WEBVTT - Ep 206 Oropouche Virus: More than a smidge worrisome 0:00:00.240 --> 0:00:04.600 By US standards, Brazil's Highway BR fourteen is certainly no 0:00:04.800 --> 0:00:09.360 Indiana Turnpike or New York State Thruway. Meandering one three 0:00:09.440 --> 0:00:12.559 hundred and fifty miles from Belem to Brasilia through the 0:00:12.640 --> 0:00:16.680 jungles and scrub of Brazil's wild interior, it is barely 0:00:16.720 --> 0:00:20.079 two lanes wide. The surface is dust in the dry season, 0:00:20.280 --> 0:00:22.400 mud in the wet and some of the ruts could 0:00:22.480 --> 0:00:26.240 swallow a Volkswagen alive. Yet, in the eyes of former 0:00:26.280 --> 0:00:30.080 President Juicellino Kubacek, who built the road between nineteen fifty 0:00:30.120 --> 0:00:34.000 six and nineteen sixty, BR fourteen is the highway of 0:00:34.080 --> 0:00:38.000 dreams for underdeveloped Brazil and the means to a new 0:00:38.040 --> 0:00:42.239 civilization on the central plateau. So it is since the 0:00:42.320 --> 0:00:46.040 road's opening in nineteen sixty, some six hundred thousand settlers 0:00:46.080 --> 0:00:49.720 have poured into the area to tap Brazil's immense riches. 0:00:50.280 --> 0:00:54.200 Every day, long lines of trucks rumble north and south, 0:00:54.640 --> 0:01:00.320 carrying out lumber, rubber, and vegetable oil. New farmlands produce beans, rice, corn, 0:01:00.400 --> 0:01:04.559 and fruit to feed Brazil's exploding population. What was once 0:01:04.760 --> 0:01:08.280 useless scrub in the central state of Goyas is now 0:01:08.440 --> 0:01:12.919 pastureland for four million head of cattle, and prospectors fanning 0:01:12.920 --> 0:01:15.840 out from the road have found a vast mineral potential, 0:01:16.120 --> 0:01:20.679 with deposits of nickel, tin, lead, zinc, copper, gold, diamonds, 0:01:20.720 --> 0:01:24.720 and quartz. Towns are sprouting every few miles. If I 0:01:24.760 --> 0:01:26.760 don't pass a certain stretch of road for two or 0:01:26.760 --> 0:01:30.640 three weeks, says one road engineer, I almost always find 0:01:30.680 --> 0:01:33.040 a new cluster of shacks there when I get back. 0:01:33.680 --> 0:01:36.479 Our Guayina, which got its start in nineteen fifty eight 0:01:36.520 --> 0:01:39.839 as a road construction camp five hundred miles north of Brasilia, 0:01:40.280 --> 0:01:43.280 is now up to eight thousand people, has its own 0:01:43.319 --> 0:01:45.880 branch of the Bank of Brazil, and will soon have 0:01:46.080 --> 0:01:49.880 a one point six million dollar factory that will refine 0:01:49.960 --> 0:01:54.720 oil from native babecue, nuts, peanuts, cotton, and sunflower seeds, 0:01:55.040 --> 0:01:57.840 and produce the cans in which to export the oil 0:01:58.200 --> 0:02:01.720 and cut up local mahogany to make cases for the cans. 0:02:48.880 --> 0:02:52.440 I love your newscaster voice, thank you, and I hate 0:02:52.480 --> 0:02:53.480 everything else about that. 0:02:56.320 --> 0:03:00.200 I think it so. That was from excerpted from a 0:03:00.480 --> 0:03:05.280 Time article published on January seventh, nineteen sixty six, titled 0:03:05.360 --> 0:03:10.040 Brazil on the Road. To dreams, and it's such a 0:03:10.080 --> 0:03:14.920 fascinating reflection. I think of how forward progress was viewed 0:03:14.919 --> 0:03:17.680 at the time, like yeah, we must go forward, and 0:03:17.720 --> 0:03:22.160 like it's it's also understandable, right right, Like there's this 0:03:22.200 --> 0:03:27.320 is economy that's driving this. But the reason that we 0:03:27.400 --> 0:03:32.680 picked this particular article or this excerpt is because that 0:03:33.560 --> 0:03:36.360 construction on that road is what is thought to have 0:03:36.560 --> 0:03:41.560 led to the spillover and spread initially of the focus 0:03:41.600 --> 0:03:46.920 of today's episode, which is or a pouch virus. Hi, 0:03:47.160 --> 0:03:50.440 I'm Aaron Welsh and I'm Erin Alman Updike, and this 0:03:50.600 --> 0:03:53.600 is this podcast, will kill you? Welcome to or a 0:03:53.600 --> 0:03:57.040 push virus? Or a push virus. Yeah, we've got one 0:03:57.080 --> 0:04:00.800 time to learn how to say that. Yeah, this morning. 