WEBVTT - Ep 21 Measles: The Worst Souvenir 0:00:00.280 --> 0:00:03.800 It begins with a rigor, followed by heats and chills 0:00:03.920 --> 0:00:06.600 during the first day. On the second day there is 0:00:06.680 --> 0:00:11.840 fever with intense malaise, thirst, lost of appetite, white tongue 0:00:12.000 --> 0:00:16.520 not actually dry, slight cough, heaviness of the head and eyes, 0:00:16.880 --> 0:00:21.280 and constant drowsiness. In most cases a humor distills from 0:00:21.280 --> 0:00:25.160 the nose and eyes, the effusion or suffusion of tears 0:00:25.200 --> 0:00:28.760 being the most certain sign of sickening for measles, more 0:00:28.800 --> 0:00:33.360 certain indeed than the exanthem. The child sneezes as if 0:00:33.360 --> 0:00:37.080 it has taken cold, the eyelids swell. There may be vomiting. 0:00:37.400 --> 0:00:40.680 More usually, there are loose green stools, and there is 0:00:40.760 --> 0:00:45.080 excessive fretfulness. On the fourth or fifth day, small red 0:00:45.120 --> 0:00:49.080 maculae like flea bites begin to appear on the forehead 0:00:49.159 --> 0:00:51.919 and the rest of the face, which coalesce as they 0:00:51.960 --> 0:00:55.240 continue to come out in increasing numbers so as to 0:00:55.360 --> 0:00:59.560 form Rasimo's clusters. These maculae will be found by the 0:00:59.600 --> 0:01:02.920 touch to be slightly elevated, although they seem level to 0:01:02.960 --> 0:01:05.600 the eye. On the trunk and limbs to which they 0:01:05.640 --> 0:01:09.600 gradually extend, they are not elevated. About the sixth day, 0:01:10.000 --> 0:01:13.839 the maculae begin to roughen and scale from the face downwards, 0:01:14.160 --> 0:01:17.520 and by the eighth day are scarcely discernible anywhere. On 0:01:17.600 --> 0:01:20.440 the ninth day the whole body is as if dusted 0:01:20.480 --> 0:01:23.959 with bran. The common people say that the spots had 0:01:24.280 --> 0:01:27.520 quote turned inwards, by which they mean that if it 0:01:27.560 --> 0:01:30.800 had been smallpox, they would have remained out longer and 0:01:30.840 --> 0:01:35.600 have proceeded to separation or maturation. The rash having thus 0:01:35.840 --> 0:01:40.000 gone in, there is an access of fever, attenuated with 0:01:40.120 --> 0:01:43.920 labored breathing and cough, the latter being so incessant as 0:01:43.920 --> 0:02:16.960 to keep the children from sleep day or night. 0:02:18.560 --> 0:02:21.200 Oh that's awful. 0:02:21.800 --> 0:02:22.520 It's not great. 0:02:24.919 --> 0:02:27.440 Yeah, but that sounds really miserable. 0:02:27.960 --> 0:02:32.680 Yes, So that was from Sydenham's account of London measles 0:02:32.720 --> 0:02:37.280 epidemic that happened all the way back in sixteen seventy. 0:02:37.720 --> 0:02:40.919 But it could be an account of what's going on today. 0:02:40.760 --> 0:02:43.200 It really could. It actually was very similar in a 0:02:43.200 --> 0:02:45.160 lot of ways to things that I read in my 0:02:45.200 --> 0:02:48.080 textbooks about describing measles. 0:02:47.760 --> 0:02:49.720 Including the common people. 0:02:49.480 --> 0:02:52.359 Part, maybe not that part, the common people. 0:02:54.880 --> 0:02:57.080 Hi i'm erin Welsh and i'm eron. 0:02:57.000 --> 0:02:59.919 Alman Updyke and this this podcast will kill you. 0:03:00.440 --> 0:03:03.679 And we're obviously talking about measles. If you haven't caught 0:03:03.680 --> 0:03:04.680 the hint yet. 0:03:05.919 --> 0:03:08.200 A lot of you asked for it and we've been 0:03:08.240 --> 0:03:10.360 wanting to do it, so here it is. 0:03:10.680 --> 0:03:12.320 Yeah, thanks for asking everyone. 0:03:12.600 --> 0:03:15.720 This one is there's a sense of urgency here though, 0:03:15.720 --> 0:03:16.800 which is very real. 0:03:17.240 --> 0:03:19.160 Yeah, why is that, Aaron? 