WEBVTT - Ep 6 Plague Part 2: TGFA 0:00:04.000 --> 0:00:08.399 June twentieth, with the help of Father Vigano, I try 0:00:08.440 --> 0:00:11.560 to persuade some English sailors, whose duty it is to 0:00:11.640 --> 0:00:14.480 bury the dead from the city and other hospitals, to 0:00:14.600 --> 0:00:16.880 let me take the bubos from the dead before they 0:00:16.920 --> 0:00:20.840 are buried. A few dollars conveniently distributed and the promise 0:00:20.840 --> 0:00:24.119 of a good tip for every case have a striking effect. 0:00:24.760 --> 0:00:27.200 The bodies, before they are carried to the cemetery, are 0:00:27.240 --> 0:00:29.960 deposed for one or two hours in a cellar. They 0:00:30.000 --> 0:00:31.960 are already in their coffins in a bed of lime. 0:00:32.600 --> 0:00:35.520 The coffin is opened, I move the lime to clear 0:00:35.560 --> 0:00:39.559 the thigh region. The bubo is exposed. Within less than 0:00:39.600 --> 0:00:42.120 a minute. I cut it away and run to my laboratory. 0:00:42.479 --> 0:00:45.920 I see a real mass of basillia, all identical from 0:00:45.920 --> 0:00:49.920 the bubou I inoculate agritubes, mice and guinea pigs. My 0:00:50.040 --> 0:00:52.680 basillis is most probably that of plague, but I am 0:00:52.720 --> 0:00:56.400 not certain. June twenty first, I go on cutting and 0:00:56.480 --> 0:01:01.320 examining bubos. I always find the same basillistly abundant. My 0:01:01.400 --> 0:01:05.440 animals inoculated yesterday are dead and show the typical plague bubos. 0:01:14.200 --> 0:01:15.839 I love that I was really nerdy. 0:01:17.080 --> 0:01:20.200 It was so perfectly like I can imagine the exact 0:01:20.400 --> 0:01:21.399 scientist he was. 0:01:21.360 --> 0:01:27.480 Like, you know, well, the exact scientist was Alexander Yerson 0:01:27.840 --> 0:01:30.560 in the year eighteen ninety four, which is when he 0:01:30.640 --> 0:01:34.360 discovered Yep, that's right, you're sinia pestis. Oh my god, 0:01:34.560 --> 0:01:38.280 the causative agent of plague. Yoursin yourson. 0:01:38.480 --> 0:01:40.000 I never knew where it got its name. 0:01:40.080 --> 0:01:43.640 Now I know, a Swiss scientist. And also, even though 0:01:43.680 --> 0:01:47.760 he probably was the first to actually describe and identify 0:01:47.880 --> 0:01:51.360 the bacterium, he did not get credit for a while 0:01:51.520 --> 0:01:54.320 because he did not publish in English, which is very interesting. 0:01:54.400 --> 0:01:57.920 Oh interesting, So what in Switzerland? What what language? Did 0:01:57.920 --> 0:01:59.200 he publish in? German or French? 0:01:59.320 --> 0:01:59.960 Probably German? 0:02:00.160 --> 0:02:01.320 Cool? Interesting? 0:02:01.520 --> 0:02:01.840 Yeah? 0:02:01.920 --> 0:02:06.480 How fun? Hi and welcome to episode six. Yes, this 0:02:06.600 --> 0:02:09.680 podcast will kill you. My name is Aaron Welsh and 0:02:09.720 --> 0:02:14.679 I'm Erin Alman Updike and this is Plague Part two. 0:02:15.120 --> 0:02:19.040 Yeah. Before we start off, we want to tell you 0:02:19.040 --> 0:02:22.360 guys about a few other podcasts that are awesome and 0:02:22.400 --> 0:02:23.800 you guys should totally check out. 0:02:23.960 --> 0:02:25.919 Yeah, as if you know you have all the time 0:02:25.919 --> 0:02:28.520 in the world to listen to all the podcasts, let's 0:02:28.520 --> 0:02:30.000 tell you about some of our favorites. Yeah. 0:02:30.120 --> 0:02:33.560 Yeah, So, our friend Matt Candais, who's also a student 0:02:33.680 --> 0:02:37.240 with us, produces a podcast called In Defensive Plants and 0:02:37.280 --> 0:02:40.880 it's an awesome, awesome botany podcast. It's like top rated 0:02:40.960 --> 0:02:42.000 on iTunes. 