WEBVTT - Rabies

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<v Speaker 1>Hey, they're extraordinaries. Heads up.

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<v Speaker 2>Today's episode is about rabies, so we'll be touching on

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<v Speaker 2>topics related to death and animal testing. Please decide if

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<v Speaker 2>that content sounds like a good fit for you or

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<v Speaker 2>for any children that might be hanging out in earshot.

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<v Speaker 1>Thanks.

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<v Speaker 2>In twenty twenty five, rabies made the news in the

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<v Speaker 2>United States. A kidney transplant recipient had passed away from

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<v Speaker 2>rabies and it was determined that their organ donor had

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<v Speaker 2>had an undiagnosed case of rabies. Humans rarely transmit rabies

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<v Speaker 2>to each other, and organ and tissue transplants are pretty

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<v Speaker 2>much the only way it happens. But how does someone

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<v Speaker 2>end up with undiagnosed rabies. Well, the man who would

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<v Speaker 2>go on to become the organ donor was holding a

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<v Speaker 2>kitten in an outbuilding when a skunk came in. The

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<v Speaker 2>skunk approached the man, who perceived that the skunk was

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<v Speaker 2>trying to kill kitten because the skunk was very hungry.

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<v Speaker 2>The man knocked the skunk unconscious they're made of pretty

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<v Speaker 2>stern stuff out in the country, and got a scratch

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<v Speaker 2>on his shin in the process. In hindsight, he should

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<v Speaker 2>have thoroughly washed out that wound and immediately gone to

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<v Speaker 2>see a doctor for rabie's treatment, but he dismissed the

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<v Speaker 2>scratch and didn't think he had been bitten. He just

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<v Speaker 2>chalked it all up to an unfortunate interaction with a

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<v Speaker 2>hungry but not necessarily rabid skunk. Five weeks later, he

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<v Speaker 2>began hallucinating, he had trouble swallowing, and two days after

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<v Speaker 2>that he appeared to have suffered a cardiac arrest. He

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<v Speaker 2>never regained consciousness and was eventually declared brain dead. His

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<v Speaker 2>family did report the skunk interaction, but cardiac arrest seemed

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<v Speaker 2>a more likely cause of death. His kidney and three

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<v Speaker 2>cornia tissue graphs were eventually given to recipients, and as

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<v Speaker 2>you now know, the kidney recipient passed away. When it

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<v Speaker 2>was determined that the kidney recipient had rabies. Some sleuthing

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<v Speaker 2>determined that the organ donor had originally died of Raebe's

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<v Speaker 2>as well. At that point, the cornea tissue grass were

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<v Speaker 2>removed and all three recipients were given treatment for rabies. Thankfully,

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<v Speaker 2>they all remained symptom free. This scenario where an organ

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<v Speaker 2>donor transmitted rabies to organ and tissue recipients has only

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<v Speaker 2>happened four times since nineteen seventy eight in the.

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<v Speaker 1>United States, but it makes the news in the United.

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<v Speaker 2>States because rabies deaths are so incredibly rare here, but

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<v Speaker 2>globally they're not rare. Around sixty thousand people die each

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<v Speaker 2>year from rabies, and many of them are children. And

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<v Speaker 2>these deaths happened despite the fact that we have a

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<v Speaker 2>vaccine that could save them if only it was administered

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<v Speaker 2>soon after the initial rabies exposure. So today we're going

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<v Speaker 2>to talk about rabies, how you can get it, how

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<v Speaker 2>you can avoid it, the history of vaccine development, and

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<v Speaker 2>what vaccines we have available today. Welcome to Daniel and

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<v Speaker 2>Kelly's Rabid Uni. Hi.

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<v Speaker 3>I'm Daniel. I'm a particle physicist, and I expected, based

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<v Speaker 3>on childhood cartoons, to worry a lot about quicksand and

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<v Speaker 3>rabi's when I was growing up.

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<v Speaker 1>Hi, I'm Kelly Wiersmith.

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<v Speaker 2>I study parasites and space, and yeah, I also thought

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<v Speaker 2>that quicksand was going to be a much bigger problem

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<v Speaker 2>as an adult than it ended up being.

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<v Speaker 3>All right, Well, then my question for you today, Kelly

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<v Speaker 3>is have you ever stepped in quicksand or had a

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<v Speaker 3>serious concern about getting rabies.

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<v Speaker 2>I never stepped in quicksand, although I did almost get

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<v Speaker 2>stuck in a salt marsh once in some mud. I

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<v Speaker 2>had a moment where I was out there by myself,

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<v Speaker 2>and I was like, am I going to be able

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<v Speaker 2>to get my foot out? Or is this the end?

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<v Speaker 2>As the tide is coming in? And it wasn't the

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<v Speaker 2>end because here I am.

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<v Speaker 3>Well probably in that case, it's just by by boot, right.

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<v Speaker 1>Yeah, yeah, I did lose that boot.

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<v Speaker 3>Whatever you donated it to future archaeology is what you did?

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<v Speaker 1>Yeah?

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<v Speaker 2>Yes, Or I polluted that estuary with some microplastics.

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<v Speaker 1>I'm so sorry.

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<v Speaker 3>No, in five thousand years, some PhD student is going

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<v Speaker 3>to write a whole thesis about the ritual processes surrounding

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<v Speaker 3>your boots.

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<v Speaker 2>Okay, sure, I wouldn't want to read that thesis, but I.

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<v Speaker 1>Hope they passed.

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<v Speaker 3>Well, what about rabies?

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<v Speaker 2>Yeah, So when we moved to this property, there were

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<v Speaker 2>two barn cats on the property and the woman was

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<v Speaker 2>moving to a place that didn't have a barn and

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<v Speaker 2>so we offered to keep the barn cats. And every

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<v Speaker 2>once in a while they'll catch a bird. And when

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<v Speaker 2>they catch a bird, I keep it This is the

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<v Speaker 2>Wienersmith family equivalent of poop in the fridge. My husband

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<v Speaker 2>is not thrilled when I do this, but I do it.

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<v Speaker 2>And so I reached down once because I thought the

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<v Speaker 2>birds and this was on my birthday.

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<v Speaker 1>I reached down.

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<v Speaker 2>I thought the cats had caught a bird, and as

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<v Speaker 2>soon as I picked it up, I shouted an expletive

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<v Speaker 2>because I realized they hadn't caught a bird. They had

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<v Speaker 2>caught a bat oho and I had picked up that

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<v Speaker 2>bat with a bear hand. And so immediately I was like, oh, no,

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<v Speaker 2>do I need to go get a rabies vaccine? And

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<v Speaker 2>so I called the Poison Control Center and they ended

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<v Speaker 2>up deciding no, it's probably fine. You probably don't need

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<v Speaker 2>a vaccine. And I was like, I don't want to

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<v Speaker 2>hear the word probably. I want to hear one hundred percent.

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<v Speaker 2>There is zero tant you're gonna get rabies.

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<v Speaker 3>You're talking to a worrier here, people.

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<v Speaker 1>That's right, you know, I did say. I was like,

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<v Speaker 1>look at I have severe anxiety.

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<v Speaker 2>If the answer isn't one hundred percent, I want to

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<v Speaker 2>come in and get the raby shot. And they're like, lady,

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<v Speaker 2>you're fine, and I was like all right, speaking your language,

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<v Speaker 2>that's right, that's right.

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<v Speaker 1>What about you.

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<v Speaker 3>Well, I didn't have to worry about rabies, but growing

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<v Speaker 3>up in northern New Mexico, you do have to worry

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<v Speaker 3>about the plague. Oh and I remember one time seeing

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<v Speaker 3>a dead squirrel and poking it, and then going home

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<v Speaker 3>excitedly telling my mom how I saw this dead squirrel

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<v Speaker 3>and played with it, and she was like, ugh, you what?

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<v Speaker 3>Oh no, And from then on I was sure that

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<v Speaker 3>I was going to get the bubonic plague, which existed,

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<v Speaker 3>you know, medieval Europe and New Mexico.

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<v Speaker 2>Yeah, well, and in like mountains in California.

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<v Speaker 1>Oh I do, I do.

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<v Speaker 2>But for both of these there are treatments if you

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<v Speaker 2>catch it pretty soon. There's antibiotics for the plague that

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<v Speaker 2>does not plague us anymore, and we have vaccines for rabies,

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<v Speaker 2>which we'll be talking about today.

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<v Speaker 3>Well that's why we joke that New Mexico is home

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<v Speaker 3>of the flea, land of the plague.

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<v Speaker 2>Oh yeah, that doesn't doesn't make me want to move there.

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<v Speaker 3>No, No, the land of entrapment. Anyway. There's a lot

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<v Speaker 3>of wonderful things about New Mexico, but you don't really

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<v Speaker 3>appreciate them growing up there.

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<v Speaker 2>As a teenager, I feel the same way about Ohio.

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<v Speaker 2>But I guess I feel the same way as an

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<v Speaker 2>adult about Ohio.

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<v Speaker 1>I'm so sorry.

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<v Speaker 3>Well, speaking of not appreciating things, I don't appreciate getting rabies,

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<v Speaker 3>but I do appreciate our listener's curiosity.

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<v Speaker 1>Yes, me too.

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<v Speaker 2>And we got a request for an episode topic from Gurjeet.

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<v Speaker 2>They wanted to know about rabies, and so I was

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<v Speaker 2>happy to oblige because rabies is an absolutely horrible topic

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<v Speaker 2>but also fascinating and so so that is Kelly's ven

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<v Speaker 2>diagram of favorite things to talk about.

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<v Speaker 3>That's right. We don't exploit true crime on this podcast,

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<v Speaker 3>but we do talk about gooey biological pain and suffering.

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<v Speaker 1>We do.

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<v Speaker 2>And I came across what I thought was a fun

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<v Speaker 2>fact while I was doing the research, which is that

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<v Speaker 2>an old treatment that did not work. So treatment is

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<v Speaker 2>in quotes here. An old treatment for rabies was that

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<v Speaker 2>you would take the hair of the dog that bit

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<v Speaker 2>you and put it on the wound, and you would

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<v Speaker 2>hope that that would save you from actually getting the disease.

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<v Speaker 3>Is that the origin of the phrase.

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<v Speaker 1>That is the origin of the phrase.

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<v Speaker 3>Now mostly used to justifyd mimosas at brunch.

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<v Speaker 2>Yes, right, and we will see that many of our

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<v Speaker 2>extraordinaries have an extraordinary desire to continue drinking in the morning.

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<v Speaker 2>So let's go ahead and see what the extraordinaries had

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<v Speaker 2>to say when we asked the phrase hair of the

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<v Speaker 2>dog came from an ineffective treatment for what disease?

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<v Speaker 3>Branchosis? Jesus Wow, what a good question. I'm going to

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<v Speaker 3>be ignorance to say alcoholism.

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<v Speaker 4>I have never heard the phrase before. Hmmm, what disease

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<v Speaker 4>would be associated with dog hair? I'm going to say

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<v Speaker 4>lime disease due to ticks.

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<v Speaker 5>The hair of the dog originally refers to the prevention

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<v Speaker 5>of rabies and is of course false. Probably has something

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<v Speaker 5>to do with the old principle of like cures like,

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<v Speaker 5>and a myth would spread very rapidly in an environment

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<v Speaker 5>of wishful thinking and despair. With dog in the phrase,

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<v Speaker 5>I'm going to go with rabies.

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<v Speaker 3>I guess it's probably something related to tuberculosis.

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<v Speaker 6>Basically a hangover, and it's so shameful that you have

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<v Speaker 6>to walk home and then you find a dive bar

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<v Speaker 6>on the way home, and you make even more terrible

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<v Speaker 6>life choices.

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<v Speaker 4>It might be a reference to rabies, the hair of

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<v Speaker 4>the dog that bit you, based on magical thinking like

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<v Speaker 4>cures like or some such.

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<v Speaker 1>It doesn't work in these parts.

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<v Speaker 3>It means if whiskey culls the hangover, whiskey'll salt it.

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<v Speaker 3>But I think it refers to an old cure for abes.

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<v Speaker 7>Since hair of the dog refers to a hangover remedy,

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<v Speaker 7>maybe alcoholism. But for some reason, I'm thinking tuberculosis, and

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<v Speaker 7>I don't know why, but I'm sure it hasn't always

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<v Speaker 7>referred to that bloody mary.

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<v Speaker 5>The next morning, I'm thinking the ineffective treatment of being

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<v Speaker 5>hungover by drinking more.

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<v Speaker 1>I don't know, sia is this or something right?

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<v Speaker 2>So it seems like there was a pretty nice split

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<v Speaker 2>here between folks who were definitely like, this has to

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<v Speaker 2>do with alcohol, and folks who were like, yeah, alcohol maybe,

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<v Speaker 2>but definitely rabies.

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<v Speaker 3>As did you go down a rabbit hole and figure

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<v Speaker 3>out if whiskey is actually good in the morning if

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<v Speaker 3>you have hangover?

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<v Speaker 2>I did not. I'm guessing that just delays the inevitable.

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<v Speaker 2>But I know I didn't look into that. That was

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<v Speaker 2>a little too far afield of the topic of the day, So.

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<v Speaker 3>For those of you looking for a scientific reason to

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<v Speaker 3>day drink, You're not going to find it on the

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<v Speaker 3>show today.

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<v Speaker 1>I'm not helping you with that. Now, that's not what

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<v Speaker 1>I'm here for.

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<v Speaker 3>You are here to tell us all the gooey details

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<v Speaker 3>about rabies. So what is Rabi's anyway, other than a

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<v Speaker 3>reason for cartoon dogs to froth at the mouth.

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<v Speaker 2>Yeah, So Rabi's is a viral disease that we think

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<v Speaker 2>has been plaguing us for at least four thousand years.

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<v Speaker 2>There are these four thousand year old tablets that we

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<v Speaker 2>found in Iraq that has a law written on it

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<v Speaker 2>that essentially says if a dog becomes rabid and the

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<v Speaker 2>ward authority makes that known to its owner, but he

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<v Speaker 2>does not watch over his dog so that it bites

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<v Speaker 2>a man and it causes his death, the owner of

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<v Speaker 2>the dog shall pay forty shekels of silver. If it

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<v Speaker 2>bites a slave and causes his death, he shall pay

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<v Speaker 2>fifteen shekels of silver.

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<v Speaker 3>Kelly, I love your old testament audiobook voice. That's awesome.

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<v Speaker 2>Well, here you could see that for four thousand years,

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<v Speaker 2>we've been putting dollar values on the value of human

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<v Speaker 2>or che values on the value of human life, and

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<v Speaker 2>we have been ranking the value of human beings. Not

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<v Speaker 2>not a good look for humanity. But the point is

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<v Speaker 2>Rabi's has been, you know, a thing that we have

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<v Speaker 2>been aware of for a really long time.

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<v Speaker 3>But in this case, is the word rabbit obviously a

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<v Speaker 3>translation describing behavior of a dog or was it already

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<v Speaker 3>understood that the dogs were ill and that's where the

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<v Speaker 3>word rabbit comes from.

