WEBVTT - Ep 103 Leptospirosis: Don't blame the rats 0:00:02.120 --> 0:00:06.120 Hi, I'm umat And when I was a graduate student, 0:00:07.040 --> 0:00:09.520 I was doing field work in Panama. It was just 0:00:09.560 --> 0:00:12.760 this amazing place with tropical birds, and I loved the 0:00:12.800 --> 0:00:14.440 field work I did. I had to like hike up 0:00:14.480 --> 0:00:18.840 these rivers in the forest and find these insects, and 0:00:18.880 --> 0:00:21.560 it was so diverse and amazing. But you know, it 0:00:21.640 --> 0:00:24.040 was also tropical, so we had we were getting bit 0:00:24.079 --> 0:00:26.880 by insects, we were getting water and boots. You know, 0:00:27.240 --> 0:00:29.680 We're dealing with a lot of animals and things. And 0:00:29.960 --> 0:00:31.600 there was five of us living in this house. It 0:00:31.680 --> 0:00:35.479 was pretty crowded, five of us and a cat. And 0:00:35.520 --> 0:00:40.040 then one morning I woke up exhausted. I had had 0:00:40.159 --> 0:00:43.960 fever the night before and these awful dreams and a headache, 0:00:44.000 --> 0:00:48.400 and I knew that something was up, and so I 0:00:48.400 --> 0:00:51.080 I just rested that day and I tried to kind 0:00:51.120 --> 0:00:53.840 of you know, nourish myself, have a lot of water, 0:00:53.920 --> 0:00:57.040 have a lot of food, and I got I felt better, 0:00:57.320 --> 0:00:59.880 you know, by the afternoon, I was even able to 0:01:00.120 --> 0:01:01.880 a walk and everything. I said, Okay, maybe this was 0:01:01.920 --> 0:01:05.360 just a short term thing. Everything will be fine. And 0:01:05.400 --> 0:01:09.560 then that night it was worse. I had this awful fever, 0:01:10.040 --> 0:01:12.720 really really bad headaches, and in the morning, I was, 0:01:12.760 --> 0:01:15.840 I was just feeling awful, and so, you know, I 0:01:15.840 --> 0:01:17.800 didn't have a car at the time, and luckily I 0:01:17.800 --> 0:01:21.080 got a friend of mine to drive drive me to 0:01:21.120 --> 0:01:23.680 a clinic. And so I got to the clinic and 0:01:24.000 --> 0:01:27.560 I explained my symptoms, and you know, they're like, well, 0:01:27.600 --> 0:01:29.960 this is this sounds like dangay, and we're going to 0:01:30.040 --> 0:01:32.400 test your blood. And so they took a blood test 0:01:32.920 --> 0:01:35.800 and they didn't find dan kay. So they sent me 0:01:35.840 --> 0:01:37.520 home and told me that you know, this is probably 0:01:37.520 --> 0:01:42.000 some virus or something, and you should probably just recover 0:01:42.280 --> 0:01:44.440 on your own. Just you know, take lots of water 0:01:44.640 --> 0:01:46.319 if I demand, just take care of yourself. And so 0:01:46.360 --> 0:01:49.360 I said, okay, but but these is just progressed, and 0:01:49.360 --> 0:01:53.040 so I started getting more fevers and the next day 0:01:53.080 --> 0:01:56.080 I was, I was really awful, but it would be 0:01:56.120 --> 0:01:59.400 also kind of cyclical. So I would feel better and 0:01:59.560 --> 0:02:01.960 you know, I think it's improving, and then suddenly it 0:02:01.960 --> 0:02:04.640 would hit me again and I would get these fevers 0:02:05.520 --> 0:02:09.560 and headaches and be sensitive to light. So two days 0:02:09.600 --> 0:02:11.640 after I went to the clinic, I woke up and 0:02:11.800 --> 0:02:15.160 my sister just happened to be visiting, and I was 0:02:15.160 --> 0:02:17.480 showing her the tropics. I was showing her my field site, 0:02:17.800 --> 0:02:20.200 and so we woke up in the morning. I was 0:02:20.240 --> 0:02:23.080 not feeling great, but I was feeling okay, and so 0:02:23.160 --> 0:02:25.639 we drove up to the kind of be tower, saw 0:02:25.639 --> 0:02:29.680 some beautiful tropical birds, and I remember driving back and 0:02:30.120 --> 0:02:35.040 just suddenly being extremely sensitive to light, slowly feeling this 0:02:35.120 --> 0:02:38.760 weakness coming over my body, this fever coming. And by 0:02:38.760 --> 0:02:40.560 the