>new name meant new disease, or was used in recognition

0:36:51.800 --> 0:36:55.480
<v Speaker 1>of a new symptom, or was just something else like

0:36:55.560 --> 0:36:59.160
<v Speaker 1>it's People don't know, but in any case, coco Elitzley,

0:36:59.440 --> 0:37:05.200
<v Speaker 1>especially the sixteenth century epidemics, has stumped researchers for decades.

0:37:05.960 --> 0:37:10.480
<v Speaker 1>The symptoms described, along with the high mortality rate, don't

0:37:10.520 --> 0:37:15.400
<v Speaker 1>seem to match any known pathogen today, but don't worry,

0:37:15.480 --> 0:37:20.239
<v Speaker 1>there are still plenty of hypotheses to go around. Historically,

0:37:20.360 --> 0:37:24.800
<v Speaker 1>epidemic typhus has been a popular guess, and more recently,

0:37:24.880 --> 0:37:30.360
<v Speaker 1>heemorrhagic fever possibly associated with rodents. This rodent association is

0:37:30.400 --> 0:37:33.879
<v Speaker 1>because both the fifteen forty five and fifteen seventy six

0:37:33.960 --> 0:37:39.400
<v Speaker 1>epidemics occurred during brief intense rainfall preceded by long periods

0:37:39.480 --> 0:37:43.880
<v Speaker 1>of megadrought, which is very similar to the Four Corners

0:37:43.920 --> 0:37:48.200
<v Speaker 1>nineteen ninety three huntavirus outbreak, where dear mice proliferated after

0:37:48.280 --> 0:37:53.680
<v Speaker 1>that same drought rainfall cycle. Others that have been proposed

0:37:53.880 --> 0:38:01.000
<v Speaker 1>include plague specifically mnemonic anthrax, sleptosporosis, malaria, diphtheria, Tessis lausborn

0:38:01.040 --> 0:38:06.120
<v Speaker 1>relapsing fever, and malaria. All of these I just mentioned

0:38:06.200 --> 0:38:11.799
<v Speaker 1>were proposed based on epidemiological characteristics or descriptions of symptoms,

0:38:12.040 --> 0:38:17.399
<v Speaker 1>not physical evidence. Not yet for those anyway. But there

0:38:17.480 --> 0:38:21.560
<v Speaker 1>is one candidate pathogen for cocolitesle that has gotten a

0:38:21.640 --> 0:38:26.440
<v Speaker 1>lot of attention recently, and that is Salmonella in Enterica

0:38:26.600 --> 0:38:33.759
<v Speaker 1>subspecies Enterica saravar paratipee s longest name for an organism

0:38:34.080 --> 0:38:39.080
<v Speaker 1>ever maybe, but a few years ago, researchers detected Salmonella

0:38:39.160 --> 0:38:44.880
<v Speaker 1>in Enterica paratifec DNA in ten individuals that were buried

0:38:45.000 --> 0:38:50.319
<v Speaker 1>during the fifteen forty five coco leisle epidemic in Wahaka

0:38:50.360 --> 0:38:54.520
<v Speaker 1>in southern Mexico. Now, the researchers who publish this paper

0:38:54.600 --> 0:38:59.200
<v Speaker 1>are not claiming that this pathogen was solely responsible for

0:38:59.360 --> 0:39:03.279
<v Speaker 1>the coco lee epidemics, but instead suggests that it may

0:39:03.320 --> 0:39:07.280
<v Speaker 1>have acted in concert with other circulating pathogens at the time.

0:39:08.680 --> 0:39:12.680
<v Speaker 1>But before we start debating which pathogen is the best candidate,

0:39:12.800 --> 0:39:17.200
<v Speaker 1>if any, let's maybe learn a bit more about the

0:39:17.200 --> 0:39:21.800
<v Speaker 1>ones proposed, keeping in mind number one what these diseases

0:39:21.840 --> 0:39:26.239
<v Speaker 1>looked like, number two, how they're transmitted, number three, case

0:39:26.280 --> 0:39:30.839
<v Speaker 1>fatality rates, number four, environmental factors, number five old World

0:39:30.960 --> 0:39:34.799
<v Speaker 1>versus New World origins, and number six that this could

0:39:34.840 --> 0:39:40.400
<v Speaker 1>have been the work of many factors acting simultaneously. And now, Aaron,

0:39:40.480 --> 0:39:41.440
<v Speaker 1>I turn it over to you.

0:39:45.719 --> 0:39:50.839
<v Speaker 2>Oh yeah, so let's take a quick break and then

0:39:50.920 --> 0:39:54.520
<v Speaker 2>let's get into some of these candidate pathogens. I have

0:39:55.239 --> 0:39:59.200
<v Speaker 2>so many thoughts already, so let's take a beat and

0:39:59.239 --> 0:40:01.120
<v Speaker 2>then get real deep into it, shall we.

0:40:01.360 --> 0:40:03.160
<v Speaker 1>Let's do it right after this break.

0:40:35.000 --> 0:40:41.560
<v Speaker 2>I am bursting right now, and part of what I

0:40:41.600 --> 0:40:45.920
<v Speaker 2>think I am bursting with is how much I can

0:40:46.040 --> 0:40:51.280
<v Speaker 2>understand how this has stumped everyone because nothing, nothing fits.

0:40:52.120 --> 0:40:52.279
<v Speaker 1>No.

0:40:55.239 --> 0:40:58.200
<v Speaker 2>When we did dancing Plague, I remember feeling like, oh,

0:40:58.239 --> 0:41:00.880
<v Speaker 2>at least some of these definitely fit, and some of

0:41:00.920 --> 0:41:04.799
<v Speaker 2>them like kind of fit a little bit. Maybe yeah this,

0:41:05.040 --> 0:41:10.920
<v Speaker 2>I'm like, uh mmmm, So let's let's get into all

0:41:10.920 --> 0:41:13.200
<v Speaker 2>of these different proposed I have feelings about it, and

0:41:13.239 --> 0:41:16.400
<v Speaker 2>I'm gonna have some more questions for you to be

0:41:16.440 --> 0:41:18.360
<v Speaker 2>able to try and like parse out some of this.

0:41:18.640 --> 0:41:20.440
<v Speaker 1>Okay, great, let's let's dig in.

0:41:22.120 --> 0:41:26.200
<v Speaker 2>So the list that you told me, Aaron, or at

0:41:26.280 --> 0:41:32.799
<v Speaker 2>least the ones that I definitely researched, included hantavirus, epidemic typhus,

0:41:33.120 --> 0:41:41.920
<v Speaker 2>pneumonic plague, leptosporosis, barton elosis, measles, smallpox, malaria, an unknown

0:41:42.040 --> 0:41:44.560
<v Speaker 2>hemorrhagic fever virus.

0:41:44.600 --> 0:41:47.560
<v Speaker 1>My personal favorite is just like choose your own adventure,

0:41:47.719 --> 0:41:51.239
<v Speaker 1>like just attribute traits that have not been observed in

0:41:51.320 --> 0:41:52.879
<v Speaker 1>one virus. But that's fun.

0:41:53.360 --> 0:42:00.840
<v Speaker 2>Yeah, And of course salmonella enterica paratyphe. See some of

0:42:00.880 --> 0:42:05.600
<v Speaker 2>these I think we can very quickly and very easily discard.

0:42:06.000 --> 0:42:08.080
<v Speaker 1>As the main contributor, Yeah, as.

0:42:07.960 --> 0:42:11.000
<v Speaker 2>The main contributor, because they not only just don't match

0:42:11.480 --> 0:42:15.600
<v Speaker 2>symptoms wise, but like you importantly mentioned, these were things

0:42:15.680 --> 0:42:18.600
<v Speaker 2>that circulated and were described very differently.

0:42:19.000 --> 0:42:19.120
<v Speaker 4>Right.

0:42:19.960 --> 0:42:23.200
<v Speaker 2>So that includes something like smallpox where one of the

0:42:23.280 --> 0:42:26.920
<v Speaker 2>predominant symptoms of smallpox and something aarin that you really

0:42:26.920 --> 0:42:30.040
<v Speaker 2>didn't mention at all in that list of symptoms is

0:42:30.080 --> 0:42:30.680
<v Speaker 2>a rash.

0:42:31.160 --> 0:42:35.799
<v Speaker 1>Yeah, okay, rash. Interesting, So there was that one illustration

0:42:35.880 --> 0:42:39.480
<v Speaker 1>of the fifteen forty five epidemic that did depict someone

0:42:39.600 --> 0:42:42.759
<v Speaker 1>with a full body rash, but in general it was

0:42:42.800 --> 0:42:46.600
<v Speaker 1>not consistently mentioned. And in fifteen seventy six there was

0:42:46.719 --> 0:42:52.319
<v Speaker 1>that Franciscan scholar who used the word tabardio, which I

0:42:52.320 --> 0:42:55.600
<v Speaker 1>think means like cloak rash or something like that, Like

0:42:56.360 --> 0:42:59.760
<v Speaker 1>it refers to the rash from typhus from epidemic typhus,

0:43:00.320 --> 0:43:04.160
<v Speaker 1>but that long quote from the physician didn't describe it,

0:43:04.719 --> 0:43:08.160
<v Speaker 1>and in general it was not like it didn't seem

0:43:08.160 --> 0:43:08.440
<v Speaker 1>to be.

0:43:08.360 --> 0:43:12.200
<v Speaker 2>A main feature of the disease, right, Yeah, So I

0:43:12.200 --> 0:43:14.640
<v Speaker 2>feel like based on that, like smallpox is just all

0:43:14.680 --> 0:43:16.359
<v Speaker 2>the way out, like it just doesn't fit.

0:43:16.520 --> 0:43:17.120
<v Speaker 1>It doesn't fit.

0:43:18.000 --> 0:43:21.040
<v Speaker 2>Same thing with measles, quite honestly. And on top of

0:43:21.080 --> 0:43:24.840
<v Speaker 2>that measles, which okay, side note. One of my favorite

0:43:24.880 --> 0:43:27.200
<v Speaker 2>things about researching for this episode is that we have

0:43:27.360 --> 0:43:32.040
<v Speaker 2>covered all of these things. Do we do Bartonella, we

0:43:32.080 --> 0:43:36.520
<v Speaker 2>did bartnella erin, we did the literal because there's a

0:43:36.520 --> 0:43:38.080
<v Speaker 2>few more things that I have on my list that

0:43:38.120 --> 0:43:40.279
<v Speaker 2>you gave me, and literally the only ones that we

0:43:40.360 --> 0:43:48.600
<v Speaker 2>haven't covered are unknown hemorrhagic fever, okay, and parvovirus B nineteen,

0:43:48.680 --> 0:43:52.000
<v Speaker 2>which like it's not that either, right, right, but we'll

0:43:52.000 --> 0:43:57.360
<v Speaker 2>get there. Everything else we've talked about, So this is

0:43:57.360 --> 0:44:00.640
<v Speaker 2>really fun and most of my sources are c our

0:44:00.680 --> 0:44:09.239
<v Speaker 2>previous episode NICs. But okay, smallpox is out. Measles. We

0:44:09.280 --> 0:44:13.440
<v Speaker 2>did measles a very very long time ago. Now, measles,

0:44:13.560 --> 0:44:17.439
<v Speaker 2>while it spread through populations and absolutely caused a lot

0:44:17.440 --> 0:44:22.000
<v Speaker 2>of morbidity and mortality, the mortality rate is nowhere near

0:44:22.200 --> 0:44:25.600
<v Speaker 2>what we're seeing with cocoa eatsle. The mortality rate of

0:44:25.640 --> 0:44:28.920
<v Speaker 2>measles was far far lower. And on top of that,

0:44:28.960 --> 0:44:33.200
<v Speaker 2>the symptoms really are just nothing like these symptoms that

0:44:33.239 --> 0:44:34.040
<v Speaker 2>are being described.

0:44:34.600 --> 0:44:38.120
<v Speaker 1>I do remember from our measles episode they're being in

0:44:38.520 --> 0:44:42.960
<v Speaker 1>entirely naive populations, measles having a much higher mortality rate.

0:44:43.640 --> 0:44:47.799
<v Speaker 1>But a again, like I still think that the symptoms don't

0:44:48.200 --> 0:44:52.360
<v Speaker 1>like where's the hemorrhage? Is there a hemorrhagic form of measles?

0:44:52.840 --> 0:44:57.239
<v Speaker 2>Not that I know of? Yeah, yeah, And like so

0:44:57.440 --> 0:45:02.799
<v Speaker 2>much of measles is a very characteristic measles rash right, right,

0:45:03.880 --> 0:45:06.400
<v Speaker 2>I think the things that make it seem like measles

0:45:06.440 --> 0:45:11.320
<v Speaker 2>are just the rapidity, which it seems to have swept

0:45:11.360 --> 0:45:15.640
<v Speaker 2>through a population, except that, like the duration of disease

0:45:15.680 --> 0:45:18.239
<v Speaker 2>with measles also tends to be longer.

0:45:18.640 --> 0:45:21.800
<v Speaker 1>Yeah. Well, and I think it's interesting that you say

0:45:22.920 --> 0:45:27.080
<v Speaker 1>the pattern of spread, because I think that keeping that

0:45:27.200 --> 0:45:31.279
<v Speaker 1>in mind for transmission root.

0:45:32.080 --> 0:45:34.239
<v Speaker 2>So that's what I wanted to get. I wanted to

0:45:34.280 --> 0:45:36.439
<v Speaker 2>ask you a little bit more questions. Okay, but let's

0:45:36.520 --> 0:45:38.320
<v Speaker 2>knock a few more off this, Yeah, first, because I

0:45:38.360 --> 0:45:42.680
<v Speaker 2>think there's some other easy ones. Okay, So it's not smallpox,

0:45:42.719 --> 0:45:45.640
<v Speaker 2>it's not measles, it's not malaria.

0:45:45.440 --> 0:45:50.319
<v Speaker 1>No cyclical fevers. Yeah, I mean, and like not to

0:45:50.360 --> 0:45:51.919
<v Speaker 1>mention a lot of other things, a lot.

0:45:51.840 --> 0:45:53.719
<v Speaker 2>Of other things. The mortality is not happening within a

0:45:53.800 --> 0:45:56.040
<v Speaker 2>number of days. It's not like that's just not how

0:45:56.120 --> 0:45:56.759
<v Speaker 2>measles works.

0:45:56.800 --> 0:46:00.640
<v Speaker 1>It doesn't seem mosquito born like that just doesn't match

0:46:00.640 --> 0:46:03.080
<v Speaker 1>the pattern of spread. Yeah.

0:46:03.920 --> 0:46:06.759
<v Speaker 2>Hepatitis B was one that you mentioned to me via

0:46:06.800 --> 0:46:07.719
<v Speaker 2>text message, Aaron.

0:46:09.840 --> 0:46:12.239
<v Speaker 1>I saw that mentioned in like last minute in a

0:46:12.400 --> 0:46:13.800
<v Speaker 1>paper that I came across.

0:46:14.000 --> 0:46:16.880
<v Speaker 2>Yeah, it was like yesterday evening and I was like, great,

0:46:17.080 --> 0:46:23.279
<v Speaker 2>more word. I love it. So hepatitis B again, we

0:46:23.360 --> 0:46:28.319
<v Speaker 2>did this episode, y'all, hepatitis B causes chronic illness, and

0:46:28.360 --> 0:46:31.600
<v Speaker 2>it absolutely accounts for, even to this day, hundreds of

0:46:31.640 --> 0:46:35.760
<v Speaker 2>thousands of debts every year. But it's a chronic infection.

