Speaker 1: She began to feel feverish and achy, and believed she
Speaker 1: had the flu. When the aches and pains grew more severe,
Speaker 1: she sought medical attention and was hospitalized before the respiratory
Speaker 1: symptoms appeared. She speaks of drowning, of perceiving a great
Speaker 1: weight on her chest, and a great exhaustion. She speaks
Speaker 1: of wanting to see her children one last time, and
Speaker 1: then of her mixed emotions about being sedated. I wanted
Speaker 1: to live, she said, of course I did. I didn't
Speaker 1: want to leave my family. They needed me.
Speaker 2: But I was just so tired. I was just so tired.
Speaker 1: She did survive, and sometimes she says she still grows
Speaker 1: so weary that she realized she'll never fully recover from
Speaker 1: her encounter with the virus. She says, it's the most
Speaker 1: horrible feeling, the tubes, the liquid in your lungs, the choking.
Speaker 1: You don't want to die that way, but you know
Speaker 1: you can't live that way either. Shoot. Yeah, dang bad one.
Speaker 3: Yeah.
Speaker 1: Every episode, Hello, Hello, I'm Aaron Welsh.
Speaker 3: And I'm Aaron Oman Updyke and.
Speaker 1: This is this podcast will kill you.
Speaker 3: Yeah it's.
Speaker 1: And this week we're talking all about hauntaviruses, and so
Speaker 1: what you just heard was an excerpt from the Book
Speaker 1: of Mice, Men and Microbes, which goes in to the
Speaker 1: history of hantaviruses, with particular focus on the Sonombree outbreak,
Speaker 1: which you'll hear a lot more about in a bit.
Speaker 3: Yeah cool, okay, cool. So let's get into our business, and.
Speaker 1: Our business is quarantine quarantinies. What are we drinking this week?
Speaker 3: This week, we're drinking the mouse Trap. It is so good,
Speaker 3: unbelievably delicious. It has, which is arguably the best liquor.
Speaker 3: I'm not even gonna I'm that's I'm immediately cutting that.
Speaker 3: It could be, it could be argued, but I think
Speaker 3: I have a different one in mine. Anyway.
Speaker 1: It's also got rosemary, simple syrup, blood orange juice, lime juice,
Speaker 1: and a splash of soda water. So we will post
Speaker 1: the recipe for this quarantiny the mouse Trap, as well
Speaker 1: as the Place Barrita on all of our social media.
Speaker 3: Which is our non alcoholic version of our quarantine. You'll
Speaker 3: be able to find the full recipes on our website
Speaker 3: as well as this podcast Will Kill You on Facebook
Speaker 3: and Instagram and TPWKY on Twitter.
Speaker 1: Okay, so I'm very excited for this episode. And I
Speaker 1: know that I say that every episode, and I genuinely
Speaker 1: mean it every episode, because.
Speaker 3: Every episode is exciting. It's something new, and we learn
Speaker 3: stuff while we're researching it, and then we get to
Speaker 3: learn more stuff as we listen to each other teach
Speaker 3: us the things that we didn't know.
Speaker 1: Let's get started. Tell me about the biology.
Speaker 3: Er Okay, I'd love to. Hantavirus is aka ortho hantaviruses.
Speaker 3: This is a group of viruses. They are single stranded,
Speaker 3: they're in an envelope, and they're an RNA virus. You
Speaker 3: just learned so.
Speaker 2: Much, okay, and what is the ortho part of all that?
Speaker 3: I don't know why they changed the name from hantaviruses
Speaker 3: to ortho hantaviruses at some point recently. The phylogeny of
Speaker 3: this is confusing to me. Sometimes they call it the
Speaker 3: order bunia Viralis. Sometimes they call that the family Bunyaviridae.
Speaker 3: Who knows. If you see the word bunia virus, that
Speaker 3: is a larger group of viruses that includes the hauntaviruses.
Speaker 3: It also includes a lot of other viruses which cause
Speaker 3: horrible diseases including crime and congo hemorrhagic fever, rift valley
Speaker 3: fav several different encephalitis viruses, and so many more.