time I got back, I was I was in 0:02:40.639 --> 0:02:44.040 bed shape. I kind of hobbled to bed and my 0:02:44.200 --> 0:02:47.280 head was killing me. And luckily I had a friend 0:02:47.280 --> 0:02:49.760 who said, you know, I think, you know, we should 0:02:49.880 --> 0:02:51.800 we should go right to the hospital right now. This 0:02:51.960 --> 0:02:56.280 is really bad. And we got to the hospital and 0:02:56.639 --> 0:02:59.560 I remember just having a hard time kind of even 0:02:59.639 --> 0:03:02.760 walking to hospital reception in the emergency room and stuff, 0:03:02.800 --> 0:03:05.720 and remember somebody bringing me a wheelchair and I thought, 0:03:05.760 --> 0:03:07.960 you know, I was like, I don't need that wheelchair, 0:03:08.520 --> 0:03:11.080 but as soon as you know, they brought it to me, 0:03:11.160 --> 0:03:13.200 I did sit down in it, and I just I 0:03:13.240 --> 0:03:16.799 was like, whow Okay, I definitely did need that wheelchair. 0:03:17.520 --> 0:03:20.840 And I remember my friends talking to the doctors and stuff, 0:03:20.880 --> 0:03:23.720 and they immediately took a blood test that was a 0:03:23.760 --> 0:03:28.119 moment when I knew things were way more serious than 0:03:28.440 --> 0:03:32.200 I had initially thought. I saw the doctor's expression and 0:03:32.280 --> 0:03:35.400 he came up with his paper and he said, this 0:03:35.680 --> 0:03:40.320 is a critical situation. Some of my liver enzymes were 0:03:40.360 --> 0:03:43.680 off the charts. We need to get to the IC immediately. 0:03:43.880 --> 0:03:46.720 So I got immediately admitted to a bed in the 0:03:46.760 --> 0:03:50.080 intensive care unit. They had me monitored my heart rate 0:03:50.360 --> 0:03:53.480 and my blood pressure and everything, and then I was 0:03:53.560 --> 0:03:56.720 under twenty four hour surveillance. Every twenty minute, somebody would 0:03:56.720 --> 0:03:59.600 come and check on me, because apparently that's how critical 0:03:59.640 --> 0:04:02.880 this isuuational so it progrets so quickly, at least from 0:04:02.880 --> 0:04:07.480 my perspective, and I remember just being extremely uncomfortable and confused, 0:04:07.520 --> 0:04:11.640 and so I did. I did improve slightly when I 0:04:11.680 --> 0:04:15.760 was in intensive care, but it still wasn't good and 0:04:15.800 --> 0:04:18.039 they still couldn't figure out what it was, and so 0:04:18.680 --> 0:04:21.880 I stayed in the hospital, and I just remember there 0:04:22.000 --> 0:04:24.520 was this routine somebody would come and take a lot 0:04:24.560 --> 0:04:27.719 of blood from me, and then you know, I would 0:04:27.760 --> 0:04:30.560 spend my time in my room and I'd be very comfortable. 0:04:30.600 --> 0:04:32.960 I was still getting these headaches this fever, but I'd 0:04:32.960 --> 0:04:37.840 also started getting pain in my stomach. I'd never experienced 0:04:37.839 --> 0:04:42.400 this before, but apparently my liver was extremely swollen, and 0:04:42.440 --> 0:04:46.400 so my stomach had become tight and tender, and i'd 0:04:46.520 --> 0:04:48.640 you know, just kind of terrifying thinking that like a 0:04:48.680 --> 0:04:51.240 single organ has flen to a level where it's like 0:04:51.760 --> 0:04:55.919 distending your body a little bit. And I spent almost 0:04:55.960 --> 0:04:59.240 two weeks in that hospital and they still couldn't figure 0:04:59.279 --> 0:05:01.960 out what it was. I was not getting any positive tests. 