0:46:35.880 --> 0:46:39.000
<v Speaker 2>It's not something that is acutely killing people, at least

0:46:39.120 --> 0:46:44.040
<v Speaker 2>not at this scale. So it's not hepatitis B. It's

0:46:44.040 --> 0:46:47.520
<v Speaker 2>not parvovirus B nineteen. It seems to me this is

0:46:47.560 --> 0:46:50.399
<v Speaker 2>one that we haven't covered, so I'll just briefly mention

0:46:50.480 --> 0:46:53.319
<v Speaker 2>it and even just doing this little dive on it

0:46:53.360 --> 0:46:56.279
<v Speaker 2>for this episode. Maybe you want to do parvovirus I do.

0:46:56.680 --> 0:46:58.360
<v Speaker 1>I definitely want to do parvoviruses.

0:46:58.560 --> 0:47:03.279
<v Speaker 2>Yeah, yeah, So parvovirus B nineteen is one specific parvovirus.

0:47:03.280 --> 0:47:06.799
<v Speaker 2>These are DNA viruses. They're transmitted person to person by

0:47:06.840 --> 0:47:13.720
<v Speaker 2>respiratory droplets. They can be quite infectious and tend to

0:47:13.760 --> 0:47:18.600
<v Speaker 2>infect kids more than adults, mostly because you develop immunity

0:47:18.640 --> 0:47:21.920
<v Speaker 2>to it. But the disease that we tend to see

0:47:22.719 --> 0:47:27.680
<v Speaker 2>in majority is a pretty mild illness, though it can

0:47:27.840 --> 0:47:32.640
<v Speaker 2>cause an aplastic anemia, and I think maybe that is

0:47:32.760 --> 0:47:35.920
<v Speaker 2>where there is this potential. Looks like there's a connection

0:47:36.040 --> 0:47:39.040
<v Speaker 2>because a lot of the symptoms that you described not

0:47:39.080 --> 0:47:42.920
<v Speaker 2>necessarily with regards to hemorrhage. But in that fifteen seventy

0:47:42.960 --> 0:47:47.719
<v Speaker 2>six description of everything being pale and the blood being

0:47:47.800 --> 0:47:50.839
<v Speaker 2>pale and et cetera, to me, that means we're not

0:47:51.800 --> 0:47:54.720
<v Speaker 2>having enough red blood cells for one reason or another.

0:47:55.840 --> 0:47:59.520
<v Speaker 2>A plastic anemia means that your body stops making red

0:47:59.560 --> 0:48:02.160
<v Speaker 2>blood cell else and that's because in the case of

0:48:02.160 --> 0:48:06.320
<v Speaker 2>parvovirus B nineteen, it's replicating and destroying your red blood

0:48:06.320 --> 0:48:10.480
<v Speaker 2>cell precursors. Replicating in and destroying your red blood cell

0:48:10.520 --> 0:48:15.760
<v Speaker 2>precursors interesting, and so it can cause this transient usually

0:48:16.320 --> 0:48:19.520
<v Speaker 2>anemia where you basically can't make any more red blood cells,

0:48:20.600 --> 0:48:24.280
<v Speaker 2>which can be really dangerous. But again, it doesn't happen

0:48:24.280 --> 0:48:27.200
<v Speaker 2>in everyone. It's not killing people outright, it's not causing

0:48:27.239 --> 0:48:29.640
<v Speaker 2>this massive amount of hemorrhage, et cetera, et cetera.

0:48:29.800 --> 0:48:32.200
<v Speaker 1>Right, And it does like it does make me think,

0:48:32.520 --> 0:48:34.799
<v Speaker 1>based on that description and the amount of hemorrhage that

0:48:34.880 --> 0:48:38.560
<v Speaker 1>was happening, that the paleness may have been doue to

0:48:38.680 --> 0:48:41.760
<v Speaker 1>that more than a plastic anemia. But I like that.

0:48:41.760 --> 0:48:45.279
<v Speaker 2>That's interesting, Yeah, And it sounds to me like there's

0:48:45.360 --> 0:48:48.160
<v Speaker 2>multiple things going on in the description. So I want

0:48:48.200 --> 0:48:51.080
<v Speaker 2>to get into like my thoughts on it, and then

0:48:51.200 --> 0:48:56.400
<v Speaker 2>talk about the more likely candidates. Okay, what were some

0:48:56.480 --> 0:48:58.640
<v Speaker 2>of the others that you told me? That seem easy

0:48:58.719 --> 0:49:00.319
<v Speaker 2>to say. I don't think it's that.

0:49:01.840 --> 0:49:04.719
<v Speaker 1>Bartonella. Do we already talk about that one.

0:49:04.760 --> 0:49:07.520
<v Speaker 2>We haven't talked about bartonella yet. Let me scroll through

0:49:07.560 --> 0:49:08.360
<v Speaker 2>my nine.

0:49:08.120 --> 0:49:11.799
<v Speaker 1>Page tablesporosis and protessis and diphtheria.

0:49:12.239 --> 0:49:14.280
<v Speaker 2>Oh my gosh, Aaron, you did not tell me diphtheria

0:49:14.320 --> 0:49:15.080
<v Speaker 2>and protessis.

0:49:15.120 --> 0:49:17.480
<v Speaker 1>Okay, well, we can rule those out, like there were

0:49:17.480 --> 0:49:19.400
<v Speaker 1>no respiratory symptoms described.

0:49:19.520 --> 0:49:22.360
<v Speaker 2>There were no respiratory symptoms described. So because of that,

0:49:22.640 --> 0:49:25.920
<v Speaker 2>I actually think that mneumonic plague is not likely to

0:49:25.960 --> 0:49:29.879
<v Speaker 2>be a cause of this. And it's interesting because some

0:49:29.960 --> 0:49:33.080
<v Speaker 2>of what was described in that fifteen seventy six outbreak

0:49:33.440 --> 0:49:35.680
<v Speaker 2>sounded a little bit like bubonic plague.

0:49:36.200 --> 0:49:38.440
<v Speaker 1>Oh, with the lymph nodes, with the lymph.

0:49:38.160 --> 0:49:42.680
<v Speaker 2>Nodes and these ulcerated nodes behind the ears, like you have,

0:49:43.440 --> 0:49:46.160
<v Speaker 2>you know, a pretty decent chain of lymph nodes back there.

0:49:46.960 --> 0:49:50.960
<v Speaker 2>And pneumonic plague, which is a form of plague caused

0:49:50.960 --> 0:49:56.520
<v Speaker 2>by your Cinia pestis. See season one for more details.

0:49:57.080 --> 0:50:01.319
<v Speaker 2>Bubonic plague would cause these very inflat aimed lymph nodes,

0:50:01.400 --> 0:50:06.080
<v Speaker 2>these boobos, though generally throughout the body and not necessarily

0:50:06.120 --> 0:50:11.279
<v Speaker 2>only in one place. And it was pneumonic plague that

0:50:11.480 --> 0:50:15.560
<v Speaker 2>was the most deadly. And with pneumonic plague, generally the

0:50:15.719 --> 0:50:21.600
<v Speaker 2>symptoms very much were pneumonia, like you had symptoms predominantly

0:50:21.800 --> 0:50:25.719
<v Speaker 2>in the lungs, and people tended to die from respiratory

0:50:25.960 --> 0:50:31.400
<v Speaker 2>failure and not from hemorrhage like it sounds like happened here. Yeah,

0:50:31.719 --> 0:50:34.640
<v Speaker 2>I will say that mneumonic plague is something that killed

0:50:34.680 --> 0:50:38.440
<v Speaker 2>people very rapidly when it happened, often in as little

0:50:38.440 --> 0:50:43.160
<v Speaker 2>as twenty four hours. And the untreated fatality rate for

0:50:43.239 --> 0:50:47.920
<v Speaker 2>pneumonic plague is nearly one hundred percent. Yeah, So is

0:50:47.960 --> 0:50:51.680
<v Speaker 2>it possible that there was plague going on that was

0:50:51.760 --> 0:50:57.200
<v Speaker 2>causing bubonic, mneumonic, even septoscemic plague. I mean, it certainly

0:50:57.239 --> 0:50:59.759
<v Speaker 2>seems possible that that was circulating me.

0:51:00.239 --> 0:51:03.640
<v Speaker 1>And this is what I find interesting though, because it

0:51:03.680 --> 0:51:07.120
<v Speaker 1>wasn't like plague was a known entity that was going to.

0:51:07.040 --> 0:51:10.640
<v Speaker 2>Be My question is how much And I would have

0:51:10.719 --> 0:51:14.200
<v Speaker 2>to go back and listen and re remember how much

0:51:14.320 --> 0:51:18.520
<v Speaker 2>plague was kind of already well described and well known

0:51:18.719 --> 0:51:23.040
<v Speaker 2>during the kind of Spanish conquista or takeover.

0:51:23.960 --> 0:51:27.759
<v Speaker 1>Well, okay, it's a good question, and this is me

0:51:28.520 --> 0:51:34.520
<v Speaker 1>grasping at wisps of memories from season one. The Black

0:51:34.600 --> 0:51:37.520
<v Speaker 1>Death happened in the middle of the fourteenth century, and

0:51:37.719 --> 0:51:40.840
<v Speaker 1>it didn't just go away like it remained in pockets.

0:51:40.880 --> 0:51:43.400
<v Speaker 1>It would rear up every now and then. You know,

0:51:43.480 --> 0:51:48.239
<v Speaker 1>there were epidemics of plague that happened on a regular basis,

0:51:48.920 --> 0:51:53.200
<v Speaker 1>And so I think given its sort of like formative

0:51:53.239 --> 0:51:58.040
<v Speaker 1>impact on medicine, Yeah, I would think that it would

0:51:58.080 --> 0:52:01.880
<v Speaker 1>have been described or recognized as plague, like it was

0:52:03.000 --> 0:52:06.160
<v Speaker 1>well known, it was familiar, and the other thing too.

0:52:06.760 --> 0:52:09.960
<v Speaker 1>And maybe this is a little unfair, but like most

0:52:10.040 --> 0:52:13.480
<v Speaker 1>papers seem to also kind of discard it or like

0:52:13.520 --> 0:52:16.200
<v Speaker 1>you mention it as this was one of the ones

0:52:16.239 --> 0:52:20.200
<v Speaker 1>considered or has been suggested, right, So like maybe we

0:52:20.239 --> 0:52:22.239
<v Speaker 1>should be giving it a more fair shake, but I

0:52:22.239 --> 0:52:23.279
<v Speaker 1>think that we have.

0:52:23.960 --> 0:52:25.680
<v Speaker 2>Yeah, I don't think it fits.

0:52:25.920 --> 0:52:26.800
<v Speaker 1>I don't think it fits.

0:52:27.040 --> 0:52:32.359
<v Speaker 2>Yeah, I don't think it fits. Bartonellosis is an interesting one.

0:52:33.760 --> 0:52:38.160
<v Speaker 2>So Bartnellosis, we did this aarin in a very non

0:52:38.160 --> 0:52:41.240
<v Speaker 2>traditional episode way because we covered all of the different

0:52:41.320 --> 0:52:42.440
<v Speaker 2>kinds of Banella.

0:52:43.080 --> 0:52:45.560
<v Speaker 1>I remember that because we were like, what have we done?

0:52:46.000 --> 0:52:50.880
<v Speaker 2>Yes, yeah, I still feel that way. But what's interesting

0:52:51.160 --> 0:52:57.000
<v Speaker 2>is that because there are so many different bacteria, so

0:52:57.080 --> 0:53:01.840
<v Speaker 2>many different species of Bartonella, that a pretty wide variety

0:53:02.160 --> 0:53:09.680
<v Speaker 2>of disease, including so Bartonella bacilliformis is what causes Carrion's disease.

0:53:10.560 --> 0:53:14.960
<v Speaker 2>Carrion's disease today is limited to the Andean Valleys of

0:53:15.120 --> 0:53:21.319
<v Speaker 2>South America, but there are many other species of Bartanella

0:53:21.400 --> 0:53:25.840
<v Speaker 2>that cause things like trench foot basilari angeomatosis. Of course

0:53:25.920 --> 0:53:31.080
<v Speaker 2>Bartanella hensley, which causes cat scratch disease. And the symptoms

0:53:32.000 --> 0:53:38.640
<v Speaker 2>don't quite fit, especially this hemorrhage. I really just keep

0:53:38.640 --> 0:53:41.319
<v Speaker 2>coming back to the hemorrhage part of it.

0:53:41.680 --> 0:53:42.760
<v Speaker 1>Yeah, it's hard to ignore.

0:53:43.239 --> 0:53:48.640
<v Speaker 2>It's really hard to ignore. But the high fevers, the headaches,

0:53:49.440 --> 0:53:52.280
<v Speaker 2>the jaundice that was mentioned in both of those descriptions,

0:53:52.680 --> 0:53:55.479
<v Speaker 2>and the pallor, which could, in addition to being from

0:53:55.520 --> 0:54:00.480
<v Speaker 2>just blood loss, be from a hemolytic anemia, which can

0:54:00.560 --> 0:54:07.280
<v Speaker 2>definitely be seen with bartonellosis, especially with bartonellosis from Bartnella bacilliformis,

0:54:07.360 --> 0:54:10.720
<v Speaker 2>which causes the most severe Bartnella that we see today.

0:54:12.320 --> 0:54:16.920
<v Speaker 2>So could it be that there was a different species

0:54:17.000 --> 0:54:22.040
<v Speaker 2>of Bartnella perhaps or the same species but causing infection

0:54:22.280 --> 0:54:24.680
<v Speaker 2>in a slightly different way during that time.

0:54:25.080 --> 0:54:25.560
<v Speaker 4>I don't know.

0:54:26.080 --> 0:54:28.839
<v Speaker 2>Maybe the things that make me feel like it's less

0:54:28.880 --> 0:54:31.279
<v Speaker 2>likely to be Bartnella is really that this was a

0:54:31.320 --> 0:54:36.600
<v Speaker 2>more protracted illness. So while the mortality rate can be

0:54:36.800 --> 0:54:41.440
<v Speaker 2>very high, according to some studies, at least Carrion's disease

0:54:41.480 --> 0:54:44.759
<v Speaker 2>has an estimated mortality rate of anywhere from forty to

0:54:44.800 --> 0:54:49.799
<v Speaker 2>eighty percent, although some studies suggest that the infection rate

0:54:50.160 --> 0:54:52.880
<v Speaker 2>in a lot of these outbreaks was actually much higher,

0:54:53.480 --> 0:54:58.880
<v Speaker 2>which means that the mortality rate comparatively was lower. Okay,

0:55:00.040 --> 0:55:03.160
<v Speaker 2>But it also is just a more protracted illness. This

0:55:03.280 --> 0:55:05.600
<v Speaker 2>was something taking place over the course of one to

0:55:05.760 --> 0:55:08.319
<v Speaker 2>four weeks, and people were dying at the end of

0:55:08.360 --> 0:55:12.560
<v Speaker 2>this very protracted illness, which is not what was described okay,

0:55:12.600 --> 0:55:13.839
<v Speaker 2>and cocoletes.

0:55:14.880 --> 0:55:21.360
<v Speaker 1>One interesting thing about Bartnella is that it's a bacterium,

0:55:21.640 --> 0:55:27.799
<v Speaker 1>and I don't know, like I'm just not up to

0:55:27.920 --> 0:55:34.080
<v Speaker 1>speed on how DNA analysis is done on like ancient specimens,

0:55:34.120 --> 0:55:35.520
<v Speaker 1>So I don't know if they would have been able

0:55:35.560 --> 0:55:37.960
<v Speaker 1>to look for Bartnella or if it would have come up.