Speaker 2: So this is a pretty.
Speaker 1: Gnarly family group.
Speaker 3: It's a gnarly group order of viruses. It's a gnarly
Speaker 3: group of viruses that love to infect humans, which not
Speaker 3: all virus groups love to do that these ones do.
Speaker 3: What's interesting about hantaviruses specifically in this family or order
Speaker 3: or whatever is that they're the only ones, for the
Speaker 3: most part, that aren't transmitted by ticks and mosquitoes. So
Speaker 3: most of the other viruses in this Bunya Veridae or
Speaker 3: buniavialis group are transmitted by ticks or mosquitoes, not hantaviruses, right,
Speaker 3: So hantaviruses, in contrast, are transmitted through rodent excrement yummies.
Speaker 3: So fun. What I love is that so arthropod born
Speaker 3: viruses that are transmitted by ticks and mosquitoes are often
Speaker 3: called arboviruses. You could call these roboviruses rodent born. I
Speaker 3: love it anyways, very very sci fi. It's very sci fi.
Speaker 3: So hontaviruses are transmitted by rodent excrement. What does that mean.
Speaker 3: It means that these viruses live their life cycle inside
Speaker 3: of rodents, and they're naturally found in rodent populations honestly
Speaker 3: across the globe. Various different hantaviruses are found in almost
Speaker 3: every continent, in different rodent species, and they circulate in
Speaker 3: these rodent populations really without causing a lot of damage.
Speaker 3: They don't harm the rodent populations. Really, They kind of
Speaker 3: do okay.
Speaker 1: Overwintering survival.
Speaker 3: Okay, so that counts. But they don't cause the kind
Speaker 3: of damage that they cause in humans in general, in
Speaker 3: the rodent populations, which suggests that they have sort of
Speaker 3: a history like these are the groups of animals that
Speaker 3: they are sort of evolved to infect, if that makes sense.
Speaker 3: So in humans hantaviruses, of which there are a number,
Speaker 3: and I'll tell you the names of a bunch of them,
Speaker 3: they cause two major diseases, sort of two distinct groups
Speaker 3: of illnesses. The first that you might have heard of
Speaker 3: is called hantavirus pulmonary syndrome. You've heard of that aaron,
Speaker 3: of course, and the other is called hemorrhagic fever with
Speaker 3: renal syndrome.
Speaker 1: That sounds quite bad, right if you had.
Speaker 3: To guess like, which one of that sounds the worst?
Speaker 1: I mean hemorrhagic fever. I would automatically say, oh my.
Speaker 3: Gosh, that sounds terrible.
Speaker 1: Right, But knowing hantaviruses and this leading.
Speaker 3: Question, so yes, it's actually hantavirus pulmonary syndrome that is
Speaker 3: the more severe of the disorders. So what I'm gonna
Speaker 3: do is I'm gonna go through each of these two disorders,
Speaker 3: hantavirus pulmonary syndrome and hemorrhagic fever with renal syndrome, talk
Speaker 3: about what's different about them, and then talk about what's
Speaker 3: similar about them. Sounds good, cool, sounds great. So hauntavirus
Speaker 3: pulmonary syndrome, We'll start with that because it's my personal favorite,
Speaker 3: and it's the one that's the one that people are
Speaker 3: probably more familiar with if you live in the United States,
Speaker 3: because this is caused primarily by sindombree virus, and this
Speaker 3: is the hauntavirus that exists in the United States in
Speaker 3: the Southwest. It's hosted or its its reservoir host is
Speaker 3: the deer mouse.
Speaker 1: I like the term hosted.
Speaker 3: Actually it's hosted by the lovely deer mouse, and it
Speaker 3: causes a disease that has a death rate of thirty
Speaker 3: eight to fifty percent.
Speaker 1: That's enormous.