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<v Speaker 2>Yeah, that's a great question. So I was listening to,

0:11:26.200 --> 0:11:27.720
<v Speaker 2>you know, to research this. I was listening to a

0:11:27.720 --> 0:11:31.440
<v Speaker 2>bunch of different like history podcast, veterinarian podcast, blah blah blah,

0:11:31.559 --> 0:11:35.160
<v Speaker 2>and almost everybody referenced this story. But I was able

0:11:35.200 --> 0:11:38.400
<v Speaker 2>to find a like, you know, history reference that was

0:11:38.400 --> 0:11:41.079
<v Speaker 2>dealing with this exact quote, and it said that another translation,

0:11:41.320 --> 0:11:44.720
<v Speaker 2>instead of translating it as rabbit, translated it as like

0:11:45.000 --> 0:11:48.640
<v Speaker 2>furious or angry. So like, is it really saying if

0:11:48.640 --> 0:11:50.720
<v Speaker 2>your dog is a jerk and we tell you your dog's

0:11:50.720 --> 0:11:52.719
<v Speaker 2>a jerk and you need to like chain that dog up,

0:11:53.240 --> 0:11:55.120
<v Speaker 2>you know we're gonna we're gonna find you if that

0:11:55.160 --> 0:11:59.120
<v Speaker 2>dog bites somebody. But references from the same time period

0:11:59.200 --> 0:12:02.000
<v Speaker 2>note that it's it seems to be that people recognize

0:12:02.000 --> 0:12:04.720
<v Speaker 2>that it is saliva that is transmitting something that will

0:12:04.800 --> 0:12:07.240
<v Speaker 2>kill people. So it suggests to me that they do

0:12:07.320 --> 0:12:10.240
<v Speaker 2>recognize that there is some disease that is being passed

0:12:10.440 --> 0:12:13.480
<v Speaker 2>by the dog through a bite and saliva has something

0:12:13.480 --> 0:12:15.800
<v Speaker 2>to do with it, which sounds like it's not just

0:12:16.480 --> 0:12:18.640
<v Speaker 2>there's a dog that's angry, and they realize some dogs

0:12:18.640 --> 0:12:21.320
<v Speaker 2>are jerks and jerks should be tied up. They actually

0:12:21.360 --> 0:12:25.720
<v Speaker 2>recognize that some dogs carry diseases and those diseases get transmitted.

0:12:25.280 --> 0:12:28.120
<v Speaker 3>Before we understood the microbiology of it all. Of course, yes,

0:12:28.200 --> 0:12:31.000
<v Speaker 3>I'm noting that the Oxford English Dictionary says that the

0:12:31.040 --> 0:12:33.400
<v Speaker 3>earliest use of the word rabbit is from the late

0:12:33.480 --> 0:12:38.600
<v Speaker 3>fifteen hundreds by George Chapman, and so obviously the Iraqis

0:12:38.880 --> 0:12:42.240
<v Speaker 3>didn't use the word rabbit itself, but the idea is

0:12:42.240 --> 0:12:45.120
<v Speaker 3>translated to the modern word rabbit. Fascinating.

0:12:45.320 --> 0:12:47.520
<v Speaker 2>Yeah, yeah, And if you look throughout time, you know,

0:12:47.559 --> 0:12:50.439
<v Speaker 2>from four thousand years ago onwards, there are lots of

0:12:50.480 --> 0:12:52.640
<v Speaker 2>different cultures who have things where you're like, oh, it

0:12:52.720 --> 0:12:55.080
<v Speaker 2>really sounds like they're talking about rabbit animals from the

0:12:55.080 --> 0:12:57.000
<v Speaker 2>point that dogs were domesticated onwards.

0:12:57.120 --> 0:12:58.880
<v Speaker 3>That was my other question is this a disease that

0:12:58.920 --> 0:13:04.400
<v Speaker 3>arises because of the mystification urbanization of civilization, the way

0:13:04.480 --> 0:13:07.400
<v Speaker 3>many diseases come from, like you know, animals in close

0:13:07.480 --> 0:13:10.640
<v Speaker 3>quarters or is this something that existed and exists among

0:13:10.720 --> 0:13:11.720
<v Speaker 3>like wild wolves.

0:13:11.920 --> 0:13:12.720
<v Speaker 1>Yeah, great question.

0:13:12.800 --> 0:13:15.280
<v Speaker 2>This is a disease that exists in the wild and

0:13:15.280 --> 0:13:19.360
<v Speaker 2>has probably existed in the wild long before animal domestications. So,

0:13:19.480 --> 0:13:23.920
<v Speaker 2>for example, in the United States, it's very common in bats, skunks, raccoons,

0:13:23.960 --> 0:13:26.680
<v Speaker 2>and foxes. You can find it in coyotes sometimes also,

0:13:27.480 --> 0:13:30.080
<v Speaker 2>so it's in a lot of wildlife. It happens to

0:13:30.120 --> 0:13:32.720
<v Speaker 2>also do really well in dogs when they aren't vaccinated,

0:13:32.760 --> 0:13:34.760
<v Speaker 2>and so when we started living with dogs, we were

0:13:34.800 --> 0:13:37.120
<v Speaker 2>bringing it closer to us and in contact with us

0:13:37.160 --> 0:13:39.520
<v Speaker 2>more often. But this is definitely something that you could

0:13:39.520 --> 0:13:41.600
<v Speaker 2>have gotten from wild animals, for example, when you were

0:13:41.679 --> 0:13:42.600
<v Speaker 2>hunting before that.

0:13:42.920 --> 0:13:45.200
<v Speaker 3>I see. So if it's an ancient disease, there must

0:13:45.200 --> 0:13:48.040
<v Speaker 3>be a lot of hilarious ancient treatments for it.

0:13:48.280 --> 0:13:50.439
<v Speaker 2>Yeah, right, So hair the dog was one of them.

0:13:50.760 --> 0:13:54.360
<v Speaker 2>Another one that I came across was you would take

0:13:54.400 --> 0:13:58.160
<v Speaker 2>a rooster, you would pull the feathers off of the

0:13:58.280 --> 0:14:00.160
<v Speaker 2>roosters anus and.

0:14:00.520 --> 0:14:01.760
<v Speaker 3>It's still alive while you're doing that.

0:14:01.920 --> 0:14:04.120
<v Speaker 2>Yeah, yeah, And I'll note it's actually you know, it's

0:14:04.120 --> 0:14:06.240
<v Speaker 2>called an anus, but it's actually a cloaca, which is

0:14:06.280 --> 0:14:08.720
<v Speaker 2>a word for sewer, because for chickens, everything comes out

0:14:08.760 --> 0:14:11.080
<v Speaker 2>of the same hole. But anyway, and then you would

0:14:11.120 --> 0:14:15.040
<v Speaker 2>put it on the bite, and if the anus swelled up,

0:14:15.120 --> 0:14:17.880
<v Speaker 2>you could assume that like the poison had been sucked

0:14:17.920 --> 0:14:19.280
<v Speaker 2>out by the anus.

0:14:19.720 --> 0:14:20.280
<v Speaker 1>This did not.

0:14:20.280 --> 0:14:22.520
<v Speaker 3>Workit what do you put on the bite, the feathers or.

0:14:22.520 --> 0:14:23.920
<v Speaker 1>The anis the anus? Yeah?

0:14:24.000 --> 0:14:25.840
<v Speaker 3>Oh wow, I totally misunderstood that.

0:14:26.080 --> 0:14:28.040
<v Speaker 2>Yeah, right, And so now maybe you have like whatever

0:14:28.120 --> 0:14:30.360
<v Speaker 2>bacteria was on the chicken's butt in your wound, which

0:14:30.360 --> 0:14:31.200
<v Speaker 2>doesn't sound good.

0:14:31.400 --> 0:14:32.840
<v Speaker 3>How long do you have to have the chicken butt

0:14:32.880 --> 0:14:33.400
<v Speaker 3>on your wound?

0:14:33.960 --> 0:14:34.240
<v Speaker 1>I don't know.

0:14:34.280 --> 0:14:35.880
<v Speaker 2>As long as it takes for it to swell up,

0:14:35.920 --> 0:14:38.160
<v Speaker 2>I guess, I don't know. And there was another one that,

0:14:38.240 --> 0:14:40.680
<v Speaker 2>unfortunately was like, oh, if the dog bit you, you have

0:14:40.760 --> 0:14:42.960
<v Speaker 2>to like take some of the dog's brain and put

0:14:42.960 --> 0:14:44.400
<v Speaker 2>that in the wound. And so like, if you didn't

0:14:44.440 --> 0:14:47.600
<v Speaker 2>have rabies before, you probably have rabies now. Yeah, So

0:14:47.640 --> 0:14:51.280
<v Speaker 2>that's unfortunate, But some of these methods probably seemed to

0:14:51.440 --> 0:14:55.200
<v Speaker 2>work because First of all, not every angry animal that

0:14:55.240 --> 0:14:57.880
<v Speaker 2>bites you has rabies, and so maybe you get bit

0:14:58.200 --> 0:15:00.720
<v Speaker 2>you tried the thing, you don't get rabies in your Like, oh,

0:15:00.760 --> 0:15:03.040
<v Speaker 2>that's great that you know the chicken butt thing worked,

0:15:03.280 --> 0:15:05.640
<v Speaker 2>but like you weren't gonna get rabies anyway, because that

0:15:05.680 --> 0:15:08.200
<v Speaker 2>dog was just a jerk. It didn't have rabies. And

0:15:08.360 --> 0:15:12.080
<v Speaker 2>not every bite or scratch actually probably has enough rabies

0:15:12.120 --> 0:15:14.320
<v Speaker 2>virus in it to give you rabies.

0:15:14.400 --> 0:15:17.080
<v Speaker 3>These are not randomized controlled trials. They're very hard to

0:15:17.120 --> 0:15:17.560
<v Speaker 3>interpret it.

0:15:17.640 --> 0:15:19.840
<v Speaker 2>Yeah, yes, right, right, yeah, so but I mean, you know,

0:15:19.880 --> 0:15:22.280
<v Speaker 2>you can laugh and be like, oh ha haha, what idiots,

0:15:22.320 --> 0:15:24.480
<v Speaker 2>How could they ever think the chicken butt thing would work?

0:15:24.680 --> 0:15:26.440
<v Speaker 2>But you know, there were probably a couple instances where

0:15:26.480 --> 0:15:28.600
<v Speaker 2>they were like, hey, you know, Fred got bit by

0:15:28.640 --> 0:15:30.440
<v Speaker 2>a dog and then he didn't get rabies after he

0:15:30.480 --> 0:15:32.280
<v Speaker 2>did the chicken butt thing, and you could be like, well,

0:15:32.840 --> 0:15:33.840
<v Speaker 2>you know, it's worth a.

0:15:33.760 --> 0:15:37.480
<v Speaker 3>Shot anytime something good happens after a human does something weird,

0:15:37.880 --> 0:15:41.000
<v Speaker 3>and you like create some mythology and you're like, better

0:15:41.040 --> 0:15:43.120
<v Speaker 3>put a chicken butt on your wrist before you go

0:15:43.200 --> 0:15:45.800
<v Speaker 3>outside if you want gold to fall from the tree

0:15:46.080 --> 0:15:49.560
<v Speaker 3>or whatever. It's amazing how these things just reinforce themselves.

0:15:49.560 --> 0:15:52.520
<v Speaker 3>We are like bad at statistics natively.

0:15:52.600 --> 0:15:58.000
<v Speaker 2>Well, I mean, what's the downside, right? I guess if

0:15:58.000 --> 0:16:00.680
<v Speaker 2>you ask the chicken, there'd be a pretty clear down sta. Wow.

0:16:01.080 --> 0:16:02.640
<v Speaker 3>You know, I haven't been to Virginia in a while,

0:16:02.680 --> 0:16:05.360
<v Speaker 3>but the culture there has really gone up the deep end.

0:16:06.160 --> 0:16:07.880
<v Speaker 2>We got rid of our chickens, so we're not so

0:16:08.040 --> 0:16:09.440
<v Speaker 2>into that kind of stuff, but.

0:16:09.560 --> 0:16:10.640
<v Speaker 3>Got rid of Wow.

0:16:10.720 --> 0:16:12.520
<v Speaker 1>Well, we gave them to our brother and sister in law.

0:16:12.600 --> 0:16:12.960
<v Speaker 3>I see.

0:16:13.080 --> 0:16:16.200
<v Speaker 2>We had enough gold falling from the sky after doing

0:16:16.200 --> 0:16:17.960
<v Speaker 2>the chicken butt thing, so we moved on.

0:16:18.040 --> 0:16:21.360
<v Speaker 3>As one does. Yeah. Yeah, So rabies is a disease.

0:16:21.400 --> 0:16:21.920
<v Speaker 3>What does it cost?

0:16:22.000 --> 0:16:24.120
<v Speaker 2>By you said it's a virus, it's a virus, and

0:16:24.320 --> 0:16:27.360
<v Speaker 2>in the United States we are pretty lucky. This virus

0:16:27.440 --> 0:16:29.480
<v Speaker 2>is not something humans need to worry about so much.

0:16:29.560 --> 0:16:33.080
<v Speaker 2>So about less than ten people in the United States

0:16:33.120 --> 0:16:34.400
<v Speaker 2>die from rabies every year.

0:16:34.680 --> 0:16:36.480
<v Speaker 1>Oh wow, that's pretty good odds.

0:16:36.600 --> 0:16:38.080
<v Speaker 3>It's like fewer than shark attacks.

0:16:38.160 --> 0:16:40.480
<v Speaker 2>Yeah yeah, I guess I don't actually know how many

0:16:40.520 --> 0:16:42.560
<v Speaker 2>shark attacks there are, but that sounds about right.

0:16:42.720 --> 0:16:44.960
<v Speaker 3>It's close to shark attacks or like struck by lightning

0:16:45.040 --> 0:16:46.520
<v Speaker 3>or something. It's like, that's very rare.

0:16:46.800 --> 0:16:47.840
<v Speaker 1>Yeah, super rare.

0:16:48.240 --> 0:16:51.440
<v Speaker 2>But about one hundred thousand people every year are vaccinated

0:16:51.600 --> 0:16:54.840
<v Speaker 2>after they have a potential rabies exposure, and so these

0:16:54.840 --> 0:16:57.960
<v Speaker 2>are probably people like veterinarians who had a stray cat

0:16:58.000 --> 0:17:00.440
<v Speaker 2>brought in that then went on to bite them, animal

0:17:00.440 --> 0:17:02.000
<v Speaker 2>control people who had to go out and get an

0:17:02.040 --> 0:17:05.040
<v Speaker 2>animal that was presumed to be rabid something like that.

0:17:05.040 --> 0:17:06.800
<v Speaker 2>So there are a lot of people exposed to animals

0:17:06.840 --> 0:17:10.000
<v Speaker 2>that might be rabid. But because we have great control

0:17:10.040 --> 0:17:12.879
<v Speaker 2>measures in great vaccines, very few people die from.

