WEBVTT - The Necessity of Patient Zero 0:00:03.080 --> 0:00:05.920 Welcome to Stuff to Blow your Mind from how Stuff 0:00:05.920 --> 0:00:14.239 Works dot com. Hey you welcome to Stuff to Blow 0:00:14.280 --> 0:00:16.920 your Mind. My name is Robert Lamb and I'm Christian Seger, 0:00:17.120 --> 0:00:21.640 and we have both been sick for like two weeks now, 0:00:21.640 --> 0:00:25.560 off and on. You and I have been alternating sicknesses. Yeah. Yeah, 0:00:26.040 --> 0:00:29.480 at least two different illnesses have have managed to wander 0:00:29.520 --> 0:00:32.479 their way through my household. Um my son is on 0:00:32.520 --> 0:00:36.280 his second illness this week, getting over something with a 0:00:36.280 --> 0:00:39.200 fever and a scratchy throat. I had it a couple 0:00:39.240 --> 0:00:42.040 of weeks ago and even took it with me to 0:00:42.159 --> 0:00:46.040 Disney World, uh or right before entering Disness Forward Disney World, 0:00:46.040 --> 0:00:49.040 I didn't actually enter the park, uh with with the illness, 0:00:49.120 --> 0:00:51.199 and you went to Disney World the same time. I 0:00:51.240 --> 0:00:54.680 went to Seattle and I caught I don't know if 0:00:54.680 --> 0:00:58.960 I got it from you or Jonathan Strickland, our colleague 0:00:59.080 --> 0:01:02.400 had laryngite this last week and he sits across from me. 0:01:02.840 --> 0:01:05.480 But sure enough, the day I got on the plane, 0:01:05.560 --> 0:01:08.720 I came down with something and I had a horrible 0:01:08.760 --> 0:01:10.640 fever by the time I got to Seattle for my 0:01:10.720 --> 0:01:14.840 vacation and was just shivering and Luckily I had three days. 0:01:15.000 --> 0:01:18.040 I ended up getting better before I attended Emerald City 0:01:18.040 --> 0:01:21.240 Comic Con last week. Otherwise I would have been patient 0:01:21.400 --> 0:01:26.520 zero at an Emerald City and infected everybody. The nomenclature 0:01:26.560 --> 0:01:29.720 that's usually used at big conventions like that is concruct 0:01:30.120 --> 0:01:32.400 because you just bound to pick something up with that 0:01:32.440 --> 0:01:35.000 many people breathing on each other and touching each other. 0:01:35.680 --> 0:01:38.240 I know people who just have like hand sanitizer in 0:01:38.240 --> 0:01:40.600 their pockets at all time, and they're just constantly like 0:01:40.680 --> 0:01:43.920 rubbing their hands within their face. But you know what, like, 0:01:44.120 --> 0:01:46.840 you're gonna just get it no matter what. Well it's 0:01:47.080 --> 0:01:49.360 you're you're combining several different things here. You have to 0:01:49.480 --> 0:01:51.400 the convention where like you said, a lot of people 0:01:51.520 --> 0:01:55.320 type space, um you know, sometimes physical interaction. And then 0:01:55.360 --> 0:01:58.280 on top of that, if you were flying there, then 0:01:58.320 --> 0:02:00.360 you're in and you're on that in the airplane vironment. 0:02:00.400 --> 0:02:03.040 So you're in this this sealed tube with all of 0:02:03.040 --> 0:02:08.959 these coughing, hacking, breathing people, and it's just gonna the 0:02:08.960 --> 0:02:11.680 illnesses are gonna be passed around. Like I think, I 0:02:11.680 --> 0:02:13.960 look back on the times when when I've gotten sick 0:02:14.000 --> 0:02:17.200 with something you know, notable, and I usually don't don't 0:02:17.240 --> 0:02:21.240 get that sick, but it's it generally follows international travel 0:02:21.960 --> 0:02:25.280 um or at least like a long journey by plane. 0:02:25.800 --> 0:02:29.280 This is no joke. Every single year I get sick 0:02:29.520 --> 0:02:33.560 one time, like like a major way, and it's always 0:02:33.639 --> 0:02:36.799 when I go on a vacation. Always, it always happens. 0:02:36.880 --> 0:02:39.360 Last year I went to Portland, got sick the minute 0:02:39.360 --> 0:02:42.320 I got there. And it's it's either airplanes or maybe 0:02:42.320 --> 0:02:45.520 it's like I'm relaxing and I'm letting my immune system 0:02:45.600 --> 0:02:49.200 drop or something. But I'll say this what you're just 0:02:49.240 --> 0:02:51.880 talking about with the coughing. Has anybody ever been on 0:02:51.919 --> 0:02:55.880 an airplane where somebody isn't hacking. Yeah, it's it's it's 0:02:55.880 --> 0:02:57.760 like there's always gonna be someone hacking. Theres always gonna 0:02:57.800 --> 0:03:01.360 be that crying child. Yeah, exactly, It's just part of traveling. 