0:03:21.120 --> 0:03:25.840 Well, I mean spoilers. There's measles going on right in 0:03:25.880 --> 0:03:27.120 the world today. 0:03:27.120 --> 0:03:29.240 So much measles today. 0:03:29.880 --> 0:03:31.760 There's a lot that's happening, and I think this is 0:03:32.000 --> 0:03:35.440 I this is a really interesting one to cover because 0:03:35.480 --> 0:03:38.640 it deals with a lot of different issues that we 0:03:38.760 --> 0:03:42.080 have sort of skirted around or skirted past, maybe touched 0:03:42.120 --> 0:03:44.560 on very briefly here and there, in terms of vaccination, 0:03:44.800 --> 0:03:48.240 in terms of how to view historical epidemics in the 0:03:48.320 --> 0:03:52.440 light of today. Yeah, measles is really one that's going 0:03:52.520 --> 0:03:53.240 to bring it all home. 0:03:53.520 --> 0:03:55.160 So I'm excited me too. 0:03:55.240 --> 0:03:57.560 It's gonna be fun. Yeah. 0:03:58.040 --> 0:04:04.680 So, speaking of fun, I think it's quarantine absolutely. 0:04:05.480 --> 0:04:07.560 And what are we drinking today today? 0:04:07.560 --> 0:04:09.960 We're drinking a rash decision. 0:04:13.280 --> 0:04:15.680 That's named because for. 0:04:15.680 --> 0:04:19.320 The characteristic measles rash. 0:04:18.320 --> 0:04:22.320 And the poor decision making of some people to not 0:04:22.440 --> 0:04:23.920 vaccinate their children. 0:04:24.240 --> 0:04:30.080 What yep, yeah, we said it. Okay, So what's in 0:04:30.120 --> 0:04:31.320 this drink that we're drinking. 0:04:32.240 --> 0:04:37.200 Well, we've got vodka, We've got grenadine, We've got ginger. 0:04:36.880 --> 0:04:38.800 Liqueur or ginger. 0:04:38.520 --> 0:04:42.360 Ale up to you. We've got lime. 0:04:42.160 --> 0:04:44.440 Juice and linoennberries. 0:04:44.880 --> 0:04:46.320 Oh yeah, if you're in Finland. 0:04:47.440 --> 0:04:50.359 Otherwise cherries if you're. 0:04:50.160 --> 0:04:53.960 Not in Finland where Lincoln berries are so abundant. 0:04:54.240 --> 0:04:59.320 Whatever small red berry to mimic the spots of the mees. 0:05:00.360 --> 0:05:02.640 And as always, we'll post the full recipe for this 0:05:02.720 --> 0:05:06.280 quarantine along with our place ba Rita, our non alcoholic 0:05:06.520 --> 0:05:09.840 version on our website as well as all of our 0:05:09.880 --> 0:05:13.080 social medias. This podcast will kill You on Instagram and 0:05:13.120 --> 0:05:16.640 Facebook and tpwky on Twitter. 0:05:16.839 --> 0:05:22.160 And also someone has someone has started a subreddit called 0:05:22.200 --> 0:05:28.080 tpwky which is really thrilling and we have seen the 0:05:28.160 --> 0:05:30.640 quarantine's posted there, So whoever is doing that, thank you 0:05:30.760 --> 0:05:31.200 very much. 0:05:31.560 --> 0:05:34.760 And you should know that Aaron Welsh checks it all 0:05:34.800 --> 0:05:35.920 the time and loves it and. 0:05:35.960 --> 0:05:42.960 Is I'm our lurker. Okay, so measles. 0:05:42.520 --> 0:05:45.000 Measles, should we talk about it? 0:05:45.400 --> 0:05:47.680 I think that's why we're here, all right. 0:05:47.880 --> 0:06:21.159 We're going to do that right after this break. All right, measles. 0:06:23.800 --> 0:06:26.479 Before I dive into the biology of measles, I want 0:06:26.520 --> 0:06:30.120 for everyone to know that we are going to be 0:06:30.200 --> 0:06:35.599 doing an entire episode focused on vaccines, where we'll talk 0:06:35.600 --> 0:06:38.200 about the history of vaccine development. Well, when I say we, 0:06:38.320 --> 0:06:41.960 I mean Aaron Welsh, I don't do that. I'll talk 0:06:41.960 --> 0:06:45.200 about how vaccines actually work in your body to give 0:06:45.240 --> 0:06:47.719 you immunity, and then we'll talk more generally about the 0:06:47.760 --> 0:06:52.400 status of vaccination across the US and the globe. Today 0:06:52.600 --> 0:06:57.480 we're talking about one disease, measles, that's often a large 0:06:57.560 --> 0:07:00.799 part of the conversation about vaccines, and we'll talk about 0:07:00.800 --> 0:07:04.880 why that is. But I'm not going to talk super 0:07:04.920 --> 0:07:08.920 broadly about vaccines because I do want to give measles 0:07:08.920 --> 0:07:11.840 the attention that it deserves specifically if that makes sense. 