0:17:12.720 --> 0:17:15.400
<v Speaker 3>This, right, And those two numbers are closely linked, right,

0:17:15.480 --> 0:17:18.359
<v Speaker 3>It's not like, why are we doing this? Hardly anybody dies,

0:17:18.600 --> 0:17:20.800
<v Speaker 3>It's like, oh, we're not feeling the rain because we're

0:17:20.840 --> 0:17:23.840
<v Speaker 3>holding an umbrella. The reason few people die is because

0:17:23.880 --> 0:17:25.240
<v Speaker 3>we vaccinate people, right.

0:17:25.440 --> 0:17:28.439
<v Speaker 2>Right, And that's not true around the world. So globally,

0:17:28.680 --> 0:17:31.679
<v Speaker 2>sixty thousand people die of rabies every year, and this

0:17:31.720 --> 0:17:34.520
<v Speaker 2>is considered a neglected tropical disease because there are parts

0:17:34.560 --> 0:17:38.000
<v Speaker 2>of the world that can't afford vaccines or can't handle

0:17:38.440 --> 0:17:42.200
<v Speaker 2>the kinds of mass vaccination efforts. You need to keep

0:17:42.280 --> 0:17:46.480
<v Speaker 2>cats and dogs that are around people vaccinated year after year,

0:17:47.200 --> 0:17:49.520
<v Speaker 2>and so we are very lucky science has a solution

0:17:49.600 --> 0:17:51.320
<v Speaker 2>to this. And in the United States we have the

0:17:51.400 --> 0:17:53.800
<v Speaker 2>infrastructure and the money to make sure it gets where

0:17:53.800 --> 0:17:55.639
<v Speaker 2>it needs to go. But in other parts of the

0:17:55.640 --> 0:17:56.600
<v Speaker 2>world that's not the case.

0:17:56.800 --> 0:17:59.600
<v Speaker 3>So we vaccinate all the pets, and then humans, if

0:17:59.600 --> 0:18:02.320
<v Speaker 3>they've been exposed, we vaccinate them. We don't use vaccinate

0:18:02.400 --> 0:18:04.000
<v Speaker 3>humans across the board.

0:18:04.119 --> 0:18:05.480
<v Speaker 1>Yeah, so it depends on who you are.

0:18:05.600 --> 0:18:07.919
<v Speaker 2>So we have a vaccine that you can give to

0:18:07.960 --> 0:18:10.600
<v Speaker 2>people who are likely to get exposed. So if you

0:18:10.800 --> 0:18:15.560
<v Speaker 2>are a veterinarian, you probably get a prophylactic vaccine. Veterinarians

0:18:15.600 --> 0:18:18.359
<v Speaker 2>get it. VET texts get it. People who work in

0:18:18.400 --> 0:18:21.480
<v Speaker 2>animal control get it. If you like to go spelunking,

0:18:21.640 --> 0:18:24.080
<v Speaker 2>I think in the United Kingdom this is called potholing.

0:18:24.720 --> 0:18:29.480
<v Speaker 1>What yeah, yeah, let's go.

0:18:29.400 --> 0:18:32.040
<v Speaker 3>For an afternoon in that pothole that nobody ever.

0:18:32.400 --> 0:18:35.480
<v Speaker 2>Well, unless you're in the UK, said plenty of UK people,

0:18:35.520 --> 0:18:35.920
<v Speaker 2>I think.

0:18:36.400 --> 0:18:38.600
<v Speaker 1>And the idea there is that caves.

0:18:38.359 --> 0:18:40.639
<v Speaker 2>Are places where you find a lot of bats, and

0:18:40.720 --> 0:18:43.960
<v Speaker 2>bats could be spreading rabies either through bites or through

0:18:44.160 --> 0:18:46.320
<v Speaker 2>you know, like saliva. You could breathe it in in

0:18:46.320 --> 0:18:49.080
<v Speaker 2>an aerosolized sort of way. If you're a hunter, you

0:18:49.160 --> 0:18:52.399
<v Speaker 2>might want to consider getting vaccinated, depending on what kind

0:18:52.400 --> 0:18:54.760
<v Speaker 2>of animals you're going after, because when you are skinning

0:18:54.800 --> 0:18:57.080
<v Speaker 2>those animals, if you have a cut, you can maybe

0:18:57.080 --> 0:18:59.800
<v Speaker 2>get some stuff in that cut that could transmit rabies

0:18:59.800 --> 0:19:02.359
<v Speaker 2>to you. So there are certain activities that can increase

0:19:02.359 --> 0:19:04.720
<v Speaker 2>your risk, and you are able to get vaccinated for

0:19:04.960 --> 0:19:07.520
<v Speaker 2>rabies ahead of time. And then if you engage in

0:19:07.560 --> 0:19:10.040
<v Speaker 2>another behavior where you think, okay, this time, I was

0:19:10.080 --> 0:19:12.640
<v Speaker 2>definitely exposed to rabies, you'll go in and get some

0:19:12.720 --> 0:19:14.720
<v Speaker 2>more vaccines to boost your immunity.

0:19:14.880 --> 0:19:17.159
<v Speaker 3>And what kind of infrastructure is required is raby is

0:19:17.160 --> 0:19:19.520
<v Speaker 3>one of the vaccines that needs to be chilled, and

0:19:19.560 --> 0:19:23.240
<v Speaker 3>it's really complicated and that's why it's not easily available everywhere.

0:19:23.440 --> 0:19:26.040
<v Speaker 2>Yeah, So the way that we make this vaccine now,

0:19:26.119 --> 0:19:27.920
<v Speaker 2>and we can talk about the history of the vaccine later,

0:19:27.960 --> 0:19:29.679
<v Speaker 2>but the way that we make the vaccine now is

0:19:29.720 --> 0:19:32.920
<v Speaker 2>we essentially grow it in human cells in the lab,

0:19:33.480 --> 0:19:36.320
<v Speaker 2>or we can grow it in like chicken embryos in

0:19:36.359 --> 0:19:38.560
<v Speaker 2>the lab. Either way, we're not like growing this in

0:19:38.600 --> 0:19:41.439
<v Speaker 2>live animals or anything like that. You extract the virus

0:19:41.520 --> 0:19:43.360
<v Speaker 2>you kill it and then you suspend it, and it

0:19:43.440 --> 0:19:44.760
<v Speaker 2>is kind of expensive.

0:19:44.800 --> 0:19:45.720
<v Speaker 1>That is part of it.

0:19:46.160 --> 0:19:48.560
<v Speaker 2>But I think a bigger problem with the vaccine is

0:19:48.560 --> 0:19:52.680
<v Speaker 2>that this vaccine does have some side effects. So for example,

0:19:52.720 --> 0:19:56.640
<v Speaker 2>some people will have a reaction called anaphylaxis where you

0:19:56.800 --> 0:19:59.640
<v Speaker 2>have trouble breathing. Some people will have like an allergic

0:19:59.680 --> 0:20:03.640
<v Speaker 2>sort of response to it. The rate of these reactions

0:20:03.880 --> 0:20:06.080
<v Speaker 2>is pretty low. And what you really need to know

0:20:06.160 --> 0:20:09.040
<v Speaker 2>here is that once you start showing symptoms for rabies,

0:20:09.760 --> 0:20:13.840
<v Speaker 2>you are nearly one hundred percent sure to die from rabies.

0:20:13.840 --> 0:20:14.240
<v Speaker 3>Oh wow.

0:20:14.560 --> 0:20:17.280
<v Speaker 2>And so if you are exposed to an animal that

0:20:17.359 --> 0:20:21.640
<v Speaker 2>has rabies, the risk of any of these issues pales

0:20:21.640 --> 0:20:24.400
<v Speaker 2>in comparison to your risk of dying of rabies, And

0:20:24.440 --> 0:20:26.119
<v Speaker 2>so you are definitely going to go ahead and get

0:20:26.119 --> 0:20:26.760
<v Speaker 2>the vaccine.

0:20:26.800 --> 0:20:29.320
<v Speaker 3>I see. Okay, so this is not the kind of

0:20:29.400 --> 0:20:32.160
<v Speaker 3>vaccine you just give everybody because there are side effects,

0:20:32.520 --> 0:20:34.720
<v Speaker 3>But if you've been exposed, then it's definitely a gamble

0:20:34.760 --> 0:20:35.600
<v Speaker 3>we're taking.

0:20:35.480 --> 0:20:38.240
<v Speaker 2>Yes, right, So between the costs and the potential side effects,

0:20:38.240 --> 0:20:40.600
<v Speaker 2>we don't want to go and vaccinate everyone, especially because

0:20:40.640 --> 0:20:42.879
<v Speaker 2>in the United States, most of us probably are not

0:20:42.880 --> 0:20:45.639
<v Speaker 2>going to encounter a rabit animal. So it seems not

0:20:45.760 --> 0:20:49.080
<v Speaker 2>worth the risk, but for people in risky professions it

0:20:49.200 --> 0:20:49.480
<v Speaker 2>might be.

0:20:49.760 --> 0:20:52.560
<v Speaker 3>So I was surprised by what you said earlier about exposure,

0:20:52.880 --> 0:20:55.200
<v Speaker 3>Like just going for a hike in a cave where

0:20:55.200 --> 0:20:59.320
<v Speaker 3>there are bats that have rabies might be enough, like aerosolized.

0:20:59.600 --> 0:21:02.200
<v Speaker 3>I thought you had to get bitten by some cartoon animal.

0:21:02.520 --> 0:21:02.760
<v Speaker 1>Yeah.

0:21:02.760 --> 0:21:04.280
<v Speaker 2>Well, so let's take a break, and when we come

0:21:04.320 --> 0:21:06.200
<v Speaker 2>back from the break, we'll go through the various ways

0:21:06.200 --> 0:21:25.720
<v Speaker 2>that you can get infected by rabies.

0:21:27.760 --> 0:21:30.200
<v Speaker 3>Okay, we're back, and we are taking a bite out

0:21:30.200 --> 0:21:34.920
<v Speaker 3>of rabies today, furiously understanding the nature of this disease.

0:21:35.520 --> 0:21:38.720
<v Speaker 3>So tell us, Kelly, how does one get exposed to

0:21:38.960 --> 0:21:41.920
<v Speaker 3>Arabi's What do we have to watch out for spelunkers

0:21:41.920 --> 0:21:43.080
<v Speaker 3>and potholers alike.

0:21:44.280 --> 0:21:46.680
<v Speaker 2>Well, the most common way, let's start with the most

0:21:46.720 --> 0:21:48.880
<v Speaker 2>common way that you get exposed to rabies, and that's

0:21:48.960 --> 0:21:52.080
<v Speaker 2>through bites and scratches from rabbit animals. And in the

0:21:52.160 --> 0:21:54.960
<v Speaker 2>United States, the most common way you're going to get

0:21:54.960 --> 0:21:56.960
<v Speaker 2>exposed to a bite or a scratch from a rabbit

0:21:57.000 --> 0:22:00.720
<v Speaker 2>animal is by interacting with a bat. So, if you

0:22:00.760 --> 0:22:03.719
<v Speaker 2>are in the sort of unlucky situation where a bat

0:22:03.800 --> 0:22:07.120
<v Speaker 2>accidentally ends up in your house and you that bat

0:22:07.160 --> 0:22:08.840
<v Speaker 2>bite you when it's trying to get out, or you

0:22:08.880 --> 0:22:10.240
<v Speaker 2>wake up in the middle of the night and there's

0:22:10.240 --> 0:22:11.240
<v Speaker 2>a bat in your room.

0:22:11.760 --> 0:22:14.240
<v Speaker 3>What, Kelly, you can just drop.

0:22:14.040 --> 0:22:19.520
<v Speaker 2>That that has happened to me. I know, I know,

0:22:19.560 --> 0:22:21.439
<v Speaker 2>I didn't know at the time, but you might in

0:22:21.480 --> 0:22:24.439
<v Speaker 2>those situations might want to call a medical professional to

0:22:24.440 --> 0:22:26.879
<v Speaker 2>be like, I found a bat in my room. I

0:22:26.960 --> 0:22:29.000
<v Speaker 2>was listening to a podcast of people who are studying

0:22:29.000 --> 0:22:32.159
<v Speaker 2>for their medical boards, and they noted that in that instant,

0:22:32.200 --> 0:22:36.280
<v Speaker 2>you're supposed to give people vaccines for rabies because you

0:22:36.320 --> 0:22:38.440
<v Speaker 2>can't be sure they didn't get bitten while they were sleeping.

0:22:38.920 --> 0:22:41.199
<v Speaker 2>And I was like, oh, man, I didn't call anyone

0:22:41.200 --> 0:22:43.520
<v Speaker 2>when that happened. I just like opened the window and

0:22:43.560 --> 0:22:45.720
<v Speaker 2>shoot the bat out. But anyway, I'm still here, so

0:22:45.760 --> 0:22:46.440
<v Speaker 2>that's good news.

0:22:46.720 --> 0:22:48.600
<v Speaker 3>Does the fact that that happen is that the origin

0:22:48.760 --> 0:22:52.520
<v Speaker 3>of like vampire myths like vampires fly in on the

0:22:52.520 --> 0:22:55.280
<v Speaker 3>wings of a bat, bite you and then fly out again.

0:22:55.440 --> 0:22:57.720
<v Speaker 2>Could be But there are also like vampire bats that

0:22:57.800 --> 0:23:01.280
<v Speaker 2>actually suck human blood when they have trouble getting access

0:23:01.280 --> 0:23:02.000
<v Speaker 2>to other mammals.

0:23:02.200 --> 0:23:03.560
<v Speaker 1>Oh boy, I'm guessing that.

0:23:03.880 --> 0:23:05.359
<v Speaker 3>So you could wake up in the middle of the

0:23:05.400 --> 0:23:07.480
<v Speaker 3>night with a bat on your face or what else.

0:23:08.160 --> 0:23:11.639
<v Speaker 2>But we hope not, but you could also, So if

0:23:11.680 --> 0:23:14.639
<v Speaker 2>that animal bites you, it's saliva gets into your body,

0:23:14.640 --> 0:23:17.120
<v Speaker 2>and that's one way that the rabies virus can get

0:23:17.119 --> 0:23:19.679
<v Speaker 2>into you. Also, if an animal scratches you, you know,

0:23:19.760 --> 0:23:22.040
<v Speaker 2>maybe they like licked their hand and then they scratch you,

0:23:22.080 --> 0:23:25.280
<v Speaker 2>and that gets the virus in your body. That's skunks, raccoons,

0:23:25.280 --> 0:23:27.800
<v Speaker 2>and foxes, which we talked about already. In the United States,

0:23:27.800 --> 0:23:31.359
<v Speaker 2>those are animals that are most frequently found to have rabies.

0:23:31.400 --> 0:23:33.560
<v Speaker 2>That doesn't mean that most of those animals in the

0:23:33.560 --> 0:23:36.520
<v Speaker 2>wild have rabies, but in the United States, the animals

0:23:36.560 --> 0:23:38.640
<v Speaker 2>that are most likely to have rabies are those four

0:23:38.720 --> 0:23:39.880
<v Speaker 2>kinds of animals.