0:55:38.320 --> 0:55:42.240
<v Speaker 1>But definitely, I know that they mentioned in the paper

0:55:42.360 --> 0:55:46.799
<v Speaker 1>that the techniques that they used could detect bacteria, many

0:55:46.840 --> 0:55:51.480
<v Speaker 1>bacterial species as well as DNA viruses, but not RNA viruses,

0:55:51.600 --> 0:55:55.319
<v Speaker 1>and so I do wonder if it was there they

0:55:55.320 --> 0:55:57.600
<v Speaker 1>would have been able to find it and that. But

0:55:57.760 --> 0:56:00.279
<v Speaker 1>you know, that doesn't mean at all that it's not

0:56:00.360 --> 0:56:03.680
<v Speaker 1>Bartonella just because they didn't find it. Like again, these

0:56:03.680 --> 0:56:08.320
<v Speaker 1>are very few samples in one specific region. That doesn't

0:56:08.800 --> 0:56:13.560
<v Speaker 1>mean that that is what happened all over Mexico. But anyway,

0:56:14.000 --> 0:56:17.560
<v Speaker 1>just thought that's interesting. But yeah, I think based on

0:56:17.600 --> 0:56:20.399
<v Speaker 1>the duration, like I don't know, it.

0:56:20.320 --> 0:56:22.680
<v Speaker 2>Just seems less It just seems less likely. I think

0:56:22.719 --> 0:56:25.640
<v Speaker 2>that one is one that's maybe not like, not quite

0:56:25.680 --> 0:56:27.920
<v Speaker 2>as easy of a just dismiss.

0:56:27.440 --> 0:56:30.840
<v Speaker 1>It, Yeah, because that interesting.

0:56:31.480 --> 0:56:36.239
<v Speaker 2>Yeah. Another one that I think based on symptoms is

0:56:36.280 --> 0:56:38.680
<v Speaker 2>worth talking in a little bit more detail about, but

0:56:38.760 --> 0:56:42.799
<v Speaker 2>I still think is very less likely more based on

0:56:43.040 --> 0:56:50.279
<v Speaker 2>kind of epidemiological data is leptosporosis. Okay, so leptosporosis is

0:56:51.239 --> 0:56:55.080
<v Speaker 2>caused by the spirokey Leptospira many different species. This is

0:56:55.120 --> 0:56:59.319
<v Speaker 2>a water borne illness. In general, it's comes to us

0:56:59.320 --> 0:57:04.360
<v Speaker 2>from the urine of other animals, and symptom wise, it

0:57:04.440 --> 0:57:09.000
<v Speaker 2>seems like some things really do seem to fit. Fever

0:57:09.400 --> 0:57:12.279
<v Speaker 2>is one of the first symptoms. There's generally a lot

0:57:12.320 --> 0:57:17.560
<v Speaker 2>of GI symptoms like nausea and vomiting and diarrhea. Rashes

0:57:17.720 --> 0:57:21.160
<v Speaker 2>tend to occur only pretty late in the course of disease,

0:57:21.240 --> 0:57:25.240
<v Speaker 2>so they're definitely not like an everyone feature, and they're

0:57:25.240 --> 0:57:31.560
<v Speaker 2>not like a predominant feature, I guess. But what does

0:57:31.640 --> 0:57:35.840
<v Speaker 2>tend to be, especially in severe disease, is signs of

0:57:36.000 --> 0:57:40.520
<v Speaker 2>organ dysfunction like jauntice because of damage to the liver,

0:57:42.200 --> 0:57:45.600
<v Speaker 2>like kidney dysfunction, which tends to be what ends up

0:57:45.680 --> 0:57:52.200
<v Speaker 2>killing people, okay, like hemolytic anemia. Okay, right, So a

0:57:52.240 --> 0:57:54.919
<v Speaker 2>lot of things are kind of ticking boxes. We do

0:57:55.120 --> 0:57:59.960
<v Speaker 2>also see in leptosperosis when it's severe disease, signs of bleach,

0:58:00.680 --> 0:58:03.920
<v Speaker 2>signs of hemorrhage, and this is usually because of a

0:58:04.080 --> 0:58:09.919
<v Speaker 2>decrease in platelets. But in general, it's mild bleeding. It's

0:58:10.080 --> 0:58:16.400
<v Speaker 2>petikia like little pinpoint purple spots. You can, however, see

0:58:16.480 --> 0:58:21.480
<v Speaker 2>more severe bleeding like massive gastrointestinal or pulmonary hemorrhage, and

0:58:21.600 --> 0:58:24.800
<v Speaker 2>pulmonary hemorrhage tends to be what kills people in the

0:58:24.840 --> 0:58:30.360
<v Speaker 2>case of leptosporosis. But this is not something that happens

0:58:30.400 --> 0:58:32.440
<v Speaker 2>for everyone who gets leptosporosis.

0:58:33.520 --> 0:58:33.920
<v Speaker 1>Yeah.

0:58:34.200 --> 0:58:38.520
<v Speaker 2>The time course of leptosporosis is generally pretty long, and

0:58:38.600 --> 0:58:42.760
<v Speaker 2>it's usually not until a kind of biphasic second round

0:58:42.960 --> 0:58:47.160
<v Speaker 2>of disease that people get very very sick, okay, where

0:58:47.160 --> 0:58:49.680
<v Speaker 2>they actually end up dying from the disease.

0:58:49.720 --> 0:58:53.520
<v Speaker 1>Whereas this was like clearly seemed to be happening over

0:58:53.560 --> 0:58:56.120
<v Speaker 1>the course of a couple of day, four days.

0:58:56.240 --> 0:58:56.560
<v Speaker 4>Yeah.

0:58:56.720 --> 0:58:57.200
<v Speaker 1>Yeah.

0:58:57.240 --> 0:58:59.960
<v Speaker 2>And the other thing that I think makes leptos sporosis

0:59:00.080 --> 0:59:02.840
<v Speaker 2>so much less likely is that you specifically mentioned that

0:59:03.000 --> 0:59:07.479
<v Speaker 2>no animals seem to have died, right. Leptosporosis is something

0:59:07.520 --> 0:59:11.000
<v Speaker 2>that infects lots and lots of different animals, and humans

0:59:11.040 --> 0:59:16.080
<v Speaker 2>are dead end hosts. And so I mean, on the

0:59:16.120 --> 0:59:19.000
<v Speaker 2>one hand, could it be that this, like I just

0:59:19.000 --> 0:59:21.480
<v Speaker 2>wouldn't expect for it to be something that could spread

0:59:21.680 --> 0:59:25.960
<v Speaker 2>across an entire region so easily and so rapidly without

0:59:26.000 --> 0:59:28.120
<v Speaker 2>having some kind of animal involvement.

0:59:28.720 --> 0:59:32.400
<v Speaker 1>Uh huh, Yeah, I feel like it would have to

0:59:32.480 --> 0:59:36.920
<v Speaker 1>have been transmitted human to human, and since sleptosporosis humans

0:59:36.920 --> 0:59:38.400
<v Speaker 1>are a dead end host, you would have to have

0:59:38.440 --> 0:59:44.000
<v Speaker 1>a like continuous reintroduction of the pathogen into the water supply. Yeah,

0:59:44.360 --> 0:59:49.240
<v Speaker 1>that's harder to imagine happening, YEP. I agree.

0:59:49.400 --> 0:59:50.000
<v Speaker 2>I agree.

0:59:50.320 --> 0:59:52.160
<v Speaker 1>All right, So now are we left.

0:59:51.920 --> 0:59:57.160
<v Speaker 2>With We're left with, oh, epidemic typhus. Yeah, that's our

0:59:57.240 --> 1:00:02.080
<v Speaker 2>last one besides the other three. So epidemic typhus you

1:00:02.120 --> 1:00:05.640
<v Speaker 2>mentioned a number of times, and I think part of

1:00:05.680 --> 1:00:08.600
<v Speaker 2>the reason that makes me think it's not epidemic typhus

1:00:08.680 --> 1:00:11.960
<v Speaker 2>is just that epidemic typhus was known, it seems.

1:00:12.920 --> 1:00:14.600
<v Speaker 1>Yeah.

1:00:14.760 --> 1:00:19.840
<v Speaker 2>But in addition to that, symptom wise epidemic typhus, which

1:00:19.880 --> 1:00:24.120
<v Speaker 2>is caused by Ricketzia prawaz echii, so a ricketzial intracellular

1:00:24.240 --> 1:00:29.760
<v Speaker 2>bacterium spread by lice. So not quite person to person,

1:00:29.920 --> 1:00:33.480
<v Speaker 2>but person to person in that you're transmitting lice person

1:00:33.560 --> 1:00:34.000
<v Speaker 2>to person.

1:00:34.240 --> 1:00:38.480
<v Speaker 1>I mean, and like we in historical epidemic typhus outbreaks,

1:00:38.520 --> 1:00:44.520
<v Speaker 1>we see massive spread of course of mortality and mortality

1:00:45.040 --> 1:00:46.760
<v Speaker 1>associated with malnutrition.

1:00:47.200 --> 1:00:49.680
<v Speaker 2>Yeah, we talked about, YEP, I remember talking about that

1:00:49.720 --> 1:00:52.960
<v Speaker 2>in a lot of detail. Yeah, pre antibiotic mortality rates

1:00:53.000 --> 1:00:56.200
<v Speaker 2>were as high as sixty percent in epidemic typhus, which

1:00:56.400 --> 1:01:01.480
<v Speaker 2>fits with this. A sudden onset of fever and headache

1:01:01.520 --> 1:01:05.400
<v Speaker 2>and abdominal pain are the kind of key symptoms, along

1:01:05.560 --> 1:01:09.360
<v Speaker 2>with central nervous system dysfunction, which could include seizures like

1:01:09.440 --> 1:01:12.440
<v Speaker 2>you mentioned, and could include delirium and a lot of

1:01:12.480 --> 1:01:19.040
<v Speaker 2>other things. But that's kind of where the overlap seems

1:01:19.080 --> 1:01:23.360
<v Speaker 2>to end. There's really not a lot of description of

1:01:23.440 --> 1:01:27.360
<v Speaker 2>hemorrhage at all when it comes to epidemic typhus. There's

1:01:27.600 --> 1:01:32.720
<v Speaker 2>not the hemolytic anemia, there's not the jaundice. There does

1:01:33.080 --> 1:01:35.760
<v Speaker 2>often tend to be a rash, and rash is something

1:01:35.800 --> 1:01:39.920
<v Speaker 2>that is often described as associated with epidemic typhus, and

1:01:39.960 --> 1:01:44.920
<v Speaker 2>we talked in that Typhus episode about the difficulties with

1:01:45.040 --> 1:01:49.720
<v Speaker 2>those historic descriptions of rash because rash appears very differently

1:01:49.800 --> 1:01:52.800
<v Speaker 2>on different colored skin, and so it's thought that maybe

1:01:52.920 --> 1:01:57.320
<v Speaker 2>rash was actually less common or maybe more common, et cetera.

1:01:59.040 --> 1:02:02.200
<v Speaker 2>But in any case, rash is definitely something that is

1:02:02.480 --> 1:02:07.040
<v Speaker 2>described as associated with typhus, and the disease here tends

1:02:07.080 --> 1:02:09.840
<v Speaker 2>to last for two to three weeks, So again we're

1:02:09.840 --> 1:02:11.920
<v Speaker 2>talking about something that tends to have a much longer

1:02:11.960 --> 1:02:14.920
<v Speaker 2>course of illness. Yeah, so I think less likely to

1:02:14.920 --> 1:02:18.480
<v Speaker 2>be epidemic typhus. Okay, so we're almost done with this

1:02:18.600 --> 1:02:21.880
<v Speaker 2>long list, and we've come to the few that I

1:02:21.960 --> 1:02:25.840
<v Speaker 2>think are either the best contenders or that we, like

1:02:25.880 --> 1:02:27.920
<v Speaker 2>you said, maybe have a little bit of evidence to

1:02:28.000 --> 1:02:31.920
<v Speaker 2>suggest maybe. Okay, so let's go through these last couple

1:02:32.040 --> 1:02:36.560
<v Speaker 2>and then we'll regroup, shall we. H. So one of

1:02:36.600 --> 1:02:42.280
<v Speaker 2>the last is hauntavirus hantavirus. There are many different hauntaviruses.

1:02:42.840 --> 1:02:46.880
<v Speaker 2>Hantaviruses are RNA viruses, so, like you mentioned, we would

1:02:46.960 --> 1:02:50.680
<v Speaker 2>never know, at least not as of this point. Yeah,

1:02:50.720 --> 1:02:55.800
<v Speaker 2>and they're generally spread by aerosolized rodent excrement, so like

1:02:56.160 --> 1:02:59.480
<v Speaker 2>rodent p has to get in your face in order

1:02:59.480 --> 1:03:05.040
<v Speaker 2>to get a hanted virus symptom. Wise, because there are

1:03:05.080 --> 1:03:07.920
<v Speaker 2>many different types of hantaviruses that have been found in

1:03:07.960 --> 1:03:11.760
<v Speaker 2>different parts of the globe, some of the symptoms do

1:03:11.960 --> 1:03:17.760
<v Speaker 2>seem to fit fairly well. And certainly snombree virus has

1:03:17.840 --> 1:03:21.120
<v Speaker 2>a mortality rate of like forty to fifty percent or

1:03:21.160 --> 1:03:24.000
<v Speaker 2>even higher than that in some outbreaks that we've seen.

1:03:25.280 --> 1:03:31.479
<v Speaker 2>The symptoms tend to be fevers, headaches, dizziness, body ache,

1:03:31.560 --> 1:03:34.000
<v Speaker 2>so it can present kind of like more like the

1:03:34.040 --> 1:03:37.439
<v Speaker 2>flu than what it sounds like. The descriptions of this

1:03:37.520 --> 1:03:42.280
<v Speaker 2>particular outbreak of coco eatsy work, but it can also

1:03:42.400 --> 1:03:49.760
<v Speaker 2>have nausea, vomiting, abdominal pain, diarrhea, And when hantaviruses cause

1:03:49.920 --> 1:03:53.120
<v Speaker 2>severe disease, there's a couple different forms or a couple

1:03:53.120 --> 1:03:56.360
<v Speaker 2>different manifestations that they can take. One, which is what

1:03:56.480 --> 1:03:59.920
<v Speaker 2>tends to be caused by synombree virus, is a cardiopole

1:04:00.040 --> 1:04:05.000
<v Speaker 2>lemonary disease which causes death within twenty four to twenty

1:04:05.040 --> 1:04:09.280
<v Speaker 2>eight hours, like within a day usually, and the symptoms

1:04:09.320 --> 1:04:13.080
<v Speaker 2>are caused by vascular permeability, by your blood vessels just

1:04:13.320 --> 1:04:17.240
<v Speaker 2>leaking everywhere and fluid and blood just leaking out of

1:04:17.280 --> 1:04:21.479
<v Speaker 2>these leaky blood vessels. So while we don't necessarily tend

1:04:21.520 --> 1:04:27.320
<v Speaker 2>to see like pure hemorrhage, we certainly see leaky blood

1:04:27.400 --> 1:04:34.120
<v Speaker 2>vessels in hantavirus infections in syndome brain infection, specifically in

1:04:34.640 --> 1:04:39.960
<v Speaker 2>other hantaviruses like Hatan virus and Pumla virus, we do

1:04:40.040 --> 1:04:44.560
<v Speaker 2>see more hemorrhage potentially, and we tend to see a

1:04:44.640 --> 1:04:49.880
<v Speaker 2>cardio renal syndrome more than a cardiopulmonary syndrome because I

1:04:49.920 --> 1:04:53.760
<v Speaker 2>know cocoliti, we didn't really see pulmonary. We didn't really

1:04:53.760 --> 1:04:59.120
<v Speaker 2>see lung involvement described, but we did see potentially kidney

1:04:59.200 --> 1:05:03.000
<v Speaker 2>involvement described, and so we do see that in a

1:05:03.040 --> 1:05:06.840
<v Speaker 2>cardiorenal form of a hantavirus. But what we tend to

1:05:06.840 --> 1:05:08.960
<v Speaker 2>see is just that your kidneys stop working and you

1:05:09.000 --> 1:05:11.520
<v Speaker 2>stop making pee and then you die because of kidney failure.

