WEBVTT - What's the deal with ticks? 0:00:00.880 --> 0:00:04.440 So Perry. When I was in college and my brother 0:00:04.640 --> 0:00:07.320 was also in college, we came home one year for 0:00:07.360 --> 0:00:11.039 Thanksgiving and my brother had a cold, and you know 0:00:11.320 --> 0:00:14.480 people get sick whenever he's a college student. He has 0:00:14.480 --> 0:00:16.400 a cold. It kind of goes on for a little while, 0:00:16.520 --> 0:00:19.720 and then it's like the day before Thanksgiving. My parents 0:00:19.760 --> 0:00:21.759 are like, you still have this cold? Like what do 0:00:21.840 --> 0:00:23.279 you think it's just a cold. He's like, yay, yeah, 0:00:23.400 --> 0:00:26.000 I think it's just a cold. There is one other 0:00:26.079 --> 0:00:29.760 thing it could be, oh like like what and he's like, well, 0:00:29.880 --> 0:00:33.320 I was hiking in lime, Connecticut, and then later I 0:00:33.400 --> 0:00:37.840 found a tick and then I noticed this very specific 0:00:37.880 --> 0:00:40.840 kind of rash on my back. It looks like a bullseye, 0:00:41.320 --> 0:00:44.680 so it could be something like lime disease. And my 0:00:44.840 --> 0:00:47.239 parents were It was like a moment which now I 0:00:47.280 --> 0:00:49.400 reflect on as a parent, where they're just like, are 0:00:49.440 --> 0:00:52.800 you kidding? It's like the day before Thanksgiving and now 0:00:52.840 --> 0:00:54.720 we have to call our friends and be like, how 0:00:54.760 --> 0:00:59.840 can we get some doxy cyclic? So teenage boys the worse, 0:01:00.080 --> 0:01:02.160 if anything, totally, is. 0:01:02.080 --> 0:01:04.959 There anything worse than a teenage boy trying to take 0:01:04.959 --> 0:01:07.839 care of their own health or ticks in lime Connecticut, 0:01:08.120 --> 0:01:09.000 and there's nothing. 0:01:09.080 --> 0:01:12.160 It was so it was so specific, and today we're 0:01:12.160 --> 0:01:15.600 going to talk about ticks and there are many, many problems. 0:01:15.600 --> 0:01:21.040 Oh, it's our creepiest episode so far, creepy Crawley episode 0:01:21.080 --> 0:01:25.080 of wellness actually, but you know, coming to you here together, 0:01:25.240 --> 0:01:29.520 we're party still Broadcast Center in Connecticut, birthplace of lime disease. 0:01:30.600 --> 0:01:33.680 No better place to discuss ticks. So far, the room 0:01:33.720 --> 0:01:36.479 has no ticks. But we'll have to say how things evolved. 0:01:39.120 --> 0:01:42.160 I'm Emily Aster, I'm an economist and a data expert. 0:01:42.280 --> 0:01:44.360 And I'm Perry Wilson, I'm a medical doctor. 0:01:44.840 --> 0:01:49.640 It's Thursday, August twentieth, twenty twenty six, and this is wellness. 0:01:49.000 --> 0:01:52.880 Actually, because you're getting a staggering amount of health and 0:01:52.920 --> 0:01:56.920 wellness information nowadays from every source imaginable, and some of 0:01:56.960 --> 0:01:58.240 it is awesome. 0:01:58.160 --> 0:02:03.240 And some of it is well well actually both Fortunately, 0:02:03.400 --> 0:02:06.160 we're both people who know how to read studies, how 0:02:06.160 --> 0:02:08.560 to parse the data, and can tell you what's worth 0:02:08.560 --> 0:02:11.120 thinking about and what you can safely ignore. 0:02:11.440 --> 0:02:13.720 But before we dig in, a note that this podcast 0:02:13.800 --> 0:02:16.360 is for educational purposes and should not be construed as 0:02:16.400 --> 0:02:19.600 medical advice. We don't know your unique situation, so talk 0:02:19.639 --> 0:02:21.520 to your doctor for personal health decisions. 0:02:23.120 --> 0:02:27.080 This week, we're asking what's the deal with ticks Perry 0:02:27.080 --> 0:02:29.440 and I will give the official smash or pass if 0:02:29.520 --> 0:02:31.840 I think we're going to pass, but let's see, and 0:02:31.919 --> 0:02:34.240 then we'll get to your question of the week. But first, 0:02:34.400 --> 0:02:36.960 let's do the health news roundup after the break. 