0:07:12.120 --> 0:07:15.320 Makes sense to me. Yeah, So stay tuned, people. 0:07:15.360 --> 0:07:17.960 Yeah, but we will talk about vaccines because vaccines are 0:07:18.000 --> 0:07:23.600 an important part of the measles story. Yes, okay, so measles. 0:07:24.400 --> 0:07:27.360 First of all, it's a virus. It's an RNA virus, 0:07:27.480 --> 0:07:30.560 which usually I say that means it's scarier than DNA 0:07:30.640 --> 0:07:33.960 viruses because they mutate and they're hard to target. But actually, 0:07:33.960 --> 0:07:37.840 it turns out measles has like very low antigenic diversity, 0:07:38.280 --> 0:07:42.040 so it hasn't changed over its history with humans. 0:07:43.080 --> 0:07:45.120 We got lucky, yeah, very. 0:07:46.000 --> 0:07:48.080 So that means that the vaccines that we developed way 0:07:48.080 --> 0:07:52.080 back when are still effective against the wild circulating virus today. 0:07:52.120 --> 0:07:54.360 So that's like the best news I have for you 0:07:54.480 --> 0:08:00.000 about measles. Downhill from here, cool, Yeah, gotta start off 0:08:00.080 --> 0:08:04.080 on a high, you know. Okay, So when you get 0:08:04.120 --> 0:08:07.920 infected with measles, the incubation period, which again is that 0:08:08.000 --> 0:08:10.480 period from when you first get infected until you start 0:08:10.480 --> 0:08:14.440 showing symptoms, lasts between ten and fourteen days. 0:08:15.120 --> 0:08:16.400 Okay, Okay. 0:08:16.640 --> 0:08:22.040 However, you become infectious up to five days before those 0:08:22.080 --> 0:08:22.880 symptoms start. 0:08:23.840 --> 0:08:27.120 You know, those are the deadly ones. Those are the 0:08:27.120 --> 0:08:28.400 ones really are. 0:08:28.800 --> 0:08:31.720 It's a very very big deal, and we've talked about 0:08:31.760 --> 0:08:34.960 it before with flu and things like that, but in 0:08:35.000 --> 0:08:38.960 the case of measles, the fact that you're infectious before 0:08:39.040 --> 0:08:43.720 you have any symptoms is an even bigger deal because 0:08:43.800 --> 0:08:48.640 the are not of measles, which again is the number 0:08:48.720 --> 0:08:54.319 of secondary infections that a single infected individual will cause 0:08:55.000 --> 0:09:01.160 if the entire population is susceptible for measles. That number 0:09:01.640 --> 0:09:05.079 is between thirteen and eighteen. 0:09:05.840 --> 0:09:06.160 Yep. 0:09:06.520 --> 0:09:09.600 It's highest one that we know, right, the highest one 0:09:09.640 --> 0:09:10.000 we know. 0:09:10.920 --> 0:09:15.960 Yeah, And what this essentially means is that for every 0:09:16.080 --> 0:09:22.360 single person who's infected, on average, ninety percent of the 0:09:22.520 --> 0:09:27.400 people they come in contact with who are susceptible will 0:09:27.480 --> 0:09:30.000 become infected with measles. 0:09:31.120 --> 0:09:33.679 That that's a horrifying statistic. 0:09:34.080 --> 0:09:34.600 Exactly. 0:09:35.679 --> 0:09:36.760 Yeah. 0:09:37.200 --> 0:09:39.800 I mean if you think about smallpox and how like 0:09:39.960 --> 0:09:42.960 massive of outbreak smallpox was able to cause. The are 0:09:43.040 --> 0:09:46.360 not of smallpox is between five and seven. And people 0:09:46.360 --> 0:09:48.920 are terrified of things like ebola or sars, and the 0:09:49.000 --> 0:09:51.680 are notts of those are like less than two for 0:09:51.800 --> 0:09:55.960 ebola or between two and three for sars. Yeah, and 0:09:56.040 --> 0:09:59.200 yet measles is this thing that infects almost everyone who 0:09:59.240 --> 0:10:02.600 comes into content act with an infected individual. 