0:23:39.880 --> 0:23:42.399
<v Speaker 3>And these rabies a kind of virus that doesn't last

0:23:42.480 --> 0:23:45.840
<v Speaker 3>very long in saliva outside the body. Like if a

0:23:45.920 --> 0:23:48.159
<v Speaker 3>bat spits on a rock and then you lick that

0:23:48.320 --> 0:23:50.960
<v Speaker 3>rock like a week later, are you okay or is

0:23:50.960 --> 0:23:52.399
<v Speaker 3>that rock like dangerous forever?

0:23:52.920 --> 0:23:53.160
<v Speaker 1>Yeah?

0:23:53.280 --> 0:23:55.679
<v Speaker 2>Right, that is a question only Daniel would ask, and

0:23:55.720 --> 0:23:59.359
<v Speaker 2>that is uh and you would probably be fine. And

0:23:59.400 --> 0:24:02.000
<v Speaker 2>I'm under the impression that that is why I was

0:24:02.040 --> 0:24:04.159
<v Speaker 2>told I didn't need to get a rabies vaccine when

0:24:04.160 --> 0:24:06.119
<v Speaker 2>I picked up that dead bat. I think they were like,

0:24:06.600 --> 0:24:09.399
<v Speaker 2>the bat's probably been long dead, you're probably fine.

0:24:09.640 --> 0:24:12.520
<v Speaker 3>Fascinating. It's amazing to me when viruses are so fragile

0:24:12.880 --> 0:24:15.440
<v Speaker 3>and yet so able to spread anyway, It's incredible.

0:24:15.520 --> 0:24:18.280
<v Speaker 2>It is, it is, And I just want to really

0:24:18.480 --> 0:24:21.640
<v Speaker 2>highlight here. I am not a medical doctor. So if

0:24:21.640 --> 0:24:23.880
<v Speaker 2>you're like, oh, Kelly said that bat had been dead

0:24:23.920 --> 0:24:25.399
<v Speaker 2>for a while that she touched, so I don't need

0:24:25.440 --> 0:24:25.960
<v Speaker 2>to call the dot.

0:24:26.040 --> 0:24:27.199
<v Speaker 1>Always call the doctor.

0:24:27.200 --> 0:24:29.280
<v Speaker 2>If you have any question about rabies, if you've been

0:24:29.320 --> 0:24:31.719
<v Speaker 2>exposed to anything that puts you at risk of rabies,

0:24:32.000 --> 0:24:32.720
<v Speaker 2>call your doctor.

0:24:32.880 --> 0:24:35.320
<v Speaker 3>And I don't suggest licking any rocks. I'm also not

0:24:35.400 --> 0:24:36.240
<v Speaker 3>a medical professional.

0:24:36.480 --> 0:24:38.400
<v Speaker 2>Yeah, yeah, no, Actually, you should probably never do anything

0:24:38.480 --> 0:24:39.199
<v Speaker 2>Daniel suggests.

0:24:39.240 --> 0:24:40.520
<v Speaker 1>It's just a bad idea.

0:24:41.359 --> 0:24:43.440
<v Speaker 3>I keep telling my kids that also, yeah.

0:24:43.320 --> 0:24:45.440
<v Speaker 2>Yeah, yeah, well so, And if you live in Africa

0:24:45.440 --> 0:24:48.800
<v Speaker 2>and Asia, you're most likely to get rabies from dog bites.

0:24:49.080 --> 0:24:50.840
<v Speaker 1>People encounter dogs a lot.

0:24:50.920 --> 0:24:53.359
<v Speaker 2>There's in a lot of countries there's not good programs

0:24:53.359 --> 0:24:56.960
<v Speaker 2>to regularly vaccinate dogs, and unfortunately, the majority of the

0:24:56.960 --> 0:24:59.119
<v Speaker 2>bites happened to children who just want to pet a

0:24:59.160 --> 0:25:01.840
<v Speaker 2>dog and then they get oh I know, and so yeah,

0:25:01.880 --> 0:25:04.960
<v Speaker 2>so saliva from rabbit animals is the most common way. Now,

0:25:04.960 --> 0:25:07.560
<v Speaker 2>it's worth noting that livestock animals like horses can also

0:25:07.640 --> 0:25:10.399
<v Speaker 2>get rabies, and so you want to be careful and

0:25:10.760 --> 0:25:14.520
<v Speaker 2>vaccinate as many animals as you're able to. Very rarely,

0:25:15.280 --> 0:25:18.399
<v Speaker 2>the virus can be aerosolized for short periods of time,

0:25:18.600 --> 0:25:21.840
<v Speaker 2>and so that's why you know, if you're spelunking or

0:25:21.880 --> 0:25:24.640
<v Speaker 2>potholing in a cave and there's a bunch of bats

0:25:25.040 --> 0:25:26.720
<v Speaker 2>and there's not a lot of sunlight in there, so

0:25:26.760 --> 0:25:29.399
<v Speaker 2>sunlight is something that kills the rabies virus pretty quickly.

0:25:30.080 --> 0:25:32.159
<v Speaker 2>You might be able to breathe in some of the

0:25:32.240 --> 0:25:36.320
<v Speaker 2>rabies virus, and that is why sometimes spelunkers will get vaccinated,

0:25:36.520 --> 0:25:38.000
<v Speaker 2>or if they're going into an area with a lot

0:25:38.040 --> 0:25:39.920
<v Speaker 2>of bats and they're worried they're going to get bit

0:25:40.720 --> 0:25:43.880
<v Speaker 2>then they'll get vaccinated as well. And a very rare

0:25:44.000 --> 0:25:48.360
<v Speaker 2>way that does sometimes result in rabies is organ transplants.

0:25:48.480 --> 0:25:51.520
<v Speaker 2>If it was missed that a donor had rabies, and

0:25:51.560 --> 0:25:54.160
<v Speaker 2>then you can transmit it that way again, very rare.

0:25:54.200 --> 0:25:55.399
<v Speaker 1>We talked about that in the opening.

0:25:55.560 --> 0:25:57.600
<v Speaker 3>So there's no way to get rabies by like listening

0:25:57.600 --> 0:25:59.000
<v Speaker 3>to a podcast about rabies.

0:25:59.160 --> 0:26:01.399
<v Speaker 2>Our listeners are saying, that's right, that's right, and you know,

0:26:01.440 --> 0:26:03.920
<v Speaker 2>I actually I feel like the more you learn about

0:26:03.920 --> 0:26:06.640
<v Speaker 2>this kind of stuff, like, yes, it's scary initially, but

0:26:06.680 --> 0:26:09.440
<v Speaker 2>once you understand how it's transmitted, you can say, Okay,

0:26:09.480 --> 0:26:11.439
<v Speaker 2>I know what I need to worry about, and then

0:26:11.480 --> 0:26:14.320
<v Speaker 2>I know when I need to call a medical professional. Yes,

0:26:14.400 --> 0:26:16.840
<v Speaker 2>I still worry because I am me, but I feel like,

0:26:17.280 --> 0:26:19.440
<v Speaker 2>you know, the scope of my worrying has narrowed a

0:26:19.480 --> 0:26:21.600
<v Speaker 2>little bit because now I understand when I need to

0:26:21.640 --> 0:26:23.720
<v Speaker 2>worry and why I need to worry, and I feel

0:26:23.760 --> 0:26:25.320
<v Speaker 2>like that gives me a little bit of control over

0:26:25.359 --> 0:26:25.880
<v Speaker 2>the situation.

0:26:26.119 --> 0:26:29.720
<v Speaker 3>Yeah, although you know, statistics doesn't help anxiety. I mean,

0:26:29.920 --> 0:26:31.840
<v Speaker 3>you can look at the numbers and be like, well,

0:26:32.119 --> 0:26:34.520
<v Speaker 3>on average, that's pretty rare. It doesn't happen to very

0:26:34.520 --> 0:26:37.480
<v Speaker 3>many people, these terrible scenarios, et cetera, et cetera. On

0:26:37.520 --> 0:26:39.080
<v Speaker 3>the other hand, you're like, yeah, but there are ten

0:26:39.160 --> 0:26:42.040
<v Speaker 3>people out there who do die raby's every year, and

0:26:42.080 --> 0:26:44.439
<v Speaker 3>those are real people. Who also looked at the numbers

0:26:44.440 --> 0:26:46.479
<v Speaker 3>and they were like, yeah, I'll probably be fine. So

0:26:46.520 --> 0:26:48.000
<v Speaker 3>the sort of two ways to look at it, from

0:26:48.040 --> 0:26:51.080
<v Speaker 3>a public health perspective on average, and then also from

0:26:51.080 --> 0:26:54.320
<v Speaker 3>the like, am I that one outlier case perspective, which

0:26:54.359 --> 0:26:56.879
<v Speaker 3>is the one I always use as a worrier?

0:26:57.000 --> 0:26:58.480
<v Speaker 1>Yeah, okay, I do see your point.

0:26:58.480 --> 0:27:00.040
<v Speaker 2>But like so in the intro, we talked about a

0:27:00.119 --> 0:27:03.600
<v Speaker 2>guy who got scratched by a skunk and bled. Presumably

0:27:03.640 --> 0:27:06.639
<v Speaker 2>what he thought was it's just a scratch. I probably

0:27:06.680 --> 0:27:09.439
<v Speaker 2>didn't get it, and I think this skunk was just

0:27:09.480 --> 0:27:13.200
<v Speaker 2>trying to eat the kitten and wasn't actually rabid, And

0:27:13.240 --> 0:27:18.520
<v Speaker 2>so they made some choices that if you knew enough

0:27:18.520 --> 0:27:21.120
<v Speaker 2>about rabies, or if you were enough of a warrior, yeah,

0:27:21.160 --> 0:27:22.880
<v Speaker 2>could have caused that person to have made a different

0:27:22.920 --> 0:27:24.800
<v Speaker 2>decision to at least call the doctor and been like,

0:27:24.920 --> 0:27:26.480
<v Speaker 2>I don't know, what do you think I got scratched

0:27:26.480 --> 0:27:28.159
<v Speaker 2>by a skunk that was angry and was willing to

0:27:28.200 --> 0:27:29.600
<v Speaker 2>approach me to try to eat a kitten.

0:27:29.800 --> 0:27:30.439
<v Speaker 1>What would you do?

0:27:30.920 --> 0:27:33.560
<v Speaker 2>I suspect that doctor would have said, we're gonna go

0:27:33.560 --> 0:27:35.159
<v Speaker 2>ahead and give you some shots, because rabies is one

0:27:35.240 --> 0:27:37.879
<v Speaker 2>hundred percent fatal, So let's not take any risks.

0:27:38.200 --> 0:27:40.160
<v Speaker 3>Yeah, although if you are a worrier and you want

0:27:40.160 --> 0:27:43.320
<v Speaker 3>to be informed by statistics, as you just suggested, then

0:27:43.480 --> 0:27:45.639
<v Speaker 3>you would be shocked at like how dangerous it is

0:27:45.680 --> 0:27:48.480
<v Speaker 3>to drive anywhere and you should probably just never get

0:27:48.480 --> 0:27:51.600
<v Speaker 3>in a car, and how dangerous household accidents are, so

0:27:51.640 --> 0:27:54.680
<v Speaker 3>you shouldn't, for example, try to do your kitchen by yourself.

0:27:54.880 --> 0:27:57.199
<v Speaker 2>But we don't want Kelly to become a shut in.

0:27:57.280 --> 0:27:59.159
<v Speaker 2>So we're going to talk about what happens once the

0:27:59.200 --> 0:28:01.760
<v Speaker 2>virus gets in your body. Daniel, what are you trying

0:28:01.800 --> 0:28:02.240
<v Speaker 2>to do here?

0:28:04.840 --> 0:28:07.600
<v Speaker 3>I'm just saying statistics and formed decisions are not the

0:28:07.600 --> 0:28:08.639
<v Speaker 3>way we live our lives.

0:28:08.720 --> 0:28:09.960
<v Speaker 1>Yeah, you're right, you're right.

0:28:09.920 --> 0:28:12.520
<v Speaker 3>But anyway, tell us about the microbiology here. What happens

0:28:12.560 --> 0:28:14.320
<v Speaker 3>when the virus gets in your body? Killing?

0:28:14.480 --> 0:28:16.159
<v Speaker 2>All right, So the virus gets in your body and

0:28:16.359 --> 0:28:18.560
<v Speaker 2>it gets into your muscle tissue. And what we've talked

0:28:18.600 --> 0:28:22.240
<v Speaker 2>about how viruses replicate. They essentially hijack the machinery inside

0:28:22.240 --> 0:28:24.359
<v Speaker 2>your cell, and they tell the cell that it needs

0:28:24.359 --> 0:28:28.200
<v Speaker 2>to start replicating the virus' genetic material and start making

0:28:28.240 --> 0:28:32.160
<v Speaker 2>proteins for the virus. So it essentially the cell becomes

0:28:32.160 --> 0:28:35.520
<v Speaker 2>like a little factory that starts making more viruses, and

0:28:35.560 --> 0:28:37.960
<v Speaker 2>then it spits the viruses out and the viruses go

0:28:38.000 --> 0:28:39.320
<v Speaker 2>out to infect more cells.

0:28:39.680 --> 0:28:41.200
<v Speaker 1>So that's generally how viruses work.

0:28:41.440 --> 0:28:43.760
<v Speaker 3>If this sounds familiar to you, reminiscent of how like

0:28:43.960 --> 0:28:47.239
<v Speaker 3>computer viruses work, that's not an accident. That's why they

0:28:47.240 --> 0:28:51.280
<v Speaker 3>call computer viruses viruses, not the other way around. Biological

0:28:51.360 --> 0:28:54.280
<v Speaker 3>viruses didn't steal this idea from hackers.

0:28:54.040 --> 0:28:55.640
<v Speaker 2>Yes, and keep that in your head because we're gonna

0:28:55.640 --> 0:28:58.000
<v Speaker 2>come back to that comparison a little bit later, all right.

0:28:58.040 --> 0:29:00.320
<v Speaker 2>So it starts by getting into like muscle tissue near

0:29:00.360 --> 0:29:02.440
<v Speaker 2>the site of the bite, and for reasons we don't

0:29:02.480 --> 0:29:05.640
<v Speaker 2>totally understand, it has the period where it replicates sort

0:29:05.680 --> 0:29:09.200
<v Speaker 2>of slowly in those muscle tissues. And thank goodness for that,

0:29:09.360 --> 0:29:12.160
<v Speaker 2>because that means there's a period where we can sort

0:29:12.160 --> 0:29:14.560
<v Speaker 2>of get a leg up on the virus. And this

0:29:14.640 --> 0:29:17.360
<v Speaker 2>is why we're able to give people a vaccine after

0:29:17.400 --> 0:29:19.840
<v Speaker 2>they get bitten that can still save their life. And

0:29:19.880 --> 0:29:21.600
<v Speaker 2>this is another part of why we don't need to

0:29:22.080 --> 0:29:25.760
<v Speaker 2>mass vaccinate everybody, because it still works if you just

0:29:25.800 --> 0:29:29.520
<v Speaker 2>give it to someone afterwards, which doesn't work quite as

0:29:29.560 --> 0:29:31.840
<v Speaker 2>well with some other things that we vaccinate against.