0:03:01.680 --> 0:03:05.040 But so we're circling around this. But our topic for 0:03:05.080 --> 0:03:09.640 today is actually the idea of a patient zero, of 0:03:09.880 --> 0:03:15.360 the first patient, the first victim bringing a disease to 0:03:15.440 --> 0:03:18.240 the human populace. Yeah, or if not to the human 0:03:18.280 --> 0:03:21.640 populace as a whole, then at least to a center 0:03:21.680 --> 0:03:25.359 of population um. These are also known as index cases, 0:03:25.400 --> 0:03:29.000 that's really the more official title, uh, the patient zero 0:03:29.160 --> 0:03:32.680 is the sexier sort of media word for for this 0:03:32.720 --> 0:03:36.119 type of individual. And it's really misleading. It's a it's 0:03:36.120 --> 0:03:38.680 a it's a misnomer, and it's misleading. We're gonna talk 0:03:38.720 --> 0:03:41.720 about why. Yeah, And and in order to discuss why, 0:03:41.760 --> 0:03:44.240 I think it's important that we we also isolate some 0:03:44.320 --> 0:03:47.680 of the mythic and fictional variations of this trope, because 0:03:47.720 --> 0:03:49.960 we're talking about the idea here that some illness or 0:03:50.040 --> 0:03:52.880 some flaw and character, and these two are often intermingled, 0:03:52.880 --> 0:03:55.680 and myth can be traced back to a single individual, 0:03:55.720 --> 0:03:58.200 And then how are we supposed to feel about that 0:03:58.440 --> 0:04:02.160 single individual and being humans and doing what we do. 0:04:02.240 --> 0:04:06.080 We usually look upon them with the stain and and 0:04:06.240 --> 0:04:08.760 write a narrative in which they're somehow the bad guy 0:04:09.560 --> 0:04:11.760 forgetting us all sick. And we know we've talked about 0:04:11.800 --> 0:04:14.080 mythology on this podcast a lot in the past, and 0:04:14.120 --> 0:04:18.240 about how how powerful these uh, these mythological ideas are 0:04:18.279 --> 0:04:21.520 even if we're not consciously invoking them. So I thought 0:04:21.640 --> 0:04:23.200 it might be a good idea to just look at 0:04:23.240 --> 0:04:26.840 some of these mythic examples and and see how they 0:04:26.839 --> 0:04:31.200 are reflected in our modern view of the patient zero. Okay, 0:04:31.279 --> 0:04:34.480 so let's let's start with what we can think of 0:04:34.600 --> 0:04:38.200 as you know, like original sinners or o G sinners. Uh. 0:04:38.800 --> 0:04:41.640 One of the most famous is, of course Pandora. Pandora's 0:04:41.640 --> 0:04:44.000 the first woman created by the gods. She opens a 0:04:44.080 --> 0:04:48.360 jar or a box depending on on on on your reading, 0:04:48.560 --> 0:04:51.920 and in doing this she unleashes all the sort of 0:04:51.960 --> 0:04:56.520 non specific evils of the world. So thanks a lot, Pandora. 0:04:56.640 --> 0:04:59.680 Now we have evil in and Uh it's very easy 0:04:59.720 --> 0:05:03.880 to see that is a gendered narrative. Certainly our our 0:05:03.880 --> 0:05:06.120 friends who used to do stuff. Mom never told you. You 0:05:06.000 --> 0:05:09.679 You probably have an episode on a Pandora somewhere about 0:05:09.720 --> 0:05:12.400 the myth of the It's all Pandora's fall or it's 0:05:12.440 --> 0:05:15.800 all Eve's fault. Yeah, even is the other big one, right? Um? 0:05:16.080 --> 0:05:19.919 Eve the first woman? And uh and and as encountered 0:05:19.920 --> 0:05:22.440 in the Old Testament, Uh, she makes the mistake of 0:05:22.480 --> 0:05:25.479 listening to a talking snake was of course Satan, who 0:05:25.480 --> 0:05:27.960 convinces her to disobey the creator guide and eat of 0:05:28.000 --> 0:05:30.120 the tree of the knowledge of good and evil, and 0:05:30.160 --> 0:05:34.040 this transmission only leads to their expulsion from the earthly paradise, 0:05:34.480 --> 0:05:37.360 our mortal legacy of having to work and wear clothes 0:05:37.440 --> 0:05:41.000 and experience painful