0:10:03.200 --> 0:10:06.640 Do you remember what the r not is of the 0:10:06.720 --> 0:10:09.199 virus that's in contagion. 0:10:09.600 --> 0:10:12.000 I don't remember what it actually is. I remember her listing. 0:10:12.640 --> 0:10:14.360 I don't know if they ever actually said it, because 0:10:14.400 --> 0:10:16.040 she just was like, we need to figure out what 0:10:16.080 --> 0:10:19.480 the r not is, But I don't remember. Yeah, we'll 0:10:19.480 --> 0:10:20.160 have to look it up. 0:10:20.440 --> 0:10:23.120 I remember her writing on the board measles fourteen. 0:10:23.559 --> 0:10:27.080 Yeah. I think she wrote polio on there too, which 0:10:27.160 --> 0:10:28.040 was like six or seven. 0:10:28.400 --> 0:10:28.880 Yeah, I think. 0:10:30.440 --> 0:10:36.560 Anyways, Okay, let's get worse. Okay, so measles is transmitted airborne, 0:10:37.120 --> 0:10:42.240 not just in respiratory droplets, but actually airborne. I told 0:10:42.280 --> 0:10:45.920 you it gets worse. So what that means is that 0:10:46.040 --> 0:10:51.640 measles can stay the virus infectious. Measles viral particles can 0:10:51.679 --> 0:10:57.600 stay suspended and alive and infectious in the forking air 0:10:58.679 --> 0:11:02.800 for up to two hours after an infected person leaves 0:11:03.080 --> 0:11:03.520 the room. 0:11:04.080 --> 0:11:06.520 Wait a second, So it's sort of like you know 0:11:06.600 --> 0:11:11.199 how pig pen in peanuts when he's got that cloud 0:11:11.200 --> 0:11:13.400 of dust around him. So if you were a measles kid, 0:11:13.480 --> 0:11:15.640 it would just be a cloud of measles that would 0:11:15.679 --> 0:11:18.360 stay in the room two hours after he left. 0:11:18.559 --> 0:11:20.720 Yeah, that's the thing. It stays in the room. And 0:11:20.760 --> 0:11:23.560 so what happens when there's okay, we have had some 0:11:23.600 --> 0:11:26.720 measles cases here in Champagne, and every time there's a 0:11:26.760 --> 0:11:29.319 new case, public Health sends out an alert and they 0:11:29.360 --> 0:11:31.440 give you a list of all the places that this 0:11:31.520 --> 0:11:35.240 person was during the time that they were infectious, along 0:11:35.320 --> 0:11:37.960 with the times that they were there, and those times 0:11:37.960 --> 0:11:41.360 include a two hour window after that person left because 0:11:41.400 --> 0:11:47.680 the room itself remains infectious. Good gracious, my god. Okay, 0:11:48.280 --> 0:11:51.000 all right, let me summarize the things we've learned so far. 0:11:51.720 --> 0:11:55.679 Measles is a virus that if I haven't before I 0:11:55.720 --> 0:11:58.760 even know I'm sick, for five full days, I can 0:11:58.760 --> 0:12:03.920 be walking around breathing, coughing into a room, and once 0:12:03.960 --> 0:12:07.680 I leave that room for two hours, people can walk 0:12:07.760 --> 0:12:12.080 into it and become infected by the air which contains 0:12:12.160 --> 0:12:16.800 my measles. And if those people are susceptible, meaning if 0:12:16.800 --> 0:12:23.160 they're unvaccinated, ninety percent of them will become infected. And 0:12:23.240 --> 0:12:26.640 then for four to five days after my symptoms resolve, 0:12:27.080 --> 0:12:28.239 I'm still infectious. 0:12:29.040 --> 0:12:30.719 Oh wow, yep. 0:12:31.120 --> 0:12:33.600 I'm just wondering the total amount of time that an 0:12:33.640 --> 0:12:35.040 individual is infectious. 