1:05:13.440 --> 1:05:15.480
<v Speaker 2>So I don't know, it doesn't it doesn't.

1:05:15.200 --> 1:05:17.680
<v Speaker 1>Fit that well, okay, but it's something.

1:05:18.000 --> 1:05:22.400
<v Speaker 2>It's something also though this is something that is spread

1:05:22.760 --> 1:05:24.680
<v Speaker 2>by rodents.

1:05:25.080 --> 1:05:28.360
<v Speaker 1>Right so far, for the most part, with like one

1:05:28.400 --> 1:05:33.080
<v Speaker 1>possible exception or two, we do not see human to

1:05:33.160 --> 1:05:38.400
<v Speaker 1>human transmission of hauntaviruses correct, which doesn't mean that it

1:05:38.440 --> 1:05:40.560
<v Speaker 1>can't happen or didn't happen in the past.

1:05:41.080 --> 1:05:41.720
<v Speaker 2>Yeah, but.

1:05:43.160 --> 1:05:50.000
<v Speaker 1>Based on the ones that circulate that we recognize today, no.

1:05:49.320 --> 1:05:55.640
<v Speaker 2>No, So that brings us to Salmonella paratype or rather

1:05:55.800 --> 1:05:59.600
<v Speaker 2>Salmonella enterica subspecies and Enterica there of are paratyphee.

1:06:00.080 --> 1:06:03.280
<v Speaker 1>See, there are multiple paratypees, there.

1:06:03.160 --> 1:06:07.560
<v Speaker 2>Really are, and it's shockingly difficult to get information on

1:06:08.040 --> 1:06:13.040
<v Speaker 2>symptoms of salmonella and Enterica subspecies and Enterica seraphar paratype

1:06:13.200 --> 1:06:18.680
<v Speaker 2>see because all of the papers describe say, you can't

1:06:18.680 --> 1:06:24.240
<v Speaker 2>tell the difference between Salmonella typhi and Salmonella paratyphe when

1:06:24.280 --> 1:06:27.000
<v Speaker 2>it comes to the symptoms of disease, at least insofar

1:06:27.080 --> 1:06:32.600
<v Speaker 2>as we know today. Okay, so we did typhoid relatively recently,

1:06:32.760 --> 1:06:36.320
<v Speaker 2>and the classic description of symptoms of typhoid start with

1:06:36.760 --> 1:06:41.200
<v Speaker 2>a fever. But there's a few things about typhoid that

1:06:41.280 --> 1:06:45.360
<v Speaker 2>really stick out to me as not fitting with your

1:06:45.400 --> 1:06:50.680
<v Speaker 2>description of Coco Latsle. Some of them include the fact

1:06:50.720 --> 1:06:53.960
<v Speaker 2>that this fever you mentioned in those descriptions that the

1:06:53.960 --> 1:06:58.960
<v Speaker 2>fever was constant, but the fever of typhoid is usually

1:06:59.000 --> 1:07:03.920
<v Speaker 2>described as not which just constant, but getting progressively worse, Okay,

1:07:03.960 --> 1:07:07.600
<v Speaker 2>day after day and rising over the course of a

1:07:07.680 --> 1:07:13.960
<v Speaker 2>couple of weeks. Right, So already we don't quite fit. Also,

1:07:15.200 --> 1:07:18.960
<v Speaker 2>classic typhoid, and we talked about this in our typhoid

1:07:18.960 --> 1:07:23.959
<v Speaker 2>episode has a relative bredacardia, which means that your heart

1:07:24.040 --> 1:07:28.640
<v Speaker 2>rate does not increase with that fever, and the description

1:07:28.760 --> 1:07:32.360
<v Speaker 2>from the fifteen seventy six outbreak very nicely specifically said

1:07:32.440 --> 1:07:36.960
<v Speaker 2>that you see really high heart rates, and in typhoid

1:07:37.000 --> 1:07:43.560
<v Speaker 2>it's less likely for that to happen. Additionally, rash is

1:07:43.600 --> 1:07:48.800
<v Speaker 2>a really common description of typhoid infection, and this rash,

1:07:48.920 --> 1:07:52.760
<v Speaker 2>it tends to be salmon colored little spots starting on

1:07:52.800 --> 1:07:56.120
<v Speaker 2>the trunk and then kind of spreading outwards from there.

1:07:57.400 --> 1:08:00.840
<v Speaker 2>And then it's usually not until the third of this

1:08:00.960 --> 1:08:04.680
<v Speaker 2>illness that you start to see GI symptoms like abdominal

1:08:04.680 --> 1:08:08.520
<v Speaker 2>pain or diarrhea, and that is when we can see

1:08:08.920 --> 1:08:12.680
<v Speaker 2>some bleeding from the intestinal tract, we can see bloody diarrhea,

1:08:13.840 --> 1:08:18.360
<v Speaker 2>and potentially this infection spreading to the bloodstream where you

1:08:18.560 --> 1:08:22.519
<v Speaker 2>can get hepatosplenomegaly, which is again where your liver and

1:08:22.560 --> 1:08:24.920
<v Speaker 2>your spleen starts to swell, and that seems to have

1:08:24.920 --> 1:08:29.000
<v Speaker 2>been described in that fifteen seventy six outbreak, where you

1:08:29.080 --> 1:08:31.960
<v Speaker 2>have your liver and your spleen becoming abnormally large and

1:08:32.000 --> 1:08:34.840
<v Speaker 2>all of your organs just getting super messed up. But

1:08:34.960 --> 1:08:38.320
<v Speaker 2>other than that, we don't really see a lot of bleeding.

1:08:40.280 --> 1:08:43.800
<v Speaker 2>We don't really see a lot of neurologic manifestations, so

1:08:43.840 --> 1:08:45.920
<v Speaker 2>we don't really tend to see the delirium, we don't

1:08:45.960 --> 1:08:48.200
<v Speaker 2>really tend to see the seizures. That kind of thing

1:08:48.280 --> 1:08:55.000
<v Speaker 2>is much less likely in typhoid, but certainly mortality rate

1:08:56.479 --> 1:09:00.719
<v Speaker 2>ranged from ten to thirty percent, so the most part

1:09:00.760 --> 1:09:05.400
<v Speaker 2>if untreated with typhoid. But it is spread fecal oral,

1:09:05.479 --> 1:09:09.160
<v Speaker 2>so easily spread person to person. And there's of course

1:09:09.280 --> 1:09:13.200
<v Speaker 2>the carrier state i e. Typhoid mary yep, meaning that

1:09:13.240 --> 1:09:15.360
<v Speaker 2>it would be really easy for this to be something

1:09:15.360 --> 1:09:19.439
<v Speaker 2>that could spread across a country because people could be

1:09:19.479 --> 1:09:23.240
<v Speaker 2>carrying it an asymptomatic for a really long time. But

1:09:23.400 --> 1:09:27.639
<v Speaker 2>in general, I feel like it's interesting and we'll talk

1:09:27.720 --> 1:09:30.360
<v Speaker 2>I know a little bit more about this that this

1:09:30.640 --> 1:09:35.000
<v Speaker 2>happens to be the pathogen that has been found in

1:09:35.160 --> 1:09:41.040
<v Speaker 2>people who likely died during this outbreak, because it seems

1:09:41.080 --> 1:09:46.000
<v Speaker 2>to me like the least good fit in terms of symptoms.

1:09:46.560 --> 1:09:51.439
<v Speaker 1>So okay, I definitely think and the authors also acknowledged

1:09:51.479 --> 1:09:54.720
<v Speaker 1>the possibility that this is just a circulating pathogen that

1:09:54.880 --> 1:10:00.559
<v Speaker 1>was there that people had. I did a bit of

1:10:00.920 --> 1:10:04.040
<v Speaker 1>digging I can't wait, a little bit of Google scholaring,

1:10:04.160 --> 1:10:08.960
<v Speaker 1>and one thing that I think is interesting and that

1:10:09.000 --> 1:10:12.679
<v Speaker 1>this sort of reminded me of, is that a paper

1:10:13.160 --> 1:10:18.719
<v Speaker 1>from even like the nineteen eighties or up to the

1:10:18.760 --> 1:10:26.320
<v Speaker 1>two thousands that describes typhoid fever is going to, I think,

1:10:27.200 --> 1:10:31.960
<v Speaker 1>look at a case of typhoid fever in a very

1:10:32.000 --> 1:10:36.080
<v Speaker 1>different setting than historically. And this also applies to typhus,

1:10:36.120 --> 1:10:42.559
<v Speaker 1>to hauntaviruses, etc. Another thing that I also wonder about

1:10:43.080 --> 1:10:47.519
<v Speaker 1>is like virulence plasmids how and I don't remember this

1:10:47.960 --> 1:10:53.400
<v Speaker 1>from our typhoid episode, Like whether there are different subspecies

1:10:53.479 --> 1:10:57.400
<v Speaker 1>or seravars that contain different virulence plasmids and some are

1:10:57.760 --> 1:11:01.040
<v Speaker 1>much more deadly or can cause different weets of symptoms

1:11:01.120 --> 1:11:07.040
<v Speaker 1>or whatever. But yeah, okay, let's talk to me about

1:11:07.120 --> 1:11:13.000
<v Speaker 1>hemorrhagic fever viruses and then we'll sort of do like

1:11:13.439 --> 1:11:15.040
<v Speaker 1>a compare and contrast.

1:11:15.160 --> 1:11:18.800
<v Speaker 2>Okay, okay, okay. So the last kind of group of

1:11:18.960 --> 1:11:22.920
<v Speaker 2>possible infections would be a viral hemorrhagic fever of like

1:11:23.400 --> 1:11:27.840
<v Speaker 2>unknown type. I guess just one of these other ones.

1:11:27.960 --> 1:11:31.080
<v Speaker 2>And what's interesting about this is that like hantavirus is

1:11:31.320 --> 1:11:34.639
<v Speaker 2>considered a viral hemorrhagic fever, like it's under this class

1:11:35.080 --> 1:11:38.120
<v Speaker 2>of viral hemorrhagic fevers. There's a great paper that I'll

1:11:38.160 --> 1:11:40.679
<v Speaker 2>link to that kind of groups all of these into

1:11:40.760 --> 1:11:44.719
<v Speaker 2>a few different categories. So we have feloviruses, which include

1:11:44.760 --> 1:11:49.519
<v Speaker 2>of course Marberg and ebolaviruses we've talked about both of those.

1:11:50.560 --> 1:11:54.240
<v Speaker 2>We have flavaviruses, which we've talked about many of these.

1:11:54.320 --> 1:11:58.040
<v Speaker 2>This includes the dengay viruses and yellow fever virus, as

1:11:58.080 --> 1:12:02.360
<v Speaker 2>well as a few other born and mosquito born viruses.

1:12:03.120 --> 1:12:06.519
<v Speaker 2>The bunia viruses which include rift valley fever that we

1:12:06.560 --> 1:12:10.800
<v Speaker 2>have not yet covered, Crimean congo hemorrhagic fever virus, and

1:12:10.960 --> 1:12:15.400
<v Speaker 2>of course the hantaviruses, which includes Nombavirushton virus, et cetera,

1:12:15.439 --> 1:12:19.320
<v Speaker 2>et cetera, as well as a virus called it a

1:12:19.360 --> 1:12:24.760
<v Speaker 2>really great name, severe fever with thrombocytopenia syndrome virus that

1:12:25.080 --> 1:12:27.719
<v Speaker 2>is a tickborn virus found in China.

1:12:28.040 --> 1:12:30.000
<v Speaker 1>That's not all one word, is it. No?

1:12:30.000 --> 1:12:32.720
<v Speaker 2>No, no, it's literally just like the name of the

1:12:32.760 --> 1:12:33.919
<v Speaker 2>syndrome virus.

1:12:34.120 --> 1:12:35.679
<v Speaker 1>Okay, okay okay.

1:12:36.680 --> 1:12:40.759
<v Speaker 2>And then there are arenaviruses, and we have not covered

1:12:40.800 --> 1:12:43.440
<v Speaker 2>any arenaviruses on this podcast.

1:12:43.600 --> 1:12:44.760
<v Speaker 1>Are you serious though?

1:12:45.439 --> 1:12:50.400
<v Speaker 2>I know, but these include matupovirus, which is the causative

1:12:50.439 --> 1:12:55.839
<v Speaker 2>agent of Bolivian hemorrhagic fever, right guanarito virus which causes

1:12:56.040 --> 1:13:02.479
<v Speaker 2>venezuela and hemorrhagic fever, Sabia virus, loss of virus, Luho virus,

1:13:02.720 --> 1:13:06.760
<v Speaker 2>chop a virus, a lot of different viruses that have

1:13:06.800 --> 1:13:12.360
<v Speaker 2>been found across the globe in different specific regions that

1:13:12.400 --> 1:13:18.320
<v Speaker 2>have caused haemorrhagic fevers of various types. Most of these,

1:13:18.560 --> 1:13:23.240
<v Speaker 2>especially when it comes to arena viruses, we really don't

1:13:23.720 --> 1:13:28.200
<v Speaker 2>have a good handle on huh okay. We don't have

1:13:28.240 --> 1:13:30.600
<v Speaker 2>a good handle on their reservoirs. We don't have a

1:13:30.640 --> 1:13:36.960
<v Speaker 2>good handle on infection, like how things are spread. So

1:13:37.960 --> 1:13:43.240
<v Speaker 2>just like in my pocket, I'm banking on an arena virus.

1:13:43.400 --> 1:13:49.720
<v Speaker 1>Okay for cocoa, yes, okay, okay, Yeah, but that's just me,

1:13:50.320 --> 1:13:52.200
<v Speaker 1>and I still have a lot of questions for you, Aarin.

1:13:52.320 --> 1:13:55.759
<v Speaker 2>So how about we pause here, we take a break,

1:13:56.560 --> 1:13:59.160
<v Speaker 2>and then we get into some more of the details

1:13:59.280 --> 1:14:02.760
<v Speaker 2>about the epitymiology of these outbreaks so that we can

1:14:02.800 --> 1:14:32.000
<v Speaker 2>try and parse this apart, shall we, Yes, let's do it.

1:14:32.439 --> 1:14:34.240
<v Speaker 2>Can I just start by asking you a question.

1:14:34.280 --> 1:14:36.000
<v Speaker 1>I was going to start by asking you a question.

1:14:36.200 --> 1:14:39.240
<v Speaker 2>Oh okay, okay, okay, I who asked first?

1:14:39.840 --> 1:14:40.760
<v Speaker 1>You could ask.

1:14:42.240 --> 1:14:44.360
<v Speaker 2>Okay. I feel like I should have asked this earlier,

1:14:44.400 --> 1:14:48.120
<v Speaker 2>but like when you were going through the symptoms and

1:14:48.200 --> 1:14:51.240
<v Speaker 2>this outbreak. So I know that the outbreaks themselves lasted

1:14:51.240 --> 1:14:52.960
<v Speaker 2>for a number of years, like a year and a half,

1:14:53.040 --> 1:14:57.240
<v Speaker 2>couple of years, four years, and people when they got

1:14:57.240 --> 1:15:01.840
<v Speaker 2>infected were dying incredibly rapidly. People were dying in a

1:15:01.960 --> 1:15:07.320
<v Speaker 2>number of days. But how quickly did this spread, say

1:15:07.360 --> 1:15:10.840
<v Speaker 2>through a family or through a town. What was the

1:15:11.320 --> 1:15:13.280
<v Speaker 2>estimated incubation period?