0:02:48.400 --> 0:02:51.160 And we're back with the health news of the week. 0:02:51.440 --> 0:02:53.680 First bit of health news. I needed to get your 0:02:53.720 --> 0:02:56.119 opinion on Emily because I saw this and I was like, oh, 0:02:56.280 --> 0:02:59.200 it turns out I'm the best parent ever. Okay. So 0:02:59.240 --> 0:03:06.080 a study shows that less unsupervised physical activity and more 0:03:06.240 --> 0:03:12.079 screen time in childhood is associated with better cognitive outcomes 0:03:12.520 --> 0:03:16.800 in adolescents. Okay, So less physical activity, more screen time, 0:03:17.240 --> 0:03:21.079 smarter kids. I'm doing great. My kids waking up and 0:03:22.320 --> 0:03:25.239 picking up an iPad while they eat their like process 0:03:25.240 --> 0:03:29.120 cereal is high quality parenting. We probably shouldn't even discuss it. 0:03:29.200 --> 0:03:32.639 Let's move on to our next helf item. So fine, 0:03:32.680 --> 0:03:33.080 what's your. 0:03:32.960 --> 0:03:37.680 Opinion of Okay, So we have seen so much data 0:03:37.720 --> 0:03:40.800 in the other direction, and I am always crapping on 0:03:40.840 --> 0:03:43.200 that data because you see a lot of DA that 0:03:43.200 --> 0:03:45.920 says screens are bad and physical activity is good, and 0:03:46.000 --> 0:03:49.560 most of that is just driven by biases, other differences 0:03:49.600 --> 0:03:55.320 between families, et cetera. This study is also bad, but 0:03:55.480 --> 0:03:58.440 it is it's in the other direction bad. And this 0:03:58.440 --> 0:04:01.240 this study has both the problem that all the other 0:04:01.280 --> 0:04:04.360 studies do, which is that it's got parents who are 0:04:04.440 --> 0:04:07.280 different in different ways. It's very small, it's like a 0:04:07.280 --> 0:04:09.720 few hundred people, so it's not that important. But it 0:04:09.800 --> 0:04:13.800 also has a very very important problem, which is that 0:04:14.000 --> 0:04:19.520 in all of their analyzes they control for a baseline 0:04:20.040 --> 0:04:24.400 cognitive metric, so it's like the outcome is a is 0:04:24.440 --> 0:04:27.479 like cognition now, and then they have some controls for 0:04:27.600 --> 0:04:29.680 like how much physical activity and screen time you have, 0:04:30.040 --> 0:04:32.640 but there's also a control for when they enrolled you 0:04:32.680 --> 0:04:36.400 in study initially what your cognition was, and so that's 0:04:36.440 --> 0:04:39.880 actually soaking up like almost all the variation because there's 0:04:39.880 --> 0:04:43.320 so much correlation over time, and when you soak up 0:04:43.320 --> 0:04:47.840 all that variation, you get a lot of random noise out. 0:04:47.720 --> 0:04:49.280 In that really just on the margins. 0:04:49.279 --> 0:04:51.960 So it's really just on the margins. And then small 0:04:52.040 --> 0:04:55.840 biases and differences will drive stuff, and some most of 0:04:55.880 --> 0:04:57.919 their stuff is not significant. There's like a little p 0:04:58.080 --> 0:05:00.880 Hackings paper has a lot of problems, but that is. 0:05:00.920 --> 0:05:01.960 Getting a lot of press though. 0:05:02.080 --> 0:05:03.880 You got a lot of press because people love people 0:05:03.960 --> 0:05:06.080 are like you. They will like people love to hear 0:05:06.160 --> 0:05:09.120 what they think already is. They love to hear they're 0:05:09.160 --> 0:05:09.719 doing a good jobs. 0:05:09.800 --> 0:05:11.760 Zee Commanuel has a whole book about why it's healthy 0:05:11.760 --> 0:05:12.680 to eat ice cream. 0:05:12.600 --> 0:05:15.880 Right, and people like that. That book sold really well. Yeah, 0:05:15.920 --> 0:05:18.159 because people want to hear that what they're doing is okay, 0:05:18.279 --> 0:05:20.960 and what you're doing probably is okay. But this study 0:05:20.960 --> 0:05:22.159 doesn't tell you anything about that. 0:05:22.560 --> 0:05:25.080 Stay tuned for our episode next week where we talk 0:05:25.080 --> 0:05:27.840 about the benefits of cocaine and methamphetamy. 