0:29:32.000 --> 0:29:34.800
<v Speaker 3>That seems pretty unusual. Right, In almost all cases you

0:29:34.880 --> 0:29:36.840
<v Speaker 3>have to vaccinate first for it to take.

0:29:36.640 --> 0:29:39.880
<v Speaker 2>Effect, right, Yeah, No, we are amazingly lucky that this

0:29:40.000 --> 0:29:43.240
<v Speaker 2>virus has this period where it like sort of sluggishly

0:29:43.280 --> 0:29:46.280
<v Speaker 2>replicates and muscles for a while before it starts heading

0:29:46.280 --> 0:29:49.959
<v Speaker 2>for the nervous system. But eventually it will start finding

0:29:50.000 --> 0:29:52.720
<v Speaker 2>nervous system cells and it will start following nerves to

0:29:52.800 --> 0:29:55.720
<v Speaker 2>your spinal cord and then start moving up to your brain.

0:29:56.640 --> 0:30:00.200
<v Speaker 2>And when it starts getting towards its final location, you

0:30:00.280 --> 0:30:04.480
<v Speaker 2>are going to start getting symptoms like fever, flu like stuff,

0:30:04.560 --> 0:30:10.000
<v Speaker 2>gastrointestinal symptoms, and sort of eerily, the location that you

0:30:10.120 --> 0:30:14.080
<v Speaker 2>got bit will start like tingling or having a prickly sensation.

0:30:14.480 --> 0:30:16.560
<v Speaker 2>And the reason that's eerie is that this is usually

0:30:16.560 --> 0:30:20.479
<v Speaker 2>happening about two months after your exposure to the virus,

0:30:20.520 --> 0:30:23.560
<v Speaker 2>so that site has like long since healed, and now

0:30:23.560 --> 0:30:25.760
<v Speaker 2>all of a sudden, you're starting to feel tingling there again.

0:30:26.600 --> 0:30:29.800
<v Speaker 2>By the time you start having these symptoms, which again

0:30:29.840 --> 0:30:31.840
<v Speaker 2>like take two months for the virus to go from

0:30:31.920 --> 0:30:34.560
<v Speaker 2>that bite site up to the point where you know,

0:30:34.640 --> 0:30:37.520
<v Speaker 2>essentially it's too late. When you start getting those symptoms.

0:30:37.920 --> 0:30:40.560
<v Speaker 2>There's more or less no way to stop the virus

0:30:40.560 --> 0:30:43.040
<v Speaker 2>at that point. It's in your central nervous system, and

0:30:43.040 --> 0:30:44.360
<v Speaker 2>we don't have good treatments for it.

0:30:45.040 --> 0:30:45.640
<v Speaker 1>At that point.

0:30:45.720 --> 0:30:50.000
<v Speaker 2>Rabies enters one of two forms, the furious form, which

0:30:50.080 --> 0:30:53.160
<v Speaker 2>is about eighty percent of the cases. Average survival time

0:30:53.160 --> 0:30:56.480
<v Speaker 2>for this is about six days. Symptoms include like you

0:30:56.560 --> 0:31:00.720
<v Speaker 2>kind of come in and out of consciousness of strangely,

0:31:00.760 --> 0:31:04.600
<v Speaker 2>you become very afraid of water. So this is called hydrophobia.

0:31:05.080 --> 0:31:07.920
<v Speaker 2>There are some videos online that I've got to admit

0:31:07.960 --> 0:31:10.400
<v Speaker 2>I don't recommend looking up. I watched them once a

0:31:10.440 --> 0:31:13.760
<v Speaker 2>couple of years ago, and they're just incredibly upsetting to watch.

0:31:13.840 --> 0:31:15.520
<v Speaker 2>But you know, someone will try to take a drink

0:31:15.560 --> 0:31:18.320
<v Speaker 2>of water because they're very thirsty, but they'll start having

0:31:18.360 --> 0:31:21.479
<v Speaker 2>these like gagging reflexes, and it's like they're really afraid

0:31:21.480 --> 0:31:23.040
<v Speaker 2>of the water and they, you know, kind of can't

0:31:23.040 --> 0:31:25.680
<v Speaker 2>figure out why. You know, it's like they're be you know,

0:31:25.800 --> 0:31:28.360
<v Speaker 2>they like they've been hijacked, which essentially, you know, their

0:31:28.400 --> 0:31:31.600
<v Speaker 2>brains have been They start to hallucinate.

0:31:31.440 --> 0:31:33.840
<v Speaker 3>And so help me understand what's happening here. This is

0:31:33.880 --> 0:31:38.200
<v Speaker 3>all due to brain inflammation as the immune system responds

0:31:38.200 --> 0:31:40.160
<v Speaker 3>to the rabies, or is this something rabies is doing

0:31:40.160 --> 0:31:41.120
<v Speaker 3>to your brain directly.

0:31:41.360 --> 0:31:41.600
<v Speaker 1>Yeah.

0:31:41.640 --> 0:31:44.600
<v Speaker 2>So one of the interesting things about doing the research

0:31:44.640 --> 0:31:47.719
<v Speaker 2>for this is that places like the World Health Organization

0:31:47.960 --> 0:31:51.120
<v Speaker 2>say that there's a bunch of inflammation in the brain

0:31:51.440 --> 0:31:55.280
<v Speaker 2>and that death occurs due to cardio respiratory arrest and

0:31:55.320 --> 0:31:57.600
<v Speaker 2>you know, you go into coma and essentially things shut down.

0:31:57.960 --> 0:32:00.880
<v Speaker 2>But other sources that I read were like, the surprisingly

0:32:01.360 --> 0:32:04.360
<v Speaker 2>little inflammation happening in some of these cases, And so

0:32:04.920 --> 0:32:07.080
<v Speaker 2>we seem a little bit confused. It looks like there's

0:32:07.480 --> 0:32:09.680
<v Speaker 2>or maybe not confused, but maybe there's a couple different

0:32:09.720 --> 0:32:13.440
<v Speaker 2>ways that rabies can lead to death. It seems like

0:32:13.480 --> 0:32:16.560
<v Speaker 2>there's a couple different competing hypotheses. It might depend on

0:32:16.640 --> 0:32:19.240
<v Speaker 2>exactly what rabies is doing. It seems to take a

0:32:19.240 --> 0:32:22.200
<v Speaker 2>couple different forms, and maybe it depends on what part

0:32:22.240 --> 0:32:24.800
<v Speaker 2>of the brain the rabies ends up in. And in

0:32:24.880 --> 0:32:27.680
<v Speaker 2>just a second, we're going to talk about a hypothesis

0:32:27.680 --> 0:32:30.760
<v Speaker 2>that relies on there not being inflammation in the brain.

0:32:30.880 --> 0:32:32.840
<v Speaker 2>So hold that thought for just a second. We will

0:32:32.880 --> 0:32:36.360
<v Speaker 2>circle back to that there's another form of rabies that

0:32:36.400 --> 0:32:39.480
<v Speaker 2>happens about twenty percent of the time called paralytic. We're

0:32:39.600 --> 0:32:43.800
<v Speaker 2>essentially starting at the scratch or bite site. The muscles

0:32:43.920 --> 0:32:47.680
<v Speaker 2>start to become essentially paralyzed, and that gradually spreads over

0:32:47.680 --> 0:32:50.120
<v Speaker 2>the course of the body, and over about eleven days,

0:32:50.120 --> 0:32:52.840
<v Speaker 2>the person tends to go into a coma and they die.

0:32:52.880 --> 0:32:55.240
<v Speaker 2>This form tends to be misdiagnosed as a bunch of

0:32:55.280 --> 0:32:58.520
<v Speaker 2>other things, so it might be underreported. But one way

0:32:58.600 --> 0:33:02.880
<v Speaker 2>or another, a rabi's death is really an unpleasant death,

0:33:03.360 --> 0:33:05.600
<v Speaker 2>and we don't have a really good way of treating

0:33:05.640 --> 0:33:08.240
<v Speaker 2>people once symptoms start showing.

0:33:08.640 --> 0:33:11.320
<v Speaker 1>But you may remember around two.

0:33:11.120 --> 0:33:14.760
<v Speaker 2>Thousand and four, long time ago, there was in the

0:33:14.800 --> 0:33:18.240
<v Speaker 2>news this Milwaukee protocol where a young girl who started

0:33:18.280 --> 0:33:21.840
<v Speaker 2>showing symptoms of rabies was brought back from rabies.

0:33:21.880 --> 0:33:22.960
<v Speaker 1>Do you remember hearing about this?

0:33:23.400 --> 0:33:25.720
<v Speaker 2>No, tell me, Okay, So there was this girl who

0:33:25.800 --> 0:33:28.040
<v Speaker 2>was at church and there was a bat flying around

0:33:28.080 --> 0:33:30.280
<v Speaker 2>the church and it like was trying to get out

0:33:30.280 --> 0:33:32.200
<v Speaker 2>the window, but it couldn't get out the window. I

0:33:32.240 --> 0:33:35.440
<v Speaker 2>think somebody hit it with a broom and it kind

0:33:35.480 --> 0:33:37.360
<v Speaker 2>of fell down and the girl was trying to help,

0:33:37.400 --> 0:33:38.880
<v Speaker 2>and so she like picked it up and kind of

0:33:39.040 --> 0:33:40.520
<v Speaker 2>tried to fling it out the window and it bit

0:33:40.600 --> 0:33:42.520
<v Speaker 2>her on the way out, but she didn't think anything

0:33:42.560 --> 0:33:44.840
<v Speaker 2>of it. She didn't end up going to see a

0:33:44.920 --> 0:33:48.280
<v Speaker 2>medical professional to get the rabies vaccine or anything. And

0:33:48.400 --> 0:33:51.600
<v Speaker 2>like weeks later she started like going down the tube.

0:33:51.680 --> 0:33:54.280
<v Speaker 3>You know, all of your stories here, which aren't very dramatic,

0:33:54.400 --> 0:33:56.920
<v Speaker 3>are also substantiating a lot of mythology. You got like

0:33:57.000 --> 0:34:01.240
<v Speaker 3>bats in bedrooms, now you've got bats in belfrieze. Maybe

0:34:01.240 --> 0:34:03.800
<v Speaker 3>these cartoons were accurate. I don't know, maybe, So what

0:34:03.840 --> 0:34:04.600
<v Speaker 3>happened to this girl?

0:34:04.840 --> 0:34:07.160
<v Speaker 2>Yeah, so, so she started showing a bunch of symptoms

0:34:07.200 --> 0:34:09.200
<v Speaker 2>and the doctors just like could not figure out what

0:34:09.280 --> 0:34:12.799
<v Speaker 2>was happening. And her mom at one point, like, you know,

0:34:12.880 --> 0:34:15.920
<v Speaker 2>she was having a chat with the pediatrician and her

0:34:15.960 --> 0:34:18.919
<v Speaker 2>mom thought to mention, like, maybe it was that bat.

0:34:18.960 --> 0:34:20.400
<v Speaker 2>There was there was a bat that bit her, And

0:34:20.440 --> 0:34:23.719
<v Speaker 2>I guess the pediatrician like just went pale when the

0:34:23.760 --> 0:34:25.719
<v Speaker 2>mom said something about like, oh, there was the bat

0:34:25.760 --> 0:34:28.319
<v Speaker 2>that bit her, And the pediatrician was like, ah, I'll

0:34:28.320 --> 0:34:30.839
<v Speaker 2>be right back and made a phone call and it

0:34:30.880 --> 0:34:33.719
<v Speaker 2>was confirmed pretty soon after that it was rabies, and

0:34:34.120 --> 0:34:36.280
<v Speaker 2>I know, and so they talked to this other doctor

0:34:36.320 --> 0:34:38.160
<v Speaker 2>and I listened to an interview with the doctor and

0:34:38.239 --> 0:34:40.120
<v Speaker 2>the doctor was like, okay. So while we were waiting

0:34:40.120 --> 0:34:42.239
<v Speaker 2>for the results, I started going through a bunch of

0:34:42.239 --> 0:34:45.160
<v Speaker 2>case reports for rabies, and there were a bunch of

0:34:45.160 --> 0:34:48.239
<v Speaker 2>folks who were saying that actually, surprisingly, a bunch of

0:34:48.280 --> 0:34:52.960
<v Speaker 2>brains didn't show evidence of massive inflammation. The brains looked

0:34:53.400 --> 0:34:56.040
<v Speaker 2>pretty good, even in people who were dead. So if

0:34:56.080 --> 0:34:58.839
<v Speaker 2>you do an autopsy, it was kind of amazing how

0:34:58.840 --> 0:35:01.439
<v Speaker 2>good the brain looked. And so there were some folks

0:35:01.480 --> 0:35:04.319
<v Speaker 2>who were guessing that actually, what was happening wasn't that

0:35:04.320 --> 0:35:07.799
<v Speaker 2>the virus was like smashing the brain to pieces, like

0:35:07.840 --> 0:35:09.880
<v Speaker 2>you know, I know, the brain gets compared to a

0:35:10.080 --> 0:35:13.160
<v Speaker 2>computer a lot, and that metaphor falls down in a

0:35:13.160 --> 0:35:14.680
<v Speaker 2>lot of ways. But we're going to go with it here.

0:35:14.680 --> 0:35:16.720
<v Speaker 2>We're going to go with the computer and the virus metaphor.

0:35:16.760 --> 0:35:19.279
<v Speaker 2>You know, it's not like the virus is smashing the

0:35:19.320 --> 0:35:23.000
<v Speaker 2>computer with a bat and totally destroying it. It's more

0:35:23.080 --> 0:35:26.160
<v Speaker 2>like the virus is messing up the way the computer

0:35:26.800 --> 0:35:29.640
<v Speaker 2>communicates with the different parts of the computer, and it's

0:35:29.640 --> 0:35:31.799
<v Speaker 2>sort of messing up the way that it, you know,

0:35:31.960 --> 0:35:36.400
<v Speaker 2>runs and so what if you could essentially put somebody

0:35:36.920 --> 0:35:40.719
<v Speaker 2>on life support to get them through a period where

0:35:40.719 --> 0:35:43.400
<v Speaker 2>the immune system has a chance to catch up. Because

0:35:43.400 --> 0:35:46.759
<v Speaker 2>some other autopsies found that there wasn't a lot of

0:35:46.920 --> 0:35:49.720
<v Speaker 2>virus left in the brain, which suggested that the immune

0:35:49.760 --> 0:35:52.880
<v Speaker 2>system was starting to catch up, but it just didn't

0:35:52.880 --> 0:35:53.600
<v Speaker 2>have enough time.

0:35:54.120 --> 0:35:55.640
<v Speaker 3>Oh interesting, if.

0:35:55.520 --> 0:35:58.440
<v Speaker 2>You could get someone through then you know, maybe their

0:35:58.440 --> 0:36:00.200
<v Speaker 2>immune system would catch up and they'd be okay. So

0:36:00.239 --> 0:36:03.480
<v Speaker 2>they ended up putting this girl in a chemical induced

0:36:03.520 --> 0:36:05.880
<v Speaker 2>coma and they put her on life support, so her

0:36:05.920 --> 0:36:09.280
<v Speaker 2>brain didn't have to worry about, you know, breathing or

0:36:09.360 --> 0:36:11.400
<v Speaker 2>you know, making her heartbeat or anything like that. That

0:36:11.480 --> 0:36:14.840
<v Speaker 2>was all done with machines, and amazingly she lived.