childbirth. So again, a very gender to 0:05:41.120 --> 0:05:45.640 blame game going on here. This one uh, primordial woman 0:05:46.200 --> 0:05:50.400 made a mistake aired in judgment listen to a talking snake, 0:05:50.720 --> 0:05:53.880 which is really a bit unfair, right because I've always 0:05:53.880 --> 0:05:55.599 looked back on that story and it's like, what is 0:05:55.600 --> 0:05:58.200 there as talking snake? You really threw a curveball here 0:05:58.800 --> 0:06:01.799 while having a talking snake? I think didn't all animals talk? 0:06:02.080 --> 0:06:04.320 I don't know my Bible that well, Joe should be, 0:06:05.160 --> 0:06:07.520 but I'm pretty sure that in the Garden of Eden 0:06:07.560 --> 0:06:11.200 all animals talked. But maybe here's what I don't remember that, 0:06:11.760 --> 0:06:14.320 but maybe that's from the Disney version that well, that's 0:06:14.320 --> 0:06:17.000 where I was going was I was thinking, like, is 0:06:17.040 --> 0:06:21.800 the talking snake the same snake from from the Jungle Book? 0:06:22.440 --> 0:06:29.880 Like an ancient relative? Yeah, exactly, maybe some cub uh, 0:06:29.960 --> 0:06:33.360 but certainly a Pandora eve. These are both examples of 0:06:33.360 --> 0:06:38.279 of of of a essentially a patient zero for human suffering. 0:06:38.640 --> 0:06:41.560 Another big one from from from the Old Testament is 0:06:41.600 --> 0:06:44.960 of course Kane. Uh. He's the first born son and 0:06:45.080 --> 0:06:47.320 his crime is a bit more complicated because you get 0:06:47.360 --> 0:06:52.120 into this issue of his sacrifice versus abel sacrifice able 0:06:52.160 --> 0:06:56.800 being his brother. But however you want to attribute it, 0:06:56.920 --> 0:06:59.880 He's remembered as being the first murder of his brother Abel. 0:07:00.040 --> 0:07:03.080 So God punished Kane to a life of wandering and 0:07:03.120 --> 0:07:05.040 set a mark on him so that no man would 0:07:05.120 --> 0:07:08.760 kill him. Yeah, that that is actually a bit of 0:07:08.880 --> 0:07:11.320 mythos is popping up in a lot of popular culture 0:07:11.440 --> 0:07:13.960 fictional lately, the mark of Kine and the idea of 0:07:14.480 --> 0:07:18.120 bearing that that that mark of the first murderer. It's 0:07:18.160 --> 0:07:20.960 a little different than disease, but I think that in 0:07:21.080 --> 0:07:24.560 Kane's case, it's definitely one of those like this is 0:07:24.640 --> 0:07:27.760 why humanity is so burdened, right, Yeah, And all three 0:07:27.800 --> 0:07:30.080 of these are examples to where the idea that the 0:07:30.120 --> 0:07:33.960 stain never watches away, right, humans are always going to 0:07:34.040 --> 0:07:38.160 be stained with original sin and or uh, females are 0:07:38.200 --> 0:07:41.640 always gonna have some degree of blame. Right. Or in 0:07:41.640 --> 0:07:45.040 the case of Kine, it it's carried on through through 0:07:45.120 --> 0:07:48.840 Kane's children. Uh. It indeed, like as if it's an 0:07:48.840 --> 0:07:53.000 infectious agent. Yeah. Absolutely, Now, we also have plenty of 0:07:53.000 --> 0:07:58.160 examples of monster patriarchs and matriarchs we have a kidna 0:07:58.320 --> 0:08:00.880 the Greek from Greek myth, so this is the mate 0:08:00.920 --> 0:08:03.880 of the giant Typhon, and she gave birth to such 0:08:03.920 --> 0:08:09.480 monsters as Cerebus, the Hydra, the Chimera, the Sphinx, the gorgon, um, 0:08:09.800 --> 0:08:13.720 uh Cilia, et cetera. I have just been reading Chuck 0:08:13.720 --> 0:08:18.840 Wendig's book Zeros, and it's um not at all about mythology, 0:08:18.920 --> 0:08:23.080 but it is about cyberculture and artificial intelligence, and they 0:08:23.120 --> 0:08:28.880 heavily play off of the ecodnah Typhon mythology within the 0:08:29.080 --> 0:08:34.920 sort of classifications of AI. Yeah, there's also lilith the First, 0:08:35.000 --> 0:08:37.920 a wife of Adam according to Jewish mythology, and you 0:08:37.960 --> 0:08:42.480 see later treatments, especially in fiction and vampire fiction, where 0:08:42.520 --> 0:08:45.600 lilith Is is held up as this demon or the 0:08:45.640 --> 0:08:49.600 first vambuire and uh to to