0:05:28.520 --> 0:05:36.440 Totally okay. Next up, the AJ updated their cholesterol targets. Yeah, 0:05:37.400 --> 0:05:40.320 tell me more. Yeah, I mean this is this is 0:05:40.360 --> 0:05:41.080 not as interesting. 0:05:41.279 --> 0:05:44.000 It's not the sexiest bit of news, but it is important. 0:05:44.040 --> 0:05:49.360 The AJA has not updated its cholesterol targets since twenty eighteen, 0:05:49.440 --> 0:05:51.159 so it's been a fair amount of time, and there's 0:05:51.160 --> 0:05:54.279 been a lot of research in the interim about the 0:05:54.320 --> 0:05:59.120 relative benefits of reducing bad cholesterol, typically LDL cholesterol. It's 0:05:59.160 --> 0:06:01.400 a big document. Go through just some of the highlights. 0:06:02.400 --> 0:06:05.920 The broad strokes here is that they recommend screening earlier 0:06:06.080 --> 0:06:10.039 and getting LDL lower for longer. So they actually say 0:06:10.080 --> 0:06:12.640 that kids should be screened between ages nine and eleven 0:06:13.600 --> 0:06:16.520 for cholesterol checking, and they sort of reduce their targets 0:06:16.560 --> 0:06:19.920 across the board, so for people, for everyone, no matter 0:06:19.960 --> 0:06:23.000 what your cardiovascular risk is, the LDL target is less 0:06:23.000 --> 0:06:26.479 than one sixty now. And then they recommend a risk 0:06:26.640 --> 0:06:31.839 assessment system. There's a scoring system called Prevent which input 0:06:31.839 --> 0:06:34.600 a bunch of stuff like are you smoker, diabetes, other things. 0:06:34.720 --> 0:06:36.760 It calculates your risk of heart disease in the next 0:06:36.839 --> 0:06:38.880 ten years, and then there are targets based on the 0:06:38.920 --> 0:06:43.080 various risk thresholds. The other addition to this from the 0:06:43.080 --> 0:06:46.960 prior guidelines was that among adults who are on therapy, 0:06:47.080 --> 0:06:50.080 like on a statin or something to reduce their bad 0:06:50.279 --> 0:06:54.800 LDL cholesterol, that we should measure APO B, which is 0:06:55.000 --> 0:06:57.880 a different lipoprotein, a different type of cholesterol that's not 0:06:57.920 --> 0:07:01.120 typically measured in the screening tests, and that all adults 0:07:01.200 --> 0:07:05.280 should have LP little a measured once. LP LITTLEA is 0:07:05.320 --> 0:07:10.480 an interesting little type of cholesterol lipoprotein that clearly is 0:07:10.520 --> 0:07:13.240 associated with heart disease risk over time. So people with 0:07:13.320 --> 0:07:16.120 higher levels do have more heart disease over time. We 0:07:16.200 --> 0:07:21.360 know that. However, it's mediated almost entirely genetically, so as 0:07:21.360 --> 0:07:25.640 opposed to LDL, which has lifestyle dietary implications, LP little 0:07:25.680 --> 0:07:27.880 A is like you get what you get, which is 0:07:27.920 --> 0:07:31.040 why they're only recommending that you measure it once. And 0:07:31.080 --> 0:07:33.600 actually the therapies to lower LP little A are still 0:07:34.560 --> 0:07:36.760 are still in the sort of research phases, although I 0:07:36.760 --> 0:07:39.640 think we'll see some commercialization soon. So yeah, get your 0:07:39.680 --> 0:07:40.400 cholesterol lower. 0:07:40.440 --> 0:07:44.000 I guess this kind of cutoff in medicine is something 0:07:44.000 --> 0:07:49.360 economists like a lot because it suggests good opportunities for 0:07:49.480 --> 0:07:53.800 figuring out how much different treatments matter, like in the 0:07:53.840 --> 0:07:56.520 real world. So it's you say, you know the cutoff 0:07:56.560 --> 0:07:58.920 is one hundred, then doctors treat people with one hundred 0:07:58.920 --> 0:08:00.880 and one different from people with nine, even though it's 0:08:00.880 --> 0:08:02.960 super super dominant. We can talk about why, but like 0:08:03.160 --> 0:08:06.040 that is definitely how it happens. And so when you 0:08:06.080 --> 0:08:10.320 move these cutoffs, it provides more interesting opportunities for identification. 