0:04:01.840 --> 0:04:04.840 We've gotten some requests over the years for this virus, 0:04:05.560 --> 0:04:08.320 and it's interesting. I feel like we've been seeing it 0:04:08.360 --> 0:04:10.960 trickle more and more in the news lately, and so 0:04:11.040 --> 0:04:12.920 we wanted to just kind of like get a lay 0:04:12.920 --> 0:04:15.279 of the land. What's going on, how is it transmitted? 0:04:15.840 --> 0:04:17.719 Why is it suddenly making headlines. 0:04:18.000 --> 0:04:20.120 It's it's gonna be a great episode because I feel 0:04:20.120 --> 0:04:22.560 like it's really going back to urine my roots. Erin 0:04:22.800 --> 0:04:25.200 of like, what got us wanting to make this podcast 0:04:25.240 --> 0:04:26.839 in the first place. And it's been a really long 0:04:26.880 --> 0:04:29.560 time since we've done a vector worn disease, since we've 0:04:29.560 --> 0:04:30.839 done an infectious disease. 0:04:31.680 --> 0:04:33.880 So I was like, how do we do this? I 0:04:33.920 --> 0:04:37.240 know there aren't many books to read on this right. 0:04:37.160 --> 0:04:42.600 Yeah, So yeah, We've got a lot for this episode 0:04:42.760 --> 0:04:44.760 and I'm excited about it. 0:04:45.000 --> 0:04:48.880 Me too, Me too. What are we drinking this week, Aaron? 0:04:49.240 --> 0:04:56.000 We're drinking sloth sprits. Yeah, or push virus is often 0:04:56.040 --> 0:05:00.760 called sloth fever or sloth flu. Been seen it called, 0:05:00.920 --> 0:05:03.800 and I don't love it, no, but we are going 0:05:03.880 --> 0:05:07.320 to honor the sloth in this way. I love sloths. 0:05:07.520 --> 0:05:10.840 I do too, I do too. Yeah, tell us what's 0:05:10.880 --> 0:05:12.520 in sloth sprits? 0:05:12.800 --> 0:05:16.440 You know, it's a delicious little concoction of passion fruit 0:05:16.960 --> 0:05:23.800 juice or whatever, nectar nectar, passion fruit, lime, mint, and 0:05:23.880 --> 0:05:25.760 you know, some bubbly of some kind. 0:05:26.160 --> 0:05:30.400 Choice's delicious, refreshing, et cetera. All the above. We'll post 0:05:30.440 --> 0:05:34.720 it on our socials. In our socials, on our socials, 0:05:34.760 --> 0:05:36.320 not our website. 0:05:35.800 --> 0:05:37.159 But on our website you can find a lot of 0:05:37.160 --> 0:05:40.920 other great stuff, like, for example, transcripts from all of 0:05:40.920 --> 0:05:44.160 our episode sources from this in every single episode, Bloodmobile. 0:05:44.200 --> 0:05:47.280 Who does the music? We've got merch This is an 0:05:47.279 --> 0:05:49.039 old one. I don't know if it's still available. 0:05:49.600 --> 0:05:51.400 I love that shirt though, met too. 0:05:53.040 --> 0:05:58.200 We've got Patreon, We've got a contact us form, a 0:05:58.240 --> 0:05:59.280 first hand account form. 0:05:59.600 --> 0:06:03.000 Listen, it's basing than Look. Yeah, this podcast will kill 0:06:03.040 --> 0:06:06.240 you dot com. It's there, It's there. I have a 0:06:06.240 --> 0:06:09.919 piece of business because this has been bothering me since 0:06:10.160 --> 0:06:13.400 we listened to the episode for like QC purposes. You 0:06:13.440 --> 0:06:16.320 know what I'm gonna say, erin I do elephant I didn't. 0:06:16.520 --> 0:06:19.880 This has bothered me deeply that I mess this up. 0:06:20.360 --> 0:06:23.520 Elephant's poop. If I had thought about it, I would have. 0:06:24.640 --> 0:06:27.080 I would have. I would have realized that fifteen pounds 0:06:27.120 --> 0:06:29.839 sounds like a lot to us, but for an elephant, 0:06:29.880 --> 0:06:32.800 which is gargantuan, right, actually doesn't sound like that much 0:06:32.839 --> 0:06:35.200 in a day. And it's true, it's not that much 0:06:35.200 --> 0:06:37.560 for an elephant in a day. Fifteen pounds is more 0:06:37.640 --> 0:06:40.920 like in one poop sash throughout the day. It's about 0:06:40.960 --> 0:06:43.800 two hundred and twenty pounds. That's