0:36:15.280 --> 0:36:17.960
<v Speaker 3>How does going into a coma help the immune system

0:36:18.000 --> 0:36:20.280
<v Speaker 3>catch up? Why does the coma slow down the virus

0:36:20.320 --> 0:36:21.360
<v Speaker 3>but not the immune system.

0:36:21.600 --> 0:36:23.560
<v Speaker 2>As far as I understand it, it's not that it's

0:36:23.600 --> 0:36:27.000
<v Speaker 2>slowing anything down. It's just that the brain no longer

0:36:27.040 --> 0:36:31.000
<v Speaker 2>has to worry about keeping the girl alive. That's all

0:36:31.040 --> 0:36:33.160
<v Speaker 2>being done by a machine. And so even if the

0:36:33.200 --> 0:36:36.400
<v Speaker 2>brain is no longer like communicating like it's supposed to,

0:36:37.239 --> 0:36:39.560
<v Speaker 2>that's okay. Machines are taking care of all of that,

0:36:39.760 --> 0:36:41.719
<v Speaker 2>so the immune system can just have the time that

0:36:41.760 --> 0:36:44.440
<v Speaker 2>it needs to catch up. Oh, I see, the machines

0:36:44.480 --> 0:36:47.640
<v Speaker 2>are playing the role of the brain until the brain

0:36:48.200 --> 0:36:50.759
<v Speaker 2>is cleared of the virus, and without the virus, the

0:36:50.760 --> 0:36:53.160
<v Speaker 2>brain will start acting normal again. And I guess his

0:36:53.200 --> 0:36:55.360
<v Speaker 2>biggest fear was that she might end up with like

0:36:55.400 --> 0:36:58.080
<v Speaker 2>locked in syndrome, where she would sort of never quite

0:36:58.320 --> 0:37:01.480
<v Speaker 2>be the same again, or never be able to communicate again,

0:37:01.480 --> 0:37:03.600
<v Speaker 2>but she'd still be kind of locked inside of there.

0:37:04.080 --> 0:37:06.719
<v Speaker 2>But she ended up making an almost complete recovery.

0:37:06.880 --> 0:37:07.080
<v Speaker 3>Wow.

0:37:07.520 --> 0:37:11.240
<v Speaker 2>And so this was heralded as maybe we finally figured

0:37:11.280 --> 0:37:13.480
<v Speaker 2>out a way to save people from rabies. And this

0:37:13.920 --> 0:37:17.920
<v Speaker 2>made the news and was absolutely huge. But in the

0:37:17.920 --> 0:37:19.680
<v Speaker 2>approximately twenty years since.

0:37:19.800 --> 0:37:21.280
<v Speaker 3>Here comes Kelly's wet blanket.

0:37:21.560 --> 0:37:23.600
<v Speaker 2>Yeah, I know, of course, right, how could it be

0:37:23.640 --> 0:37:28.960
<v Speaker 2>any other way? Loads of attempts have been made using

0:37:28.960 --> 0:37:32.440
<v Speaker 2>this protocol, and now you see papers called things like

0:37:32.560 --> 0:37:36.359
<v Speaker 2>the demise of the Milwaukee protocol because it doesn't seem

0:37:36.440 --> 0:37:39.040
<v Speaker 2>to work in most cases. And it looks like the

0:37:39.080 --> 0:37:42.400
<v Speaker 2>girl for which this worked, her immune system had started

0:37:42.440 --> 0:37:47.359
<v Speaker 2>making some antibodies to rabies pretty early on. And we're

0:37:47.400 --> 0:37:49.360
<v Speaker 2>not quite sure why. It looks like maybe there's some

0:37:49.440 --> 0:37:52.560
<v Speaker 2>variability some people. I don't know, maybe she got exposed

0:37:53.000 --> 0:37:56.520
<v Speaker 2>to something Raybi's ish early in her life, Like there's

0:37:56.520 --> 0:37:58.719
<v Speaker 2>some subset of people who just seemed to be able

0:37:58.760 --> 0:38:01.880
<v Speaker 2>to mount a quick response, and maybe she just was

0:38:01.920 --> 0:38:04.000
<v Speaker 2>one of those people, and putting her on life support

0:38:04.080 --> 0:38:05.560
<v Speaker 2>might have given her a little bit of an edge.

0:38:05.880 --> 0:38:08.000
<v Speaker 2>But it looks like it just doesn't help the majority

0:38:08.000 --> 0:38:12.040
<v Speaker 2>of people. And so it's possible that this protocol takes

0:38:12.040 --> 0:38:15.440
<v Speaker 2>the probability of death one symptoms for Raby's start and

0:38:15.560 --> 0:38:18.200
<v Speaker 2>brings it from one hundred percent to like ninety nine

0:38:18.239 --> 0:38:20.640
<v Speaker 2>point five percent. And I guess I'll be honest, if

0:38:20.680 --> 0:38:22.880
<v Speaker 2>if my kids got rabies and they were like, what

0:38:22.920 --> 0:38:25.360
<v Speaker 2>do you think about going to extraordinary measures to increase

0:38:25.360 --> 0:38:28.400
<v Speaker 2>their probability by point five percent, I'd be like, yess

0:38:28.560 --> 0:38:30.560
<v Speaker 2>that button, Yeah, yeah, I don't have to think about that.

0:38:30.640 --> 0:38:31.239
<v Speaker 1>Let's do it.

0:38:31.520 --> 0:38:33.080
<v Speaker 2>But you know the problem is, you know this is

0:38:33.120 --> 0:38:35.359
<v Speaker 2>going to come up like maybe ten times a year

0:38:35.360 --> 0:38:38.239
<v Speaker 2>in the United States, and for those families, no doubt,

0:38:38.560 --> 0:38:40.640
<v Speaker 2>you know that would be important to have some options.

0:38:41.040 --> 0:38:43.360
<v Speaker 2>But in areas, you know, the areas where you're getting

0:38:43.360 --> 0:38:47.000
<v Speaker 2>those sixty thousand cases of raby's death. It's not really

0:38:47.040 --> 0:38:49.640
<v Speaker 2>feasible to do these kind of procedures. It's not even

0:38:49.719 --> 0:38:52.880
<v Speaker 2>feasible in a lot of cases to have vaccine.

0:38:52.400 --> 0:38:53.720
<v Speaker 1>Available for these people.

0:38:54.120 --> 0:38:56.280
<v Speaker 2>And so, you know, I think if if in general

0:38:56.320 --> 0:38:58.359
<v Speaker 2>we're worried about trying to reduce the number of people

0:38:58.360 --> 0:39:00.880
<v Speaker 2>who die globally from this disease, what we want to

0:39:00.920 --> 0:39:04.080
<v Speaker 2>be focusing on is getting vaccines, you know, affordable and

0:39:04.120 --> 0:39:07.200
<v Speaker 2>distributed throughout the world. So there's some people still working

0:39:07.239 --> 0:39:10.239
<v Speaker 2>on tinkering with this protocol. Hopefully this can be used

0:39:10.280 --> 0:39:13.880
<v Speaker 2>to bring the numbers of rabies deaths to zero, but

0:39:13.920 --> 0:39:15.279
<v Speaker 2>there's a lot of people who don't believe in this

0:39:15.280 --> 0:39:19.360
<v Speaker 2>technique anymore. And Kelly has wet blanketed her way through

0:39:19.880 --> 0:39:23.640
<v Speaker 2>segment two, and it is time for a break, and

0:39:23.719 --> 0:39:26.160
<v Speaker 2>when we come back, we'll talk about the history of

0:39:26.200 --> 0:39:45.960
<v Speaker 2>the rabies vaccine.

0:39:46.960 --> 0:39:49.920
<v Speaker 3>All right, we're back and we're talking about Raebi's today, Kelly,

0:39:49.960 --> 0:39:52.279
<v Speaker 3>we ended the last segment with a little bit of

0:39:52.320 --> 0:39:56.000
<v Speaker 3>a wet blanket about the prospects for surviving rabies. So

0:39:56.080 --> 0:39:59.200
<v Speaker 3>let's make everybody feel good by talking about another glorious

0:39:59.239 --> 0:40:03.200
<v Speaker 3>story of vac development, science in action, saving lives. How

0:40:03.200 --> 0:40:05.600
<v Speaker 3>did this all happen? When did we get started trying

0:40:05.640 --> 0:40:07.240
<v Speaker 3>to make a vaccine against rape's?

0:40:07.520 --> 0:40:09.080
<v Speaker 1>Okay, yay, science all right.

0:40:09.120 --> 0:40:11.480
<v Speaker 2>So around the early eighteen hundreds, we started to figure

0:40:11.520 --> 0:40:14.960
<v Speaker 2>out that saliva was important for transmitting the virus from

0:40:15.160 --> 0:40:17.920
<v Speaker 2>organism to organism, and that was important because that meant

0:40:17.960 --> 0:40:21.239
<v Speaker 2>we could start keeping this virus in labs and in

0:40:21.440 --> 0:40:24.680
<v Speaker 2>lab animals. And if you are not comfortable with animal research,

0:40:24.680 --> 0:40:27.640
<v Speaker 2>you might want to skip the last part of this episode.

0:40:27.920 --> 0:40:31.000
<v Speaker 2>So Louis Pastor starts working in his lab in the

0:40:31.040 --> 0:40:34.080
<v Speaker 2>eighteen eighties and they decide that they're going to tackle

0:40:34.160 --> 0:40:38.719
<v Speaker 2>a rabies vaccine. They had already developed two different vaccines.

0:40:38.800 --> 0:40:42.200
<v Speaker 2>One was for foul cholera. I didn't realize that chickens

0:40:42.200 --> 0:40:45.000
<v Speaker 2>got cholera, but you know, maybe that's because we've got

0:40:45.000 --> 0:40:47.880
<v Speaker 2>a vaccine for it now, and another for anthrax. So

0:40:48.160 --> 0:40:50.279
<v Speaker 2>there were some other vaccines. They had experience with that.

0:40:51.000 --> 0:40:54.080
<v Speaker 2>And at the same time, Emil Roux, do you know

0:40:54.120 --> 0:40:55.680
<v Speaker 2>how to say that, Daniel?

0:40:55.920 --> 0:40:56.920
<v Speaker 3>I think you said that correctly.

0:40:57.239 --> 0:41:01.400
<v Speaker 2>Yes, nice, all right. Emil ru had developed a technique

0:41:01.440 --> 0:41:03.720
<v Speaker 2>for inoculating dogs with rabies.

0:41:03.920 --> 0:41:06.280
<v Speaker 3>You could start with butter and flour all mixed together

0:41:06.320 --> 0:41:07.120
<v Speaker 3>into a thick sauce.

0:41:10.160 --> 0:41:14.600
<v Speaker 1>That was a food joke, of course, a delicious food joke.

0:41:14.800 --> 0:41:17.040
<v Speaker 3>Everything delicious starts with the rue. That's what I learned.

0:41:17.200 --> 0:41:18.960
<v Speaker 2>Yeah, no, I'm not going to go into too many

0:41:19.000 --> 0:41:22.960
<v Speaker 2>details because what it involved was much less appetizing than that.

0:41:24.480 --> 0:41:27.600
<v Speaker 2>But but he found a way to keep a series

0:41:27.640 --> 0:41:30.640
<v Speaker 2>of animals with rabies in the lab and a technique

0:41:30.680 --> 0:41:33.960
<v Speaker 2>for starting to dry out the virus. As you noted earlier,

0:41:33.960 --> 0:41:36.839
<v Speaker 2>if the virus dries out, it sort of stops being

0:41:36.880 --> 0:41:39.400
<v Speaker 2>able to infect people. And actually, we had a series

0:41:39.440 --> 0:41:42.719
<v Speaker 2>of really great questions from the Extraordinaries where they sent

0:41:42.800 --> 0:41:45.160
<v Speaker 2>us emails and they're like, well, in the polio episode,

0:41:45.239 --> 0:41:48.480
<v Speaker 2>you were saying that there was a live virus version

0:41:48.960 --> 0:41:51.760
<v Speaker 2>and a dead virus version, but then in another episode

0:41:51.760 --> 0:41:54.319
<v Speaker 2>you told us that viruses aren't even alive. So what

0:41:54.400 --> 0:41:55.480
<v Speaker 2>do you mean by that?

0:41:55.760 --> 0:41:56.440
<v Speaker 3>Good question?

0:41:56.680 --> 0:41:59.719
<v Speaker 2>Yes, such a fantastic question got me to rethink, you know,

0:41:59.760 --> 0:42:01.239
<v Speaker 2>the way I was explaining it, in the way it

0:42:01.239 --> 0:42:04.280
<v Speaker 2>gets explained in like the you know, literature in general.

0:42:04.880 --> 0:42:07.960
<v Speaker 2>So I think essentially what it means is like viruses

0:42:08.280 --> 0:42:10.600
<v Speaker 2>are able to infect you, but if you mess them

0:42:10.680 --> 0:42:14.040
<v Speaker 2>up a little bit, they lose some function that allows

0:42:14.040 --> 0:42:16.799
<v Speaker 2>them to infect you. And one way that you can

0:42:16.840 --> 0:42:19.080
<v Speaker 2>mess up the rabies virus is by drying it out.

0:42:19.400 --> 0:42:22.040
<v Speaker 2>And whether we understand what's happened to the virus or not,

0:42:22.520 --> 0:42:25.520
<v Speaker 2>once you've dried it out a little bit, something that

0:42:25.520 --> 0:42:27.799
<v Speaker 2>it was able to do before it now can't do.

0:42:28.000 --> 0:42:31.439
<v Speaker 2>So it can't complete the process of getting into one

0:42:31.440 --> 0:42:34.839
<v Speaker 2>of your cells, forcing your cells to make copies of it,

0:42:35.200 --> 0:42:36.880
<v Speaker 2>and then getting out of the cell so that it

0:42:36.880 --> 0:42:40.120
<v Speaker 2>can go and infect additional cells. Something about that no

0:42:40.200 --> 0:42:43.960
<v Speaker 2>longer works when it gets dried out. But the virus

0:42:44.040 --> 0:42:47.320
<v Speaker 2>still looks virus enough, like enough of it is still

0:42:47.400 --> 0:42:51.600
<v Speaker 2>sort of like present to be recognizable by your immune system,

0:42:51.920 --> 0:42:55.360
<v Speaker 2>so your immune system can produce antibodies so that the

0:42:55.400 --> 0:42:58.160
<v Speaker 2>next time it sees it it can attack it. Does

0:42:58.200 --> 0:42:59.839
<v Speaker 2>that make sense, Yeah, that makes sense?

0:43:00.040 --> 0:43:00.360
<v Speaker 1>Okay.

0:43:00.520 --> 0:43:03.399
<v Speaker 2>So emil Rue had figured out how you can keep

0:43:03.400 --> 0:43:07.120
<v Speaker 2>animals in the lab with rabies and how you can

0:43:07.200 --> 0:43:10.799
<v Speaker 2>start drying out parts of these animals after you euthanize them.