0:12:35.160 --> 0:12:39.000 The total amount of time is probably a good two weeks. Okay, 0:12:39.480 --> 0:12:42.760 So okay, So let's talk about the symptoms. It starts, 0:12:43.240 --> 0:12:46.760 as the name of our future spinoff podcast would suggest, 0:12:46.920 --> 0:12:51.240 with a fever, and in this case with measles, we're 0:12:51.240 --> 0:12:53.920 talking about a really high fever, often up to one 0:12:54.040 --> 0:12:57.839 hundred and four ooh, one hundred and four fahrenheit forty 0:12:57.880 --> 0:13:04.520 degrees celsius. So the virus invades your bronchioles first. Your 0:13:04.559 --> 0:13:08.000 bronchioles are the tubes in your lungs. 0:13:07.679 --> 0:13:08.480 Where the air goes. 0:13:09.520 --> 0:13:12.560 It infects the epithelial cells, which we've talked about a 0:13:12.600 --> 0:13:14.840 lot in this podcast, because a lot of viruses infect 0:13:14.880 --> 0:13:17.800 those epithelial cells, which are the cells that line your bronchioles. 0:13:18.160 --> 0:13:20.240 And so that's why the first set of symptoms that 0:13:20.280 --> 0:13:24.760 you see after fever are respiratory symptoms, a cough, runny nose, 0:13:24.920 --> 0:13:27.480 You can get conjunctivitis if it moves up into your eye. 0:13:28.559 --> 0:13:31.680 And then within two to three days of after symptoms begin, 0:13:32.240 --> 0:13:36.400 you'll often get something called I believe it's coplic. It 0:13:36.480 --> 0:13:37.319 might be coplic. 0:13:37.640 --> 0:13:42.000 Oh yeah, coplic spots. Yeah yeah, I've read about the dude. 0:13:42.440 --> 0:13:43.199 Yeah, oh cool. 0:13:44.280 --> 0:13:47.040 So these are these small white spots in your mouth. 0:13:47.559 --> 0:13:50.960 And while these spots don't appear in every single case, 0:13:51.440 --> 0:13:56.120 they are a very common manifestation and there's pretty much 0:13:56.160 --> 0:14:00.679 nothing else that causes these particular types of spots. So 0:14:00.720 --> 0:14:02.840 they're what we call You're going to learn how to 0:14:02.840 --> 0:14:08.600 talk like a doctor pathonemonic for a disease pathonomonic. It's 0:14:08.640 --> 0:14:13.000 a really fun word. It basically means that it's a 0:14:13.000 --> 0:14:18.040 specific symptom that is very specifically characteristic and indicative of 0:14:18.080 --> 0:14:23.200 a particular disease. So once you see this symptom coplic spots, 0:14:23.240 --> 0:14:25.120 you can say that kid has measles. 0:14:25.400 --> 0:14:27.000 Can you spell that. 0:14:27.640 --> 0:14:31.640 Pa thho gno monic? 0:14:32.520 --> 0:14:34.600 Huh pathonomic it's. 0:14:34.440 --> 0:14:37.640 A weird word. Yeah, But so other examples, We've actually 0:14:37.680 --> 0:14:41.000 talked about some other diseases that have pathanomonic findings. Rice 0:14:41.040 --> 0:14:45.000 water stool is pathonomonic for what disease. So it's like 0:14:45.040 --> 0:14:48.520 a dead giveaway of cholera exactly. Yeah, it's like dead giveaway. 0:14:48.520 --> 0:14:52.160 It's like there's nothing else. There's no other diseases that 0:14:52.200 --> 0:14:55.040 you would see this symptom in essentially, So anyways, that's 0:14:55.120 --> 0:14:56.680 your voguet word for the day. 0:14:57.080 --> 0:14:57.600 I love it. 0:14:58.360 --> 0:15:01.440 So after those copleic spots, in another few days, you'll 0:15:01.480 --> 0:15:05.520 break out in a rash. And this is the classic 0:15:05.760 --> 0:15:08.760 measles rash. It's often called the bucket of paint rash. 0:15:08.880 --> 0:15:10.680 That's how I learned it in class. 0:15:10.880 --> 0:15:12.680 Can you explain to me what that means? Because you 0:15:12.760 --> 0:15:14.560 suggested that as a drinking. 