0:02:42.639 --> 0:02:45.560 He interviews really awesome people and it's just a really 0:02:45.639 --> 0:02:48.840 great podcast in general. You know, dot dot dot lookout 0:02:48.840 --> 0:02:54.000 for a crossover episode in the future. We also made 0:02:54.000 --> 0:02:56.600 a Twitter friend, which to me is the most exciting 0:02:56.600 --> 0:02:59.160 thing in the world. I don't know if that's nerdy, 0:02:59.200 --> 0:03:01.360 but when we got our first Twitter friend, I was like, 0:03:01.520 --> 0:03:02.960 I wanted to die of excitement. 0:03:03.440 --> 0:03:06.160 Yeah, as someone who doesn't really do Twitter at all, 0:03:06.320 --> 0:03:08.760 I was in the dark about this, but it was 0:03:08.800 --> 0:03:09.920 Aaron was really excited. 0:03:10.040 --> 0:03:13.320 I was. I almost like, I squealed so hard. But anyways, 0:03:13.360 --> 0:03:16.560 we made friends because I found this podcast called The 0:03:16.600 --> 0:03:20.200 Fems of STEM, which is this amazing podcast all about 0:03:20.400 --> 0:03:23.760 the history of women in science, technology, engineering, and math, 0:03:23.800 --> 0:03:26.920 which is STEM and each episode focuses on a different 0:03:27.080 --> 0:03:30.040 woman and all of her amazing accomplishments in the field. 0:03:30.080 --> 0:03:34.000 It's super interesting. It's hosted by a badass lady named Michelle. 0:03:34.200 --> 0:03:34.640 It's great. 0:03:34.680 --> 0:03:35.800 You should definitely check it out. 0:03:36.200 --> 0:03:39.040 There's also another super cool podcast we want to tell 0:03:39.080 --> 0:03:41.720 you about, and it's created and produced by our friend 0:03:41.800 --> 0:03:47.320 Shane Campbell Stayton and his and his friend Arian Darby. 0:03:47.720 --> 0:03:50.640 It's called The Biology of Superheroes, and in it they 0:03:50.680 --> 0:03:53.160 talk about some of your favorite comic book heroes and 0:03:53.200 --> 0:03:56.000 the biological principles underlying their superpowers. 0:03:56.480 --> 0:03:59.640 It's gonna be amazing. The first episode is being released 0:03:59.640 --> 0:04:00.720 on Too Number first. 0:04:00.600 --> 0:04:02.600 So it'll already be out by the time this episode 0:04:02.640 --> 0:04:05.240 is Oh cool, great, I was gonna say, the first 0:04:05.240 --> 0:04:08.880 episode just dropped and it's all about Peter Parker and 0:04:08.920 --> 0:04:10.400 his spidy physiology. 0:04:10.480 --> 0:04:12.560 My god, I can't wait to listen. 0:04:12.720 --> 0:04:14.040 Yeah, it's gonna be really good. 0:04:14.120 --> 0:04:15.000 I'm thrilled about. 0:04:15.000 --> 0:04:16.240 It's going to be super high quality. 0:04:16.360 --> 0:04:21.760 Yeah, Mage, Mage, what are we chatting about today? Erin, Well, 0:04:22.080 --> 0:04:22.800 this week. 0:04:22.720 --> 0:04:26.440 Just like last week, we're doing something a little bit unusual. 0:04:27.080 --> 0:04:30.560 So the topic of plague is so huge that we 0:04:30.640 --> 0:04:33.159 needed to split it up into two weeks. So this 0:04:33.440 --> 0:04:34.200 is part two. 0:04:34.480 --> 0:04:37.760 So if you missed part one, pause here, go and 0:04:37.880 --> 0:04:41.880 download episode five and then meet us back here in 0:04:42.040 --> 0:04:42.560 like an hour. 0:04:42.720 --> 0:04:46.080 Yeah that that that Episode five will give you the 0:04:46.120 --> 0:04:51.240 biological background and historical context that you may need for 0:04:51.279 --> 0:04:55.240 this next episode. Yeah, so this episode we're gonna be 0:04:55.240 --> 0:04:58.800 talking all about the plague in modern times and ending 0:04:58.839 --> 0:05:01.800 with the discussion of the an outbreak in Madagascar and 0:05:01.839 --> 0:05:03.520 what that means for the rest of the world. 0:05:04.240 --> 0:05:04.960 Cool. 0:05:05.200 --> 0:05:08.159 I guess we should start though, with our quarantinies. 0:05:08.360 --> 0:05:09.800 It's quarantine time. 0:05:10.240 --> 0:05:12.120 What do we have on the menu for this episode? 0:05:12.240 --> 0:05:14.160 Erin another boobo baby though? 0:05:14.279 --> 0:05:17.719 Oh? Okay, is this one the mnemonic variety? 