0:43:11.200 --> 0:43:13.919
<v Speaker 2>They call it attenuating the virus, so essentially start making

0:43:13.920 --> 0:43:16.400
<v Speaker 2>it so that the virus can't infect people as well anymore.

0:43:16.800 --> 0:43:19.920
<v Speaker 2>And I mentioned this just because Pasteur often seems to

0:43:19.920 --> 0:43:22.400
<v Speaker 2>get credit for like coming up with the rabies vaccine,

0:43:22.719 --> 0:43:24.799
<v Speaker 2>as though nobody had done any prior work at all.

0:43:25.280 --> 0:43:27.480
<v Speaker 2>But just like just about all scientific advances, he was

0:43:27.520 --> 0:43:29.400
<v Speaker 2>building on the work that other people were doing at

0:43:29.400 --> 0:43:32.680
<v Speaker 2>the time. Okay, So Pastor gets to work and he

0:43:32.920 --> 0:43:36.200
<v Speaker 2>starts working in rabbits, because working with rabbid dogs is

0:43:36.239 --> 0:43:40.920
<v Speaker 2>probably absolutely petrifying, and working with rabid rabbits is probably

0:43:41.280 --> 0:43:45.080
<v Speaker 2>much less petrifying. And so he creates a series of

0:43:45.160 --> 0:43:47.919
<v Speaker 2>rabbits that have rabies. He works on the system where

0:43:48.000 --> 0:43:51.760
<v Speaker 2>essentially he takes out the rabbit's nervous systems. He drives

0:43:51.800 --> 0:43:54.480
<v Speaker 2>them out for different lengths of time, and now he

0:43:54.600 --> 0:43:59.160
<v Speaker 2>essentially has virus that has been inactivated because he has

0:43:59.239 --> 0:44:02.319
<v Speaker 2>the nervous system cells that the rabbit had and he

0:44:02.400 --> 0:44:04.040
<v Speaker 2>has dried them out to kill the virus.

0:44:04.400 --> 0:44:08.240
<v Speaker 3>And how does a rabbit rabbit react? I mean, anybody

0:44:08.280 --> 0:44:10.920
<v Speaker 3>who has seen monty python, for example, knows.

0:44:10.719 --> 0:44:11.480
<v Speaker 1>To be terrifed.

0:44:12.160 --> 0:44:13.719
<v Speaker 2>Right then they can jump at your neck and they

0:44:13.719 --> 0:44:14.960
<v Speaker 2>know where the jugular.

0:44:14.600 --> 0:44:17.360
<v Speaker 3>Is, and you're like, oh, is that also medically accurate.

0:44:18.200 --> 0:44:21.920
<v Speaker 2>Yeah, probably, Yeah. And you know the way the night

0:44:22.040 --> 0:44:26.239
<v Speaker 2>was able to survive with like no limbs. Yeah, that's

0:44:26.239 --> 0:44:27.239
<v Speaker 2>what pastor looks like.

0:44:27.280 --> 0:44:28.680
<v Speaker 1>When the experiments were done, I.

0:44:28.680 --> 0:44:30.800
<v Speaker 3>Would love to have been a science consultant for the

0:44:30.840 --> 0:44:31.480
<v Speaker 3>Monty python.

0:44:31.800 --> 0:44:33.439
<v Speaker 1>Oh my gosh, me too, Me too.

0:44:34.040 --> 0:44:37.040
<v Speaker 2>I read a variety of different sources, and I did

0:44:37.080 --> 0:44:40.640
<v Speaker 2>not find descriptions of how the rabbits were behaving. I

0:44:40.680 --> 0:44:44.200
<v Speaker 2>think they were much less interested in rabbit behavior and

0:44:44.480 --> 0:44:47.480
<v Speaker 2>much more interested in just accessing something they could use

0:44:47.480 --> 0:44:50.200
<v Speaker 2>for a vaccine. Sure, and so they actually were able

0:44:50.239 --> 0:44:52.879
<v Speaker 2>to show that if you gave a dog some of

0:44:52.920 --> 0:44:55.319
<v Speaker 2>this material from the rabbits that had been dried out,

0:44:55.840 --> 0:44:58.960
<v Speaker 2>and then you exposed the dog to rabies, a dog

0:44:59.000 --> 0:45:01.160
<v Speaker 2>would not get rabies. And so they were like, holy cow,

0:45:01.239 --> 0:45:03.840
<v Speaker 2>this vaccine thing seems to be working. This works in dogs,

0:45:04.280 --> 0:45:07.120
<v Speaker 2>but they were not ready to start testing it in people.

0:45:07.800 --> 0:45:10.920
<v Speaker 2>In June of eighteen eighty five, a child who was

0:45:10.960 --> 0:45:13.520
<v Speaker 2>already starting to show signs of rabies, which we've already

0:45:13.520 --> 0:45:16.600
<v Speaker 2>said it's too late at that point, was brought in.

0:45:16.760 --> 0:45:19.240
<v Speaker 2>They tried to give her the vaccine she passed away.

0:45:19.640 --> 0:45:22.120
<v Speaker 2>That didn't work. That wasn't a great sign, but they

0:45:22.200 --> 0:45:24.319
<v Speaker 2>kept doing the work. And then a little bit later,

0:45:24.360 --> 0:45:28.440
<v Speaker 2>in eighteen eighty five, a boy named Joseph Meister came in.

0:45:28.640 --> 0:45:30.319
<v Speaker 2>He was a nine year old boy. He was bit

0:45:30.360 --> 0:45:32.480
<v Speaker 2>by a rabid dog a bunch of times, like more

0:45:32.520 --> 0:45:35.759
<v Speaker 2>than ten times. This kid had initially been brought to

0:45:35.880 --> 0:45:38.240
<v Speaker 2>Emil ru who we talked about a little bit earlier,

0:45:38.600 --> 0:45:41.680
<v Speaker 2>and Emil was like, I do not feel comfortable giving

0:45:41.800 --> 0:45:44.759
<v Speaker 2>this kiddo the vaccine. He wasn't one hundred percent clear

0:45:44.760 --> 0:45:46.840
<v Speaker 2>about his reasons, but based on what he wrote in

0:45:46.880 --> 0:45:49.640
<v Speaker 2>other places, we think that it's because he was like, look,

0:45:49.719 --> 0:45:52.839
<v Speaker 2>I've tested it in dogs. My vaccine seems pretty good

0:45:52.840 --> 0:45:54.480
<v Speaker 2>in dogs, but I just don't feel comfortable giving it

0:45:54.520 --> 0:45:56.280
<v Speaker 2>to people yet it could be way too dangerous.

0:45:56.520 --> 0:45:58.160
<v Speaker 3>Yeah, that's a terrifying decision.

0:45:58.160 --> 0:46:00.839
<v Speaker 2>They have to make, yes, absolutely right, because you know,

0:46:01.320 --> 0:46:03.600
<v Speaker 2>if this kid was actually bitten by a rabbit dog,

0:46:04.400 --> 0:46:06.239
<v Speaker 2>you might be the only one who can save his life.

0:46:06.280 --> 0:46:08.080
<v Speaker 2>But if he was just bitten by some dog that's

0:46:08.120 --> 0:46:11.960
<v Speaker 2>a jerk, you might kill him with your vaccine. And

0:46:12.040 --> 0:46:15.640
<v Speaker 2>so he passed, but Pastor's lab decided to go for it.

0:46:16.120 --> 0:46:18.680
<v Speaker 2>Pasteor was a chemist so he couldn't do the injection.

0:46:18.920 --> 0:46:24.840
<v Speaker 2>But his colleague Jacques Joseph Grancher, why couldn't it just

0:46:24.880 --> 0:46:28.279
<v Speaker 2>be people with boring English names that make scientific advances.

0:46:28.760 --> 0:46:33.080
<v Speaker 2>I don't know, but my apologies to the French speaking world. Anyway,

0:46:33.120 --> 0:46:36.160
<v Speaker 2>he administered the rabies vaccine they had been working on,

0:46:36.560 --> 0:46:39.719
<v Speaker 2>and then he gave this kid twelve additional doses that

0:46:40.080 --> 0:46:42.640
<v Speaker 2>had a vaccine that had been dried for less and

0:46:42.800 --> 0:46:45.560
<v Speaker 2>less time, so essentially he gave him stronger and stronger

0:46:45.680 --> 0:46:50.320
<v Speaker 2>versions of the virus each time, and this kid survived.

0:46:51.160 --> 0:46:54.000
<v Speaker 2>He's the first person we know of to survive being

0:46:54.040 --> 0:46:57.880
<v Speaker 2>exposed to rabies get a vaccine and now he lives,

0:46:58.680 --> 0:47:01.040
<v Speaker 2>which is amazing. And then they pulled this trick off

0:47:01.080 --> 0:47:03.640
<v Speaker 2>again a little bit later with a kid who was

0:47:03.640 --> 0:47:06.960
<v Speaker 2>a shepherd. Around this point, they also had the first

0:47:07.000 --> 0:47:10.200
<v Speaker 2>what we call prophylactic vaccine, which is where you get

0:47:10.320 --> 0:47:13.480
<v Speaker 2>a vaccine before you get exposed. And this was essentially

0:47:13.520 --> 0:47:18.240
<v Speaker 2>because while they were administering the vaccine, somebody accidentally injected

0:47:18.239 --> 0:47:20.839
<v Speaker 2>themselves with the vaccine and they were like, well, now

0:47:20.880 --> 0:47:23.080
<v Speaker 2>we're going to see how that goes.

0:47:23.200 --> 0:47:26.280
<v Speaker 3>I guess now we know about that experiment.

0:47:26.000 --> 0:47:28.480
<v Speaker 2>That's right, But that turned out okay, And so that

0:47:28.719 --> 0:47:32.239
<v Speaker 2>was the start of our vaccine procedure with rabies. And

0:47:32.239 --> 0:47:34.359
<v Speaker 2>then a bunch of labs around the world, you know,

0:47:34.440 --> 0:47:37.320
<v Speaker 2>came to see how this worked, and they started growing

0:47:37.360 --> 0:47:40.480
<v Speaker 2>you know, rabbits in their labs and trying this procedure,

0:47:40.600 --> 0:47:42.320
<v Speaker 2>and then the rabies vaccine. You know, a bunch of

0:47:42.320 --> 0:47:44.440
<v Speaker 2>different labs popped up around the world that produced these

0:47:44.520 --> 0:47:47.680
<v Speaker 2>rabies vaccines and that's how it started.

0:47:47.840 --> 0:47:50.680
<v Speaker 3>My favorite thing is when science can develop a treatment

0:47:50.800 --> 0:47:54.239
<v Speaker 3>that helps save children's lives. You know, like how many

0:47:54.320 --> 0:47:57.080
<v Speaker 3>children were bitten by dogs or scratched by dogs and

0:47:57.120 --> 0:48:01.040
<v Speaker 3>then died a horrible, painful, excruciating death of rabies. Like

0:48:01.280 --> 0:48:06.040
<v Speaker 3>anytime when we can reduce childhood suffering, ya, science, Yes, And.

0:48:05.960 --> 0:48:09.120
<v Speaker 2>That's part of like why this story also makes me

0:48:09.160 --> 0:48:13.000
<v Speaker 2>so upset because there are children dying around the world.

0:48:12.719 --> 0:48:13.880
<v Speaker 1>In the tens of thousands.

0:48:14.120 --> 0:48:19.080
<v Speaker 2>Yeah that shouldn't be because science has the solution, but

0:48:19.160 --> 0:48:21.520
<v Speaker 2>we haven't found a way to get them access to it.

0:48:21.520 --> 0:48:24.040
<v Speaker 3>It's a political or financial or an engineering issue.

0:48:24.160 --> 0:48:27.280
<v Speaker 2>Yeah, right, and that stinks when science has the answer

0:48:27.360 --> 0:48:29.560
<v Speaker 2>and it's it's not getting to them. So let's let's

0:48:29.560 --> 0:48:32.400
<v Speaker 2>go ahead and talk real quick about what happens today.

0:48:32.640 --> 0:48:33.600
<v Speaker 1>We talked about.

0:48:33.320 --> 0:48:36.480
<v Speaker 2>How if you have a job where you know you're

0:48:36.480 --> 0:48:40.080
<v Speaker 2>going to get exposed regularly to animals that might have rabies,

0:48:40.120 --> 0:48:42.080
<v Speaker 2>you can get the vaccine ahead of time. So the

0:48:42.160 --> 0:48:45.919
<v Speaker 2>vaccine is grown up in cell cultures, so you don't

0:48:45.920 --> 0:48:47.960
<v Speaker 2>need like whole humans. We just have figured out how

0:48:48.000 --> 0:48:50.600
<v Speaker 2>to keep some subset of human cells alive in like

0:48:50.640 --> 0:48:53.760
<v Speaker 2>a petri dish or some you know, chicken embryos alive.

0:48:54.160 --> 0:48:57.200
<v Speaker 2>We grow up the virus in there, we extract the virus,

0:48:57.239 --> 0:48:59.680
<v Speaker 2>we kill it, and then you get that vaccine. That's

0:48:59.719 --> 0:49:02.920
<v Speaker 2>star it's giving you some immunity. Then if you subsequently

0:49:02.960 --> 0:49:07.000
<v Speaker 2>get exposed to rabies, you'll get some boosters.

0:49:07.120 --> 0:49:09.919
<v Speaker 3>Wait, I just realized I didn't understand something basic. When

0:49:10.080 --> 0:49:13.160
<v Speaker 3>my dog gets a rabies vaccine, it's not the same

0:49:13.239 --> 0:49:15.200
<v Speaker 3>vaccine as I get. Is it. Is there a human

0:49:15.200 --> 0:49:16.719
<v Speaker 3>in a dog version or is it the same thing.

0:49:17.239 --> 0:49:19.440
<v Speaker 2>I did not do extra research on the dog version.

0:49:19.520 --> 0:49:22.239
<v Speaker 2>I do know that there's a couple different versions of vaccines.

0:49:22.320 --> 0:49:25.200
<v Speaker 2>So for example, sometimes if there's a lot of rabies

0:49:25.239 --> 0:49:28.759
<v Speaker 2>in a wild population, they will put some vaccines in

0:49:29.040 --> 0:49:33.480
<v Speaker 2>food and essentially drop the food from planes and like

0:49:33.560 --> 0:49:36.560
<v Speaker 2>feed coyotes. And that is a totally different version than

0:49:36.600 --> 0:49:39.879
<v Speaker 2>what humans get because it's way less regulated. And so

0:49:39.960 --> 0:49:42.920
<v Speaker 2>I know that depending on what animal the vaccine is getting,

0:49:42.920 --> 0:49:45.960
<v Speaker 2>there's different regulations, and so they can give different kinds

0:49:45.960 --> 0:49:46.600
<v Speaker 2>of vaccines.