pounds, and they poop 0:06:43.880 --> 0:06:46.440 like twelve to fifteen times a day. So that's how 0:06:46.440 --> 0:06:49.599 the wow maths. Yeah, twelve to fifteen times a day. 0:06:49.800 --> 0:06:56.280 They're basically it's just they're just poopish. Yeah, the constant wow. 0:06:56.440 --> 0:07:02.720 I love knowing that fat for more poop facts. What's 0:07:02.760 --> 0:07:04.760 really funny, Aaron is in that episode when you say 0:07:04.800 --> 0:07:09.000 fifteen pounds, I'm like, fifty pounds because I also clearly 0:07:09.200 --> 0:07:12.120 was like that sounds like so much. I numbers are 0:07:12.120 --> 0:07:14.280 really hard to conceptualize sometimes. 0:07:14.320 --> 0:07:17.040 I mean, when you're talking about pounds of poop, it 0:07:17.080 --> 0:07:23.240 really does feel Yeah. Yeah, So anyways, anyways, that's my correction. Oh, 0:07:23.280 --> 0:07:25.960 I just wanted to mention this is technically the start 0:07:25.960 --> 0:07:30.600 of season nine. I know, there's no break, and so 0:07:30.640 --> 0:07:32.520 if we if you hear AU say season nine or 0:07:32.560 --> 0:07:35.200 new season or whatever, it's only for at this point 0:07:35.200 --> 0:07:37.640 our file, organizational system, our file. 0:07:37.720 --> 0:07:41.240 But and also like I think, our hearts because I'm 0:07:41.240 --> 0:07:43.080 really proud that we've made it to season nine. 0:07:43.120 --> 0:07:45.960 Are you hitting me? Yeah? We doing this for that long? Yeah, 0:07:46.120 --> 0:07:50.960 Halloween twenty seventeen. Yeah, we're still there's still more things 0:07:50.960 --> 0:07:51.640 that can kill you. 0:07:51.880 --> 0:07:55.920 So speaking of a whole season planned, but first we 0:07:56.000 --> 0:08:00.160 begin with or a poosh virus right after this break 0:08:14.800 --> 0:08:19.160 or a pooshe virus is an arbovirus, which means that 0:08:19.200 --> 0:08:23.880 it's a virus that is transmitted by arthropods, an arthropod 0:08:23.960 --> 0:08:27.480 born virus. Some of our favorites that we've ever covered, 0:08:27.520 --> 0:08:31.960 I think are arboviruses vector born diseases in general. 0:08:31.840 --> 0:08:35.280 I mean disease ecology really, you know, Yeah, it's in 0:08:35.280 --> 0:08:36.520 our heart of hearts. True. 0:08:36.600 --> 0:08:39.440 But one of the things that's quite unique about this 0:08:39.559 --> 0:08:42.480 virus compared to any other that we have covered before, 0:08:42.600 --> 0:08:45.120 is that it's transmitted by a whole new arthropod that 0:08:45.160 --> 0:08:48.280 we have never talked about on this podcast, and that. 0:08:48.320 --> 0:08:51.400 Is a midge. A midge, So let's talk about what 0:08:51.440 --> 0:08:54.560 image is, shall we. Yeah, I am, I can't I 0:08:54.640 --> 0:08:56.679 truly can't wait. I mean that sincerely. 0:08:58.080 --> 0:09:00.680 So a midge or a biting midge is a type 0:09:00.679 --> 0:09:04.120 of biting fly, And the term biting midge is not 0:09:04.240 --> 0:09:08.720 a very scientific grouping of biting fly whatsoever, because in 0:09:08.760 --> 0:09:13.280 some places these might be called sandflies, even though they 0:09:13.320 --> 0:09:15.400 might not be what we would have called sand flies. 0:09:16.400 --> 0:09:20.199 In other places, they might be called no sums. And 0:09:20.400 --> 0:09:23.760 there's probably even more other terms that people use for these, 0:09:23.920 --> 0:09:26.839 but in any case, these are teeny tiny, and by 0:09:26.840 --> 0:09:30.640 teeny tiny, I mean they're like one to three millimeters long. 0:09:31.040 --> 0:09:34.680 Like the there's pictures of them online on someone's thumbnail 0:09:34.920 --> 0:09:37.560 where they barely take up the space that like between 0:09:37.559 --> 0:09:39.080 your cuticle and your thumb. 0:09:38.920 --> 0:09:43.520 Like barely, Sam, Yeah, no, barely, Sam. 0:09:43.559 --> 0:09:47.439 There's other pictures online of them next to a mosquito, 0:09:48.440 --> 0:09:51.360 and you think of mosquitos, like, they're not very large 0:09:51.480 --> 0:09:53.840 compared to many other types of flies. 