0:05:02.200 --> 0:05:06.400 They were prescribing me kind of general antibiotics. But eventually 0:05:06.400 --> 0:05:09.720 I started to feel a little better. I'd lost a 0:05:09.760 --> 0:05:12.440 lot of weight. I was weak, but after about two 0:05:12.440 --> 0:05:16.200 weeks I was released from the hospital, but I was 0:05:16.760 --> 0:05:21.680 still very weak, and it really bothered me that we 0:05:21.760 --> 0:05:24.600 didn't know what it was. I mean, is this something 0:05:24.640 --> 0:05:28.360 that was dormant that could come back again? And research 0:05:28.480 --> 0:05:31.440 something this serious? I really wanted to know. Could it be? 0:05:31.880 --> 0:05:36.040 You know, It's just not knowing was really really stressful, 0:05:37.120 --> 0:05:40.640 and so I ended up going to Canada. I'm a 0:05:40.720 --> 0:05:43.440 Canadian citizen, and I went to Canada and I called 0:05:43.520 --> 0:05:47.320 the hospital beforehand, and it turns out they had a 0:05:47.440 --> 0:05:51.279 tropical medicine program going on there with the med students. 0:05:51.720 --> 0:05:54.640 When I called them and told them my situation. They 0:05:54.680 --> 0:05:57.159 put me in touch with this doctor who's teaching this course, 0:05:57.320 --> 0:05:59.080 and it turns out they don't get a lot of 0:05:59.080 --> 0:06:03.560 tropical these patients in Canada. So I was talking to 0:06:03.600 --> 0:06:05.520 him about all the stuff I'd read and trying to 0:06:05.920 --> 0:06:08.120 try to figure out what, you know, what I had, 0:06:08.120 --> 0:06:10.680 and he asked me if it was okay if I 0:06:10.720 --> 0:06:14.080 could participate in trying to help figure out what was 0:06:14.120 --> 0:06:16.320 going on. And so he had a bunch of these 0:06:16.360 --> 0:06:21.120 med students around the bed and it was like an 0:06:21.160 --> 0:06:23.839 episode of House or something, one of those medical dramas 0:06:23.880 --> 0:06:25.919 where they try to figure out what you have, and 0:06:26.040 --> 0:06:31.480 different medical students gave their hypotheses. The experienced doctors said, well, 0:06:31.720 --> 0:06:34.960 maybe that's something you should pursue. Oh maybe that that's 0:06:35.000 --> 0:06:39.240 not right because you know of these chart readings or something, 0:06:39.800 --> 0:06:41.640 and they were trying to figure out what it might 0:06:41.720 --> 0:06:45.320 be to try to look for antibodies or some indication 0:06:45.440 --> 0:06:47.680 of what I had. And so then I left the 0:06:47.720 --> 0:06:50.200 hospital and I was recovering slowly, and then it wasn't 0:06:50.279 --> 0:06:52.640 until three months later I got a call and one 0:06:52.640 --> 0:06:57.800 of the medical students found figured it out. It was leptospirosis. 0:06:58.920 --> 0:07:01.840 And so when I found out that it was leptospurosis, 0:07:01.920 --> 0:07:05.320 now I had, you know, a diagnosis. I could start 0:07:05.360 --> 0:07:09.520 thinking about what the mode of transmission was. And I 0:07:09.560 --> 0:07:12.000 remembered when I was living in that house with those 0:07:12.040 --> 0:07:15.280 five people and that cat. That cat didn't like me 0:07:15.520 --> 0:07:18.880 very much, and I would go on these runs on 0:07:19.360 --> 0:07:22.160 pipeline on this road, this muddy road, and I would 0:07:22.200 --> 0:07:25.000 leave my shoes outside because this one time this cat 0:07:25.080 --> 0:07:28.080 keyed in my shoes and I didn't realize until I 0:07:28.160 --> 0:07:30.760 was walking around and I could smell something weird. And 0:07:30.800 --> 0:07:32.720 it was an outdoor cat too, so it was probably 0:07:32.800 --> 0:07:36.920 grabbing all sorts of rats and rodents outside and also, 0:07:37.000 --> 0:07:42.560 you know, a potential vector for leptosporrosis. So that time 0:07:42.640 --> 0:07:45.640 I also happened to have this cut in my foot, 0:07:46.400 --> 0:07:49.760 and so there's this possibility that it was this direct 0:07:50.320 --> 0:07:54.920 blood transmission that got me infected. But yeah, so that's 0:07:54.960 --> 0:08:43.640 that's the story of me getting leptosporrosis. It is. 0:08:45.440 --> 0:08:49.439 I remember that so vividly, and it was terrifying. 