0:08:10.480 --> 0:08:14.000 So economists listening, you got like two years, and then 0:08:14.040 --> 0:08:17.360 you can use these new cutoffs to do stuff exciting. 0:08:17.400 --> 0:08:19.680 I love a good natural experiment, good natural experiment. 0:08:20.800 --> 0:08:22.800 Also, I think my LDL is higher than one hundred, 0:08:22.920 --> 0:08:25.200 so I'm I'm a bit concerned. But let's move on. 0:08:25.240 --> 0:08:28.360 But I suspect you're not at borderline risk, which is 0:08:28.360 --> 0:08:29.880 what the one hundred target is. It's one hundred and 0:08:29.880 --> 0:08:32.080 sixty for people with low risk. Okay, great, yeah, but 0:08:32.120 --> 0:08:34.040 you can ensue maybe who knows. I know there's family 0:08:34.080 --> 0:08:35.880 history stuff in the risk score, so you can check 0:08:35.920 --> 0:08:39.520 it out. All right, has there been a new album drop? 0:08:39.760 --> 0:08:44.760 If so, be careful because a new study finds a 0:08:44.840 --> 0:08:48.800 fifteen percent increase in traffic fatalities on the day of 0:08:48.840 --> 0:08:52.439 a top ten streaming album release compared to the day 0:08:53.000 --> 0:08:56.400 before or after. So the idea here being we're in 0:08:56.440 --> 0:09:00.760 our car Taylor drops her new album and we're like 0:09:00.920 --> 0:09:04.400 just we're rocking out, our eyes are closed, and traffic 0:09:04.440 --> 0:09:08.120 fatalities go up quite a bit. I think you have 0:09:08.120 --> 0:09:09.240 a connection to this paper. 0:09:09.520 --> 0:09:12.160 Yeah. So the senior author on this paper is a 0:09:12.200 --> 0:09:15.040 guy named Babu Jenna who is at Harvard, who is 0:09:15.160 --> 0:09:18.280 perfect for the Wellness Actually podcast because Bapu is an 0:09:18.360 --> 0:09:21.320 mdphd and his PhD is in economics. He was actually 0:09:21.360 --> 0:09:24.280 my student at Chicago and there aren't very many people 0:09:24.280 --> 0:09:28.360 with an mdphd in economics. It's an unusual combination of things. 0:09:28.920 --> 0:09:31.440 But he writes a lot of very interesting papers that 0:09:31.520 --> 0:09:34.400 have some similarities to this. So he has some papers 0:09:34.440 --> 0:09:37.800 on how more people die of heart attacks during marathons, 0:09:37.960 --> 0:09:40.000 not because they are running, but because you cannot get 0:09:40.040 --> 0:09:42.560 to the hospital if you have a heart attack. 0:09:43.520 --> 0:09:45.600 Oh, because there's the roads are all closed and stuff. 0:09:46.080 --> 0:09:49.320 Yeah, marathons are deadly. Look it up. But in this case, 0:09:49.480 --> 0:09:52.560 what they find is they use this nice identification strategy 0:09:52.600 --> 0:09:56.440 around album releases, and they show that people are more 0:09:56.440 --> 0:10:01.360 distracted and it's particularly men. Not that surprising, And I 0:10:01.400 --> 0:10:04.079 would guess if I had to guess, and I didn't, 0:10:04.120 --> 0:10:06.040 I don't think they have a lot of heterogeneity by 0:10:06.120 --> 0:10:09.040 like what type of music it is. But I would guess, 0:10:09.080 --> 0:10:13.280 like the Noah Kahan album, like people are not you know, 0:10:13.400 --> 0:10:16.200 like driving going you're just like you're not going ninety 0:10:16.360 --> 0:10:19.040 or just like cry maybe you're crying. So anyway, Oh 0:10:19.040 --> 0:10:19.480 that's true. 0:10:19.600 --> 0:10:23.400 Yeah, Okay, what I wonder you know, I did see 0:10:23.440 --> 0:10:26.680 in the study that they adjusted for the day of 0:10:26.720 --> 0:10:30.240 the week and and like the number of subscriptions to 0:10:30.280 --> 0:10:32.839 the service and stuff. Over time, Like there's obviously confounders here, 0:10:32.840 --> 0:10:35.640 But what I was kind of thinking is like how 0:10:35.720 --> 0:10:40.560 sophisticated are record producers or distribution companies in terms of 0:10:40.559 --> 0:10:44.080 