to draw in a 0:08:49.679 --> 0:08:53.400 less mythic and certainly more pop cultural example, I'm I 0:08:53.480 --> 0:08:55.920 was always a big fan of Blade two lad to 0:08:56.040 --> 0:08:59.040 the Fantastiermo de Toro movie, and that has a wonderful 0:08:59.080 --> 0:09:02.560 patient zero plot in it. Yes it does. Yeah, The 0:09:02.600 --> 0:09:04.600 whole plot line here is there's a patient zero for 0:09:04.640 --> 0:09:08.040 a new strain of vampiresm when it turns the vamps 0:09:08.080 --> 0:09:12.040 into reapers who feed on the blood of vampires. And 0:09:12.080 --> 0:09:15.160 so you have this character Jared Nomack who's the sort 0:09:15.160 --> 0:09:18.000 of tragic supervillain of the of the film. Yeah, and 0:09:18.160 --> 0:09:20.679 that's an interesting take on it because, like you can 0:09:20.760 --> 0:09:25.480 look at vampiresm mythology in general as being about disease, right, 0:09:25.800 --> 0:09:27.520 but then this sort of flips it on its head. 0:09:27.559 --> 0:09:30.600 It's a disease for the disease carriers in a situation 0:09:30.640 --> 0:09:34.959 where the disease changes, there's something is tweaked in the 0:09:35.280 --> 0:09:38.320 illness and suddenly it becomes all the more dangerous. And 0:09:38.360 --> 0:09:41.080 that kind of mutation is is actually very real and 0:09:41.120 --> 0:09:43.040 part of what we're going to talk about today with 0:09:43.480 --> 0:09:48.679 these ideas of patient zeros in major epidemic breakouts. Yeah, now, 0:09:48.679 --> 0:09:50.800 what are a few more here We've recently been talking 0:09:50.800 --> 0:09:54.520 about the expanse Yeah, and there's the character Juliet mal 0:09:54.840 --> 0:09:57.679 on that show who's infected with the protomolecule and that 0:09:57.760 --> 0:10:00.199 becomes a major plot point in the first book, in 0:10:00.240 --> 0:10:02.760 the first couple of seasons of the show. In Stephen 0:10:02.800 --> 0:10:06.280 King's The Stand. Uh, some of some of you King 0:10:06.320 --> 0:10:08.640 fans that they might remember that there's a there's a 0:10:08.760 --> 0:10:12.880 one individual, Charles Campion, I believe. Is he the security 0:10:12.880 --> 0:10:16.000 guard who like ends up like leaving the base when 0:10:16.000 --> 0:10:19.360 he's not supposed to believe, so he becomes eight. He 0:10:19.440 --> 0:10:24.319 becomes the patient zero for Captain Trips super flu the 0:10:23.920 --> 0:10:28.040 stand is truly like the epidemic story of our time. 0:10:28.200 --> 0:10:30.240 I I anytime I get a really bad flu. I 0:10:30.240 --> 0:10:33.920 referred to it his Captain Trips. Yeah, And there's this 0:10:34.000 --> 0:10:36.320 movie that came out maybe two or three years ago 0:10:36.360 --> 0:10:38.640 that I thought of. It's called Contracted. They've made a 0:10:38.640 --> 0:10:41.760 sequel to it as well. It's a zombie movie technically, 0:10:41.800 --> 0:10:44.800 but it's about, uh. The whole thing is about a 0:10:44.800 --> 0:10:51.079 woman who contracts zombie ism I guess as a sexually 0:10:51.080 --> 0:10:55.480 transmitted disease from a patient zero, and it's a slow 0:10:56.840 --> 0:11:00.440 burn of her basically like going through the initial stages 0:11:00.440 --> 0:11:03.040 of the disease. The movie ending with her turning into 0:11:03.040 --> 0:11:06.960 a zombie. But apparently Contracted, to which I have not seen, 0:11:07.480 --> 0:11:10.320 is about finding the patient zero, and this is kind 0:11:10.320 --> 0:11:13.160 of a familiar trope to some of these films, such 0:11:13.160 --> 0:11:18.320 as The Ring and potentially even it follows like I've understand, 0:11:18.000 --> 0:11:21.160 I've understood that if they do a follow up film, 0:11:21.240 --> 0:11:23.080 that's going to be what it deals with is kind 0:11:23.080 --> 0:11:26.320 of blaming the agent, I mean, the patient zero there is, Yeah, 0:11:26.360 --> 0:11:28.200 there is sort of an element of that in the 0:11:28.280 --> 0:11:30.920 in the original. It follows if they ever come out 0:11:30.920 --> 0:11:32.840 of the sequel that kind of h I kind of 0:11:32.840 --> 0:11:34.720 hope they believe it where it is. But but yeah, 