0:09:53.920 --> 0:09:56.280 Depending on the mosquito. But yeah, yeah, some of them 0:09:56.280 --> 0:09:57.920 are heaty, scary ones. 0:09:58.000 --> 0:10:01.720 Yeah, right, but they're but compared to a mosquito, they're 0:10:01.760 --> 0:10:02.720 like so deeny. 0:10:02.720 --> 0:10:03.760 They're like the size of a. 0:10:03.720 --> 0:10:08.520 Mosquito's head that is cheni, I know, kind of adorable. 0:10:09.160 --> 0:10:12.000 And in this case, we're talking about these biting midges 0:10:12.000 --> 0:10:17.200 in the family serato Pogona dae, specifically this species. There's 0:10:17.240 --> 0:10:20.200 one major species that we think is the primary vector 0:10:20.240 --> 0:10:25.840 for oropoosch virus, and that is Culaicoid's paraensis. Yes, and 0:10:26.200 --> 0:10:29.960 these biting midges in this family and in this genus, 0:10:30.280 --> 0:10:34.280 they share some similarities with mosquitoes, but also quite a 0:10:34.360 --> 0:10:37.200 lot of differences. First of all, they're quite small. They're 0:10:37.320 --> 0:10:40.400 proboscis that they use to bite us and do their 0:10:40.400 --> 0:10:44.120 blood feeding is not nearly as long or robust as mosquitoes, 0:10:44.160 --> 0:10:46.240 so they can't as easily bite through our clothing. 0:10:47.040 --> 0:10:49.079 Oh that's good news. It is good news. 0:10:49.400 --> 0:10:52.520 However, they're so small that they can fit through things 0:10:52.600 --> 0:10:57.480 like most of our screensh No, yes, yes, so they're 0:10:57.520 --> 0:11:00.360 harder to keep out of your house and things like that. Okay, 0:11:01.040 --> 0:11:05.360 But similar to mosquitoes, their larvae are aquatic, and similar 0:11:05.400 --> 0:11:08.400 to mosquitoes, it is only the females who blood feed 0:11:08.480 --> 0:11:12.680 in order to mature their eggs. So in the case 0:11:12.720 --> 0:11:16.920 of oropush virus, this midge Quliicoid's paraensis will take a 0:11:16.920 --> 0:11:20.960 blood meal from an infected person or animal. We'll get there, 0:11:21.640 --> 0:11:24.560 and then upon their next blood meal, we'll spit that 0:11:24.720 --> 0:11:28.000 virus back out into another host. And that is kind 0:11:28.040 --> 0:11:30.280 of all that I can say about the transmission cycle. 0:11:30.679 --> 0:11:35.120 Sometimes in these virus or arbovirus or vector borne disease episodes, 0:11:35.120 --> 0:11:38.200 we can get into a lot more detail about what's 0:11:38.240 --> 0:11:41.079 going on inside that vector, about how long it takes 0:11:41.080 --> 0:11:43.520 for this virus to disseminate and then be able to 0:11:43.520 --> 0:11:47.600 be transmitted. It is amazing how relatively little we know 0:11:47.800 --> 0:11:52.720 about this virus. So we think that this one species, 0:11:52.800 --> 0:11:56.080 Kuloicoid's paraensis, this one species of biting midge is the 0:11:56.120 --> 0:12:01.280 primary vector to humans and probably to other animals. But 0:12:02.320 --> 0:12:05.200 much like many other vector born diseases that we've covered 0:12:05.200 --> 0:12:08.520 on this podcast, there are kind of two different cycles 0:12:08.640 --> 0:12:11.760 of this virus. Right, there's a wild cycle or a 0:12:11.800 --> 0:12:16.880 sylvatic cycle, and there's an urban cycle. And in the 0:12:16.920 --> 0:12:22.240 wild or silvatic cycle. It's thought that sloths, especially three 0:12:22.240 --> 0:12:25.000 toe sloths as well as I know, right. 0:12:24.920 --> 0:12:27.600 They're like, I'm sorry, but they are the cuter slot, 0:12:28.040 --> 0:12:33.560 but you apologize just like by far. Yeah, it's quite dramatic, 0:12:33.880 --> 0:12:35.920 it is. They're the ones with a mask. 0:12:36.040 --> 0:12:38.160 If you haven't, if you don't distinctly know off the 0:12:38.160 --> 0:12:39.920 top of your head the differences between a two tone 0:12:39.920 --> 0:12:43.200 and in addition to the number of toes, the three 0:12:43.240 --> 0:12:45.400 toes are the ones with the black and white little mask, 0:12:46.160 --> 0:12:48.800 and the two toes are brown and have a little. 