picking that date? Like do they know? Like are they 0:10:44.120 --> 0:10:47.040 going for a date that's gonna be that's important in 0:10:47.080 --> 0:10:48.439 a way that we're not adjusting here for and I 0:10:48.440 --> 0:10:49.800 don't know what it is, Like are they looking for 0:10:49.880 --> 0:10:53.080 dates that are high literally high traffic? Like do they 0:10:53.080 --> 0:10:55.000 want to release on dates when there are a lot 0:10:55.040 --> 0:10:56.800 of people on the road just to get those get 0:10:56.840 --> 0:10:58.360 those clicks, get those streams? Do not? 0:10:58.800 --> 0:11:01.880 I think that that is stretching crewdu I mean, is 0:11:01.920 --> 0:11:05.800 the right question to ask about identification? But I think 0:11:05.880 --> 0:11:10.040 it is very unlikely that this that surely they are 0:11:10.120 --> 0:11:12.280 choosing for some reason. But as long as that reason 0:11:12.360 --> 0:11:16.880 is not about traffic fatalities, which seems less plausible than 0:11:16.920 --> 0:11:21.000 this identification strategy, is fine, all right, And based on 0:11:21.040 --> 0:11:23.880 the timing of choosing book releases, I would say it's 0:11:23.920 --> 0:11:28.120 mostly random. Somebody in the office is like, I've thought 0:11:28.160 --> 0:11:31.360 about it, and July fifteenth, it's like they're just like. 0:11:31.440 --> 0:11:36.400 Yeah, all right. Whenever do you worry about kids listening 0:11:36.440 --> 0:11:38.560 to music when they drive. My daughter is always listening 0:11:38.559 --> 0:11:40.600 to music and does, like I do, worry that it's 0:11:40.760 --> 0:11:41.920 one extra I would. 0:11:41.720 --> 0:11:44.520 Prefer my children never drive, So I'm going to go 0:11:44.640 --> 0:11:47.240 with I just don't. I don't like the idea of 0:11:47.320 --> 0:11:51.240 children children driving. I haven't thought about the music part 0:11:51.280 --> 0:11:53.880 of it, honestly, I'm still getting past the driving part. 0:11:56.120 --> 0:11:59.040 That is it for the health news of the week. Now, 0:12:00.080 --> 0:12:01.200 what's the deal with ticks? 0:12:02.400 --> 0:12:03.079 What's the deal? 0:12:03.200 --> 0:12:03.839 What's the deal? 0:12:04.679 --> 0:12:05.200 What's going on? 0:12:05.240 --> 0:12:07.080 Ticks? Ticks? Why are you here? 0:12:07.440 --> 0:12:07.720 Oh? 0:12:07.880 --> 0:12:08.360 Geez? 0:12:08.880 --> 0:12:15.600 Okay, all right, I have to start with a corrections 0:12:15.720 --> 0:12:20.560 buds per usually at the at the end of last 0:12:20.559 --> 0:12:22.520 week's episode, when we said this week is what's the 0:12:22.559 --> 0:12:24.720 deal with ticks? I think I made a comment like 0:12:25.200 --> 0:12:29.000 those those bugs, I call them bugs, and you know, 0:12:29.040 --> 0:12:31.320 the entomololi just get really upset when you call an 0:12:31.360 --> 0:12:35.120 animal a bug that's not a bug, even like insects, 0:12:35.559 --> 0:12:38.400 Like there's some insects which are bugs, but not all 0:12:38.400 --> 0:12:39.240 insects are bugs. 0:12:40.000 --> 0:12:42.439 Okay, it's like a square and a rectangle. 0:12:42.960 --> 0:12:44.880 Yeah, but like bug, I thought that bug was a 0:12:44.880 --> 0:12:47.520 colloquial term for a creepy crawley thing. But there's also 0:12:47.800 --> 0:12:51.720 like an entomological term for this is not ticks aren't bugs. 0:12:52.480 --> 0:12:55.679 They're not even insects. They're not even insects. They are 0:12:55.840 --> 0:12:59.640 a racknids. They're more closely related to spiders than they 0:12:59.640 --> 0:13:03.960 are to mosquitoes or other blood suckers. That's interesting. 0:13:04.240 --> 0:13:07.439 That is interesting. Are they so? And also like related 0:13:07.440 --> 0:13:09.840 to mites, yes, different kinds of mites. 0:13:09.679 --> 0:13:12.199 Yeah, other iracnid racknin type stuff. 0:13:12.440 --> 0:13:15.439 Yep, I'm already I don't like I don't like bugs. 0:13:16.160 --> 0:13:18.240 I guess in this case, that's fine because this isn't 0:13:18.240 --> 0:13:20.080 about bugs, as previously noted. 