1:15:13.360 --> 1:15:19.080
<v Speaker 1>Here? Great question? I don't know. Ugh, maybe there are

1:15:19.120 --> 1:15:22.080
<v Speaker 1>more accounts out there, but none of the papers that

1:15:22.120 --> 1:15:26.160
<v Speaker 1>I read mentioned in incubation period or like a possible

1:15:26.280 --> 1:15:27.719
<v Speaker 1>estimated incubation period.

1:15:28.680 --> 1:15:31.759
<v Speaker 2>Wow, that was a whole entire column of my table,

1:15:31.800 --> 1:15:33.400
<v Speaker 2>and I really thought it was going to help parsing

1:15:33.400 --> 1:15:34.080
<v Speaker 2>support Aaron.

1:15:34.600 --> 1:15:39.240
<v Speaker 1>I know, I know. So it's difficult too, because I think,

1:15:39.640 --> 1:15:43.360
<v Speaker 1>you know, the movement of it seemed really erratic. It

1:15:43.400 --> 1:15:47.639
<v Speaker 1>didn't seem to move in like an outward spreading radius.

1:15:47.720 --> 1:15:49.519
<v Speaker 1>It would be like all of a sudden it was there.

1:15:49.720 --> 1:15:54.960
<v Speaker 1>But also let's consider the time and communication and limitations

1:15:55.000 --> 1:15:58.120
<v Speaker 1>in terms of like did that town get hit before

1:15:58.160 --> 1:16:01.680
<v Speaker 1>this town? If there was there's two days difference or

1:16:01.720 --> 1:16:04.640
<v Speaker 1>even a week difference, would that have been something detected

1:16:04.880 --> 1:16:10.120
<v Speaker 1>or like even able to be observed. I guess right, Yeah,

1:16:10.479 --> 1:16:15.519
<v Speaker 1>I know, I wish I had that answer. Okay, but

1:16:15.840 --> 1:16:18.840
<v Speaker 1>let me ask you a question real quick. Okay, what

1:16:19.160 --> 1:16:22.720
<v Speaker 1>causes nose blade? What's happening in a nose bleed?

1:16:23.240 --> 1:16:26.000
<v Speaker 2>There's potentially a lot of different things that can cause

1:16:26.000 --> 1:16:28.960
<v Speaker 2>a nose bleed, but there's two different places in your

1:16:29.040 --> 1:16:34.599
<v Speaker 2>nose that you tend to bleed from. Because your nose,

1:16:34.960 --> 1:16:39.559
<v Speaker 2>your nasal mucosa, essentially the skin is very thin and

1:16:39.800 --> 1:16:43.960
<v Speaker 2>there's a lot of vasculature there. So most nose bleeds

1:16:44.080 --> 1:16:47.280
<v Speaker 2>come from the anterior vessels, the vessels that are like

1:16:47.320 --> 1:16:52.120
<v Speaker 2>closer to where your nose opening is. Okay, yeah, and

1:16:52.160 --> 1:16:56.920
<v Speaker 2>you have this like plexus of vessels that if that

1:16:57.120 --> 1:17:01.320
<v Speaker 2>mucosa gets dried out or if there's any trauma to it,

1:17:01.360 --> 1:17:05.440
<v Speaker 2>can just very easily start to bleed from that plexus

1:17:05.479 --> 1:17:11.439
<v Speaker 2>of vessels. This can also happen if you have say thrombocytopenia,

1:17:11.760 --> 1:17:13.960
<v Speaker 2>that is, you don't have any platelets to be able

1:17:14.000 --> 1:17:17.720
<v Speaker 2>to clot any bleeding that happens there. So there's a

1:17:17.760 --> 1:17:21.639
<v Speaker 2>lot of different things that can potentially cause that anterior bleeding.

1:17:22.360 --> 1:17:27.479
<v Speaker 2>There's also posterior nose bleeds that happen farther back in

1:17:27.520 --> 1:17:32.080
<v Speaker 2>your nose, and those tend to be more commonly from

1:17:32.160 --> 1:17:36.320
<v Speaker 2>that type of bleeding disorder or like disease in the

1:17:36.320 --> 1:17:41.040
<v Speaker 2>blood vessels, say, from like atherosclerosis or something like that. Okay,

1:17:41.240 --> 1:17:45.600
<v Speaker 2>And those posterior nose bleeds can be massive and like

1:17:45.680 --> 1:17:46.880
<v Speaker 2>really difficult to stop.

1:17:47.320 --> 1:17:50.120
<v Speaker 1>Interesting, And so a lot of these nose bleeds and

1:17:50.160 --> 1:17:51.880
<v Speaker 1>I feel like I'm a little bit hung up on

1:17:51.920 --> 1:17:54.760
<v Speaker 1>the nosebleed thing, and maybe I shouldn't be, but like

1:17:55.240 --> 1:17:59.080
<v Speaker 1>they do seem to be massive hemorrhaging out the nose.

1:17:59.280 --> 1:18:02.200
<v Speaker 1>So could that be a combination of like some type

1:18:02.200 --> 1:18:07.920
<v Speaker 1>of clotting issue combined with like what disease could do

1:18:08.080 --> 1:18:11.480
<v Speaker 1>that or would do that? How? What's about the genesis?

1:18:11.840 --> 1:18:14.080
<v Speaker 2>I feel like we have talked about a number of

1:18:14.120 --> 1:18:17.479
<v Speaker 2>diseases that can cause nose bleeds. Generally, when we see

1:18:17.520 --> 1:18:21.799
<v Speaker 2>nose bleeds, it's not isolated nose bleeds. If it's caused

1:18:22.000 --> 1:18:26.320
<v Speaker 2>from say a hemorrhagic virus of some kind or something

1:18:26.360 --> 1:18:29.479
<v Speaker 2>that's causing thrombocidepenia. But that would be one of the

1:18:29.479 --> 1:18:31.720
<v Speaker 2>major things that I would think about. Thrombaside opinia is

1:18:31.720 --> 1:18:34.200
<v Speaker 2>when we don't have enough platelets, And we've talked in

1:18:34.240 --> 1:18:37.040
<v Speaker 2>a number of our episodes now about how essential our

1:18:37.040 --> 1:18:42.160
<v Speaker 2>platelets are to be able to stop bleeding when it starts.

1:18:42.800 --> 1:18:45.559
<v Speaker 2>So because your nose just happens to be a place

1:18:45.680 --> 1:18:49.560
<v Speaker 2>much like your gingiva, like in our vitamin C episode

1:18:50.000 --> 1:18:52.719
<v Speaker 2>way back when we talked about how you get bleeding

1:18:52.800 --> 1:18:56.599
<v Speaker 2>from the gums because you just don't have like any

1:18:56.680 --> 1:19:00.160
<v Speaker 2>collagen left. And so it's not even about in that

1:19:00.200 --> 1:19:02.960
<v Speaker 2>case not being able to stop bleeding. It's just that

1:19:02.960 --> 1:19:06.400
<v Speaker 2>that's a place that's really easy to bleed from. Okay,

1:19:06.720 --> 1:19:10.280
<v Speaker 2>your nose is very similar. Same thing with your eyes,

1:19:10.439 --> 1:19:15.000
<v Speaker 2>and you described maybe seeing bloodshot eyes. So the mucosa

1:19:15.000 --> 1:19:17.240
<v Speaker 2>of your eyes is just another place where things are

1:19:17.360 --> 1:19:21.360
<v Speaker 2>very thin and there's a lot of really small blood vessels.

1:19:21.840 --> 1:19:26.400
<v Speaker 2>So if you have a tendency towards bleeding because you say,

1:19:26.680 --> 1:19:32.520
<v Speaker 2>don't have any platelets to stop bleeding, then little tiny

1:19:32.840 --> 1:19:36.799
<v Speaker 2>blood vessels breaking can lead to large amounts of bleeding.

1:19:37.479 --> 1:19:41.839
<v Speaker 1>Okay, interesting, that makes sense.

1:19:42.360 --> 1:19:44.280
<v Speaker 2>It's the same thing in your GI tract.

1:19:45.080 --> 1:19:51.240
<v Speaker 1>Yeah, So it's not necessarily an indicator of any particular disease.

1:19:51.680 --> 1:19:54.320
<v Speaker 1>It's just like this is maybe already when things have

1:19:55.520 --> 1:19:56.920
<v Speaker 1>gone well wrong.

1:19:58.000 --> 1:20:03.280
<v Speaker 2>Yeah, I would say it's an indicator that your coagulation

1:20:03.520 --> 1:20:05.519
<v Speaker 2>state is totally screwed up.

1:20:05.920 --> 1:20:08.360
<v Speaker 1>Okay, yeah, Okay.

1:20:08.479 --> 1:20:11.200
<v Speaker 2>We saw it in you can see it in DIC,

1:20:12.080 --> 1:20:16.360
<v Speaker 2>which we talked about so DIC is disseminated intravascular coagulation.

1:20:16.439 --> 1:20:18.800
<v Speaker 2>We talked about it in our Sepsist episode. We talked

1:20:18.800 --> 1:20:22.720
<v Speaker 2>about it in our Snake Bite episode. We've talked about

1:20:22.720 --> 1:20:25.240
<v Speaker 2>it in a few other episodes. But basically, just anything

1:20:25.320 --> 1:20:29.040
<v Speaker 2>that's going to like completely screw up your body's ability

1:20:29.120 --> 1:20:34.120
<v Speaker 2>to clot properly, you could potentially see nosebleeds. Now that

1:20:34.200 --> 1:20:38.240
<v Speaker 2>being said, there are a lot of diseases that are

1:20:38.280 --> 1:20:44.679
<v Speaker 2>considered like hemorrhagic diseases of some kind we don't usually

1:20:44.720 --> 1:20:48.479
<v Speaker 2>see described like actual and we've talked about this in

1:20:48.520 --> 1:20:52.240
<v Speaker 2>a few episodes, Like it doesn't usually mean that you're

1:20:52.400 --> 1:20:56.679
<v Speaker 2>just bleeding out of places like hemorrhagic doesn't often mean

1:20:58.000 --> 1:21:00.840
<v Speaker 2>the way that you think of hemorrhage with where like

1:21:00.960 --> 1:21:03.440
<v Speaker 2>blood is just gushing out of orifices.

1:21:03.520 --> 1:21:06.640
<v Speaker 1>All right, this is not Richard Preston's the hot zone.

1:21:06.439 --> 1:21:09.599
<v Speaker 2>Exactly, but it sounds like it is in the case

1:21:09.640 --> 1:21:10.960
<v Speaker 2>of cocolitesly I mean.

1:21:12.439 --> 1:21:16.800
<v Speaker 1>Yeah. And it's interesting too because this does appear in

1:21:16.920 --> 1:21:21.720
<v Speaker 1>both Spanish accounts as well as indigenous Nawa accounts of

1:21:22.479 --> 1:21:26.800
<v Speaker 1>the disease. Yeah, all right, so let's before we get

1:21:26.800 --> 1:21:30.200
<v Speaker 1>into more questions, let's just do a quick recap. So

1:21:30.240 --> 1:21:33.720
<v Speaker 1>I have a list of the symptoms. This is in

1:21:34.000 --> 1:21:36.439
<v Speaker 1>not any specific order, but these are the ones that

1:21:36.479 --> 1:21:40.519
<v Speaker 1>were mentioned primarily in that account by that physician. So

1:21:40.760 --> 1:21:47.559
<v Speaker 1>excessive thirst, continuous and high fever, headache, confusion, delirium, rapid pulse,

1:21:48.240 --> 1:21:53.120
<v Speaker 1>nasal hemorrhage, bleeding from mouth, eyes, ears, genitals, tongue black

1:21:53.160 --> 1:21:57.080
<v Speaker 1>and dry, swollen lymph nodes in neck, jaundice, chest pain,

1:21:57.479 --> 1:22:02.880
<v Speaker 1>bloody stool, stomach pain, sometimes rash. Autopsy showed enlarged liver,

1:22:03.360 --> 1:22:07.360
<v Speaker 1>black heart, dry stomach, black lungs urine green or black,

1:22:07.520 --> 1:22:13.400
<v Speaker 1>then pale, and no notable respiratory symptoms. The disease seemed

1:22:13.400 --> 1:22:17.280
<v Speaker 1>to have a three to five day duration, incredibly high

1:22:17.360 --> 1:22:20.280
<v Speaker 1>case fatality rate with the overall mortality rate of like

1:22:20.320 --> 1:22:25.160
<v Speaker 1>fifty to eighty percent, again not necessarily attributable to one

1:22:25.240 --> 1:22:32.920
<v Speaker 1>pathogen alone, and there was actually that. One Franciscan scholar, Sahagoon,

1:22:33.080 --> 1:22:35.920
<v Speaker 1>wrote that quote many died of hunger and because no

1:22:35.920 --> 1:22:38.759
<v Speaker 1>one was able to care for them. In many cases,

1:22:38.840 --> 1:22:41.599
<v Speaker 1>every member of a household fell ill without a single

1:22:41.640 --> 1:22:44.400
<v Speaker 1>person left to give them even a cup of water

1:22:44.479 --> 1:22:48.960
<v Speaker 1>to the sick end quote. So it has also been

1:22:49.000 --> 1:22:55.240
<v Speaker 1>described as disproportionately attacking young adults and adolescents, and it

1:22:55.560 --> 1:23:01.320
<v Speaker 1>also has been said to have disproportionately affected the indigenous population.

1:23:02.720 --> 1:23:07.559
<v Speaker 1>Not all accounts describe this, and I do kind of

1:23:07.840 --> 1:23:10.720
<v Speaker 1>want to get into this in a little more detail

1:23:11.080 --> 1:23:14.799
<v Speaker 1>because I think it can help maybe resolve the question

1:23:15.400 --> 1:23:21.600
<v Speaker 1>of Old World versus New World pathogen. If this disproportionate

1:23:22.160 --> 1:23:29.280
<v Speaker 1>impact on indigenous populations was a true phenomenon, where was

1:23:29.320 --> 1:23:35.120
<v Speaker 1>that coming from? Was it socioeconomic factors? So one person

1:23:35.240 --> 1:23:39.519
<v Speaker 1>described that people who were quote rich, well dressed, and

1:23:39.520 --> 1:23:42.240
<v Speaker 1>with a comfortable living were not affected by the disease

1:23:42.720 --> 1:23:46.320
<v Speaker 1>end quote. So was it just socioeconomic factors? And so

1:23:46.360 --> 1:23:49.599
<v Speaker 1>it was a New World disease that everyone was in

1:23:49.720 --> 1:23:55.320
<v Speaker 1>theory immunologically susceptible to But it was just that the

1:23:55.360 --> 1:23:58.599
<v Speaker 1>indigenous population, who had been suffering the greatest losses due

1:23:58.600 --> 1:24:04.120
<v Speaker 1>to forced labor and minds, ridiculous taxation, et cetera. Spanish

1:24:04.200 --> 1:24:09.560
<v Speaker 1>witnesses did recognize this disproportion impact and the living conditions

1:24:09.600 --> 1:24:13.360
<v Speaker 1>and how it affected the rate of disease. Quote. The

1:24:13.439 --> 1:24:16.600
<v Speaker 1>reason why so many Indians die of pestilence is a

1:24:16.640 --> 1:24:19.360
<v Speaker 1>god secret. I do not find any better answer than

1:24:19.360 --> 1:24:22.280
<v Speaker 1>that in the past, the Indians were not as badly

1:24:22.400 --> 1:24:26.080
<v Speaker 1>mistreated and oppressed as they are today. With heavy workloads.