0:15:14.720 --> 0:15:17.960 Like if someone took a bucket of paint and spilled 0:15:17.960 --> 0:15:22.240 it over your head, okay, because the rash starts up 0:15:22.240 --> 0:15:25.680 at your hairline and then it slowly works its way 0:15:25.760 --> 0:15:28.920 down across your face, over your trunk, onto your arm. 0:15:29.000 --> 0:15:30.920 So it's literally like if you took a bucket of paint, 0:15:31.080 --> 0:15:34.200 like the gatorade buckets after a football game or something, 0:15:34.400 --> 0:15:36.120 and you dumped it on top and now you have 0:15:36.160 --> 0:15:38.000 gatorade dripping down your face. 0:15:38.120 --> 0:15:41.560 Okay, So it's like the trajectory of exactly of where 0:15:41.560 --> 0:15:43.880 it's going to pass through. Yeah, not that you look 0:15:43.960 --> 0:15:45.680 like a bucket of paint has been dropped on you. 0:15:46.040 --> 0:15:49.440 Well, well, it also is that the rash becomes confluent 0:15:49.600 --> 0:15:52.400 and so it does pretty much cover your whole body. 0:15:52.440 --> 0:15:54.560 So it starts out as individual spots, but then those 0:15:54.560 --> 0:15:57.640 spots kind of merge together, so it does I mean, 0:15:57.680 --> 0:15:59.920 it doesn't actually look like paint because it's your skin, 0:16:00.080 --> 0:16:01.320 but you know, right. 0:16:01.200 --> 0:16:03.520 But that don't help me visualize what this what this 0:16:03.560 --> 0:16:03.960 looks like? 0:16:04.240 --> 0:16:07.200 Yeah, oh good, I'm glad. And so that rash, that 0:16:07.320 --> 0:16:11.160 rash is mostly caused actually by your immune system killing 0:16:11.520 --> 0:16:14.480 cells that are infected with the virus. So not caused 0:16:14.480 --> 0:16:18.760 by the virus itself necessarily okay. Now, in most cases, 0:16:19.280 --> 0:16:22.040 this rash is kind of one of the final symptoms. 0:16:22.080 --> 0:16:24.960 After a few days of this rash, both the rash 0:16:24.960 --> 0:16:27.400 and the fever will start to subside, and you'll recover 0:16:27.880 --> 0:16:32.560 in most cases. But not everyone will recover. For every 0:16:32.560 --> 0:16:38.040 one thousand people infected with measles, one or two will die, 0:16:38.240 --> 0:16:42.200 and at least one will develop acute encephalitis, which is 0:16:42.280 --> 0:16:47.800 an infection of your brain that can cause permanent brain damage. 0:16:47.840 --> 0:16:50.840 You can also get a lot of secondary bacterial infections 0:16:50.880 --> 0:16:54.560 like pneumonia, which is pretty common after a measles infection 0:16:54.880 --> 0:16:57.920 because of the damage that measles does to your respiratory tract. 0:16:59.280 --> 0:17:05.320 But and this part is a really big deal, measles 0:17:05.480 --> 0:17:11.560 also causes suppression of your immune system in general, and 0:17:11.640 --> 0:17:15.360 not just while you're infected, but for weeks or months 0:17:15.520 --> 0:17:20.920 after infection after you recover. If you recover, your immunal compromised, 0:17:21.600 --> 0:17:25.800 which means you're more susceptible to infection from other pathogens. 0:17:27.240 --> 0:17:32.760 And not yet done. It gets even more serious than that, 0:17:32.840 --> 0:17:37.400 because recent data has shown that infection with the measles 0:17:37.480 --> 0:17:44.800 virus destroys your immunologic memory. What so yes, this is 0:17:44.840 --> 0:17:48.200 the part I was hoping you didn't know because it's 0:17:48.240 --> 0:17:55.480 so terrifying. So it destroys your immune system's capacity for memory. 0:17:55.520 --> 0:17:58.760 And our immune system is essentially built on the fact 0:17:58.840 --> 0:18:02.040 that we have cells that live for a really long 0:18:02.080 --> 0:18:06.639 time and provide us with defenses against things we've already 0:18:06.680 --> 0:18:10.600 been exposed to. That's what immuneo logic memory is. Diesels 0:18:10.640 --> 0:18:13.760 wipe that out. So anything that you had been previously 0:18:13.880 --> 0:18:17.600 exposed to and should be able to fight off, you can't. 0:18:18.960 --> 0:18:20.840 It's like you had never been exposed. 0:18:20.920 --> 0:18:21.840 Oh my god. 0:18:21.920 --> 0:18:25.240 Okay, first question, Okay, I have two questions. 