0:13:21.920 --> 0:13:22.680 That crawl on you. 0:13:22.760 --> 0:13:23.480 They crawl on you. 0:13:24.080 --> 0:13:26.360 No, agreed, No, this is this is a creepy episode. 0:13:26.360 --> 0:13:30.440 As we said, all right, so ticks eat blood. They 0:13:30.679 --> 0:13:35.000 need blood in order to move forward with their life cycle. 0:13:35.600 --> 0:13:37.960 And when they get on you, they get on and 0:13:38.000 --> 0:13:41.480 they feed in your blood and they get enormous. They 0:13:41.520 --> 0:13:45.760 can go like up six hundred times their weight while 0:13:45.760 --> 0:13:47.280 they suck your juices. 0:13:47.480 --> 0:13:50.360 It's super gross. I've never had a tick on me 0:13:50.440 --> 0:13:51.800 that got that big, but I have had like a 0:13:51.800 --> 0:13:54.520 tick on a dog that is just just gigantic. 0:13:54.679 --> 0:13:57.760 And yeah, okay, we. 0:13:59.480 --> 0:14:01.480 Have to stop. We have to take a break already 0:14:01.840 --> 0:14:02.959 have made it this far. 0:14:03.360 --> 0:14:06.840 Okay, But it turns out that the stage of the 0:14:06.840 --> 0:14:08.959 tick that matters the most is the nymph. They're very, 0:14:09.040 --> 0:14:12.440 very very small, which is which is why they are 0:14:12.480 --> 0:14:14.640 the most dangerous, because that is the thing that you 0:14:14.679 --> 0:14:17.120 would not see or it's very hard to see. It 0:14:17.200 --> 0:14:19.400 looks like a little tiny poppy seed. 0:14:19.920 --> 0:14:22.880 Yeah, dear tech nymph in particular, which are you know, 0:14:22.880 --> 0:14:25.720 the main vectors for lime disease, which is which is 0:14:25.720 --> 0:14:27.520 the big the big one when it comes to tick 0:14:27.640 --> 0:14:30.160 born diseases, but by no means the only one. And 0:14:30.240 --> 0:14:32.360 you mentioned that blood meals are necessary to advance in 0:14:32.400 --> 0:14:34.120 the stage of the life cycle, and like not just 0:14:34.280 --> 0:14:37.000 the way that well, everyone has to eat to grow bigger, 0:14:37.080 --> 0:14:40.760 but ticks go from you know, larva to nymph to 0:14:41.760 --> 0:14:43.920 I think one more stage and then adult, and each 0:14:43.960 --> 0:14:46.880 of those things needs a blood meal to like unlock 0:14:46.920 --> 0:14:50.200 the genetic machinery. So they literally level up every time 0:14:50.760 --> 0:14:53.200 they feed off of someone. And yeah, if you don't 0:14:53.200 --> 0:14:55.560 get them off, they feed until they get gigantic and 0:14:55.560 --> 0:14:57.720 then they just fall off on the ground and then 0:14:57.760 --> 0:15:01.120 go through their next little molting life SiGe and wait 0:15:01.160 --> 0:15:02.440 for the next blood meal to come by. 0:15:03.040 --> 0:15:05.960 So for lime disease, which we are going to get to, 0:15:06.040 --> 0:15:08.080 but we're actually gonna there's a lot to talk about. 0:15:08.080 --> 0:15:10.960 So we're going gonna start the episode by talking about 0:15:11.080 --> 0:15:13.120 things that are not lime disease, and then we're gonna 0:15:13.120 --> 0:15:16.120 get to lime. But for lime, the one thing I 0:15:16.120 --> 0:15:17.880 will say now is that the tick has to stay 0:15:17.880 --> 0:15:20.120 attached for something like thirty six to forty eight hours. 0:15:20.200 --> 0:15:22.840 You actually have quite a long time to remove the 0:15:22.920 --> 0:15:27.160 tick in lime disease before it would cause disease. Is 0:15:27.200 --> 0:15:30.240 not going to be true for for every everything else. 0:15:30.360 --> 0:15:32.240 So we're gonna get to line, but we're gonna start 0:15:32.280 --> 0:15:37.560 with generally what can happen. Ticks so responsible for many diseases, 0:15:37.640 --> 0:15:39.320 and they kind of work in three different ways. So 0:15:39.360 --> 0:15:42.360 I thought, rather than talking about the entire list, we'll 0:15:42.400 --> 0:15:44.880 say for listeners. Perry had a like spreadsheet and had 0:15:44.880 --> 0:15:46.840 like forty five rows, and I thought he was gonna 0:15:46.840 --> 0:15:49.160 we were gonna go through every tick disease, Tick disease 0:15:49.240 --> 0:15:52.800 number thirty sevens like this episode would be boring, and 0:15:52.840 --> 0:15:54.880 so instead we're gonna we're gonna focus a little bit 0:15:54.880 --> 0:15:57.320 on the sort of three ways that the tick can 0:15:57.440 --> 0:16:01.080 actually impact you your health, impact your health. 