1:24:26.520 --> 1:24:29.680
<v Speaker 1>They are skinny and delicate. The disease finds them overworked

1:24:29.680 --> 1:24:34.360
<v Speaker 1>and without resistance, so they are finished. End quote. Okay,

1:24:34.439 --> 1:24:38.439
<v Speaker 1>so if we do New World, then for the most part,

1:24:38.479 --> 1:24:43.640
<v Speaker 1>socioeconomic factors and living conditions would explain the difference in

1:24:44.120 --> 1:24:49.120
<v Speaker 1>susceptibility or attack rate or mortality rate. If it's an

1:24:49.120 --> 1:24:52.400
<v Speaker 1>old world pathogen, it's probably a combination of those things.

1:24:52.439 --> 1:24:56.240
<v Speaker 1>Socioeconomic factors are still there, they're not going away. But

1:24:56.320 --> 1:24:58.800
<v Speaker 1>it also might be something about if it's an old

1:24:58.840 --> 1:25:03.840
<v Speaker 1>world pathogen quote unquote more familiar to the immune systems

1:25:03.840 --> 1:25:07.760
<v Speaker 1>of the Spanish colonizers, and there is a little bit

1:25:07.760 --> 1:25:14.519
<v Speaker 1>of evidence in this respect, because if socioeconomic status meant

1:25:14.560 --> 1:25:18.679
<v Speaker 1>that you were not only protected from getting super sick

1:25:18.720 --> 1:25:21.480
<v Speaker 1>if you did get infected, but that it also prevented

1:25:21.520 --> 1:25:25.559
<v Speaker 1>you from getting infected, then we would still see high

1:25:25.600 --> 1:25:29.200
<v Speaker 1>death rates among those who were exposed to disease, if

1:25:29.200 --> 1:25:31.800
<v Speaker 1>that makes sense. And so you have a bunch of

1:25:31.800 --> 1:25:35.479
<v Speaker 1>these Spanish members of these religious orders who did a

1:25:35.479 --> 1:25:37.760
<v Speaker 1>lot of the caring for the ill and a lot

1:25:37.760 --> 1:25:41.040
<v Speaker 1>of the burying of the bodies, these priests and so on,

1:25:41.680 --> 1:25:46.320
<v Speaker 1>and they are not described as having high death rates,

1:25:47.520 --> 1:25:52.440
<v Speaker 1>nor are the Spanish physicians that performed so many autopsies

1:25:52.479 --> 1:25:59.439
<v Speaker 1>without the slightest bit of ppe. So one author also

1:25:59.479 --> 1:26:03.479
<v Speaker 1>suggested that maybe the reason for the disparity in these

1:26:03.520 --> 1:26:06.480
<v Speaker 1>mortality or attack rates is that the root of transmission

1:26:06.560 --> 1:26:10.680
<v Speaker 1>was somehow unique to the indigenous populations. We don't know

1:26:10.720 --> 1:26:13.280
<v Speaker 1>what the root of transmission was, but given that the

1:26:13.320 --> 1:26:17.920
<v Speaker 1>Spanish colonizers and indigenous populations lived pretty similar day to

1:26:18.000 --> 1:26:21.719
<v Speaker 1>day lives at that point, or at least not terribly

1:26:21.840 --> 1:26:27.599
<v Speaker 1>drastically different in terms of like completely separate lives, it

1:26:27.680 --> 1:26:31.040
<v Speaker 1>doesn't necessarily seem like it was that I don't know,

1:26:32.040 --> 1:26:36.519
<v Speaker 1>because if the disease was transmitted through direct contact lice, fleas,

1:26:36.760 --> 1:26:40.439
<v Speaker 1>blood or other bodily fluids, respiratory droplets, mosquitoes, or water,

1:26:40.680 --> 1:26:42.600
<v Speaker 1>there's really no way that the Spanish would have just

1:26:42.720 --> 1:26:50.400
<v Speaker 1>been completely spared if they had been as susceptible. So okay,

1:26:50.680 --> 1:26:53.200
<v Speaker 1>that was my sort of new world, ole world thing.

1:26:54.640 --> 1:26:57.880
<v Speaker 1>Root of transmission we don't know. We can compare the

1:26:57.920 --> 1:27:03.040
<v Speaker 1>spread of cocolites to the other epidemics that were happening

1:27:03.080 --> 1:27:05.439
<v Speaker 1>in the sixteenth century, and it seems very similar to

1:27:05.520 --> 1:27:08.800
<v Speaker 1>those that were spread person to person, like smallpox, chicken pox,

1:27:08.840 --> 1:27:12.320
<v Speaker 1>and measles. We can go over some of the other

1:27:12.520 --> 1:27:16.679
<v Speaker 1>possible roots of transmission too, like waterborne or lousborne, or

1:27:17.120 --> 1:27:19.439
<v Speaker 1>like a rodent reservoir. We kind of already touched on

1:27:19.520 --> 1:27:24.360
<v Speaker 1>that geography. Again, we only have a few accounts to

1:27:24.400 --> 1:27:28.120
<v Speaker 1>rely on, but it seems like everywhere was impacted, with

1:27:28.200 --> 1:27:31.920
<v Speaker 1>the possible exception of some of the coastal areas. There

1:27:31.920 --> 1:27:34.720
<v Speaker 1>are many different reasons why that could be. Maybe a

1:27:34.760 --> 1:27:38.599
<v Speaker 1>less ferrulent variant of the disease made it there, people

1:27:38.640 --> 1:27:41.519
<v Speaker 1>were more immune, or the vector or reservoir wasn't as

1:27:41.560 --> 1:27:45.640
<v Speaker 1>prevalent or just something else interrupted transmission, could be a

1:27:45.640 --> 1:27:46.720
<v Speaker 1>whole lot of things going on.

1:27:47.280 --> 1:27:54.439
<v Speaker 2>Yeah, but was that trend like persistent across the years.

1:27:54.760 --> 1:28:00.000
<v Speaker 1>I guess, I don't know. I don't know. Yeah.

1:28:00.160 --> 1:28:01.240
<v Speaker 4>Yeah.

1:28:01.280 --> 1:28:06.759
<v Speaker 1>And then there's the environmental factors, which this mega drought

1:28:06.800 --> 1:28:11.360
<v Speaker 1>and then period of intense rainfall, and so some researchers

1:28:11.400 --> 1:28:16.720
<v Speaker 1>have suggested that as evidence for rodent associated it's like

1:28:16.760 --> 1:28:20.600
<v Speaker 1>this proliferation of rodents. But could it also be contaminated

1:28:20.640 --> 1:28:25.599
<v Speaker 1>water supply because we know that you know, drought, excessive rainfall,

1:28:25.720 --> 1:28:29.120
<v Speaker 1>and just in general, like disruption and chaos in everyday

1:28:29.160 --> 1:28:32.519
<v Speaker 1>life is water supply is one of the first things

1:28:32.560 --> 1:28:37.519
<v Speaker 1>to get all screwed up. And so I think it's

1:28:37.880 --> 1:28:43.639
<v Speaker 1>an interesting question about like the symptoms, Does whatever disease

1:28:43.840 --> 1:28:48.320
<v Speaker 1>that actually cause this have to include every one of

1:28:48.320 --> 1:28:53.200
<v Speaker 1>those symptoms? Which symptoms do we concentrate on first? Which

1:28:53.280 --> 1:28:56.599
<v Speaker 1>accounts are reliable? Like what if this physician never actually

1:28:56.640 --> 1:28:59.759
<v Speaker 1>performed an autopsy and he's just hearing word of mouth.

1:29:00.160 --> 1:29:03.400
<v Speaker 1>Then you have a physician who's looking at someone and saying,

1:29:03.720 --> 1:29:06.800
<v Speaker 1>these are the things you're experiencing, versus someone who's like,

1:29:06.920 --> 1:29:11.080
<v Speaker 1>this is what I'm experiencing, Like it's an interesting, I

1:29:11.120 --> 1:29:16.200
<v Speaker 1>don't know, interesting questions, but but yeah, let's sort of

1:29:16.400 --> 1:29:20.400
<v Speaker 1>get into a few of these things. So I feel

1:29:20.400 --> 1:29:24.240
<v Speaker 1>like the New World versus Old World discussion plays a

1:29:24.320 --> 1:29:27.880
<v Speaker 1>role in the hemorrhagic fever virus potential.

1:29:28.400 --> 1:29:32.000
<v Speaker 2>Yeah, because I think when I would think about a

1:29:32.080 --> 1:29:38.080
<v Speaker 2>hemorrhagic fever virus as the causative agent, it doesn't seem

1:29:38.280 --> 1:29:42.120
<v Speaker 2>likely that it would have been a hemorrhagic fever imported

1:29:42.160 --> 1:29:44.200
<v Speaker 2>from the Old World to the New World for a

1:29:44.200 --> 1:29:48.280
<v Speaker 2>few reasons. One because then I would expect I don't know,

1:29:48.560 --> 1:29:52.840
<v Speaker 2>something similar to have been reported somewhere else first, right,

1:29:53.280 --> 1:29:55.920
<v Speaker 2>But I think that that argument stands for like any

1:29:56.040 --> 1:29:59.360
<v Speaker 2>pathogen that was brought over, right, if it was something

1:29:59.360 --> 1:30:02.719
<v Speaker 2>that was brought over, how could it be something brand

1:30:02.760 --> 1:30:09.400
<v Speaker 2>new that hadn't been seen by the Spanish conquistadors beforehand. Yeah, right,

1:30:09.439 --> 1:30:11.360
<v Speaker 2>And that is the part that I think makes it

1:30:11.439 --> 1:30:15.439
<v Speaker 2>so hard to think could it have been anything that

1:30:15.560 --> 1:30:21.240
<v Speaker 2>was brought over, right, unless it was something that was

1:30:21.400 --> 1:30:23.839
<v Speaker 2>brought I don't.

1:30:23.640 --> 1:30:30.440
<v Speaker 1>Know, brought over and then mutated into a more virulent strain.

1:30:31.600 --> 1:30:35.639
<v Speaker 2>Or something perhaps not brought from Europe but brought from

1:30:35.800 --> 1:30:41.240
<v Speaker 2>Africa during slave trade that maybe we was happening, but

1:30:41.360 --> 1:30:44.439
<v Speaker 2>we don't have as great of records on it. Perhaps,

1:30:45.439 --> 1:30:50.479
<v Speaker 2>but that also still doesn't explain why Spanish colonizers seem

1:30:50.520 --> 1:30:51.880
<v Speaker 2>to have been less affected.

1:30:52.640 --> 1:30:56.120
<v Speaker 1>Yeah, per se, unless it's just again down.

1:30:55.880 --> 1:31:01.840
<v Speaker 2>To socioeconomics and exposure and things like that.

1:31:02.240 --> 1:31:06.520
<v Speaker 1>Yeah, right, But so many of these hemorrhagic fever viruses

1:31:06.520 --> 1:31:10.919
<v Speaker 1>that we do know are transmitted direct contact through bodily fluids,

1:31:11.000 --> 1:31:14.720
<v Speaker 1>right many, And that happens a lot, not all the time,

1:31:14.720 --> 1:31:19.200
<v Speaker 1>but a lot during caring for the sick and also

1:31:19.320 --> 1:31:22.599
<v Speaker 1>taking care of the bodies of people who have succumbed

1:31:22.600 --> 1:31:27.920
<v Speaker 1>to disease, And we don't see records of like the

1:31:27.960 --> 1:31:31.000
<v Speaker 1>Spanish priests dying at higher rates.

1:31:31.240 --> 1:31:33.960
<v Speaker 2>Right Well, And what's interesting is that that's the problem

1:31:34.000 --> 1:31:38.000
<v Speaker 2>I think with lumping all of the hemorrhagic fever viruses together. Yes,

1:31:38.840 --> 1:31:44.400
<v Speaker 2>the fela viruses like Marbourg and Ebola, Yes, are spread

1:31:44.439 --> 1:31:49.800
<v Speaker 2>direct person to person through contaminated bodily fluids. The flavaviruses

1:31:49.920 --> 1:31:54.720
<v Speaker 2>are often spread by mosquito vectors. So could this be

1:31:54.800 --> 1:31:58.720
<v Speaker 2>something that was a hemorrhagic flavavirus of some kind that

1:31:58.760 --> 1:32:01.040
<v Speaker 2>we don't know of? Because I don't think that it

1:32:01.080 --> 1:32:03.840
<v Speaker 2>was dang gay or yellow fever, but.

1:32:03.800 --> 1:32:07.439
<v Speaker 1>It doesn't seem mosquito born.

1:32:08.640 --> 1:32:10.840
<v Speaker 2>I mean, I feel like I don't have a good

1:32:10.920 --> 1:32:14.599
<v Speaker 2>enough handle on the spread of this thing.

1:32:15.360 --> 1:32:18.880
<v Speaker 1>Yeah, I mean rapid, rapid is rapiden.

1:32:19.000 --> 1:32:21.720
<v Speaker 2>Right, rapid and sudden, which I would say probably goes

1:32:21.760 --> 1:32:26.240
<v Speaker 2>against the mosquito born because in general, you're going to

1:32:26.280 --> 1:32:29.439
<v Speaker 2>need time for it to be in the mosquito and

1:32:29.479 --> 1:32:31.759
<v Speaker 2>then causing more infection, et cetera.

1:32:32.360 --> 1:32:34.600
<v Speaker 1>Well, and then like where did it come from.

1:32:34.640 --> 1:32:37.519
<v Speaker 2>And why would it Why I would expect to be

1:32:37.600 --> 1:32:41.360
<v Speaker 2>more infection at the coasts because if you have like

1:32:41.479 --> 1:32:44.680
<v Speaker 2>a new mosquito coming in, or even honestly even a

1:32:44.720 --> 1:32:47.439
<v Speaker 2>new infection coming in, you're gonna it's gonna come into

1:32:47.439 --> 1:32:50.880
<v Speaker 2>the ports. So any kind of imported infection, how did

1:32:50.920 --> 1:32:53.679
<v Speaker 2>it not come through the ports and cause more disease

1:32:53.760 --> 1:32:55.120
<v Speaker 2>in the coasts than in inland.

1:32:55.520 --> 1:32:59.240
<v Speaker 1>Yeah, yeah, I don't. I don't know.

1:33:00.360 --> 1:33:03.479
<v Speaker 2>But there's a lot of other hemorrhagic fever viruses as well,

1:33:03.560 --> 1:33:07.679
<v Speaker 2>the arena viruses and the bunia viruses, a contavirus. Many

1:33:07.800 --> 1:33:11.120
<v Speaker 2>of those, well, the arenaviruses can be transmitted a lot

1:33:11.160 --> 1:33:14.800
<v Speaker 2>of different ways, including person to person, but some of

1:33:14.800 --> 1:33:18.560
<v Speaker 2>them maybe not so much. A lot of them are

1:33:18.920 --> 1:33:23.559
<v Speaker 2>from rodent vectors. So could it be that it was

1:33:24.720 --> 1:33:28.519
<v Speaker 2>a rodent vector disease that's somehow mutated to be able

1:33:28.520 --> 1:33:34.680
<v Speaker 2>to be transmitted person to person. Sure, Sure, I mean,

1:33:35.520 --> 1:33:37.679
<v Speaker 2>I mean maybe it seems possible.

1:33:38.080 --> 1:33:40.280
<v Speaker 1>Yeah, But I.

1:33:40.200 --> 1:33:44.680
<v Speaker 2>Think that what that comes back to is how to

1:33:45.080 --> 1:33:49.800
<v Speaker 2>prioritize when we're thinking about this hundreds of years ago

1:33:50.600 --> 1:33:58.040
<v Speaker 2>outbreak or outbreaks. Is which of these symptoms do we trust?