Speaker 3: It's enormous. It's a very very scary illness. So here's
Speaker 3: how it happens. There's four different phases of HPS hauntavirus
Speaker 3: pulmonary syndrome. Okay, it starts after an incubation period of
Speaker 3: between nine and twenty four days, usually about one to
Speaker 3: five weeks, which is a pretty wide incubation period. And
Speaker 3: that's again the time from when you're infected to the
Speaker 3: time when you first show symptoms. And so after that
Speaker 3: incubation period, the first phase is the febrile phase. Febrile
Speaker 3: means fever, so as you can guess, this starts with
Speaker 3: a fever. You'll also have muscle aches and malaise. You'll
Speaker 3: probably have a headache, some dizziness kind of like you
Speaker 3: have the flu. You might even have some nausea or
Speaker 3: abdominal pain. But what's important is that you don't have
Speaker 3: upper respiratory symptoms like you would with the cold or
Speaker 3: the flu, So no stuff, no sore throat things like that.
Speaker 3: You could end up with a cough at the end
Speaker 3: of this phase. Now, this phase, the febrile phase lasts
Speaker 3: between three and five days, but it could last as
Speaker 3: long as twelve.
Speaker 1: So again, is it because are these wide ranging incubation
Speaker 1: times and certain phases because there are just a relatively
Speaker 1: low number of cases that for comparison proper. Is it
Speaker 1: just that the virus really is host like individual dependent.
Speaker 3: I think it's probably a combination of both. So hantavirus
Speaker 3: pulmonary syndrome. We don't there's not There haven't been a
Speaker 3: ton of cases of this, so you're definitely gonna have
Speaker 3: wider variation because of that when you have a small
Speaker 3: sample size. But it's also very likely that your exposure
Speaker 3: will determine how much virus you're exposed to, and then
Speaker 3: that can have a really huge impact on incubation period.
Speaker 2: Right. Yeah.
Speaker 1: Also, I really like that this is just a total
Speaker 1: side note, but it started with a fever.
Speaker 2: Would have also been a great name for this podcast.
Speaker 1: It would have been.
Speaker 3: Oh shit, oh god, that's a good name. That's future podcast,
Speaker 3: Future podcast. And the bummer about this first phase is
Speaker 3: that it's super hard to diagnose because your symptoms are
Speaker 3: very nondescript, and you're about to see that after this phase,
Speaker 3: it gets bad really quick. So phase two is the
Speaker 3: cardiopulmonary phase. This is the beefy part of the disease,
Speaker 3: and it happens really fast. Within twenty four to forty
Speaker 3: eight hours after these symptoms start, up to fifty percent
Speaker 3: of infected people will die. Ooh yeah. So basically you
Speaker 3: present with shock and pulmonary edema. So let's talk about these.
Speaker 3: We've talked about shock before. Shock is what happens when
Speaker 3: for some reason, your blood pressure is going to drop
Speaker 3: and you're not going to get blood profusion to your tissues,
Speaker 3: so your organs are going to start to die because
Speaker 3: they don't have adequate blood flow. In this case, the
Speaker 3: symptoms that happen are in large part due to what's
Speaker 3: called vascular permeability, which means your blood vessels become leaky,
Speaker 3: especially the blood vessels in your lungs. So the fluid
Speaker 3: that's supposed to be in your blood vessels, aka your blood,
Speaker 3: starts leaking out into the space between your cells in
Speaker 3: your lungs, and that results in what's called pulmonary edema,
Speaker 3: which means fluid on your lungs.
Speaker 1: Oh so I knew that that's what that meant, but
Speaker 1: I didn't know how that happened. Yeah, that's very interesting.
Speaker 3: That's how it happens in this case. Pulmonary deal can
Speaker 3: happen other ways as well. Yeah, oh, I want to
Speaker 3: know all the ways. I'm sure we'll have so many
Speaker 3: diseases to talk about. Various forms of pulmonary edema. But
Speaker 3: it's often from fluid leaking out from your your blood vessels.
Speaker 3: It's not always straight up blood like in this case.
Speaker 3: It's often whole blood that's able to get through. Sometimes
Speaker 3: it's just plasma or just like the fluid and not
Speaker 3: like your entire like red blood cells and stuff. It
Speaker 3: just depends on how big the holes that are allowing
Speaker 3: the leakage are. If that kind of.
Speaker 1: Makes that's so interesting, it's very cool.