0:05:18.080 --> 0:05:22.400 Yes? Absolutely, okay, okay, Yeah, so this one's made with vodka. 0:05:22.680 --> 0:05:25.920 Okay, so it's just another it's a extra dry martini 0:05:26.680 --> 0:05:28.640 with vodka and and. 0:05:28.520 --> 0:05:31.520 This time we used an olive just to mix it 0:05:31.600 --> 0:05:35.280 up first. Maybe olives are more pneumonic. 0:05:50.360 --> 0:05:53.839 Well, how about we start with an overview of the 0:05:53.880 --> 0:05:56.120 biology just as a refresher. 0:05:56.440 --> 0:06:00.159 That's a great idea. So just to review, Plague is 0:06:00.200 --> 0:06:03.599 a disease that is caused by a bacteria known, as 0:06:03.640 --> 0:06:08.240 we mentioned as your Sinia pestis. It is spread in 0:06:08.320 --> 0:06:12.320 several different ways and the root of transmission determines the 0:06:12.360 --> 0:06:15.320 type of disease that you get. So the most famous 0:06:15.360 --> 0:06:20.280 form is bubonic plague, and that disease is acquired when 0:06:20.560 --> 0:06:23.479 it is transmitted by the bite of an infected flea. 0:06:23.600 --> 0:06:27.520 Pneumonic plague, on the other hand, is when a bubonic 0:06:27.560 --> 0:06:30.880 plague spreads to infect your lungs and then can be 0:06:30.920 --> 0:06:35.240 transmitted via respiratory droplets aka coughing. And then the third 0:06:35.320 --> 0:06:38.120 type of plague is known as septostemic plague, and that 0:06:38.160 --> 0:06:42.880 means that the bacterium has infected your bloodstream and proliferated 0:06:42.960 --> 0:06:43.599 in your blood. 0:06:43.839 --> 0:06:46.440 And there are different mortality rates associated with each of 0:06:46.480 --> 0:06:47.679 these forms, right. 0:06:47.560 --> 0:06:51.400 Absolutely so. Bubonic plague is the least fatal of the three. 0:06:51.960 --> 0:06:55.440 It has mortality rates of thirty to sixty percent if untreated, 0:06:55.760 --> 0:06:58.920 and then mneumonic plague is the most virulent and it 0:06:59.000 --> 0:07:02.159 has up to add percent mortality rate if left untreated. 0:07:02.520 --> 0:07:05.000 The good news is all three of these types of 0:07:05.040 --> 0:07:09.120 disease are treatable with antibiotics as long as you get 0:07:09.120 --> 0:07:10.640 to them fast enough. 0:07:11.120 --> 0:07:14.600 Super super dupes. Okay, I think that's a good I 0:07:14.600 --> 0:07:15.840 think that's a good little. 0:07:15.560 --> 0:07:17.280 Biology in a nutshell. 0:07:28.920 --> 0:07:31.559 So now let's pick up where we left off last week, 0:07:31.760 --> 0:07:34.080 which is more or less at the beginning of what 0:07:34.200 --> 0:07:37.880 historians called the third pandemic. So we talked about last week, 0:07:38.240 --> 0:07:41.080 the first pandemic, which was the Plague of Justinian, the 0:07:41.120 --> 0:07:44.760 second pandemic, which was the Black Death, and then the 0:07:44.880 --> 0:07:48.560 local epidemics that followed that in the centuries after. The 0:07:48.640 --> 0:07:53.040 third pandemic began in eighteen fifty five in China and 0:07:53.120 --> 0:07:56.600 spread to India and some other places as well. Over 0:07:56.600 --> 0:08:00.000 the course of that one year, more than twelve million 0:08:00.200 --> 0:08:02.440 people died in those two countries alone. 0:08:02.920 --> 0:08:03.480 Wow. 0:08:03.600 --> 0:08:07.400 Yeah, twelve million, twelve million. Although the death toll of 0:08:07.440 --> 0:08:10.320 the third pandemic could not hold a candle to that 0:08:10.400 --> 0:08:11.400 of the Black Death. 0:08:11.360 --> 0:08:14.920 Right, nothing can no the Black Death. It's the mother 0:08:15.000 --> 0:08:16.640 of all plagues, Yeah, definitely. 0:08:17.160 --> 0:08:19.920 One of the significant outcomes of it was that by 0:08:20.000 --> 0:08:23.520 the early nineteen hundreds, plague was endemic and wild rodent 0:08:23.600 --> 0:08:25.440 populations all around the world. 