0:08:49.960 --> 0:08:53.400 It sounds awful, I remember hearing about it after the fact. 0:08:53.800 --> 0:08:59.439 Yeah, well, Uma, I'm so glad that you are better 0:08:59.720 --> 0:09:03.680 and that everything you know eventually turned out okay. And 0:09:04.440 --> 0:09:09.199 also thank you so much again for sharing your story, 0:09:09.240 --> 0:09:13.360 because for those of you who are longtime listeners, you 0:09:13.440 --> 0:09:18.720 may have recognized Umat's voice from season one when he 0:09:19.360 --> 0:09:21.720 provided the first hand account for malaria. 0:09:22.320 --> 0:09:25.959 Let's hope Uman, that there's no more diseases that we 0:09:26.040 --> 0:09:28.280 need to have you provide a first hand account. 0:09:27.880 --> 0:09:33.000 For Let's let's hope. Hi, I'm erin. 0:09:32.920 --> 0:09:35.480 Welsh and I'm erin Allman Updike and this. 0:09:35.640 --> 0:09:37.240 Is this podcast will kill you. 0:09:37.840 --> 0:09:40.760 And today we're talking about leptosporrosis. 0:09:41.160 --> 0:09:42.319 Leptosporosis. 0:09:43.360 --> 0:09:45.640 Yeah, can I make Can I make a quick confession? 0:09:45.800 --> 0:09:47.439 I just want to say this off the bat. Of 0:09:47.559 --> 0:09:54.160 course I don't know why, but leptosporosis, lee jonella, and 0:09:54.360 --> 0:09:59.679 leshmaniasis constantly confused in my brain. Interesting those three, and 0:09:59.800 --> 0:10:01.000 now we've covered all of them. 0:10:01.600 --> 0:10:04.319 That's like me and Gerard Butler and Clive Owen, they're 0:10:04.360 --> 0:10:05.120 the same person. 0:10:05.320 --> 0:10:08.439 They actually are the same person. So that's very valid. 0:10:09.679 --> 0:10:12.240 Well, and so now you don't have to worry about 0:10:12.320 --> 0:10:16.040 getting them confused anymore because this is just we're done right. 0:10:17.679 --> 0:10:20.679 I'm really excited for this episode because when I was 0:10:21.040 --> 0:10:24.760 going through emails to be like, Okay, what do people 0:10:24.840 --> 0:10:27.680 want to hear? I was so surprised at the number 0:10:27.840 --> 0:10:31.640 of requests for leptosporosis. Yeah, And one of the reasons, 0:10:31.679 --> 0:10:34.280 it seems like, is because this is a disease that 0:10:34.400 --> 0:10:39.040 affects not just humans but also many animal species. And 0:10:39.720 --> 0:10:43.319 it's just it's so much more prevalent and important than 0:10:43.360 --> 0:10:47.200 I think I realized, even after, you know, watching Uma 0:10:47.360 --> 0:10:48.840 go through this horrible ordeal. 0:10:49.440 --> 0:10:51.640 Yeah. I think it's it's easy to think of this 0:10:51.800 --> 0:10:54.880 as a disease of the tropics or as a disease 0:10:54.960 --> 0:10:58.480 of you know, other places, but it's a worldwide pathogen, 0:10:58.640 --> 0:11:01.160 as we'll talk about, and I think a lot of 0:11:01.240 --> 0:11:04.120 pet owners and veterinarians are probably a lot more familiar 0:11:04.240 --> 0:11:07.720 with it than maybe the general public. Yes, totally, Yeah, 0:11:08.240 --> 0:11:09.600 I'm excited it's going to be good. 0:11:11.000 --> 0:11:14.800 First things first, it's quarantiny time, It's quarantine any time. 0:11:15.120 --> 0:11:16.640 What are we drinking this week? 0:11:16.920 --> 0:11:19.320 We're drinking I smell a rat? 0:11:21.800 --> 0:11:23.680 And why are we drinking? I smell a rat? 0:11:24.000 --> 0:11:28.200 It turns out, Aaron, that rats are a very important 0:11:28.240 --> 0:11:32.760 part of the overall distribution and prevalence and life cycle 0:11:33.040 --> 0:11:34.480 of leptospira. 0:11:35.520 --> 0:11:39.240 And I also want to say just right here that 0:11:39.320 --> 0:11:44.200 we are not trying to intentionally further the stigma against rats. 0:11:44.360 --> 0:11:45.280 Don't blame the rat. 0:11:45.600 --> 0:11:48.280 Don't blame the rat. Rats are just one piece of 0:11:48.320 --> 0:11:52.760 the puzzle. Many other animals do this. But the title 0:11:52.960 --> 0:11:54.200 was too good to pass up. 0:11:54.640 --> 0:11:58.719 Yeah, because who doesn't want to drink? Who doesn't want 0:11:58.720 --> 0:11:59.719 to drink I Smell a Rat? 0:12:00.080 --> 0:12:03.280 And really, I mean, once you hear the recipe, though, 0:12:03.360 --> 0:12:04.880 you're definitely going to want to drink it. 0:12:05.080 --> 0:12:06.280 Please tell me what isn't it? 0:12:06.640 --> 0:12:11.120 It is a shrub. It's a mango habanero mint shrub. 