0:11:34.800 --> 0:11:36.640 the idea that they need to find out whoever the 0:11:36.679 --> 0:11:39.400 first person is, who's contracted this curse, because that's our 0:11:39.480 --> 0:11:42.840 human tendency, right, we want to find out where did 0:11:42.880 --> 0:11:47.520 it begin? Uh? Who can we blame? Um? And it's 0:11:47.720 --> 0:11:51.280 it becomes this complicated game that is both both that 0:11:51.280 --> 0:11:55.679 that has certainly elements of of of important science to it, uh, 0:11:55.720 --> 0:11:58.880 and in terms of containing and figuring out how the 0:11:58.880 --> 0:12:02.760 illness works, that also draws in all of these less 0:12:02.800 --> 0:12:06.000 scientific mythic ideas. So let's unravel this a little bit. 0:12:06.320 --> 0:12:10.240 What what is exactly a patient zero or an index case? 0:12:10.880 --> 0:12:14.240 So as we've been discussing it, we're essentially talking about 0:12:14.280 --> 0:12:18.320 the first known patient to exhibit symptoms of a given illness. Uh. 0:12:18.360 --> 0:12:21.480 And yeah, it's one that plays out into so many 0:12:21.520 --> 0:12:24.280 of our dramas about infectious disease. Some of the examples 0:12:24.280 --> 0:12:26.920 we didn't touch on that have been mentioned in some 0:12:27.000 --> 0:12:30.000 of our sources, or contagion that came out in twenty eleven, 0:12:30.280 --> 0:12:33.960 twelve Monkeys and twenty eight days later came out in 0:12:33.960 --> 0:12:36.720 twenty in two thousand and two, and the outbreak was 0:12:36.760 --> 0:12:39.520 in a lot of my notes. Yeah yeah, yeah, um. 0:12:39.600 --> 0:12:44.240 But as Robert mentioned earlier, scientists prefer the term index case. 0:12:44.679 --> 0:12:47.560 The reason why is identifying a single person as the 0:12:47.600 --> 0:12:52.000 patient zero both gives an incorrect impression about how a 0:12:52.080 --> 0:12:55.840 disease might emerge, and it insinuates that somebody should be 0:12:55.920 --> 0:12:59.720 blamed for the outbreak right. Um. At the same time, 0:13:00.240 --> 0:13:02.839 it's important to find out what's going on with these 0:13:02.880 --> 0:13:05.600 cases because then if you know their history, you can 0:13:05.640 --> 0:13:09.120 help researchers determine how and when the upbreak started. So 0:13:09.559 --> 0:13:12.680 some refer to this as detective work, or actually start 0:13:12.760 --> 0:13:17.319 referred to as shoe leather epidemiology in one of the articles. 0:13:17.440 --> 0:13:20.200 Uh So, basically, the idea here is you backtrack the 0:13:20.240 --> 0:13:24.040 disease and once patient zero is identified, you try to 0:13:24.080 --> 0:13:26.920 figure out how they got sick, So were they in 0:13:27.040 --> 0:13:30.319 contact with a certain species of animal or what kind 0:13:30.320 --> 0:13:32.520 of activities did they do right before they got sick, 0:13:32.559 --> 0:13:34.600 or how exposed were they, Like do they have open 0:13:34.640 --> 0:13:37.080 wounds or did they breathe something in did they ingest 0:13:37.160 --> 0:13:40.520 something or was it just something in the air. So, 0:13:41.160 --> 0:13:43.880 what today's research is really going to ask us to 0:13:43.920 --> 0:13:49.640 consider is that this is a state of harnessing scientific 0:13:49.679 --> 0:13:55.280 authority to enact coercive measures while drawing upon contemporary beliefs 0:13:55.280 --> 0:13:59.760 that either race or class or sexuality could lend to 0:13:59.840 --> 0:14:05.240 the patient zero's propensity for disease. Because when patient zero 0:14:05.400 --> 0:14:10.000 is defined as someone with distinguishing traits, whether that's behavior 0:14:10.160 --> 0:14:13.840 or sexuality or race, it makes it easier for those 0:14:13.840 --> 0:14:17.360 of us with different characteristics to reassure ourselves that we're 0:14:17.440 --> 0:14:20.800 not at risk. This doesn't have to do with us, right, Uh. 0:14:20.840 --> 0:14:24.800 And they typically locate disease origins as being in quote 0:14:25.040 --> 0:14:28.080 pre modern parts of the world. So there's a concern 0:14:28.160 --> 0:14:31.920 that this narrative deflects attention away from the structural