1:33:59.040 --> 1:34:03.200
<v Speaker 2>Which of these symptoms were definitely caused by the pathogen

1:34:03.439 --> 1:34:07.200
<v Speaker 2>that we think killed people in this case, versus which

1:34:07.240 --> 1:34:11.200
<v Speaker 2>of them were a secondary bacterial infection on top of

1:34:11.240 --> 1:34:15.040
<v Speaker 2>something else. Yep, although that seems less likely given the

1:34:15.080 --> 1:34:17.360
<v Speaker 2>time course of this illness. I just can't get over

1:34:17.400 --> 1:34:18.360
<v Speaker 2>how rapid this was.

1:34:19.520 --> 1:34:22.479
<v Speaker 1>Yeah, And to be honest, I don't know, And I

1:34:22.520 --> 1:34:26.360
<v Speaker 1>think it also probably would have been worth me looking

1:34:26.400 --> 1:34:30.640
<v Speaker 1>into what predominant understanding of disease there was, so like,

1:34:30.960 --> 1:34:35.160
<v Speaker 1>was it the humoral theory of disease? Are certain symptoms

1:34:35.280 --> 1:34:39.440
<v Speaker 1>emphasized over others given those sorts of biases?

1:34:39.560 --> 1:34:39.760
<v Speaker 4>Right?

1:34:39.880 --> 1:34:44.799
<v Speaker 1>Like if someone has a fever, is that a primary symptom?

1:34:44.960 --> 1:34:47.280
<v Speaker 1>Or is that like Okay, it's just a low grade fever.

1:34:48.000 --> 1:34:52.719
<v Speaker 1>Is the bleeding, I mean, that's just seems so stark

1:34:53.360 --> 1:34:57.240
<v Speaker 1>and so dramatic, But then there's stuff like rapid pulse

1:34:58.000 --> 1:35:02.120
<v Speaker 1>abdominal pain. A lot of these symptoms are very general

1:35:01.720 --> 1:35:06.640
<v Speaker 1>general can be severe manifestations of many different types of infections.

1:35:08.800 --> 1:35:13.280
<v Speaker 2>But there's also I think enough descriptions that tell us

1:35:13.680 --> 1:35:17.000
<v Speaker 2>that whatever this was, it was a pathogen that was

1:35:17.240 --> 1:35:23.160
<v Speaker 2>very rapidly affecting a wide variety of our organs, and

1:35:23.200 --> 1:35:27.919
<v Speaker 2>that was certainly causing a significant degree of what sounds

1:35:28.040 --> 1:35:32.160
<v Speaker 2>like hemolytic anemia, because in all of the descriptions there

1:35:32.240 --> 1:35:35.920
<v Speaker 2>was jaundice, in all of the descriptions, there was some

1:35:36.200 --> 1:35:39.920
<v Speaker 2>amount of bleeding, be it bloody diarrhea or bleeding from

1:35:39.960 --> 1:35:44.960
<v Speaker 2>the mucus membranes. And was it truly trauma level hemorrhagic

1:35:45.160 --> 1:35:48.519
<v Speaker 2>We don't know, but it's very likely that if you're

1:35:48.520 --> 1:35:52.200
<v Speaker 2>having this degree of hemolytic anemia, that you're also having

1:35:52.320 --> 1:35:57.080
<v Speaker 2>issues with your other blood cells, including your platelets, which

1:35:57.120 --> 1:35:58.960
<v Speaker 2>means that you're going to be at risk of bleeding,

1:35:59.040 --> 1:36:01.759
<v Speaker 2>even if it's just the like your nose is constantly

1:36:01.840 --> 1:36:04.559
<v Speaker 2>dripping and not truly a faucet coming out of it,

1:36:04.720 --> 1:36:06.640
<v Speaker 2>right yeah.

1:36:06.800 --> 1:36:11.439
<v Speaker 1>And I mean the illustrations show gushing, gushing, right yeah.

1:36:11.439 --> 1:36:15.400
<v Speaker 2>But is that gushing like in combination with vomiting or

1:36:16.040 --> 1:36:16.400
<v Speaker 2>or is.

1:36:16.360 --> 1:36:20.000
<v Speaker 1>That like this is the degree with which we suffered exactly? Yes,

1:36:20.320 --> 1:36:21.320
<v Speaker 1>good point.

1:36:22.439 --> 1:36:25.640
<v Speaker 2>And so I think that all of those symptoms, including

1:36:26.720 --> 1:36:28.800
<v Speaker 2>you know, the changes in the color of the urine,

1:36:28.960 --> 1:36:31.360
<v Speaker 2>to me, that says this is affecting the kidneys in

1:36:31.360 --> 1:36:35.920
<v Speaker 2>addition to affecting the liver and the spleen, the pulse

1:36:35.960 --> 1:36:39.040
<v Speaker 2>being high, and the fevers. That just means you're sick. Right,

1:36:40.000 --> 1:36:43.920
<v Speaker 2>that could be from anything, but all of these and

1:36:44.040 --> 1:36:49.000
<v Speaker 2>the rapidity of the infection just sounds so viral to me.

1:36:50.000 --> 1:36:53.599
<v Speaker 1>Okay, before we go further, can I just do a

1:36:53.640 --> 1:36:57.360
<v Speaker 1>little bit of a dive into the other end of things,

1:36:57.400 --> 1:37:01.760
<v Speaker 1>the bacterial side of things, okay, please, okay, because I

1:37:01.840 --> 1:37:05.760
<v Speaker 1>wanted to do a little bit of research about typhus

1:37:05.840 --> 1:37:10.200
<v Speaker 1>and typhoid. Okay, So, Epidemic typhus was one of the

1:37:10.240 --> 1:37:14.120
<v Speaker 1>earliest diseases to be proposed as the cause of Cocolitzli.

1:37:14.400 --> 1:37:18.280
<v Speaker 1>Hans Censer wrote about it in that book Rat'slice in History.

1:37:19.479 --> 1:37:24.920
<v Speaker 1>During the Cocolaitzlei epidemics. Typhus was a recognized disease, but

1:37:25.200 --> 1:37:28.000
<v Speaker 1>most people did not use the name for typhus to

1:37:28.040 --> 1:37:31.360
<v Speaker 1>describe what was happening. But there is a precedent for

1:37:31.439 --> 1:37:36.160
<v Speaker 1>typhus being described with more superlative or extreme names, like

1:37:36.240 --> 1:37:40.160
<v Speaker 1>those that emphasize the severity of infection, and there exists

1:37:40.160 --> 1:37:43.320
<v Speaker 1>at least one description from the late fifteenth early sixteenth

1:37:43.400 --> 1:37:48.479
<v Speaker 1>centuries of typhus causing a severe nosebleed. The Italian physician

1:37:48.600 --> 1:37:52.599
<v Speaker 1>Frakastorius wrote, quote, I have often seen cases where three

1:37:52.640 --> 1:37:55.679
<v Speaker 1>pounds of blood burst from the nostrils, yet the patient

1:37:55.760 --> 1:37:59.320
<v Speaker 1>died soon after end quote. And so I got a

1:37:59.320 --> 1:38:02.960
<v Speaker 1>little bit curious about typhus and nose bleeds, and so

1:38:03.040 --> 1:38:07.639
<v Speaker 1>I just put the words nose bleed and typhus into

1:38:07.760 --> 1:38:12.080
<v Speaker 1>Google scholar and what I actually got were primarily results

1:38:12.120 --> 1:38:17.280
<v Speaker 1>for typhoid. And that's something I remember from doing those episodes.

1:38:17.360 --> 1:38:22.280
<v Speaker 1>Typhus and typhoid weren't really distinguished as separate diseases until

1:38:22.280 --> 1:38:25.719
<v Speaker 1>like the early to mid eighteen hundreds or so, because

1:38:25.760 --> 1:38:29.920
<v Speaker 1>they do have similar courses of disease and would also

1:38:30.080 --> 1:38:33.600
<v Speaker 1>tend to proliferate during similar times of like chaos or

1:38:33.760 --> 1:38:38.200
<v Speaker 1>unrest or war, even though they're transmitted differently. Epidemic typhus

1:38:38.280 --> 1:38:43.040
<v Speaker 1>via lice, typhoid, fecal oral Also, I kept coming across

1:38:43.040 --> 1:38:47.640
<v Speaker 1>the phrase abdominal typhus that actually means typhoid, which was

1:38:48.080 --> 1:38:52.120
<v Speaker 1>very confusing for me. I was like, but what is it? So?

1:38:52.240 --> 1:38:56.519
<v Speaker 1>But I don't entirely know whether or not tabardillo, the

1:38:56.560 --> 1:39:01.120
<v Speaker 1>Spanish word for typhus, was also historically used for typhoid,

1:39:01.320 --> 1:39:07.320
<v Speaker 1>or whether it was distinguished from typhoid, I don't know.

1:39:07.439 --> 1:39:10.560
<v Speaker 1>But in any case, so going back to my Google scholaring,

1:39:11.120 --> 1:39:14.920
<v Speaker 1>what I found were a bunch of historical reports of

1:39:15.080 --> 1:39:21.559
<v Speaker 1>nosebleed in people with this abdominal typhus aka typhoid. A

1:39:21.640 --> 1:39:25.280
<v Speaker 1>report of a typhoid outbreak associated with oysters that was

1:39:25.320 --> 1:39:29.520
<v Speaker 1>published in nineteen thirty nine describes nosebleed as a cardinal

1:39:29.600 --> 1:39:34.080
<v Speaker 1>symptom of typhoid and says that in that particular outbreak,

1:39:34.120 --> 1:39:39.240
<v Speaker 1>it was the most common symptom observed and in young kids.

1:39:39.400 --> 1:39:43.519
<v Speaker 1>Delirium also seems to be a common symptom that we

1:39:43.600 --> 1:39:46.080
<v Speaker 1>found in a different paper, but in this oyster paper,

1:39:46.320 --> 1:39:51.880
<v Speaker 1>hemorrhage happened to be the most common complication. Another paper

1:39:51.920 --> 1:39:55.560
<v Speaker 1>from nineteen thirty four describes a case study of typhoid

1:39:55.600 --> 1:40:02.320
<v Speaker 1>fever with hemorrhagic onset. Quote. In August nineteenth, nineteen thirty three,

1:40:02.439 --> 1:40:07.160
<v Speaker 1>at about three am, the patient suffered a sudden, profuse nosebleed.

1:40:07.640 --> 1:40:12.520
<v Speaker 1>A physician was consulted, who packed her nose. The bleeding, however, continued,

1:40:12.840 --> 1:40:16.840
<v Speaker 1>and the patient was admitted to the hospital end quote.

1:40:17.000 --> 1:40:20.479
<v Speaker 1>And typhoid, as we talked about, can be transmitted by

1:40:20.520 --> 1:40:26.520
<v Speaker 1>asymptomatic carriers. I know that they're different diseases, but paratife

1:40:26.600 --> 1:40:30.240
<v Speaker 1>C DNA has been found in an eight hundred year

1:40:30.280 --> 1:40:34.080
<v Speaker 1>old skeleton of a woman in Trondheim, Norway, so that

1:40:34.160 --> 1:40:38.240
<v Speaker 1>suggests an old world origin of at least paradifec. So

1:40:38.439 --> 1:40:41.920
<v Speaker 1>I think that, you know, like I said, there's a

1:40:41.960 --> 1:40:46.040
<v Speaker 1>lot that historically may have been reported and may have

1:40:46.080 --> 1:40:51.320
<v Speaker 1>been attributed falsely to some of these diseases like typhoid,

1:40:52.080 --> 1:40:56.120
<v Speaker 1>and searching for typhus and nose bleeds or typhoid and

1:40:56.200 --> 1:41:00.040
<v Speaker 1>nose bleeds is certainly cherry picking Google scholar, But I

1:41:00.439 --> 1:41:04.479
<v Speaker 1>just find that interesting because I was curious whether there

1:41:04.520 --> 1:41:08.599
<v Speaker 1>had ever been something like that reported before. And then

1:41:08.720 --> 1:41:12.160
<v Speaker 1>also I came across when I was looking for nose bleeds,

1:41:12.520 --> 1:41:17.639
<v Speaker 1>I came across the fact that black tongue is often

1:41:17.800 --> 1:41:23.559
<v Speaker 1>another characteristic of typhus slash typhoid people. I've seen it

1:41:23.600 --> 1:41:24.000
<v Speaker 1>in both.

1:41:24.080 --> 1:41:24.920
<v Speaker 2>So what he other?

1:41:27.960 --> 1:41:30.479
<v Speaker 1>I mean? And maybe you could do this for literally

1:41:30.520 --> 1:41:33.480
<v Speaker 1>any of the diseases, right, countavirus, nosebleed.

1:41:33.840 --> 1:41:36.560
<v Speaker 2>Oh, I'm sure you would find it exactly. Oh, I

1:41:36.640 --> 1:41:37.840
<v Speaker 2>kind of can I try it?

1:41:38.000 --> 1:41:38.360
<v Speaker 1>Sure?

1:41:39.640 --> 1:41:40.599
<v Speaker 2>Yeah, it exists, Saren.

1:41:41.360 --> 1:41:44.840
<v Speaker 1>Yeah, So maybe all we learned from that whole dive

1:41:45.080 --> 1:41:48.160
<v Speaker 1>was that nosebleed is not as specific a symptom as

1:41:48.200 --> 1:41:53.040
<v Speaker 1>we thought, and that these diseases can take on many

1:41:53.080 --> 1:41:53.960
<v Speaker 1>different forms.

1:41:54.640 --> 1:41:59.719
<v Speaker 2>Definitely, I think that's definitely true. And again it's going

1:41:59.760 --> 1:42:04.520
<v Speaker 2>to you what symptoms you have and what symptoms predominate

1:42:04.680 --> 1:42:08.520
<v Speaker 2>are also going to vary depending on what the underlying

1:42:09.240 --> 1:42:14.000
<v Speaker 2>immune state of a person or a population is. Yeah,

1:42:14.360 --> 1:42:17.120
<v Speaker 2>but I still can't get over the rapidity aspect of it.

1:42:17.720 --> 1:42:20.280
<v Speaker 1>Well, I mean that could be influenced by immune state as.

1:42:20.160 --> 1:42:24.719
<v Speaker 2>Well, definitely, But it just seems like everything at least

1:42:24.720 --> 1:42:29.600
<v Speaker 2>that we know about typhoid and typhus today our longer

1:42:29.720 --> 1:42:30.320
<v Speaker 2>courses of.

1:42:30.360 --> 1:42:34.839
<v Speaker 1>Disease, Yeah, for sure. So is it something that changed.

1:42:35.240 --> 1:42:39.000
<v Speaker 1>Was it a virulence plasmid, was it a different serov

1:42:39.160 --> 1:42:43.240
<v Speaker 1>art or was it just acting, you know, sort of

1:42:43.280 --> 1:42:48.240
<v Speaker 1>swooping in opportunistically when the person's immune system was suppressed

1:42:48.400 --> 1:42:53.680
<v Speaker 1>from another pathogen, right, or just was there in the

1:42:53.720 --> 1:42:56.120
<v Speaker 1>background not doing anything right?

1:42:56.240 --> 1:42:59.120
<v Speaker 2>I mean, because what I think is interesting is in

1:42:59.160 --> 1:43:03.719
<v Speaker 2>the paper where they found the paratyphee in the dental pulp.

1:43:04.160 --> 1:43:04.519
<v Speaker 1>Uh huh.