Speaker 3: You can imagine that all of this edema makes it
Speaker 3: really hard to breathe. It also because your heart is
Speaker 3: sort of right in between your lungs, makes it hard
Speaker 3: for your heart to beat, and so that's why you
Speaker 3: end up going into cardiogenic shock, which means your heart
Speaker 3: The reason that you go into shock is because your
Speaker 3: heart is not pumping enough blood out.
Speaker 1: And that's only because it's restricted in space by your
Speaker 1: lungs filling up with your own fluid slash blood.
Speaker 3: Yeah, and because you're bleeding out into your own body,
Speaker 3: so there's not enough blood getting to your heart, so
Speaker 3: it's a double.
Speaker 1: Your blood pressure is just like exactly totally down.
Speaker 3: Yeah, yeah, cool, right, So.
Speaker 1: This result is horrifying.
Speaker 3: It's very horrifying. There's because of this, because of all
Speaker 3: the blood that you're leaking out, your blood is then
Speaker 3: not making it to your other organs, so your kidneys
Speaker 3: will likely start to fail, so you might end up
Speaker 3: with what's called aliguria, which means low urine, few urine,
Speaker 3: it's not good. And yeah, so that basically fifty percent
Speaker 3: of people are going to die. However, the other fifty
Speaker 3: percent or sometimes more, it could be as low as
Speaker 3: thirty percent of people who die, So fifty to seventy
Speaker 3: percent of people will then somehow progress to the diuretic phase,
Speaker 3: which is phase three of this disease, which is when
Speaker 3: your pulmonary edema clears up, your urine output increases, and
Speaker 3: the fever and shock resolve. Okay, don't ask me exactly
Speaker 3: how that happens. Yeah, I would love to have a
Speaker 3: great answer on that. It is unclear to me if
Speaker 3: you're you're an output goes low, that's a very bad sign.
Speaker 3: If you then all of a sudden start peeing out
Speaker 3: a lot, that's actually a good sign because it means
Speaker 3: that something is somehow your body is trying to re equilibrate,
Speaker 3: and then you're entering the diuretic phase. After that, you're
Speaker 3: in what's called the convalescent phase, which can last for
Speaker 3: several months. So this is a very long recovery period
Speaker 3: and often often people recover fully, but it is also
Speaker 3: possible to have long term pulmonary symptoms, like decreased blood
Speaker 3: flow in your lungs because of just how much damage
Speaker 3: has been caused.
Speaker 1: Okay, that's yeah, yeah, and how like the damage in
Speaker 1: your lungs is caused by the like in the blood
Speaker 1: vessels themselves or yeah.
Speaker 3: We'll talk about exactly what causes that, what allows for
Speaker 3: that blood to leak out in just a second, because
Speaker 3: it's it's a really important part of this disease. So
Speaker 3: that's HPS hantavirus pulmonary syndrome. Let's talk about hemorrhagic fever
Speaker 3: with renal syndrome. So this is the other form of
Speaker 3: hantavirus which many people I guess if you live in
Speaker 3: Europe or Asia, this might be what's more familiar to you.
Speaker 3: If you live in the US, you might never have
Speaker 3: heard of this. This is caused by a number of
Speaker 3: different hauntaviruses, including soul virus, which was first discovered in Soul,
Speaker 3: Korea and is hosted by the Norway rat, and the
Speaker 3: black rat. Hatan virus also discovered in Korea, which is
Speaker 3: hosted by the striped field mouse. Uh, pumala is that
Speaker 3: how you say that? Pumala pumala virus which is from
Speaker 3: Finland and hosted by the bank vowl. And do Brava virus,
Speaker 3: do brava do brava, dobrava virus whatever, which one of
Speaker 3: those covered in Slovenia and is hosted by the yellow
Speaker 3: necked field mouse. Oh, that's a lot of viruses. So
Speaker 3: all of these viruses, which are different haunted viruses, cause
Speaker 3: various forms of HFRS hemorrhagic fever with renal syndrome.
Speaker 1: This is so one of the things, just to pause
Speaker 1: that I noticed too many acronyms tell me about it.