0:12:11.679 --> 0:12:14.280 So this is like a drinking vinegar. You muddle all 0:12:14.320 --> 0:12:17.040 of these you know, fruits and ingredients together with sugar, 0:12:17.160 --> 0:12:20.000 let it sit, and then you can use that as 0:12:20.240 --> 0:12:23.199 a great base for a cocktail like this one with 0:12:23.559 --> 0:12:27.400 tequila for instance, or you can use it as a 0:12:27.559 --> 0:12:31.640 plusy burita as well with no alcohol. Delicious either way. 0:12:32.040 --> 0:12:35.199 And we will post the full recipe for I Smell 0:12:35.240 --> 0:12:38.120 a Rat the quarantini as well as the plasy Burrita 0:12:38.240 --> 0:12:40.520 on our website this podcast will Kill You dot com, 0:12:40.720 --> 0:12:42.880 as well as on all of our social media channels 0:12:43.720 --> 0:12:44.000 and on. 0:12:44.080 --> 0:12:46.679 Our website, this podcast will kill you dot com. You 0:12:46.800 --> 0:12:51.040 can find all of the best website type things you 0:12:51.200 --> 0:12:51.720 can find. 0:12:52.800 --> 0:12:54.679 Do you think people even need to hear this at 0:12:54.720 --> 0:12:55.080 this point? 0:12:55.080 --> 0:12:57.760 I don't know really, Just check out our website. Yeah, 0:12:57.840 --> 0:12:58.439 there like that. 0:12:58.720 --> 0:13:02.960 I like that, Arin, I am so ready to learn. 0:13:03.400 --> 0:13:05.880 So can we take a quick break and get started. 0:13:06.200 --> 0:13:34.280 Let's do it. Leptosporosis is a disease caused by a 0:13:34.400 --> 0:13:41.800 bacterium in the genus Leptospira or leptospira. These are spirokeets, 0:13:42.480 --> 0:13:45.880 which means those little tirly quirkscrew dudes. Like a few 0:13:45.960 --> 0:13:51.880 other pathogens we've covered, like treponema, the causative agent of syphilis, burelia, 0:13:52.000 --> 0:13:55.040 which causes lime disease, have we done any others? 0:13:55.520 --> 0:13:57.400 I was trying to think of that and I can't 0:13:57.440 --> 0:13:59.320 come up with anymore me neither those. 0:13:59.200 --> 0:14:03.840 Are the two I remember. Yeah, So, this spira keet, 0:14:03.920 --> 0:14:07.480 it turns out, is not just one bug, it's not 0:14:07.640 --> 0:14:11.839 just one species. And it seems like from what I 0:14:11.920 --> 0:14:15.760 could read, the classification and species definition seems to be 0:14:16.480 --> 0:14:20.360 in flux currently, so different papers have a lot of 0:14:20.400 --> 0:14:23.640 different numbers cited, but it seems like there's over sixty 0:14:23.760 --> 0:14:28.000 different species. I think that's the consensus in the genus Leptospira, 0:14:29.480 --> 0:14:34.120 and importantly, this includes more than three hundred sero VARs 0:14:34.800 --> 0:14:38.880 asterisk a note Aaron, I would like to talk about 0:14:38.880 --> 0:14:43.200 this a little bit more, okay, because in our episode 0:14:43.240 --> 0:14:47.160 on Salemonilla, we talked about the idea of like species 0:14:47.280 --> 0:14:50.880 and subspecies in seravars, and in that episode, I feel 0:14:50.920 --> 0:14:53.160 like I did a very bad job of trying to 0:14:53.240 --> 0:14:56.920 define what seravars actually are, and when it comes to 0:14:57.120 --> 0:14:59.880 leptosporosis and salmonella and a lot of other back TOI, 0:15:00.880 --> 0:15:05.080 serr VARs are really important epidemiologically a lot of times 0:15:05.200 --> 0:15:08.280 in distinguishing like was this outbreak all from this source 0:15:08.560 --> 0:15:11.600 or from that source, et cetera. So I wanted to 0:15:11.640 --> 0:15:13.560 give a little bit of a better definition of what 0:15:13.680 --> 0:15:18.040 a cero var actually is in this case. Basically, ser 0:15:18.120 --> 0:15:21.840 of vrs are determined based on the surface antigens, so 0:15:22.000 --> 0:15:26.560 differences in those surface proteins and things, which of course 0:15:26.640 --> 0:15:28.880 are some of the main things that our bodies use 0:15:29.000 --> 0:15:34.040 to recognize various pathogens, right right, And so serrvars are 0:15:34.280 --> 0:15:38.320 like strains or isolates that differ in their surface antigens. 