0:08:25.680 --> 0:08:26.200 Wow. 0:08:26.640 --> 0:08:29.160 And by this time both the black rat and its 0:08:29.240 --> 0:08:32.560 flea had a global distribution. This was thanks to the 0:08:32.559 --> 0:08:37.280 widespread rapid global travel that was now possible. Infected rats 0:08:37.320 --> 0:08:41.400 brought infected fleas onto boats which would enter every port town. 0:08:41.600 --> 0:08:43.560 At the edges of these port towns, you would find 0:08:43.640 --> 0:08:47.200 human dwellings encroaching onto natural areas, which allowed for the 0:08:47.240 --> 0:08:51.400 intermingling of domestic and wild rodents, and the rat fleas 0:08:51.480 --> 0:08:54.280 had no preference. They were just happy to have so 0:08:54.320 --> 0:08:58.640 many available hosts. If humans and wild rodents came into 0:08:58.640 --> 0:09:02.559 close contact, as they did following deforestation, or whenever human 0:09:03.080 --> 0:09:06.839 settlements were built in previously natural areas, plague could make 0:09:06.880 --> 0:09:09.240 the jump from rodent to human hosts via the bite 0:09:09.280 --> 0:09:11.960 of an infected flea, and this is what the Third 0:09:12.000 --> 0:09:16.000 pandemic saw, pockets of plague, some larger than others, popping 0:09:16.040 --> 0:09:19.920 up in parts of every continent except for Antarctica, and 0:09:20.120 --> 0:09:21.679 also most of Western. 0:09:21.320 --> 0:09:23.920 Europe actually, which is interesting. 0:09:23.520 --> 0:09:28.120 Funny considering the Black Death was most impacted a lot 0:09:28.160 --> 0:09:31.760 of Western Europe. It was during this pandemic in the 0:09:31.880 --> 0:09:35.800 late nineteenth century that substantial medical research was finally done 0:09:35.840 --> 0:09:39.080 on the plague. Its root of transmission via infected fleas 0:09:39.320 --> 0:09:43.120 was identified, the importance of rat populations was realized, the 0:09:43.160 --> 0:09:48.720 causative agent little Basilli Rcinia pests was described. Even with 0:09:48.840 --> 0:09:52.520 all these pretty monumental advances in the medical underpinnings of plague, 0:09:52.559 --> 0:09:54.880 there was still a long way to go. The earliest 0:09:54.960 --> 0:09:58.520 vaccines and antibiotics used to prevent or treat plague infection 0:09:59.160 --> 0:10:02.320 were developed in the late eighteen hundreds, but these weren't 0:10:02.320 --> 0:10:05.880 all that great. If you received either, your chances of 0:10:05.960 --> 0:10:09.240 dying were reduced by about twenty or thirty percent. Wow, 0:10:09.720 --> 0:10:14.160 it's it, yeah, gosh promising, but not really that reassuring. 0:10:14.280 --> 0:10:14.839 No. 0:10:14.840 --> 0:10:17.720 No, improvements continued to be made, and now there is 0:10:17.760 --> 0:10:20.839 a functional plague vaccine, but it still has its problems, 0:10:20.840 --> 0:10:23.560 mostly with longevity in the protection it offers, and on 0:10:23.600 --> 0:10:28.559 the logistical side it takes multiple courses to immunize. Antibiotics, 0:10:28.600 --> 0:10:30.840 on the other hand, are still effective against plague. 0:10:30.960 --> 0:10:34.480 Than now, goodness for now, for now, but fake goodness, 0:10:34.480 --> 0:10:35.240 thanks for now. 0:10:35.520 --> 0:10:38.480 In the nineteen forties is when streptomycin, which is usually 0:10:39.000 --> 0:10:42.360 used to treat plague now it was discovered. Even with 0:10:42.480 --> 0:10:46.000 all of these ways to combat plague, it persisted. But 0:10:46.080 --> 0:10:50.240 actually that verb tenses is wrong. It continues to persist 0:10:50.880 --> 0:10:54.040 in many regions of the world, including Madagascar. Plague is 0:10:54.080 --> 0:10:56.920 considered to be an endemic disease. And what is an 0:10:57.000 --> 0:10:57.720 endemic disease? 