0:16:01.160 --> 0:16:05.640 Yeah, yes, yeah, so I think. I mean, honestly, the 0:16:05.680 --> 0:16:09.760 tick born diseases are super fascinating. But yes, three big ways. 0:16:10.320 --> 0:16:12.360 The first thing that a tick can do to make 0:16:12.400 --> 0:16:15.320 you sick is it can infect you with something, be 0:16:15.360 --> 0:16:18.640 it virus, bacteria, et cetera. And we'll obviously talk about 0:16:19.160 --> 0:16:21.360 a sampling of those, but just so you know, there 0:16:21.400 --> 0:16:24.280 are many more, and we'll miss, uh, we'll miss quite 0:16:24.280 --> 0:16:26.200 a few of them in the interest of time. The 0:16:26.240 --> 0:16:30.040 second thing a tick can do is poison you. So 0:16:30.960 --> 0:16:35.360 we'll talk about some ticks that have substances in their saliva, 0:16:35.440 --> 0:16:38.920 so non infectious, but nevertheless chemical substances that can have 0:16:39.480 --> 0:16:44.920 really devastating effects on humans. And the third thing is 0:16:44.960 --> 0:16:49.160 that they can rewire your immune system. And there is 0:16:49.240 --> 0:16:51.760 a few themes that have come up in the Wellness 0:16:51.760 --> 0:16:54.680 Actually podcast when it comes to allergy and immunology, and 0:16:54.760 --> 0:16:58.960 one of them is this understanding that when you deliver 0:16:59.200 --> 0:17:02.360 something into your body not through the normal way, like 0:17:02.440 --> 0:17:06.280 not by eating it, you can get allergic to the 0:17:06.280 --> 0:17:08.280 substance in a way that you wouldn't get if you 0:17:08.640 --> 0:17:12.160 ate it. And because ticks are injecting stuff, basically directly 0:17:12.200 --> 0:17:14.840 into your bloodstream. It opens up the door to all 0:17:14.840 --> 0:17:16.639 sorts of really interesting allergies. So I think if we 0:17:16.720 --> 0:17:19.320 hit some representative sampling there before we get to all 0:17:19.359 --> 0:17:20.680 the lime disease stuff, that would be great. 0:17:20.760 --> 0:17:23.119 Okay, So we're gonna start with the infection one because 0:17:23.160 --> 0:17:26.560 it has is actually both the way the lime works 0:17:26.600 --> 0:17:29.040 and also the way that what I think is by 0:17:29.080 --> 0:17:34.920 far the scariest tick disease works. So the scariest tick 0:17:35.000 --> 0:17:39.200 disease I think is poasen. Is that how you saying it? 0:17:39.640 --> 0:17:42.760 Poson polawson? Yeah, pos and virus, the. 0:17:42.720 --> 0:17:45.280 Posts and virus, and the post and virus is spread 0:17:45.280 --> 0:17:49.359 by the same tick as lime disease. It is the 0:17:49.400 --> 0:17:53.560 black leg deer tick. And this is the thing. There 0:17:53.560 --> 0:17:57.840 are two really really scary aspects of this. So one 0:17:58.040 --> 0:18:01.119 is that it can happen very fat. So lime disease 0:18:01.160 --> 0:18:04.159 needs a very long time this virus for the tick 0:18:04.680 --> 0:18:08.800 the chick to be attached. And this virus needs fifteen minutes. Yeah, 0:18:08.840 --> 0:18:11.800 and it is very possible for you to miss I mean, 0:18:11.800 --> 0:18:13.680 it's very possible to miss a tick for two days. 0:18:13.760 --> 0:18:16.520 It's really possible to miss it tick for fifteen minutes. 0:18:16.640 --> 0:18:19.560 One hundred percent. If you see a deer tick on 0:18:19.600 --> 0:18:22.159 you and it has bitten, like it's not crawling, but 0:18:22.480 --> 0:18:24.840 it's in and you have to pull it off, and 0:18:25.000 --> 0:18:29.560 in theory it could have transmitted poots and virus. 