0:12:48.600 --> 0:12:50.319 Pig nose, which is also cute, but it is a 0:12:50.400 --> 0:12:51.439 different way, you. 0:12:51.400 --> 0:12:53.800 Know, And I do like how fuzzy like their fur 0:12:54.000 --> 0:12:57.080 is like longer and anyways, this is not an episode 0:12:57.080 --> 0:12:57.720 about slots. 0:12:58.240 --> 0:13:00.480 It should be it could be done. 0:13:01.200 --> 0:13:03.560 So it is thought that sloths, as well as non 0:13:03.640 --> 0:13:07.880 human primates like capuchins and howler monkeys and some bird species, 0:13:08.280 --> 0:13:12.800 these are probably the most important vertebrate hosts of this virus. 0:13:14.000 --> 0:13:17.800 But when it comes to the vector species, we don't 0:13:18.000 --> 0:13:23.840 really know exactly which arthropods, which biting insects are playing 0:13:23.880 --> 0:13:26.960 the biggest role in transmission in this wild cycle. 0:13:27.040 --> 0:13:28.280 Especially so we. 0:13:28.320 --> 0:13:33.359 Know that this biting midge, the Culicoiles paraensis, is definitely 0:13:33.520 --> 0:13:37.040 present in the selvatic cycle. It definitely can and does 0:13:37.320 --> 0:13:41.080 bite freely other animals in addition to humans. But there's 0:13:41.120 --> 0:13:45.960 some evidence that various mosquito species, including some Clex mosquitoes 0:13:46.000 --> 0:13:49.920 which transmit a wide variety of other illnesses, and some 0:13:50.080 --> 0:13:52.840 eighties mosquitoes which are the primary vectors for things like 0:13:53.000 --> 0:13:57.040 dengae virus which circulates in the same area as or 0:13:57.040 --> 0:14:00.800 a pooch virus. Some of these mosquite have been found 0:14:00.840 --> 0:14:03.560 to be infected with or a push virus, but we 0:14:03.600 --> 0:14:07.520 don't really know are they what we call competent vectors, 0:14:08.160 --> 0:14:11.920 can they actually transmit this virus to other animals, and 0:14:11.960 --> 0:14:13.600 like how big of a role do they play in 0:14:13.600 --> 0:14:16.400 the environment. We don't know, which is fascinating. 0:14:17.240 --> 0:14:21.160 Okay, so a question about that, like what is the 0:14:21.320 --> 0:14:26.520 midge's habitat preferences? Great question, We don't really know. We 0:14:26.560 --> 0:14:27.240 don't really know. 0:14:27.600 --> 0:14:33.320 Apparently the larva, especially of these species, this species in particular, 0:14:33.800 --> 0:14:37.520 wasn't even like described and identified until the nineteen nineties, 0:14:39.680 --> 0:14:42.400 which is so recent, and so we really just don't 0:14:42.440 --> 0:14:45.479 know nearly as much as we should about the natural ecology. 0:14:45.560 --> 0:14:48.200 And while other biting midge species are known to be 0:14:48.280 --> 0:14:52.440 important vectors of a variety of animal diseases like blue 0:14:52.440 --> 0:14:57.200 tongue virus and other viral infections as well, I don't 0:14:57.200 --> 0:15:00.360 think that they have historically been considered as imp important 0:15:00.400 --> 0:15:04.120 of a vector of human diseases compared to something like mosquitoes. 0:15:04.480 --> 0:15:07.920 And so that's probably part of why their natural ecology 0:15:08.000 --> 0:15:11.480 and just their understanding as vectors and just in general 0:15:11.680 --> 0:15:15.400 is not as robust as it's just it's. 0:15:15.240 --> 0:15:18.640 Just so interesting because I feel like they they occupy well, 0:15:18.680 --> 0:15:22.640 do they occupy a similar niche as mosquitoes? They yeah, 0:15:22.840 --> 0:15:28.520 But like there's there's like why do midges play less role? 0:15:28.680 --> 0:15:32.080 This is like a bigger question than, but you can 0:15:32.120 --> 0:15:34.640 ask it in general. You know, mosquitoes are what we 0:15:34.680 --> 0:15:36.440 think of when we think of like vector born diseases 0:15:36.440 --> 0:15:42.400 like mosquitoes, ticks and and midges don't feature very heavily. 