0:10:57.880 --> 0:11:00.480 Erin, an endemic disease is a disease. It is sort 0:11:00.480 --> 0:11:03.479 of constantly occurring at low levels in a population. 0:11:03.920 --> 0:11:07.560 Thank you You're welcome. Although the pandemic was declared to 0:11:07.559 --> 0:11:10.680 be over in nineteen fifty nine, so the third pandemic 0:11:10.800 --> 0:11:15.000 was according to the WHO done thirty nine, that was, 0:11:15.040 --> 0:11:18.880 by no means the last year that plague caused an epidemic. 0:11:18.960 --> 0:11:19.600 Oh, definitely not. 0:11:20.000 --> 0:11:22.800 Let's take a little detour to Vietnam in the nineteen sixties, 0:11:24.040 --> 0:11:26.640 in the midst of the Vietnam War, oh dear, when 0:11:26.679 --> 0:11:30.160 the US military was over there, fighting in a pointless 0:11:30.200 --> 0:11:34.280 war they never should have started, and devastating entire communities. 0:11:34.400 --> 0:11:40.680 Getting political not really, sorry though, well getting factual. 0:11:42.120 --> 0:11:45.440 Side note. Did you know that in Vietnam this war 0:11:45.559 --> 0:11:48.800 is referred to as the American War either resistance war 0:11:48.800 --> 0:11:49.480 against America. 0:11:49.520 --> 0:11:51.480 I did hear that? Yes, I did know that. 0:11:51.880 --> 0:11:54.800 Anyway, One of the tactics employed by the US military 0:11:54.880 --> 0:11:58.600 during this time was using chemical warfare to destroy crops 0:11:58.640 --> 0:12:01.520 and sterilize the land. They did this to try to 0:12:01.559 --> 0:12:04.280 weaken the North Vietnamese army by depriving them of food. 0:12:04.600 --> 0:12:09.000 The problem with that, besides being morally bankrupt and evil, 0:12:09.880 --> 0:12:12.920 is that the army would just come into your food 0:12:12.920 --> 0:12:16.920 from civilians, so it mostly had the effect of starving 0:12:17.080 --> 0:12:20.800 entire communities and villages to death, which honestly was probably 0:12:20.880 --> 0:12:23.440 the intention of the US military all along to weekend 0:12:23.480 --> 0:12:24.640 the army by terrorism. 0:12:24.720 --> 0:12:25.760 Yeah, it sounds like the point. 0:12:25.840 --> 0:12:29.040 The US Department of Defense estimates that about twelve percent 0:12:29.120 --> 0:12:31.680 of the farmable land and forest was sterilized during this 0:12:31.760 --> 0:12:36.040 bombing campaign, although the Vietnamese government puts the amount closer 0:12:36.040 --> 0:12:41.480 to forty five percent. Jesus, what this destruction did was 0:12:41.559 --> 0:12:45.400 to drive the wild rodents out of these deforested, destroyed 0:12:45.480 --> 0:12:48.800 areas into human settlements where there was at least still 0:12:48.840 --> 0:12:49.680 some food. 0:12:49.800 --> 0:12:50.439 Whoa. 0:12:50.480 --> 0:12:53.800 As you might expect, this resulted in a massive outbreak 0:12:53.800 --> 0:12:54.840 of bubonic plague. 0:12:54.920 --> 0:12:58.559 Oh my god, that is not something you learn about 0:12:58.600 --> 0:13:00.440 in like seventh grade history class. 0:13:00.480 --> 0:13:00.800 It's not. 0:13:01.200 --> 0:13:02.080 Holy crap. 0:13:02.480 --> 0:13:06.960 Between nineteen sixty five and nineteen seventy, over twenty five 0:13:07.040 --> 0:13:11.360 thousand plague cases were reported in South Vietnam. That's just 0:13:11.400 --> 0:13:13.160 the reported ones, not actual. 0:13:13.360 --> 0:13:15.000 Wow, the actual. 0:13:14.600 --> 0:13:18.480 Total was probably closer to one hundred thousand to a 0:13:18.559 --> 0:13:22.800 quarter of a million. Not not joking, not exaggerating. That's 0:13:22.800 --> 0:13:23.360 what I found. 0:13:23.559 --> 0:13:24.920 Holy crap. 0:13:25.040 --> 0:13:28.319 In a country where, prior to US invasion there were 0:13:28.360 --> 0:13:31.680 only about fifteen cases a year. Reported. 