0:49:46.880 --> 0:49:48.920
<v Speaker 3>But the same principle should apply, right, that if you

0:49:48.960 --> 0:49:51.720
<v Speaker 3>have this weekend vaccine, it should help a dog's immune

0:49:51.760 --> 0:49:53.960
<v Speaker 3>system or a human's immune system, even if those immune

0:49:53.960 --> 0:49:55.400
<v Speaker 3>systems and the biology are different.

0:49:55.520 --> 0:49:57.160
<v Speaker 2>Yeah, I mean they might grow it up in dog

0:49:57.200 --> 0:49:59.400
<v Speaker 2>cell cultures rather than human cell culture so that you

0:49:59.440 --> 0:50:01.720
<v Speaker 2>don't get like a orgic reactions or something, but probably

0:50:01.800 --> 0:50:04.560
<v Speaker 2>the idea is pretty similar. But again I want to reiterate,

0:50:04.680 --> 0:50:06.880
<v Speaker 2>I didn't actually research how those vaccines are made. I

0:50:06.920 --> 0:50:09.400
<v Speaker 2>was focusing on human stuff for this episode. Okay, so

0:50:09.560 --> 0:50:14.040
<v Speaker 2>if you're a veterinarian, you got your vaccines ahead of time,

0:50:14.120 --> 0:50:16.600
<v Speaker 2>then you get bit by a rabid cat, you'll get

0:50:16.640 --> 0:50:19.280
<v Speaker 2>a couple extra vaccines after you know you've gotten bitten,

0:50:19.360 --> 0:50:22.720
<v Speaker 2>just to boost your immune system. And that is almost

0:50:22.719 --> 0:50:26.239
<v Speaker 2>one hundred percent effective, and you are very unlikely to

0:50:26.320 --> 0:50:29.840
<v Speaker 2>die from rabies in that situation, which is absolutely amazing

0:50:29.920 --> 0:50:33.800
<v Speaker 2>ya science. Okay, if you have never gotten a rabies

0:50:33.880 --> 0:50:36.560
<v Speaker 2>vaccine before, we do something a little bit different, and

0:50:36.600 --> 0:50:38.920
<v Speaker 2>this is pretty awesome, I think. So we have something

0:50:38.960 --> 0:50:43.520
<v Speaker 2>called rabies immune globulin. So essentially what they do is

0:50:43.560 --> 0:50:48.640
<v Speaker 2>they immunize either people or horses with the rabies vaccine

0:50:49.400 --> 0:50:52.440
<v Speaker 2>and then they draw blood and they extract the plasma.

0:50:53.360 --> 0:50:55.840
<v Speaker 2>We've talked about plasma before when we were talking about

0:50:55.840 --> 0:51:00.160
<v Speaker 2>making synthetic blood and stuff. In the plasma, you have antibodies.

0:51:00.560 --> 0:51:04.799
<v Speaker 2>We've talked about antibodies they bind to something on in

0:51:04.840 --> 0:51:07.960
<v Speaker 2>this case, the rabies virus and they inactivate it. For example,

0:51:08.000 --> 0:51:09.799
<v Speaker 2>maybe they make it so that the virus can no

0:51:09.880 --> 0:51:12.560
<v Speaker 2>longer bind to a muscle sell and get into it,

0:51:12.920 --> 0:51:15.120
<v Speaker 2>and so they essentially make it so that the virus

0:51:15.160 --> 0:51:17.879
<v Speaker 2>can't do what it needs to do to replicate. They

0:51:17.920 --> 0:51:20.800
<v Speaker 2>neutralize it in some way, and so they take out

0:51:21.000 --> 0:51:24.960
<v Speaker 2>the antibodies that the human or horse immune system made

0:51:26.280 --> 0:51:29.480
<v Speaker 2>and then they inject that into you near the bite site.

0:51:29.840 --> 0:51:34.120
<v Speaker 2>So essentially you outsourced the initial immune response from some

0:51:34.239 --> 0:51:37.920
<v Speaker 2>other organism and that gives you a head start. So

0:51:37.920 --> 0:51:40.759
<v Speaker 2>while your immune system is responding to the vaccine and

0:51:40.880 --> 0:51:44.120
<v Speaker 2>is trying to make its own response to rabies. You're

0:51:44.160 --> 0:51:47.160
<v Speaker 2>borrowing someone else's immune response to give you a head start.

0:51:47.680 --> 0:51:49.200
<v Speaker 2>You know, maybe that will do the trick. Maybe that

0:51:49.239 --> 0:51:51.359
<v Speaker 2>will bind to all of the viruses that are trying

0:51:51.360 --> 0:51:54.000
<v Speaker 2>to get into muscles initially, and then just in case,

0:51:54.160 --> 0:51:56.719
<v Speaker 2>you know, your body will start making your own antibodies

0:51:56.760 --> 0:51:58.479
<v Speaker 2>and you'll get a series of I think it's something

0:51:58.560 --> 0:52:01.680
<v Speaker 2>like three vaccines. It used to be you'd get a

0:52:01.719 --> 0:52:06.279
<v Speaker 2>bunch of vaccines in like your abdominal region. And I

0:52:06.320 --> 0:52:08.480
<v Speaker 2>think there's a little bit of folklore where people used

0:52:08.480 --> 0:52:10.960
<v Speaker 2>to think it was like twenty vaccines that all had

0:52:11.000 --> 0:52:13.759
<v Speaker 2>to go through your abdominal wall into your stomach, and

0:52:13.800 --> 0:52:16.399
<v Speaker 2>it was super painful, And it wasn't like that.

0:52:16.520 --> 0:52:17.800
<v Speaker 1>Like it was painful.

0:52:17.880 --> 0:52:20.160
<v Speaker 2>It was like in your sort of tummy region, but

0:52:20.200 --> 0:52:22.799
<v Speaker 2>it didn't need to go like into your stomach through

0:52:22.840 --> 0:52:27.120
<v Speaker 2>your abdominal wall. But now it is way less uncomfortable.

0:52:27.120 --> 0:52:29.759
<v Speaker 2>It's like two or three shots usually in like the

0:52:29.840 --> 0:52:32.640
<v Speaker 2>muscle in your arm. We also have like a version

0:52:32.640 --> 0:52:35.040
<v Speaker 2>that goes just like right under your skin. Now way

0:52:35.120 --> 0:52:38.959
<v Speaker 2>less painful. Yes, the next day you probably feel pretty sore,

0:52:39.120 --> 0:52:42.360
<v Speaker 2>especially after the third shot, but you're probably not gonna

0:52:42.400 --> 0:52:43.680
<v Speaker 2>die of radiance.

0:52:43.560 --> 0:52:46.640
<v Speaker 1>So yay, definitely worth.

0:52:46.480 --> 0:52:48.920
<v Speaker 2>It, Definitely worth it. Yeah, So those are our treatments.

0:52:48.920 --> 0:52:51.880
<v Speaker 2>But so in the United States, about one hundred thousand

0:52:51.880 --> 0:52:54.359
<v Speaker 2>people need to get those series of shots after they

0:52:54.360 --> 0:52:57.160
<v Speaker 2>get exposed to an animal that might be rabin. But

0:52:57.360 --> 0:52:59.520
<v Speaker 2>the main thing that we do that protects us is

0:52:59.520 --> 0:53:02.520
<v Speaker 2>we have this system where each state has a series

0:53:02.520 --> 0:53:05.680
<v Speaker 2>of laws where you have to vaccinate your dogs and

0:53:05.760 --> 0:53:08.680
<v Speaker 2>your cats. And that's the main thing that protects us

0:53:08.719 --> 0:53:11.319
<v Speaker 2>because globally, most of the people who get bit are

0:53:11.360 --> 0:53:12.080
<v Speaker 2>getting bit.

0:53:11.920 --> 0:53:13.960
<v Speaker 3>By dogs, not by bats in their bedroom.

0:53:14.400 --> 0:53:16.480
<v Speaker 2>Not by bats in their bedroom. Yeah, dogs are a

0:53:16.520 --> 0:53:18.840
<v Speaker 2>much bigger risk. And so if we could just have

0:53:18.920 --> 0:53:22.000
<v Speaker 2>similar programs where everybody had to vaccinate their dogs. And

0:53:22.040 --> 0:53:26.440
<v Speaker 2>maybe there's some cultural problems, cultural difficulties, hurdles to get across,

0:53:26.680 --> 0:53:28.319
<v Speaker 2>but I think a lot of it is like having

0:53:28.320 --> 0:53:32.040
<v Speaker 2>the infrastructure, the ability to get the vaccines there, the

0:53:32.080 --> 0:53:34.600
<v Speaker 2>ability to make sure that you've got records so that

0:53:34.640 --> 0:53:37.400
<v Speaker 2>you're giving the vaccines every single year. But if you

0:53:37.400 --> 0:53:39.960
<v Speaker 2>could get that stuff in place, we could have a

0:53:39.960 --> 0:53:42.200
<v Speaker 2>lot fewer deaths and the few times that people do

0:53:42.239 --> 0:53:43.960
<v Speaker 2>get bit by rabbit animals. If you could have the

0:53:44.040 --> 0:53:47.480
<v Speaker 2>human vaccines available, we wouldn't have to have about sixty

0:53:47.520 --> 0:53:51.160
<v Speaker 2>thousand people every year dying from this horrible disease.

0:53:51.600 --> 0:53:54.040
<v Speaker 3>Yeah, let's hope that the folks in charge of that

0:53:54.120 --> 0:53:54.719
<v Speaker 3>figure it out.

0:53:54.840 --> 0:53:57.040
<v Speaker 2>Yeah, I hope. So so should we end? For anybody

0:53:57.080 --> 0:54:00.799
<v Speaker 2>who I know we've discussed statistics isn't how we live

0:54:00.840 --> 0:54:03.080
<v Speaker 2>our lives. But do we want to end on a

0:54:03.120 --> 0:54:07.040
<v Speaker 2>couple notes about how to try to prevent rabies in

0:54:07.080 --> 0:54:07.520
<v Speaker 2>your life?

0:54:07.680 --> 0:54:10.480
<v Speaker 3>Yeah? Okay, exactly other than vaccinateing in your pets and

0:54:10.520 --> 0:54:12.960
<v Speaker 3>closing the windows in your bedroom, what should you do

0:54:13.080 --> 0:54:14.000
<v Speaker 3>to avoid rabies?

0:54:14.080 --> 0:54:14.360
<v Speaker 7>All right?

0:54:14.400 --> 0:54:16.000
<v Speaker 2>Well, so I'll note this was a little bit surprising.

0:54:16.000 --> 0:54:19.160
<v Speaker 2>You're supposed to vaccinate your cats and dogs, also your ferrets.

0:54:20.360 --> 0:54:22.480
<v Speaker 2>I get there are some places that have rules about

0:54:22.520 --> 0:54:25.960
<v Speaker 2>vaccinating ferrets. You can also vaccinate things like horses. My

0:54:26.040 --> 0:54:30.480
<v Speaker 2>recommendation anything you can vaccinate, vaccinate. Keep your pets from

0:54:30.520 --> 0:54:33.279
<v Speaker 2>interacting with wild animals, so you know, maybe don't just

0:54:33.360 --> 0:54:36.840
<v Speaker 2>let your animals run wild. I am mostly talking to me.

0:54:37.080 --> 0:54:38.840
<v Speaker 2>I live on a farm. Sometimes I just let my

0:54:38.880 --> 0:54:40.440
<v Speaker 2>dog out and I'm like, oh, I have fun, see

0:54:40.440 --> 0:54:42.480
<v Speaker 2>you in a few hours. Maybe I should be more

0:54:42.480 --> 0:54:46.480
<v Speaker 2>careful about that. Report stray animals to local authorities. You

0:54:46.520 --> 0:54:49.240
<v Speaker 2>shouldn't touch wild animals, like if you see a skunk

0:54:49.280 --> 0:54:52.480
<v Speaker 2>that looks sick, call animal control or something. Don't touch

0:54:52.520 --> 0:54:54.840
<v Speaker 2>them on your own. That poor animal could be rabid.

0:54:54.840 --> 0:54:57.000
<v Speaker 2>They could give it to you. Keep bats out of

0:54:57.040 --> 0:54:59.000
<v Speaker 2>your house. Make sure you have like screens on your

0:54:59.000 --> 0:55:02.000
<v Speaker 2>windows if possible. If you are going to do a

0:55:02.040 --> 0:55:04.640
<v Speaker 2>high risk activity like splunking in a cave that has

0:55:04.680 --> 0:55:08.200
<v Speaker 2>a lot of bats, consider trying to get the vaccine preventively.

0:55:08.239 --> 0:55:10.640
<v Speaker 2>You can talk to your doctor and if you think

0:55:10.680 --> 0:55:12.200
<v Speaker 2>you've been exposed to the rabies.

0:55:11.960 --> 0:55:15.239
<v Speaker 1>Virus, wash the area thoroughly.

0:55:14.960 --> 0:55:17.719
<v Speaker 2>And then immediately go seek medical attention. And if you

0:55:17.760 --> 0:55:21.440
<v Speaker 2>are ever unsure, call a doctor or go see a doctor.

0:55:21.760 --> 0:55:23.440
<v Speaker 2>For me, I think I'm supposed to call my local

0:55:23.520 --> 0:55:27.479
<v Speaker 2>poison control center for advice, but like call nine one one,

0:55:27.520 --> 0:55:30.200
<v Speaker 2>figure out who you have to talk to. Don't worry about,

0:55:30.280 --> 0:55:33.920
<v Speaker 2>you know, looking silly or something. This is a serious disease.

0:55:34.040 --> 0:55:35.359
<v Speaker 2>Don't mess around, that's right.

0:55:35.360 --> 0:55:38.320
<v Speaker 3>Don't worry about finishing this podcast before you call your doctor.

0:55:38.400 --> 0:55:40.280
<v Speaker 3>Pause it right now and call your doctor.

0:55:40.400 --> 0:55:43.160
<v Speaker 1>Yes, right, And Kelly is not a medical doctor.

0:55:43.280 --> 0:55:45.280
<v Speaker 2>Kelly is not the kind of doctor that most people

0:55:45.320 --> 0:55:48.399
<v Speaker 2>recognize as being a doctor. When they ask is there're

0:55:48.400 --> 0:55:50.759
<v Speaker 2>a doctor on the plane, they don't mean me, So

0:55:51.320 --> 0:55:52.680
<v Speaker 2>don't take medical advice from me.

0:55:53.520 --> 0:55:54.680
<v Speaker 1>Talk to a medical doctor.

0:55:54.880 --> 0:55:57.680
<v Speaker 3>Thank you Kelly for that tour of the history of rabies,

0:55:57.719 --> 0:56:01.520
<v Speaker 3>and thank you Gurjeet for sending us curious question. If

0:56:01.560 --> 0:56:04.360
<v Speaker 3>there are things you want to hear a deep dive about,

0:56:04.440 --> 0:56:06.640
<v Speaker 3>please don't hesitate to write to us. We want to

0:56:06.640 --> 0:56:09.879
<v Speaker 3>hear from you. Questions at Danielankelly dot org.

0:56:10.040 --> 0:56:12.919
<v Speaker 1>Thanks everyone, have a good day, avoid skunks.

0:56:21.120 --> 0:56:24.680
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