0:15:42.720 --> 0:15:48.720 Why why great question, I don't know, so yeah, But 0:15:48.960 --> 0:15:51.880 so that's we think though, that this is the main 0:15:52.000 --> 0:15:54.600 vector species. There's one other species of Kuliquoides as well 0:15:54.600 --> 0:15:56.560 that has sometimes been found to be infected that might 0:15:56.560 --> 0:15:59.360 play a role, especially in the urban cycle as well. 0:15:59.640 --> 0:16:03.080 And the urban cycle meaning in the human cycle of. 0:16:03.120 --> 0:16:04.040 Or A push virus. 0:16:04.320 --> 0:16:10.080 It really is us humans who play the primary vertebrate host. 0:16:10.360 --> 0:16:12.800 Our domestic animals do not seem to play a big 0:16:12.880 --> 0:16:15.320 role in the maintenance of this virus in urban cycles, 0:16:15.520 --> 0:16:16.960 except maybe chickens. 0:16:17.440 --> 0:16:22.240 Even then, Yes, we don't study it enough. 0:16:22.720 --> 0:16:26.600 Will know a lot more in the coming years, but 0:16:26.800 --> 0:16:28.960 there is still so much that we don't really know 0:16:29.400 --> 0:16:33.560 about this virus. What we do know is how it 0:16:33.600 --> 0:16:37.240 tends to present. Even though the symptoms of or A 0:16:37.280 --> 0:16:43.160 push virus really overlap with so many other arboviral so 0:16:43.200 --> 0:16:47.119 like vector born viral illnesses and just other viral illnesses 0:16:47.160 --> 0:16:51.720 in general, so they're very nonspecific. The symptoms tend to 0:16:51.760 --> 0:16:53.160 start with a fever. 0:16:53.800 --> 0:16:54.400 Classically. 0:16:54.800 --> 0:16:59.880 Classically, headache is a very very common symptom, as well 0:17:00.440 --> 0:17:05.440 as muscle aches, joint aches, dizziness. You might get chills. 0:17:06.080 --> 0:17:10.840 Oftentimes people will have like ocular symptoms, eye symptoms like photophobia, 0:17:10.960 --> 0:17:12.720 like your eyes hurt if you're trying to look at 0:17:12.720 --> 0:17:16.320 the light. Or sometimes people get like redness in their eyes, 0:17:17.280 --> 0:17:20.240 not like as full on as like a you know, 0:17:20.320 --> 0:17:23.280 red eye, like pink eye infection, but just a bit 0:17:23.320 --> 0:17:25.160 of like redness overall in the eyes. 0:17:25.359 --> 0:17:29.080 Isn't doesn't that happen with zica or chicken guna, It 0:17:29.119 --> 0:17:32.960 can happen with Yeah, I just feel like it was 0:17:33.000 --> 0:17:37.320 like a feature symptom in one of those mosquito born ones. 0:17:37.440 --> 0:17:40.840 That is more than I can remember, Aaron. It could 0:17:40.880 --> 0:17:43.480 be a false memory, that's possible. 0:17:44.040 --> 0:17:48.160 Sometimes people will have some like GI symptoms like nausea, vomiting, 0:17:48.240 --> 0:17:51.639 abdominal pain. Sometimes they might have anorexia, like you just 0:17:51.640 --> 0:17:53.600 feel so sick you don't really want to eat anything. 0:17:54.800 --> 0:17:57.639 Sometimes people can get a rash, and I've seen it 0:17:57.680 --> 0:18:01.680 described as kind of a Rubella type of rash. And Rubella, 0:18:01.960 --> 0:18:05.200 if you don't remember, is another viral illness, not vector 0:18:05.200 --> 0:18:11.760 born that causes this red, splotchy, pinpricky type of rash 0:18:12.160 --> 0:18:14.119 that often is on like the torso and then can 0:18:14.119 --> 0:18:17.200 spread to the face and spread downward. But it's really 0:18:17.480 --> 0:18:20.520 like a very kind of non specific viral looking rash, 0:18:20.680 --> 0:18:24.320 is the way I would describe it. And rarely sometimes 0:18:24.320 --> 0:18:27.480 people can have haemorrhagic symptoms, so that might be things 0:18:27.480 --> 0:18:29.800 that look like you're having a bit of bleeding, but 0:18:29.960 --> 0:18:33.359 not like bleeding everywhere, but maybe your gums or maybe 0:18:33.400 --> 0:18:36.720 a nose bleed or other kind of mucosal type of bleeding. 0:18:38.359 --> 0:18:40.919 How is the virus causing these symptoms? 0:18:43.920 --> 0:18:48.800 Great question, aarin no idea. Okay, we know so little. 