Speaker 1: It's ridiculous. It's ridiculous, Okay. So then the hemorrhagic one, So.
Speaker 3: The hemorrhagic one. We've got at least four different viruses
Speaker 3: that we're talking about here, and they cause the same disease,
Speaker 3: but with varying degrees of severity. So, for example, Pumala
Speaker 3: virus in Finland has a very low estimated mortality rate
Speaker 3: between one and three percent, whereas Hatan virus has a
Speaker 3: mortality rate of between five and fifteen percent, so it's
Speaker 3: a much more severe illness. What's interesting is that because
Speaker 3: these viruses cause diseases of varying severity in different countries,
Speaker 3: they have different names for them. So for a while,
Speaker 3: the disease that hunt On virus causes was called KHF
Speaker 3: or Korean hemorrhagic fever. Pumla virus it's often the disease
Speaker 3: it causes is often called nephropathia epidemica. It's absurd, they're
Speaker 3: all the same disease. I'm gonna argue, and hopefully you'll
Speaker 3: agree with me by the end of this episode, that
Speaker 3: all of the diseases caused by hauntavirus should be called
Speaker 3: the same thing. I'm not alone. I have an article
Speaker 3: to site for it, so let's get into it. HFRS
Speaker 3: it has five stages, not just four like we saw
Speaker 3: with HPS, and it starts similarly first phase febrile fever,
Speaker 3: muscle aches, headache, nausea. You also might get flushing of
Speaker 3: your face, and that's because again we know there's going
Speaker 3: to be vascular involvement, and so anytime your your blood
Speaker 3: vessels are dilating, you might get flushing of your face
Speaker 3: because you've got blood flow there. That makes sense, Yeah,
Speaker 3: And you'll move more quickly into the second phase, which
Speaker 3: is the hypotensive phase. So this is again where your
Speaker 3: blood pressure drops. You'll also likely have what's called thrombocytopenia,
Speaker 3: which you also do see in HPS, and it just
Speaker 3: means that you have a low platelet count. A low
Speaker 3: platelet count is bad because it means you're likely to
Speaker 3: bleed out. So platelets are what's responsible for clotting. So
Speaker 3: without platelets, you are at a higher risk of bleeding.
Speaker 3: So then because of the thrombocidopenia, you might have certain
Speaker 3: skin bleeding manifestations little red purple dots, which basically are
Speaker 3: small hemorrhages happening under your skin. And then you'll move
Speaker 3: into the oliguric phase, which though we didn't have a
Speaker 3: phase called oliguria in HPS, we did see that you
Speaker 3: also have a drop in your an output. The biggest
Speaker 3: difference here is that the effects of h FRS tend
Speaker 3: to happen mostly in the kidneys instead of in the lungs.
Speaker 3: So we see your kidneys starting to fail first rather
Speaker 3: than your lungs filling up with fluid. So you're not
Speaker 3: gonna have a cough, You're not going to have the
Speaker 3: pulmonary edema. Does that make sense?
Speaker 1: Why? Why are they different? Or is that am I
Speaker 1: jumping the gun?
Speaker 3: You're jumping the gun a little bit. Let's finish out
Speaker 3: this HFRS. Once you see that decrease in you're an output,
Speaker 3: it's bad news. But again, HFRS overall has a much
Speaker 3: lower mortality rate. So most people are going to start
Speaker 3: to recover, and then they'll enter the polyuric phase, which
Speaker 3: means a lot of p they'll start to diaryse and
Speaker 3: pee a whole bunch out, uh, and then convalesce.
Speaker 2: Cool.
Speaker 3: Cool, So the question is not cool, It's terrible. Not cool.
Speaker 3: But here's the thing what I think is really important
Speaker 3: and what makes these diseases really really cool, and also
Speaker 3: why pathophysiology is my favorite subject. Right now is that
Speaker 3: even though these sound like okay, HPS, you're going to
Speaker 3: have fluid all over your heart and lungs and you're
Speaker 3: going to die because you can't breathe and your heart
Speaker 3: can't beat HFRS. Your kidneys are going to shut down,
Speaker 3: and maybe you'll be able to recover, and maybe you won't.