0:13:31.960 --> 0:13:32.680 Oh my god. 0:13:33.640 --> 0:13:37.640 Most of the cases occurred in small, isolated villages where 0:13:37.840 --> 0:13:41.160 I couldn't find exact figures, but I'm sure the death 0:13:41.240 --> 0:13:42.520 rate was really high. 0:13:42.600 --> 0:13:47.280 Yeah, because if you don't have access to medicine, then 0:13:47.760 --> 0:13:50.240 even if you're getting bubonic plague, that's still a sixty 0:13:50.280 --> 0:13:52.960 percent mortality rate. You know, that's ridiculous. 0:13:53.360 --> 0:13:56.280 Some American soldiers also came down with the plague, but 0:13:56.320 --> 0:13:58.800 they were able to get treatment right away, surprise, surprise, 0:13:58.920 --> 0:14:01.360 and most of them were vaccine it. Anyway, this is 0:14:01.440 --> 0:14:04.319 just one of the many, nasty, shameful chapters of American history. 0:14:05.559 --> 0:14:08.000 That is a whole other podcast. There are multiple, many 0:14:08.040 --> 0:14:11.240 other podcasts about that. Yeah, Okay, back to plague. Back 0:14:11.280 --> 0:14:12.120 to plague. 0:14:12.840 --> 0:14:15.600 A lot of you, particularly those listening in the US, 0:14:15.880 --> 0:14:17.720 may think of plague as a thing of the past, 0:14:18.040 --> 0:14:22.560 a medieval disease that has been gone for centuries. Although 0:14:22.840 --> 0:14:25.360 you'd maybe have to be living under a rock if 0:14:25.360 --> 0:14:28.600 you still think that with this latest outbreak in Madagascar. 0:14:28.960 --> 0:14:31.400 But even with this plague outbreak, you may think that 0:14:31.440 --> 0:14:33.520 you don't have to worry about plague living in the US. 0:14:33.800 --> 0:14:37.800 Wrong. Well, you're probably mostly right to think about that. Wrong, 0:14:38.000 --> 0:14:40.480 We'll get into the details of that more later, but 0:14:40.600 --> 0:14:44.000 in terms of natural infections, yeah, yeah, that's true. 0:14:44.160 --> 0:14:46.960 Did you know though, that there have been over a 0:14:47.080 --> 0:14:49.880 thousand cases of plague in the US since the early 0:14:49.960 --> 0:14:52.600 nineteen hundreds. A thousand, that's it, but. 0:14:52.560 --> 0:14:54.840 Still still still still that's a thousand people. 0:14:55.280 --> 0:14:57.840 In the early nineteen hundreds, plague tended to pop up 0:14:57.880 --> 0:15:01.320 in port towns when plague infected ras disembarked from ships 0:15:01.360 --> 0:15:03.600 and their fleas headed into town for a little barfing. 0:15:03.640 --> 0:15:10.120 Fund outbreaks were reported in San Francisco, Oakland, Hawaii, some 0:15:10.200 --> 0:15:13.560 Oregon coastal towns, and several of these outbreaks were dominated 0:15:13.600 --> 0:15:16.440 by the pneumonic, more deadly form of the disease. The 0:15:16.480 --> 0:15:20.040 fleas then headed east overland, transmitting plague into the wild 0:15:20.160 --> 0:15:23.840 rodent populations of the Southwest and West. After about the 0:15:23.920 --> 0:15:26.760 nineteen twenties, plague ceased to be a port city disease 0:15:26.800 --> 0:15:30.240 in the US and instead became one of incidental contact 0:15:30.320 --> 0:15:34.720 with dead or infected animals. Every year from the nineteen 0:15:34.760 --> 0:15:38.680 twenties until now, cases of plague were reported YEP. One 0:15:38.720 --> 0:15:41.720 boy from New Mexico died after skinning a dead coyote. 0:15:41.800 --> 0:15:44.520 He came across. Same for another, but this time it 0:15:44.560 --> 0:15:47.840 was a squirrel instead of a coyote. Another with a rabbit, because, 0:15:47.880 --> 0:15:48.160 like we. 0:15:48.160 --> 0:15:52.960 Mentioned before, the dead bodies remain infectious, right because they're 0:15:53.040 --> 0:15:58.200 basically just full of bacteria. So especially some rodent species, 0:15:58.200 --> 0:16:02.160 but especially carnivores, are very hard hit by plague and 0:16:02.240 --> 0:16:04.720 so they have very high back to your loads. So 0:16:04.840 --> 0:16:08.000 basically we're saying, don't play with roadkill, guys, I. 0:16:07.960 --> 0:16:10.040 Know, which is kind of a shame because roadkill can 0:16:10.080 --> 0:16:11.840 be really a useful study thing. 