0:18:49.160 --> 0:18:50.800 I have a bit on this later on, but i'll 0:18:50.800 --> 0:18:53.600 tell you now erin. We know so little about the 0:18:53.680 --> 0:18:56.560 like pathophysiology of what this virus is doing in our bodies, 0:18:56.840 --> 0:18:59.280 what sells? Is it even infecting? What sells? Does it 0:18:59.320 --> 0:19:02.520 preferentially and effect? And where does it replicate? Like are 0:19:02.560 --> 0:19:05.960 there specific tropisms, meaning are there certain types of cells 0:19:05.960 --> 0:19:09.320 that it preferentially is going to infect and how and 0:19:09.359 --> 0:19:10.320 why those cells? 0:19:10.359 --> 0:19:12.760 And what are these symptoms? We don't know. We don't 0:19:12.800 --> 0:19:14.600 know any of that as far as I can tell. 0:19:14.840 --> 0:19:18.159 Okay, okay, So yeah, we don't know why it's causing 0:19:18.240 --> 0:19:21.960 these very non specific viral type symptoms. 0:19:22.600 --> 0:19:24.879 But it is another thing though. 0:19:24.760 --> 0:19:26.600 That we see with our push virus that we see 0:19:26.600 --> 0:19:29.720 with a lot of other arboviral diseases, is that the 0:19:30.280 --> 0:19:33.400 course of your symptoms can be what we call biphasic, 0:19:34.480 --> 0:19:37.679 meaning that three to ten days or so after you 0:19:37.720 --> 0:19:41.199 get infected, that's the usual incubation period. So after you 0:19:41.240 --> 0:19:45.160 get these bites from these midges and you get infected, 0:19:45.520 --> 0:19:48.320 you start with these symptoms that I've described, and that 0:19:48.400 --> 0:19:52.719 first phase usually lasts like two to four days or so, okay, 0:19:52.800 --> 0:19:55.320 and then you will get better, but then a week 0:19:55.400 --> 0:19:57.959 to ten days later you might have a resurgence of 0:19:58.240 --> 0:20:02.240 very similar symptoms. How often does this happen, we don't 0:20:02.400 --> 0:20:04.879 really know, because again there's so much that we don't know, 0:20:05.040 --> 0:20:07.560 but it suggested that it's like in up to sixty 0:20:07.600 --> 0:20:11.000 percent of cases, which is quite high, so quite common 0:20:11.040 --> 0:20:14.280 that you would have this kind of bi phasic illness. 0:20:14.320 --> 0:20:16.760 And most of the time, I think the. 0:20:16.640 --> 0:20:19.359 Best news about or a push virus is that the 0:20:19.520 --> 0:20:22.920 vast majority of the time this is a self limited disease, 0:20:23.000 --> 0:20:26.520 meaning those symptoms that I describe. You feel miserable, you 0:20:26.560 --> 0:20:28.639 feel sick. Maybe it comes back and it lasts for 0:20:28.760 --> 0:20:31.880 quite a while, but then you get better. When this 0:20:31.960 --> 0:20:35.480 disease causes more severe symptoms, which it can, it can 0:20:35.600 --> 0:20:39.520 result in a meningitis or a meninjo encephalitis, meaning infection 0:20:39.640 --> 0:20:42.440 in the brain brain stem, causing swelling in your central 0:20:42.480 --> 0:20:47.479 nervous system. Even in those cases, people almost always recover 0:20:47.560 --> 0:20:50.800 and recover completely as far as we know, and there 0:20:50.800 --> 0:20:55.879 are asterisks there, but up until twenty twenty four or 0:20:55.880 --> 0:20:59.919 a PUSH virus had not been known to cause any deaths. 0:21:00.640 --> 0:21:05.640 That's no longer true, but we'll talk more about it later, Okay. 0:21:06.320 --> 0:21:09.159 Immunity immunity, great question. We don't know. 0:21:10.000 --> 0:21:13.000 Okay, we don't know how good of immunity we generate. 0:21:13.200 --> 0:21:17.000 Is our antibody immunity like long lasting? Can you get 0:21:17.000 --> 0:21:17.800 reinfected with this? 0:21:18.000 --> 0:21:21.680 We don't know. Are there different strains or like subtypes? 