0:15:39.600 --> 0:15:44.840 In the case of leptosporosis, there are over sixty different species, 0:15:45.240 --> 0:15:49.040 not all of which are pathogenic, but which include over 0:15:49.200 --> 0:15:52.640 three hundred ser of VARs at least two hundred or 0:15:52.680 --> 0:15:54.880 over two hundred of which are pathogenic. 0:15:55.520 --> 0:15:58.240 It seems like more are being discovered all the time. 0:15:58.680 --> 0:16:03.560 I am not surprised. So anyways, I hope that was 0:16:03.600 --> 0:16:06.080 at least a little more helpful than my description in 0:16:06.200 --> 0:16:07.280 the salmonella episode. 0:16:07.600 --> 0:16:07.880 It was. 0:16:07.960 --> 0:16:12.960 It's really interesting. Yeah, before we move back to leptosporosis, 0:16:13.120 --> 0:16:16.200 I just want to take a moment to share something 0:16:16.240 --> 0:16:17.160 about salmonella. 0:16:17.480 --> 0:16:18.160 Oh love it. 0:16:18.400 --> 0:16:21.320 A listener reached out to us, and you know how, 0:16:21.600 --> 0:16:24.240 in the salmonella episode, we were like, oh, is it 0:16:24.360 --> 0:16:28.600 pronounced Daniel Salmon or Daniel Salmon the person who salmonella 0:16:28.680 --> 0:16:29.240 is named after. 0:16:29.440 --> 0:16:29.760 Uh huh. 0:16:30.240 --> 0:16:34.320 So someone tweeted at us and said it's pronounced Salmon 0:16:34.920 --> 0:16:39.600 because he is one of her ancestors, which is so thrilling. 0:16:41.760 --> 0:16:43.760 Oh. I love that. I feel like we've had a 0:16:43.840 --> 0:16:46.280 couple times where people have emailed us saying like, I'm 0:16:46.320 --> 0:16:48.520 related to one of the people you talked about, and 0:16:48.640 --> 0:16:50.760 I don't know why. It thrills me. 0:16:51.000 --> 0:16:53.120 Oh on every single time. 0:16:53.160 --> 0:16:56.320 It's so cool. My heart is beating quickly. I love it. 0:16:59.120 --> 0:17:02.960 Back to letos back to leptosporosis, all right, if you're 0:17:03.000 --> 0:17:08.400 related to anyone, no, okay, So anyways, that's the pathogen. 0:17:08.520 --> 0:17:10.920 A lot of different species, a lot of different serivars. 0:17:12.000 --> 0:17:14.320 Like I said up top, this is a pathogen that 0:17:14.480 --> 0:17:18.720 is found worldwide, and while it is more prevalent or 0:17:18.720 --> 0:17:22.359 at least more common, in the tropics, this is mostly 0:17:22.520 --> 0:17:27.119 just because it can be an environmentally transmitted pathogen. This 0:17:27.359 --> 0:17:30.000 is something that can persist in the environment for weeks 0:17:30.119 --> 0:17:33.000 to months, in the water and in the soil, and 0:17:33.119 --> 0:17:35.200 the climate in the tropics is just a little better 0:17:35.320 --> 0:17:41.320 suited for Leptospira growth and survival. But this is a 0:17:41.440 --> 0:17:48.240 bacterium that can infect almost any mammal, pretty much all mammals, 0:17:49.320 --> 0:17:53.040 some of them. Some mammal species are very good reservoirs, 0:17:53.160 --> 0:17:56.440 which means that they can harbor this bacterium mostly in 0:17:56.520 --> 0:18:00.639 their kidneys at really high levels for months at a 0:18:00.720 --> 0:18:04.680 time and pee it out all over the place, often 0:18:04.760 --> 0:18:09.320 without showing any symptoms or getting sick at all. Other 0:18:09.440 --> 0:18:14.200 species are less great reservoirs, and they may get sick 0:18:14.280 --> 0:18:17.720 to varying degrees. But what's really important is that this 0:18:17.960 --> 0:18:22.240 can infect literally almost any mammal, including marine mammals, which 0:18:22.240 --> 0:18:23.720 I always find fascinating. 