0:16:12.120 --> 0:16:14.000 Sure, yeah, but just wear gloves. 0:16:15.560 --> 0:16:17.240 Wear gloves when you play with roadkill. 0:16:17.360 --> 0:16:17.760 Yeah. 0:16:18.040 --> 0:16:21.280 Several people also got sick when their pets contracted plague 0:16:21.280 --> 0:16:24.520 from infected wild rodents, like the cats that we mentioned 0:16:24.640 --> 0:16:28.000 last episode. So sad sorry for you cat people out there, 0:16:28.440 --> 0:16:28.840 just like. 0:16:29.280 --> 0:16:31.880 Trying to love on your cat and they're sick and 0:16:31.920 --> 0:16:34.160 they're like coughing, and you're like, oh, poor baby, and 0:16:34.160 --> 0:16:35.760 then they cough in your face and then you both 0:16:35.800 --> 0:16:38.720 die of plague. Yeah. 0:16:39.040 --> 0:16:42.440 Since nineteen sixty five, there have been over four hundred 0:16:42.440 --> 0:16:45.200 and sixty cases of plague in the US. Wow, with 0:16:45.360 --> 0:16:47.200 sixteen percent of those infected dying. 0:16:47.800 --> 0:16:50.680 Geez, that's a really high mortality rate. 0:16:51.000 --> 0:16:53.520 Yeah, with the use of antibiotics and everything. 0:16:53.600 --> 0:16:56.480 Yeah, I wonder if that is largely to do with 0:16:56.720 --> 0:16:59.200 people not being able to recognize it or doctors not 0:16:59.280 --> 0:17:01.280 wanting to die I know, something like plague. 0:17:01.480 --> 0:17:04.600 Right, So there's that kind of begs the question why 0:17:04.920 --> 0:17:07.240 is plague still killing people when there's a vaccine, when 0:17:07.240 --> 0:17:11.960 there's antibiotics, And probably that depends on where you are geographically, 0:17:12.040 --> 0:17:16.480 definitely big time. But overall, plague is still a very 0:17:16.600 --> 0:17:21.400 nasty disease. Yeah, And antibiotics, even if administered early, can't 0:17:21.440 --> 0:17:24.640 always save you or even save you from the nasty 0:17:24.680 --> 0:17:27.560 side effects that you will get from from plague infection. 0:17:28.080 --> 0:17:31.080 Plus, even if you can, you know, even if you 0:17:31.640 --> 0:17:34.880 live in a place like the United States where if 0:17:34.880 --> 0:17:37.439 you have health insurance at least, then you in theory 0:17:37.520 --> 0:17:40.600 have access to a physician to get antibiotics. And even 0:17:40.680 --> 0:17:43.560 if you have a physician that diagnoses it early, we 0:17:43.600 --> 0:17:46.720 don't always go to the doctor when we're feeling sick 0:17:47.119 --> 0:17:49.800 until and with something like plague that can come on 0:17:49.920 --> 0:17:53.160 so rapidly, you might not get those antibiotics until too late, 0:17:53.400 --> 0:17:54.840 even if you had access to them. 0:17:55.000 --> 0:17:59.360 Yeah, So and so in some areas, it could be 0:17:59.640 --> 0:18:03.479 that it's underdiagnosed. Definitely, we're not diagnosed early enough. But 0:18:03.520 --> 0:18:06.680 in other areas where plague is endemic, such as Madagascar, 0:18:07.040 --> 0:18:09.639 getting antibiotics to people who need them is often a 0:18:09.760 --> 0:18:13.600 huge logistical struggle and there is a lot of underreporting 0:18:13.680 --> 0:18:17.520 of the disease, which can prolong an epidemic. The story 0:18:17.600 --> 0:18:21.040 of the plague in Madagascar starts in eighteen ninety eight, 0:18:21.200 --> 0:18:23.960 when the disease first appeared after a ship from India 0:18:24.000 --> 0:18:27.240 full of rice rats and plague arrived at the island. 0:18:28.280 --> 0:18:31.560 Since then, there have been plague deaths every year, some 0:18:31.680 --> 0:18:35.000 years worse than others. The plague, usually in bubonic form, 0:18:35.119 --> 0:18:37.960 tends to pop up every year in Madagascar between September 0:18:38.000 --> 0:18:40.399 and April, but this year it was a little early. 