0:21:21.880 --> 0:21:25.600 So there definitely are, Okay, there definitely are. And this 0:21:25.680 --> 0:21:27.960 is actually a really important part of our push biology 0:21:27.960 --> 0:21:28.640 that we do know. 0:21:28.680 --> 0:21:29.720 Quite a bit about. Okay. 0:21:30.240 --> 0:21:35.760 So, similar to flu viruses oropush viruses, are an RNA 0:21:36.119 --> 0:21:40.520 virus that has a segmented genome, which means their genome 0:21:40.600 --> 0:21:43.800 is not just like one piece of RNA, it's three 0:21:43.840 --> 0:21:48.159 different chunks. They're named small, medium, in large, SM, and 0:21:48.320 --> 0:21:53.800 L and similar to flu viruses, if a host like 0:21:53.840 --> 0:21:57.560 say a sloth, is infected with two different strains of 0:21:57.600 --> 0:21:59.919 this virus at the same time, it can lead to 0:22:00.119 --> 0:22:03.119 a mixing up of different chunks of their genome and 0:22:03.160 --> 0:22:06.240 result in a completely new version of this virus, often 0:22:06.240 --> 0:22:09.200 one that is drastically different than either of the so 0:22:09.280 --> 0:22:13.840 called parent viruses. There's actually a few other viruses that 0:22:13.960 --> 0:22:17.800 have different names, Equito's virus, Madre de Dios virus, and 0:22:18.200 --> 0:22:22.080 perdos virus. I might be pronouncing that one wrong, which 0:22:22.119 --> 0:22:26.000 that one doesn't infect humans, but these contain parts of 0:22:26.040 --> 0:22:29.520 the oropushe virus and then another segment from a related 0:22:29.640 --> 0:22:31.960 virus in the same what we call zero group, the 0:22:32.000 --> 0:22:36.840 same group of viruses. So yes, the fact that oropush 0:22:36.920 --> 0:22:40.760 can recombine is a really important aspect of the like 0:22:40.880 --> 0:22:44.320 virology of this virus, and we think it was probably 0:22:44.359 --> 0:22:46.960 involved in the most recent outbreak that we saw twenty 0:22:47.000 --> 0:22:48.840 twenty four twenty twenty five, and we'll talk a little 0:22:48.840 --> 0:22:49.880 bit more about that later in this. 0:22:49.840 --> 0:22:55.560 Episode, changing virulence patterns and all of those things. 0:22:55.640 --> 0:22:59.320 Yeah, and speaking of transmission, so this is a virus 0:22:59.320 --> 0:23:02.520 that is transmitted via vectors, right via these biting midges. 0:23:03.040 --> 0:23:06.320 There has not been shown so far any direct human 0:23:06.359 --> 0:23:09.480 to human transmission, so even if you're sick and miserable, 0:23:09.640 --> 0:23:14.000 you're not transmitting it to other people. However, similar to 0:23:14.119 --> 0:23:17.560 zica virus, there is now evidence that our push can 0:23:17.600 --> 0:23:21.280 be transmitted across the placenta, so if someone is infected 0:23:21.320 --> 0:23:23.880 while they're pregnant, it can infect the fetus, and it's 0:23:23.880 --> 0:23:26.640 been thought to be associated with a number of stillbirths, 0:23:27.000 --> 0:23:31.960 fetal losses, so miscarriages, and things like microcephaly, which is 0:23:32.000 --> 0:23:34.840 when the brain does not fully develop, similar to how 0:23:34.840 --> 0:23:38.800 we saw with zicavirus. Unlike with zecavirus, we don't know 0:23:39.119 --> 0:23:41.720 enough about the virology yet to understand what's going on 0:23:42.080 --> 0:23:46.040 or how common or any of that. But epidemiologically, this 0:23:46.080 --> 0:23:49.200 pattern seems to have come out of this most recent 0:23:49.200 --> 0:23:51.000 outbreak that we've seen, and so we do think that 0:23:51.040 --> 0:23:53.880 it's crossing the placenta and can cause damage to the fetus, 0:23:54.480 --> 0:23:55.640 which is pretty serious. 0:23:55.800 --> 0:24:00.600 But no sexually transmitted or great question. Great question. 0:24:01.160 --> 0:24:03.159 At least one paper that I saw said that they 0:24:03.280 --> 0:24:06.159 thought that they had detected it in semen. Does that 0:24:06.240 --> 0:24:08.000 mean that it's able to be transmitted? 0:24:08.200 --> 0:24:11.880 Right? We don't know. It's a huge open question, right, Okay, yep. 0:24:13.800 --> 0:24:18.480 Question about the habits of these biting midges when you 0:24:18.520 --> 0:24:21.840 know how like mosquitoes love down and dusk doesn't mean 0:24:21.880 --> 0:24:23.480 that they don't bite you in other times of day, 0:24:23.520 --> 0:24:26.560