0:18:25.320 --> 0:18:25.639 Okay. 0:18:25.800 --> 0:18:28.520 The first one is that you said that it destroys 0:18:29.080 --> 0:18:32.200 the capacity. So does that mean that if you get infected, 0:18:32.320 --> 0:18:36.320 let's say, with something again, then you will not develop 0:18:37.160 --> 0:18:40.600 protective antibodies to that you could continue to get reinfected 0:18:40.600 --> 0:18:40.840 with that. 0:18:41.359 --> 0:18:44.199 So I that's a really good question. I don't know 0:18:44.640 --> 0:18:49.199 if it transiently suppresses your immune system overall and then 0:18:49.240 --> 0:18:52.359 it wipes out all of your memory cells. But I 0:18:52.440 --> 0:18:55.520 believe after the period of immune suppression, so like after 0:18:55.560 --> 0:18:57.520 a few weeks or months, you would be able to 0:18:57.600 --> 0:19:01.240 then mount an immune response. But it's just that it 0:19:01.280 --> 0:19:03.720 would have. It would be like mounting an immune response 0:19:03.760 --> 0:19:07.080 all over again, like you had never been exposed. 0:19:06.880 --> 0:19:09.320 But once that, once you had been re exposed to 0:19:09.400 --> 0:19:13.520 whatever it was, then subsequently, if you were exposed that 0:19:13.720 --> 0:19:15.120 you can still build memory. 0:19:15.160 --> 0:19:16.520 It's just sort of it wipes out. 0:19:16.560 --> 0:19:19.320 It basically clears out your hard drive. Yeah, starts you 0:19:19.359 --> 0:19:20.640 back in zero add stuff again. 0:19:20.720 --> 0:19:22.760 Okay, yeah, second question. 0:19:22.720 --> 0:19:28.080 Yeah, how great question. There is a paper on that, 0:19:28.240 --> 0:19:31.439 but it was getting very in depth technically on the 0:19:31.560 --> 0:19:35.159 like this is how these immune blah blah blahs, and 0:19:35.200 --> 0:19:38.120 I couldn't I couldn't deal with it, So I'll link 0:19:38.160 --> 0:19:42.320 to that paper. Yeah. And the other thing is I 0:19:42.320 --> 0:19:44.359 don't think that it's entirely clear. This is a pretty 0:19:44.359 --> 0:19:48.560 recent paper. We didn't realize just we knew about the 0:19:48.600 --> 0:19:52.080 short term suppression of your immune system. We didn't know 0:19:52.200 --> 0:19:54.760 until very recently. And the way that we actually found 0:19:54.760 --> 0:19:57.280 this out is looking at like long term data trends 0:19:57.359 --> 0:20:01.879 of mortality rates. So I don't think that it's entirely clear. 0:20:01.920 --> 0:20:04.560 There's mouse models that show that it's possible for measles 0:20:04.560 --> 0:20:07.320 to wipe out those cells, but it's not one hundred 0:20:07.359 --> 0:20:10.800 percent clear how the heck, measles is so powerful and 0:20:10.840 --> 0:20:12.159 destroys your immune system so. 0:20:12.280 --> 0:20:14.400 Much, that's amazing. 0:20:14.720 --> 0:20:18.119 It's it's oh my gosh. So measles infection is not 0:20:18.640 --> 0:20:22.760 just it can kill you by killing you outright. It's 0:20:22.800 --> 0:20:27.520 also associated with short term increases in opportunistic infection and 0:20:28.119 --> 0:20:32.919 long term I'm talking years increased mortality rates due to 0:20:33.119 --> 0:20:38.160 non measles disease. This is something that makes a lot 0:20:38.200 --> 0:20:43.040 of sense in light of vaccination, because what we know 0:20:43.440 --> 0:20:48.280 is that vaccination with the measles vaccine not only protects 0:20:48.280 --> 0:20:52.200 you from measles, but at a population level, it decreases 0:20:52.280 --> 0:20:58.399 mortality from non measles diseases for years after vaccination. And 0:20:58.480 --> 0:21:02.639 the reason that that is what's happening with vaccination is 0:21:02.640 --> 0:21:06.520 because of how strong the effect of infection with measles 0:21:07.000 --> 0:21:10.360 is on your immune system. It just destroys it. 0:21:10.920 --> 0:21:12.480 I think that the long and short of it is 0:21:12.480 --> 0:21:17.359 that being vaccinated against measles and getting measles naturally and 0:21:17.359 --> 0:21:20.040 then gaining immunity to it are not the same thing 0:21:20.440 --> 0:21:21.440 any respect. 