0:18:29.520 --> 0:18:31.000 And the pous and virus is very scary. 0:18:31.040 --> 0:18:33.679 It's very scary. So all right, if you if you 0:18:33.720 --> 0:18:36.040 look this up, what you'll find it's that POAs and 0:18:36.119 --> 0:18:37.879 virus is a virus with no treatment and a ten 0:18:37.920 --> 0:18:42.159 percent case fatality rate, which is like, oh, so I 0:18:42.200 --> 0:18:44.320 can walk through the woods of Connecticut where a deer 0:18:44.359 --> 0:18:46.840 tick abound, and I can have a tick on me 0:18:46.880 --> 0:18:48.399 for fifteen minutes and then I have a ten percent 0:18:48.440 --> 0:18:53.520 death rate. This is not entirely true, but the broad 0:18:53.640 --> 0:18:57.360 strokes and the way the data we have will lead 0:18:57.400 --> 0:18:59.320 to some people saying these things. So, so what the 0:18:59.400 --> 0:19:04.320 virus does in most people is nothing. Now, that's not 0:19:04.359 --> 0:19:06.000 what you'll see when you google. What you'll see when 0:19:06.040 --> 0:19:08.520 you Google is that polas and virus causes meningitis. So 0:19:08.560 --> 0:19:13.080 it's a brain inflammatory virus. And indeed, if you develop 0:19:13.800 --> 0:19:17.520 meningitis from polos and virus, you're going to go to 0:19:17.520 --> 0:19:20.240 the hospital. You're going to be very sick. It's a virus, 0:19:20.280 --> 0:19:23.520 so antibiotics don't work. You're going to get supportive care 0:19:24.080 --> 0:19:28.399 ivy fluids and pain control and fingers crossed. And the 0:19:28.440 --> 0:19:31.800 case fatality rate is about ten percent, So that's super scary. 0:19:33.040 --> 0:19:36.480 But most people don't ever get symptoms from it. 0:19:36.720 --> 0:19:40.000 Yeah, And I think we sort of have to know 0:19:40.080 --> 0:19:43.800 that that has to be true just based on the 0:19:43.840 --> 0:19:47.560 base rate. You know, there are many, many, many cases 0:19:47.640 --> 0:19:50.600 of lime every year spread by the same tick. There 0:19:50.640 --> 0:19:53.280 are very small number of cases of this, so so 0:19:53.320 --> 0:19:56.000 far in twenty twenty six there have been thirty. Last 0:19:56.080 --> 0:19:58.000 year there were seventy six. That's a very small number. 0:19:58.040 --> 0:19:59.879 Of the US is three hundred and thirty million people. 0:20:00.280 --> 0:20:03.479 The Northeast has many, many, many tens of millions of people. 0:20:03.880 --> 0:20:07.320 This is a very small number. And there is some 0:20:08.320 --> 0:20:10.920 sero prevalence work, which means like testing people to see 0:20:10.960 --> 0:20:12.760 if there's evidence that they've been exposed to this with 0:20:12.880 --> 0:20:15.840 suggest much higher rates of exposure, so. 0:20:15.800 --> 0:20:18.120 Have an antibody to the virus, but you never were sick. 0:20:18.320 --> 0:20:21.280 Yeah, So one way to think about this is conditional 0:20:21.320 --> 0:20:24.639 on arriving at the hospital very sick. With this, the 0:20:24.680 --> 0:20:27.960 fatality rate is quite high. The vast majority of people 0:20:27.960 --> 0:20:31.480 who get this do not actually develop this virus. So 0:20:31.960 --> 0:20:33.919 it's not that it's not scary, like it is. This 0:20:34.000 --> 0:20:37.800 is very scary. It's very scary, but there are many 0:20:38.040 --> 0:20:41.160 other things that are scarier in the world. Yeah. 0:20:41.240 --> 0:20:43.679 Yeah, If insofar as this motivates you to like do 0:20:43.840 --> 0:20:46.520 the anti tick measures, we'll talk about some of the 0:20:46.520 --> 0:20:48.440 things you can do to prevent getting tick bites, then great. 0:20:49.000 --> 0:20:50.520 But yeah, don't let keep you up at night. 0:20:51.119 --> 0:20:52.959 I mean I do if you think, like things like 0:20:52.960 --> 0:20:55.879 this are very salient to people. When you say, you know, 0:20:55.920 --> 0:20:57.480