factors 0:14:32.000 --> 0:14:36.640 that can affect transmission and health health outcomes. Um so, yeah, 0:14:36.680 --> 0:14:39.280 I mean, and it's it's also incredibly difficult to nail 0:14:39.280 --> 0:14:42.040 down a patient zero. Yeah, yeah, it's it's it's one 0:14:42.040 --> 0:14:44.560 of these ideas that certainly works better in fiction than 0:14:44.600 --> 0:14:48.760 it does in reality. Yeah, absolutely, it seems right, like, uh, 0:14:49.040 --> 0:14:51.240 twenty eight days later, it's really easy to say, like, oh, 0:14:51.360 --> 0:14:53.400 the monkey bit this person and then this person spreading 0:14:53.440 --> 0:14:55.160 you know what I mean, Like like, it's it's very 0:14:55.200 --> 0:14:56.600 easy to do it that way. That's not how the 0:14:56.640 --> 0:14:59.560 real world works, right, I mean, it's it's irresistible from 0:14:59.560 --> 0:15:03.040 a fiction all standpoint because it invokes those myths. But 0:15:03.040 --> 0:15:05.960 but yeah, actually finding that individual there. We're going to 0:15:06.000 --> 0:15:09.840 discuss some cases of alleged patient zeros, but for the 0:15:09.840 --> 0:15:13.000 most part, it's a rather difficult ansercise, Yeah, because the 0:15:13.080 --> 0:15:15.920 thing here is that infectious agents can percolate in the 0:15:16.040 --> 0:15:20.520 environment for years, sometimes even decades without being detected, and 0:15:20.680 --> 0:15:23.440 when they do enter the human population, it could be 0:15:23.480 --> 0:15:27.600 through more than just one person. Also, some people are 0:15:27.720 --> 0:15:31.960 more capable of spreading disease than others. So one argument 0:15:32.040 --> 0:15:34.320 is basically, well, instead of thinking of it in terms 0:15:34.320 --> 0:15:38.600 of patients zeros, maybe we should be thinking of super spreaders. 0:15:38.640 --> 0:15:41.880 And there's also a terminology for people who are referred 0:15:41.920 --> 0:15:45.240 to as super shedders as well, and these are the 0:15:45.240 --> 0:15:48.360 people who shed many more types of the virus into 0:15:48.400 --> 0:15:51.880 an environment. So yeah, so we've got a lot to 0:15:51.960 --> 0:15:54.080 unpack here. I think we're gonna see more of it 0:15:54.080 --> 0:15:56.800 when we look at the examples. Now, you might well 0:15:56.840 --> 0:15:59.960 ask yourself, well, how does one become the first carry 0:16:00.080 --> 0:16:03.000 or of a particular illness. Well, the answer here, of course, 0:16:03.080 --> 0:16:05.360 is that that they mutate, They leap from a non 0:16:05.440 --> 0:16:08.440 human host to a human when they adapt and sustain. 0:16:08.960 --> 0:16:13.640 So for many zoonotic infectious diseases, the first step involves 0:16:13.800 --> 0:16:17.160 the species jump. All right, We've seen this, and you've 0:16:17.160 --> 0:16:19.040 seen this in a number of examples that have propped 0:16:19.120 --> 0:16:20.880 up in the news over the years, you know, bird flu, 0:16:21.160 --> 0:16:24.760 swine flu. The idea that these these are strains of 0:16:24.800 --> 0:16:29.560 influenza that have thus far been isolated to a non 0:16:29.680 --> 0:16:33.640 human animal, but through close proximity, this thing is able 0:16:33.680 --> 0:16:37.400 to jump to us and then sustain itself in this 0:16:37.480 --> 0:16:40.160 new host. Yeah, and we're gonna see in some of 0:16:40.160 --> 0:16:43.840 these examples that bats are actually a huge factor in 0:16:44.280 --> 0:16:47.240 zooonotic infections. Uh. The other thing that I was going 0:16:47.280 --> 0:16:49.400 to mention too is this reminds me of our episode 0:16:49.400 --> 0:16:52.800 on the guinea worm, where it was the other way around, 0:16:53.280 --> 0:16:56.480 and that the guinea worm jumped to dogs from humans. Yeah, 0:16:56.560 --> 0:16:59.040 it isn't. Essentially, we thought we had it wiped out 0:16:59.080 --> 0:17:00.720 and then we found out it it had jumped to 0:17:00.880 --> 0:17:03.480 dogs as a as a new hiding place, thus complicating 0:17:03.480 --> 0:17:07.000 our efforts to eradicate it. Uh and uh, you know, 0:17:07.040 --> 0:17:09.479 so anyway they get into a human they can they 0:17:09.480 --> 0:17:11.600 can spread through the human population. And to put that 0:17:11.640 --> 0:17:15.840 in perspective, about six of all existing human infectious diseases 0:17:16.160 --> 0:17:19.960 are zooonotic. So it's not a it's not a case 0:17:19.960 --> 0:17:23.120 where oh this is this. This is a strange situation 0:17:23.200 --> 0:17:26.520 where this this illness jump from one species to another. 