0:18:23.960 --> 0:18:29.760 Yeah. Question, you are saying this bacterium, do you mean 0:18:29.920 --> 0:18:33.600 like the genus overall or are there species differences in 0:18:33.720 --> 0:18:37.600 terms of like which animals are best reservoirs for which 0:18:37.960 --> 0:18:40.080 species or seravars? Great? 0:18:40.200 --> 0:18:45.119 Great, great, great question. Yes, there are differences where some 0:18:45.359 --> 0:18:48.760 species or some serivars are maybe more common in certain 0:18:48.880 --> 0:18:52.680 animal species and others are more common in other species. 0:18:53.200 --> 0:18:56.840 But of the pathogenic species of Leptospira, they can have 0:18:57.000 --> 0:18:59.600 been shown in the lab to infect nearly any mammal 0:18:59.680 --> 0:19:01.040 if you expose them to. 0:19:01.119 --> 0:19:05.040 It, any given leptosperra pathogenic species, right. 0:19:05.040 --> 0:19:07.600 Exactly, So it probably shouldn't be saying this bacterium like 0:19:07.680 --> 0:19:15.800 this genus. Okay, these pathogenic spirokeets. Yeah, but excellent question. 0:19:17.520 --> 0:19:22.080 So when it comes to humans, we generally get exposed 0:19:22.480 --> 0:19:27.040 either through direct contact with infected domestic animals like cattle 0:19:27.240 --> 0:19:32.640 or dogs, or more commonly, through exposure to infected water 0:19:32.800 --> 0:19:39.240 sources or infected soil, and exposure happens in a variety 0:19:39.280 --> 0:19:44.000 of ways. These spirokeets can corkscrew their way in through 0:19:44.080 --> 0:19:47.679 any little cuts or abrasions on our skin. They can 0:19:47.840 --> 0:19:51.040 enter directly. If you get infected water in your eyes 0:19:51.200 --> 0:19:53.720 or your mouth, they can enter through your mucous membranes. 0:19:54.320 --> 0:19:57.480 Even if you swallow a bunch of contaminated water or 0:19:57.680 --> 0:20:01.040 drinking water sources become contaminated, you can get infected that 0:20:01.200 --> 0:20:04.520 way as well. And that is true for animals as well. 0:20:04.600 --> 0:20:06.760 So that's the way that all other animals are also 0:20:06.840 --> 0:20:09.959 being infected through abrasions on their skin or through their 0:20:10.040 --> 0:20:10.840 mucous membranes. 0:20:11.280 --> 0:20:15.400 Which makes sense about high infection rate in some animals 0:20:15.480 --> 0:20:18.520 because if you just imagine dogs, a lot of dogs 0:20:18.640 --> 0:20:20.520 love drinking out of puddles. 0:20:20.359 --> 0:20:24.080 As I will. My veterinarian when my dog was a 0:20:24.160 --> 0:20:27.119 puppy was like, oh, we could vaccinate for a leptospira, 0:20:27.240 --> 0:20:29.720 Like is your dog a puddle liquor? And I was like, 0:20:30.119 --> 0:20:34.639 are not all dogs lickers? So yes, if you have 0:20:34.680 --> 0:20:36.359 a puddle liquor that they will be. 0:20:36.440 --> 0:20:38.600 Exposed total liquor. Unbelievable. 0:20:41.000 --> 0:20:45.960 So, these highly mobile little spirokeets, once they get into 0:20:46.080 --> 0:20:50.159 our bodies, corkscrew their way directly into our bloodstream and 0:20:50.400 --> 0:20:55.520 begin to replicate. They cause a bacteryemia, which is bacteria 0:20:55.600 --> 0:20:58.160 in our blood. That's all that means over the course 0:20:58.280 --> 0:21:01.119 of usually about a week or so. Oh and then 0:21:01.280 --> 0:21:06.120 once those bacteria reach high enough numbers. And what's fascinating 0:21:06.280 --> 0:21:10.320 about leptosporosis is that the amount of bacterymia can be 0:21:10.640 --> 0:21:14.840 incredibly high. Like we're talking millions of bacteria per milli 0:21:14.920 --> 0:21:18.399 liter of blood, which is very high even before you 0:21:18.480 --> 0:21:21.200 show any symptoms. And this is way higher than what 0:21:21.280 --> 0:21:23.840 we would see from a bacterymia in like an E. 0:21:24.000 --> 0:21:26.879 Coli or something without our bodies freaking out about it. 0:21:27.600 --> 0:21:31.840 Why is that? Why does it produce such a high bacterymia, Well. 0:21:31.800 --> 0:21:36.240 It seems like our bodies are very good at detecting 0:21:36.400 --> 0:21:39.320 and mounting a response to very low levels of antigen 0:21:39.400 --> 0:21:43.040 from something like ecoli, but essentially just don't even recognize 0:21:43.160 --> 0:21:46.520 leptosperosis antigen until it's at very very high levels. 