0:21:21.520 --> 0:21:22.480 What's that exactly? 0:21:23.160 --> 0:21:27.639 Being naturally infected will lead you to have adverse health outcomes, 0:21:28.040 --> 0:21:32.800 probably ones that you won't even realize vaccinated protects you exactly. 0:21:32.920 --> 0:21:35.400 They're not even comparable, because that's something that I think 0:21:35.440 --> 0:21:38.080 a lot of people, you know, it's like, oh, well, 0:21:38.760 --> 0:21:40.720 why can't I just let my kid get the chicken 0:21:40.720 --> 0:21:43.240 pox instead of you know, giving him the chicken pox 0:21:43.320 --> 0:21:47.440 vaccine or whatever. And in this case, especially with measles, 0:21:47.720 --> 0:21:51.800 that is not the case. Vaccination protects you not just 0:21:51.840 --> 0:21:56.440 from measles, but it protects your immune system, and infection 0:21:56.600 --> 0:22:02.840 with measles wipes your immune system out. It's amazing, remarkable. 0:22:02.880 --> 0:22:03.800 I had no idea. 0:22:04.200 --> 0:22:11.520 I'm glad. It was really fun to get to tell you. Yeah, 0:22:11.560 --> 0:22:15.520 so that is that's measles, that's the virus. That's how 0:22:15.560 --> 0:22:20.920 it makes you sick. So it's all I've got aaron. Okay, 0:22:21.720 --> 0:22:23.960 so how did we get here? How did we learn 0:22:24.040 --> 0:22:25.119 how to fight this sucker? 0:22:25.800 --> 0:22:26.680 It's a good story. 0:22:26.720 --> 0:22:28.280 Cool, shall we take a quick break. 0:22:29.119 --> 0:22:32.400 Let's do it, but for real, because I'm gonna get 0:22:32.400 --> 0:22:56.639 a quarantinie. The measles virus probably came from something like 0:22:56.920 --> 0:22:58.400 bovine render pest. 0:22:58.440 --> 0:23:01.240 Oh future episode. 0:23:01.800 --> 0:23:08.200 Someday, or canine distemper virus, but archaeological evidence isn't really 0:23:08.280 --> 0:23:10.400 clear on that, so we don't really know exactly where 0:23:10.440 --> 0:23:11.440 it came from. 0:23:11.600 --> 0:23:12.679 Okay, but what do we know? 0:23:12.800 --> 0:23:15.520 Well, we know that the musles virus would have needed 0:23:15.520 --> 0:23:19.840 a pretty large population density with a sufficient influx of 0:23:19.840 --> 0:23:23.639 susceptible people in order for it to be sustained. Makes sense, 0:23:24.560 --> 0:23:29.120 it's a crowd disease. Yeah, But saying pretty large population 0:23:29.200 --> 0:23:31.440 density isn't exactly me being precise. 0:23:31.520 --> 0:23:34.520 So let's get some precision here. 0:23:34.640 --> 0:23:42.320 Erin, I mean that's my middle name, not at all. Okay, 0:23:43.440 --> 0:23:46.959 but there is some pretty cool math here actually. All right, 0:23:47.000 --> 0:23:50.240 So some researchers calculated that the virus has to move 0:23:50.320 --> 0:23:53.359 to a new host at least twenty six times a 0:23:53.440 --> 0:23:55.600 year if it's going to survive in a population. 0:23:55.840 --> 0:24:00.680 Interesting, that makes sense if it's too too weak two 0:24:00.720 --> 0:24:01.320 weak disease. 0:24:02.280 --> 0:24:07.080 Yeah, yeah, at a bare minimum, there needs to be 0:24:07.280 --> 0:24:10.760 twenty six susceptible people in a population every year for 0:24:10.840 --> 0:24:12.280 measles to persist. 0:24:12.560 --> 0:24:16.200 Okay, but there are a lot of butts. 0:24:16.560 --> 0:24:18.879 But then those people would have to be inclose or 0:24:19.000 --> 0:24:24.280 frequent enough contact for transmission, and then you know, once 0:24:24.320 --> 0:24:27.480 infected and hopefully recovered, you were immune. So new susceptibles 0:24:27.520 --> 0:24:31.160 had to come in from somewhere either being born whatever. Basically, 0:24:31.440 --> 0:24:33.840