0:18:41.000 --> 0:18:43.200 Aerin Can you tell me a little bit about the 0:18:43.240 --> 0:18:45.240 plague situation in Madagascar today? 0:18:45.680 --> 0:18:48.119 I would love to. So we're going to walk through 0:18:48.200 --> 0:18:52.560 this entire outbreak, and then we're going to talk about what, 0:18:52.960 --> 0:18:57.280 honestly a great job who has done in trying to 0:18:57.320 --> 0:18:59.080 contain this pretty. 0:18:58.800 --> 0:19:01.000 Much, so I cannot wait to hear it. 0:19:01.119 --> 0:19:05.879 I'm excited. So, the current plague outbreak in Madagascar begins 0:19:06.440 --> 0:19:07.760 on August twenty. 0:19:07.480 --> 0:19:08.920 Third, twenty seventeen. 0:19:09.119 --> 0:19:13.160 Twenty seventeen. Yeah, August twenty third of this day year, 0:19:13.920 --> 0:19:18.639 when a thirty one year old male reported malaria like symptoms. 0:19:18.680 --> 0:19:22.719 He started to come down with malaria like symptoms so headache, fever, 0:19:22.880 --> 0:19:27.080 malaise on the twenty seventh of August. So four days later, 0:19:27.840 --> 0:19:33.760 he began experiencing respiratory symptoms while in a shared taxi. 0:19:34.320 --> 0:19:35.960 Uh oh. He later died. 0:19:36.520 --> 0:19:36.960 Uh oh. 0:19:37.520 --> 0:19:41.119 His body was prepared for his funeral at a hospital 0:19:41.560 --> 0:19:46.000 without any safety procedures. Thirty one people who came into 0:19:46.080 --> 0:19:50.639 contact with this individual case, either directly or indirectly through 0:19:50.800 --> 0:19:55.040 like shared taxi contacts or contacts with the funeral people 0:19:55.880 --> 0:19:58.480 became ill and four of them died. 0:19:58.840 --> 0:20:00.000 How many people became ill? 0:20:00.200 --> 0:20:03.719 Thirty one people from that one person initially. 0:20:03.600 --> 0:20:07.679 And he died how soon after showing symptoms within a 0:20:07.680 --> 0:20:10.040 few days. Okay, that's okay. 0:20:10.480 --> 0:20:14.800 The outbreak was officially detected on September eleventh, after a 0:20:14.840 --> 0:20:17.480 forty seven year old female was admitted to the hospital 0:20:17.520 --> 0:20:22.280 with respiratory failure because of pneumonic plague. So that was 0:20:22.320 --> 0:20:25.959 when they first realized that this was an outbreak. By 0:20:26.000 --> 0:20:28.880 the twenty eighth of September, So this is just one 0:20:29.000 --> 0:20:33.439 month after that initial man. There had already been fifty 0:20:33.480 --> 0:20:37.919 one cases of pneumonic plague, the bad one the bad one, 0:20:37.960 --> 0:20:41.880 and twelve deaths reported. There had been an additional fifty 0:20:41.920 --> 0:20:45.199 three cases of the bubonic plague and seven deaths elsewhere 0:20:45.240 --> 0:20:45.880 in the country. 0:20:46.280 --> 0:20:49.040 Interesting, mm hmmm. I have questions about the origin. 0:20:49.400 --> 0:20:52.080 Yeah, I do too. And so there wasn't at least 0:20:52.119 --> 0:20:54.080 what I found a ton of detail on, like the 0:20:54.119 --> 0:20:57.480 specifics of how many index cases there might have been. 0:20:57.920 --> 0:21:00.560 They had the details of this specific story. 0:21:00.920 --> 0:21:04.000 And so this guy who was the index case right, 0:21:04.560 --> 0:21:07.280 had mneumonic plague, yes, and so those people. 0:21:07.119 --> 0:21:09.800 Where he had bubonic plague, that became mnemonic. 0:21:09.480 --> 0:21:13.159 For surekay okay, And so those people that got bubonic plague, 0:21:13.200 --> 0:21:17.400 that indicates that there was a bubonic plague outbreak exactly, 0:21:17.400 --> 0:21:20.000 not related to him, necessarily. 0:21:19.480 --> 0:21:23.119 Necessarily exactly, yeah, okay, because bubonic plague is not transmitted 0:21:23.119 --> 0:21:25.480 person to person, that's transmitted by the bites of the fleet. 0:21:25.600 --> 0:21:26.600