1:43:04.560 --> 1:43:07.320
<v Speaker 2>I did read that paper. That's the only paper about

1:43:07.360 --> 1:43:12.400
<v Speaker 2>actual coca leads together read. But one of the things

1:43:12.400 --> 1:43:16.439
<v Speaker 2>that they said is that finding it in the dental

1:43:16.479 --> 1:43:21.960
<v Speaker 2>pulp does suggest that the person or the people died

1:43:22.400 --> 1:43:27.720
<v Speaker 2>with high levels of this bacterium in their bloodstreams.

1:43:27.040 --> 1:43:28.960
<v Speaker 1>Specifically, Uh huh.

1:43:28.960 --> 1:43:32.360
<v Speaker 2>Okay, because my first reaction was, well, we know that

1:43:32.479 --> 1:43:37.599
<v Speaker 2>Salmonella enterica subspecies enterica blah blah blah blah, paradifee and

1:43:37.880 --> 1:43:43.920
<v Speaker 2>typhe both can very easily establish asymptomatic infections and live

1:43:44.000 --> 1:43:48.400
<v Speaker 2>within us predominantly in our gallbladder for weeks, if not months,

1:43:48.439 --> 1:43:52.439
<v Speaker 2>if not years, and so finding it in a person

1:43:52.760 --> 1:43:56.680
<v Speaker 2>isn't that interesting right on its own? Because this is

1:43:56.720 --> 1:44:00.360
<v Speaker 2>something that circulates and can be present in people. But

1:44:00.560 --> 1:44:03.439
<v Speaker 2>knowing that it's not likely to end up in someone's

1:44:03.520 --> 1:44:08.880
<v Speaker 2>dental pulp upon death unless it was in their bloodstream

1:44:09.600 --> 1:44:11.240
<v Speaker 2>is very interesting.

1:44:11.000 --> 1:44:13.280
<v Speaker 1>In an epidemic graveyard.

1:44:13.960 --> 1:44:20.400
<v Speaker 2>In an epidemic graveyard, however, it's still I mean, I

1:44:20.640 --> 1:44:24.760
<v Speaker 2>just it. It's so interesting to me how much the

1:44:24.840 --> 1:44:29.720
<v Speaker 2>symptoms and the time course don't seem to fit. Not

1:44:29.880 --> 1:44:32.120
<v Speaker 2>to mention, and I think this is where I really

1:44:32.160 --> 1:44:34.280
<v Speaker 2>wish that we had a little bit more data, like

1:44:34.360 --> 1:44:39.599
<v Speaker 2>granular data on how rapidly this was spreading through homes

1:44:39.640 --> 1:44:42.800
<v Speaker 2>and through families, right, because when you get down as

1:44:42.840 --> 1:44:47.360
<v Speaker 2>well to the incubation period of something like a typhoid,

1:44:47.760 --> 1:44:50.120
<v Speaker 2>we're looking at a much longer incubation period than we

1:44:50.200 --> 1:44:53.400
<v Speaker 2>are for many of the viral hemorrhagic fevers, and again

1:44:53.479 --> 1:44:57.719
<v Speaker 2>viral hemorohagic fevers. This is really really broad. But thinking

1:44:57.840 --> 1:45:00.920
<v Speaker 2>of more of the bunya viruses or the viruses which

1:45:00.920 --> 1:45:04.680
<v Speaker 2>seem more likely candidates than the flavaviruses and the filoviruses

1:45:04.760 --> 1:45:09.400
<v Speaker 2>in this case, right, I think that the time course

1:45:10.479 --> 1:45:14.880
<v Speaker 2>fits a little bit better. Not to mention the mortality rate.

1:45:14.920 --> 1:45:17.320
<v Speaker 2>I mean, again, we would likely be looking at something

1:45:17.400 --> 1:45:20.519
<v Speaker 2>that is causing a disproportionately high mortality rate because of

1:45:20.560 --> 1:45:23.000
<v Speaker 2>the population that it's affecting, or because it was a

1:45:23.000 --> 1:45:26.800
<v Speaker 2>particularly virulent strain or sero of VR or sub subsero VAR.

1:45:29.000 --> 1:45:34.639
<v Speaker 2>But it still just seems to me to fit better

1:45:35.160 --> 1:45:37.559
<v Speaker 2>in terms of the time course, in terms of how

1:45:37.640 --> 1:45:41.559
<v Speaker 2>rapid the disease was, in terms of how it seems

1:45:41.680 --> 1:45:43.760
<v Speaker 2>to have spread. But we don't know. We don't have

1:45:43.800 --> 1:45:46.000
<v Speaker 2>that granular of data.

1:45:46.439 --> 1:45:49.000
<v Speaker 1>You know. Erin I think I could be convinced of anything,

1:45:49.200 --> 1:45:53.840
<v Speaker 1>Like I feel like I don't, I know so much more,

1:45:54.439 --> 1:45:57.920
<v Speaker 1>and I'm just like, yep, I still have no idea.

1:45:58.120 --> 1:46:02.280
<v Speaker 2>Yeah, I feel like I just want for it to

1:46:02.360 --> 1:46:05.000
<v Speaker 2>be a viral hemorrhoagic fever, and I don't know why

1:46:05.439 --> 1:46:07.960
<v Speaker 2>I can feel it being a bias for me right now.

1:46:08.840 --> 1:46:12.960
<v Speaker 1>And I feel slightly similarly about typhoid. I think only

1:46:13.000 --> 1:46:15.679
<v Speaker 1>because of my Google scholaring and nosebleed and the fact

1:46:15.720 --> 1:46:19.200
<v Speaker 1>that it was mentioned in many papers as being a

1:46:19.240 --> 1:46:23.120
<v Speaker 1>cardinal sign of early disease. I don't understand that.

1:46:23.120 --> 1:46:25.960
<v Speaker 2>For times, I don't either, especially because like I definitely

1:46:26.000 --> 1:46:27.599
<v Speaker 2>don't remember reading it.

1:46:27.720 --> 1:46:31.479
<v Speaker 1>At all, and so it's like, again, there is so

1:46:31.640 --> 1:46:35.040
<v Speaker 1>many grains of salt. This is like my salt shaker

1:46:35.160 --> 1:46:38.559
<v Speaker 1>that it's shake it everywhere, right, And I do love

1:46:38.600 --> 1:46:42.800
<v Speaker 1>a salty dish, so it's all always full. But we

1:46:42.880 --> 1:46:47.240
<v Speaker 1>have to consider the sources yep, for these accounts, who's

1:46:47.280 --> 1:46:50.439
<v Speaker 1>writing these symptoms, what emphasis are they placing on them?

1:46:50.520 --> 1:46:53.800
<v Speaker 1>How accurate are these symptoms, How accurate is the translation,

1:46:54.760 --> 1:46:58.360
<v Speaker 1>How accurate is everything? How much evolutionary gap there is

1:46:58.400 --> 1:47:01.880
<v Speaker 1>between what pathogens exis then and what they look like today.

1:47:02.240 --> 1:47:05.960
<v Speaker 1>How much is our care of these pathogens today influenced

1:47:05.960 --> 1:47:09.360
<v Speaker 1>by the hospital systems by being able to give someone iv,

1:47:09.920 --> 1:47:15.400
<v Speaker 1>antibiotics whatever. For these conditions that we're treating. We're going

1:47:15.439 --> 1:47:17.439
<v Speaker 1>to do the best we can at putting ourselves in

1:47:17.439 --> 1:47:20.479
<v Speaker 1>that time period, but we are super limited by both

1:47:20.640 --> 1:47:23.200
<v Speaker 1>that time period as well as our own biases.

1:47:23.880 --> 1:47:28.439
<v Speaker 2>Also the like nodules behind the ears that were full

1:47:28.479 --> 1:47:29.320
<v Speaker 2>of us.

1:47:31.840 --> 1:47:33.360
<v Speaker 1>Back to Google scholar, we go.

1:47:35.280 --> 1:47:36.960
<v Speaker 2>I mean, that doesn't sound like a virus at all.

1:47:37.000 --> 1:47:40.120
<v Speaker 2>I'm about to talk myself out of a viral hemorrhotic

1:47:40.160 --> 1:47:43.760
<v Speaker 2>fever because that symptom doesn't make sense. I wonder how

1:47:43.800 --> 1:47:48.000
<v Speaker 2>many people that physician examined to say that that was

1:47:48.000 --> 1:47:49.720
<v Speaker 2>a symptom that was seen in all of them.

1:47:50.200 --> 1:47:52.000
<v Speaker 1>That's a good question, no idea.

1:47:52.640 --> 1:47:56.080
<v Speaker 2>So many of our episodes where we actually deep dive

1:47:56.160 --> 1:48:00.800
<v Speaker 2>on an individual pathogen, we still have so much like

1:48:01.240 --> 1:48:04.680
<v Speaker 2>sometimes the symptoms are this, or sometimes it's that. Sometimes

1:48:04.800 --> 1:48:08.240
<v Speaker 2>the incubation period is two days, sometimes it's three weeks,

1:48:08.720 --> 1:48:13.320
<v Speaker 2>and that's usually comes from a lack of clear data, right,

1:48:14.320 --> 1:48:16.200
<v Speaker 2>And so in this case, I think it really just

1:48:16.320 --> 1:48:19.639
<v Speaker 2>highlights how difficult it is to try and make these

1:48:19.680 --> 1:48:25.640
<v Speaker 2>retrospective diagnoses when there's such limited data and such difficulty

1:48:25.680 --> 1:48:29.519
<v Speaker 2>in interpreting that data. What it makes me feel like

1:48:29.760 --> 1:48:32.960
<v Speaker 2>is it's amazing that we've been able to identify the

1:48:33.040 --> 1:48:35.200
<v Speaker 2>causative agent of any outbreaks.

1:48:35.560 --> 1:48:40.040
<v Speaker 1>Ever, It's true, you know, it's true. Yeah, But it

1:48:40.320 --> 1:48:40.840
<v Speaker 1>also I.

1:48:40.760 --> 1:48:44.040
<v Speaker 2>Think does like because we have for a lot of things,

1:48:44.120 --> 1:48:47.919
<v Speaker 2>it makes these kinds of ones that much more interesting

1:48:48.000 --> 1:48:51.080
<v Speaker 2>because it's like, what is it about these outbreaks that

1:48:51.120 --> 1:48:55.760
<v Speaker 2>have made them so difficult to pinpoint to a particular pathogen?

1:48:56.360 --> 1:48:56.479
<v Speaker 3>Hm?

1:48:57.360 --> 1:49:03.600
<v Speaker 1>Well, you know, we don't know. Turns out, but I

1:49:03.640 --> 1:49:04.479
<v Speaker 1>had so much fun.

1:49:04.520 --> 1:49:06.760
<v Speaker 2>I just want to read. Can you tell me where

1:49:06.760 --> 1:49:07.439
<v Speaker 2>I can read more?

1:49:07.880 --> 1:49:12.120
<v Speaker 1>I absolutely can. There is a whole lot here. So

1:49:12.200 --> 1:49:16.320
<v Speaker 1>there are several papers by Akuna Soto at All that

1:49:16.880 --> 1:49:19.200
<v Speaker 1>really go into a lot of these and do some

1:49:19.400 --> 1:49:25.080
<v Speaker 1>great analyzes of drought and putting forth different hypotheses. And

1:49:25.120 --> 1:49:29.280
<v Speaker 1>then there is the Nature, Ecology and Evolution paper from

1:49:29.360 --> 1:49:33.040
<v Speaker 1>twenty eighteen titled Salmonla and Terika Genomes from Victims of

1:49:33.080 --> 1:49:37.960
<v Speaker 1>a major sixteenth century epidemic in Mexico. Really fascinating. But

1:49:38.040 --> 1:49:39.760
<v Speaker 1>I want to give a special shout out to the

1:49:39.800 --> 1:49:46.320
<v Speaker 1>supplemental information. It was the best supplemental information I've ever read.

1:49:46.520 --> 1:49:50.120
<v Speaker 1>Do not sleep on it. I absolutely really appreciated the

1:49:50.160 --> 1:49:54.000
<v Speaker 1>amount of work that people put into that. And then finally,

1:49:54.040 --> 1:49:56.200
<v Speaker 1>if you want to get a little bit more background

1:49:56.360 --> 1:50:01.320
<v Speaker 1>on the history of the Aztec Empire and Mesoamerica, there's

1:50:01.439 --> 1:50:04.599
<v Speaker 1>a great book called Fifth Son by Kamila Townsend that

1:50:04.880 --> 1:50:05.839
<v Speaker 1>I really enjoyed.

1:50:06.400 --> 1:50:11.320
<v Speaker 2>I actually didn't have that many papers for this episode

1:50:11.760 --> 1:50:16.439
<v Speaker 2>because I mostly just read over my notes from all

1:50:16.479 --> 1:50:19.679
<v Speaker 2>of our old episodes. How fun. But I do have

1:50:19.840 --> 1:50:26.040
<v Speaker 2>a few additional sources on Salmonella paratyphe. I now want

1:50:26.080 --> 1:50:28.439
<v Speaker 2>to read the supplemental material for that one paper, but

1:50:28.600 --> 1:50:30.720
<v Speaker 2>they did not read it. And I also have a

1:50:30.760 --> 1:50:34.320
<v Speaker 2>couple of really great papers on the pathogenesis and the

1:50:34.439 --> 1:50:39.000
<v Speaker 2>like molecular pathogenesis of all of the different viral hamorrhagic fevers,

1:50:39.280 --> 1:50:41.559
<v Speaker 2>so if you want to read more about all of those,

1:50:41.760 --> 1:50:44.880
<v Speaker 2>and then a bonus one on parvovirus just as a

1:50:44.880 --> 1:50:47.760
<v Speaker 2>teaser for a future episode. But you can find the

1:50:47.800 --> 1:50:50.680
<v Speaker 2>list of our sources from this episode and all of

1:50:50.720 --> 1:50:53.560
<v Speaker 2>our episodes on our website This podcast will Kill You

1:50:53.600 --> 1:50:55.679
<v Speaker 2>dot com under the episode stap.

1:50:56.280 --> 1:50:58.960
<v Speaker 1>Thank you to Bloodmobile for providing the music for this

1:50:59.080 --> 1:51:01.000
<v Speaker 1>episode and all of our episodes.

1:51:01.680 --> 1:51:05.600
<v Speaker 2>Thank you so much to Tom Bryfogel for the incredible

1:51:05.640 --> 1:51:06.760
<v Speaker 2>audio mixing.

1:51:06.840 --> 1:51:09.400
<v Speaker 1>And thank you to you listeners. We hope that you

1:51:09.840 --> 1:51:11.800
<v Speaker 1>enjoyed this and learn something new.

1:51:12.960 --> 1:51:15.360
<v Speaker 2>I know that I did, so I'm holding that everyone

1:51:15.360 --> 1:51:18.080
<v Speaker 2>else did and isn't just like wtf did we even

1:51:18.120 --> 1:51:19.280
<v Speaker 2>talk about in this episode?

1:51:19.479 --> 1:51:22.519
<v Speaker 1>Right? Write in your thoughts please please do you want

1:51:22.560 --> 1:51:23.040
<v Speaker 1>more of these?

1:51:23.080 --> 1:51:24.080
<v Speaker 2>Because I bet there's more?

1:51:24.720 --> 1:51:26.120
<v Speaker 1>Yes I do.

1:51:26.600 --> 1:51:29.920
<v Speaker 2>And especial thank you as always to our patrons. Thank

1:51:29.920 --> 1:51:31.920
<v Speaker 2>you so much for your support.

1:51:32.400 --> 1:51:36.880
<v Speaker 1>Yes, it really means the world to us. Well until

1:51:36.920 --> 1:51:39.160
<v Speaker 1>next time, wash your hands.

1:51:39.120 --> 1:52:01.240
<v Speaker 4>You filthy animals. Ou