0:21:47.000 --> 0:21:50.720 What interesting, I know, huh. 0:21:51.240 --> 0:21:55.400 Right, Then, after they get to these very very high 0:21:55.440 --> 0:21:58.400 levels in our blood, these bacteria start burrowing their way 0:21:58.520 --> 0:22:02.040 through our endothelials that line our blood vessels and into 0:22:02.400 --> 0:22:05.800 various organs. And that is usually the point at which 0:22:05.840 --> 0:22:09.160 symptoms will tend to start to appear. So the total 0:22:09.240 --> 0:22:13.440 incubation period is anywhere from seven to fourteen days, could 0:22:13.480 --> 0:22:16.359 be as long as a month, and rarely is shorter 0:22:16.440 --> 0:22:16.639 than that. 0:22:17.600 --> 0:22:21.119 Okay. And once these bacteria leave the blood and start 0:22:21.240 --> 0:22:25.600 burrowing and finding their way to organs and whatnot, does 0:22:25.680 --> 0:22:28.600 that mean that they straight up leave the blood? Would 0:22:28.640 --> 0:22:30.520 you be able to detect them in the blood? 0:22:31.080 --> 0:22:34.320 Excellent question. They don't leave the blood entirely, but these 0:22:34.440 --> 0:22:39.879 are still difficult bacteria to detect because like other spira 0:22:39.960 --> 0:22:41.840 keets that we've talked about on this podcast, they don't 0:22:41.880 --> 0:22:44.760 gram stain very well, and so they're just not as 0:22:44.840 --> 0:22:46.840 easy to pick up. And I do think that the 0:22:47.160 --> 0:22:49.760 amount of bacteremia tends to go down once they enter 0:22:49.840 --> 0:22:50.439 our organs. 0:22:50.720 --> 0:22:54.560 Okay, yeah, okay, that plays a relevant role in the 0:22:54.720 --> 0:22:55.359 history section. 0:22:55.640 --> 0:22:59.480 Oh I bet I can't wait bacteremia okyeah? Okay, all right? 0:23:00.040 --> 0:23:07.040 Boilers or just foreshadowing foreshadowing? Yeah, yeah. When it comes 0:23:07.160 --> 0:23:12.520 to animals, various animal species that get infected, they can 0:23:12.720 --> 0:23:18.000 remain infected and primarily in the proximal tubules of the kidney, 0:23:18.080 --> 0:23:21.520 which is just so interesting. That this pathogen loves that 0:23:21.800 --> 0:23:26.040 particular part of a kidney for literally months, in some 0:23:26.240 --> 0:23:29.760 cases up to a year, and then because they're in 0:23:29.920 --> 0:23:32.440 the tubules of the kidney where your kidney is making urine, 0:23:32.520 --> 0:23:35.680 this pathogen is just being shed beautifully at very high 0:23:35.760 --> 0:23:40.160 levels in the urine. So for some animals this process 0:23:40.240 --> 0:23:44.800 can be completely asymptomatic, and for other animals, including dogs 0:23:45.480 --> 0:23:48.399 and in some cases including cattle, they can also get 0:23:48.480 --> 0:23:52.320 sick from leptosporosis. And what's interesting is that, especially in 0:23:52.400 --> 0:23:57.440 the case of dogs, which there's maybe more detailed clinical 0:23:57.480 --> 0:24:00.000 information at least that I could find on dogs compared 0:24:00.119 --> 0:24:03.200 to some other animals, the disease actually can look a 0:24:03.280 --> 0:24:07.000 lot like the disease in humans. So let's talk about 0:24:07.040 --> 0:24:11.680 what those symptoms actually look like. First of all, this 0:24:11.840 --> 0:24:15.600 is something that even in humans can be entirely asymptomatic. 0:24:16.000 --> 0:24:19.800 You could just be shedding shatteria in your urine, okay. 0:24:20.119 --> 0:24:24.840 And importantly, for humans, some papers call humans dead end hosts. 0:24:25.440 --> 0:24:29.639 We're not truly dead end hosts, but transmission from humans 0:24:29.680 --> 0:24:33.240