0:17:26.600 --> 0:17:29.119 This seems to largely be how how they work like 0:17:29.200 --> 0:17:33.639 this is this is a common factor in in in studying, preventing, 0:17:33.720 --> 0:17:37.560 and fighting infectious disease. So why then, why is it 0:17:37.600 --> 0:17:43.240 important for science to be able to attribute a patient zero. Well, 0:17:43.800 --> 0:17:46.000 there are two main factors here, of course, One is 0:17:46.240 --> 0:17:48.680 the chance to better contain the outbreak. If you can 0:17:48.720 --> 0:17:51.840 pinpoint who brought it, then you can you can follow 0:17:52.040 --> 0:17:54.840 the chain, you can try and contain it. You can 0:17:54.640 --> 0:17:57.200 you can do everything you can to prevent the further 0:17:57.320 --> 0:18:00.480 spread of the illness. Uh. And then second, it's the 0:18:00.560 --> 0:18:03.240 chance to determine where and when the outbreak started based 0:18:03.240 --> 0:18:06.800 on the patient's personal history. It gets one closer, one 0:18:06.840 --> 0:18:10.080 step closer to the to the source because essentially you're 0:18:10.160 --> 0:18:13.720 you're you're condensing the history of the illness to the 0:18:13.760 --> 0:18:17.960 history of the person, right and that can conceivably be 0:18:18.000 --> 0:18:21.520 easier to to to track down Now. An example of 0:18:21.560 --> 0:18:25.280 this in action would be uh when medical professionals traced 0:18:25.280 --> 0:18:28.960 the two thousand fourteen West African outbreak of Ebola back 0:18:29.000 --> 0:18:31.680 to a two year old child who died on December six, 0:18:31.920 --> 0:18:37.159 two thou thirteen. By January one, the child's mother, three 0:18:37.240 --> 0:18:40.160 year old sister, and grandmother had died as well. So 0:18:40.320 --> 0:18:43.720 this this was a town in Guiana, which sits adjacent 0:18:43.720 --> 0:18:48.760 to the borders of Liberia and Sierra Leone, so there's 0:18:48.840 --> 0:18:52.280 easy access for it to spread into different regions, which 0:18:52.320 --> 0:18:55.440 explains how it managed to spread through three countries within 0:18:55.600 --> 0:18:58.320 a matter of months. Isolating the patients zero in this 0:18:58.320 --> 0:19:01.000 case allowed researchers to map the trammission of the virus 0:19:01.040 --> 0:19:04.280 and better understood stand how and where it was spreading. 0:19:04.800 --> 0:19:08.040 But as we'll explore, this helpful concept can also spin 0:19:08.080 --> 0:19:11.359 out of control thanks to the complications of of human 0:19:11.400 --> 0:19:14.840 prejudice and just the power of this mythic idea that 0:19:14.840 --> 0:19:17.680 that there's a single individual to blame, there's something as 0:19:17.720 --> 0:19:21.600 complex as the mutation and spread of an infectious disease. 0:19:21.640 --> 0:19:25.440 In fact, I believe in that UH particular Ebola case, 0:19:25.480 --> 0:19:29.679 I believe that there were some factors of witchcraft being blamed. Um. 0:19:29.760 --> 0:19:33.399 So it's important to see, you know, patient zero not 0:19:33.520 --> 0:19:36.399 only works in a medical situation and that like we 0:19:36.440 --> 0:19:37.920 need to apply it so that we can try to 0:19:37.960 --> 0:19:40.720 contain the upbreak figure out what's origins are, but it 0:19:40.760 --> 0:19:44.040 also works from the human cultural perspective of trying to 0:19:44.119 --> 0:19:46.840 understand what's going on, right, right, Why don't we take 0:19:46.840 --> 0:19:49.320 a quick break and when we get back, what we're 0:19:49.320 --> 0:19:51.679 going to take a look at some patient zeros of 0:19:51.800 --> 0:20:00.520 note throughout history. Alright, we're back, So, yeah, we're gonna 0:20:00.520 --> 0:20:03.040 talk about some patient zeros here. And this first one 0:20:03.359 --> 0:20:06.919 I'm particularly fond of because the story actually comes up 0:20:06.960 --> 0:20:11.440 in the first season of The Nick, which was was 0:20:11.520 --> 0:20:15.480 It is a fabulous Cinemax uh TV series starring Clive 0:20:15.520 --> 0:20:20.879 Owen about the just the rapid advances in the medical 0:20:20.920 --> 0:20:25.120 profession UH in the early twentieth century and it's a 0:20:25.280 --> 0:20:29.120 really rough story for this particular individual. I'm sure most 0:20:29.160 --> 0:20:31.280 of you have been thinking about her as we've been 0:20:31.280 --> 0:20:34.880 talking about patients zero. Of course we mean typhoid Mary. Yeah, 0:20:34.880 --> 0:20:38.359 the name itself has become synonymous with someone who unknowingly 0:20:38.440 --> 0:20:42.639 spreads a disease. Yeah, and so typhoid Mary was actually 0:20:42.680 --> 0:20:46.080 a woman named Mary Malone or Malan. She was an 0:20:46.080 --> 0:20:50.119 Irish immigrant and she was forcibly quarantined after officials determined 0:20:50.160 --> 0:20:53.439 that she was spreading disease to unsuspecting families that she 0:20:53.560 --> 0:20:56.119 worked for as a cook. Now, the idea here was 0:20:56.160 --> 0:21:00.359 basically that she worked in these homes and members of 0:21:00.400 --> 0:21:03.240 the homes they would develop typhoid fever. They would get 0:21:03.280 --> 0:21:08.040 it from salmonilla ty fi. So they quarantined her on 0:21:08.240 --> 0:21:12.240 two occasions for a total of twenty six years, and 0:21:12.320 --> 0:21:15.720 she subsequently even sued the New York Department of Health 0:21:15.800 --> 0:21:20.040 because she was basically imprisoned, but she was unsuccessful. Is 0:21:20.119 --> 0:21:22.360 that what they cover in the neck? Do they talk 0:21:22.400 --> 0:21:25.360 about her quarantining They the quarantine is kind of set 0:21:25.400 --> 0:21:27.240 up at the end. It basically there's a character in 0:21:27.280 --> 0:21:30.840 the show who's who inspects outbreaks and tries to get 0:21:30.880 --> 0:21:32.639 to the bottom of it. And there's a strong, uh 0:21:32.920 --> 0:21:36.639 you know, immigrant um aspect of the plot as well. 0:21:36.720 --> 0:21:39.280 But you have a couple of the characters who were 0:21:39.520 --> 0:21:43.520 investigating this outbreak and trying to determine what's causing it. Yeah, 0:21:43.640 --> 0:21:47.600 So I mean we can see here not only was 0:21:47.680 --> 0:21:50.240 she a woman and it made it gendered, but she 0:21:50.320 --> 0:21:52.320 was also Irish and at the time there was a 0:21:52.400 --> 0:21:56.000 lot of prejudice against Irish immigrants, so of course it 0:21:56.080 --> 0:21:58.840 worked very well for them to say, well, this is 0:21:58.880 --> 0:22:01.480 the person who this whole thing broke out with. It's 0:22:01.520 --> 0:22:05.640 it's her that's responsible for this. She's actually not technically 0:22:05.960 --> 0:22:08.680 what we would refer to as a patient zero though. Yeah, 0:22:08.680 --> 0:22:11.239 I guess she might qualify as a as a as 0:22:11.320 --> 0:22:15.200 a what a super shudder, Yeah, either a super spreader 0:22:15.320 --> 0:22:19.520 or a super shredder. Uh. That sounds like some kind 0:22:19.520 --> 0:22:22.760 of teenage mutant Ninja Turtles. There was super Shredder and 0:22:23.200 --> 0:22:26.120 the second one. I believe it's that they're shredding them mutate, 0:22:27.760 --> 0:22:31.440 but her case, it's actually similar to um that movie 0:22:31.480 --> 0:22:34.240 twenty eight weeks later. So the idea here is it's 0:22:34.240 --> 0:22:36.920 somebody who can spread the disease, but they're also immune 0:22:36.920 --> 0:22:40.720 to it. So she didn't get sick herself, but she 0:22:40.720 --> 0:22:43.640 she was supposedly spreading it to all these other people. Yeah, 0:22:43.680 --> 0:22:46.439 she was an asymptomatic carrier, so which means that she 0:22:46.480 --> 0:22:48.720 carried the disease, she transmitted it, but she exhibited no 0:22:48.840 --> 0:22:52.560 symptoms herself. And that that's what made her inadvertently so 0:22:52.560 --> 0:22:56.280