Speaker 3: These two seem like very different diseases, but they're not.
Speaker 3: They're so closely related, and if you understand what's happening
Speaker 3: inside of your cells, it's the exact same thing. So
Speaker 3: here's what happens. Hantaviruses infect your endothelial cells. These are
Speaker 3: the cells that line your blood vessels. Okay, they get
Speaker 3: into those endothelial cells, they replicate, and they cause damage.
Speaker 3: They don't necessarily kill the cells themselves, but they cause
Speaker 3: enough damage that other cells come in and things like
Speaker 3: histamine are released, which causes vasodilation and increased vascular permeability.
Speaker 3: This means that your blood vessels are now leaky, so
Speaker 3: you have fluid loss and blood loss and hypotension. This
Speaker 3: is the exact same mechanism that happens in HPS and
Speaker 3: in HFRS. The only difference is what tissue is the
Speaker 3: hantavirus primarily infecting the endothelial cells of your lungs or
Speaker 3: the endothelial cells of your kidneys.
Speaker 1: And why is there a difference, Like, why is there
Speaker 1: a differential preference?
Speaker 3: Right that no idea?
Speaker 1: Huh yeah? Interesting, right? Is it really sort of this
Speaker 1: old world new world situation in terms of pulmon versus renal?
Speaker 3: Yeah, so the ones in South America do tend to
Speaker 3: cause more HPS like symptoms, at least from what I read. Okay,
Speaker 3: so yeah, it's just it's so interesting, hmm. But yeah,
Speaker 3: they are transmitted in exactly the same way. So they're
Speaker 3: transmitted in the excrement of rodents. So basically you have
Speaker 3: to aerosolize pee or poop from a rat or a
Speaker 3: mouse or a vole that's infected and inhale it. But
Speaker 3: what I think is so cool is that you have
Speaker 3: these two diseases which on their face seem so different,
Speaker 3: and yet the underlying mechanism that causes the disease is
Speaker 3: exactly the same.
Speaker 1: Yeah, that's super interesting.
Speaker 3: Oh, I should say very importantly, for the most part,
Speaker 3: the disease cannot be transmitted person to person. There's like
Speaker 3: one case where it possibly a huntavirus. Andy's virus in
Speaker 3: South America was possibly transmitted person to person, but every
Speaker 3: other hauntavirus in as many studies as they've tried, has
Speaker 3: never been shown to be able to be transmitted from
Speaker 3: person to person. It's exclusively from aerosolized rodent excrement. So, Aaron,
Speaker 3: tell me about this. How did we get here? How
Speaker 3: did this all start?
Speaker 1: Okay? I think I can answer that. When we picked
Speaker 1: hantaviruses to cover this season, I don't think either of
Speaker 1: us realized just how large the world of hantaviruses it is,
Speaker 1: and also how much the story is still developing. Okay,
Speaker 1: but before we get to where we are today, let's
Speaker 1: as always go back to where we started, or at
Speaker 1: least where the virus started. Hantaviruses have been around for
Speaker 1: millions of years. They can be found in rodents on
Speaker 1: every continent except for Antarctica, and their diversity is astounding.
Speaker 1: But when did humans start to get involved?
Speaker 3: Yeah?
Speaker 1: As early humans began to farm and form stationary settlements
Speaker 1: and store food, which is a key factor, many rodent
Speaker 1: species settled with them, and the easy access to food
Speaker 1: and shelter promoted this close relationship. Because of this, humans
Speaker 1: have probably been exposed to or infected with hantaviruses for millennia,
Speaker 1: but it's not until really, like a long time ago,
Speaker 1: nine hundred and sixty a D. I'm like, oh, but
Speaker 1: it's not until that time, right, So nine hundred and
Speaker 1: sixty a D. Thousand years ago that we get our
Speaker 1: first bit of evidence for this, a Chinese medical account
Speaker 1: of a disease that sounds a whole lot like heemorrhagic
Speaker 1: fever with renal syndrome. But then it more or less
Speaker 1: disappears from medical textbooks for almost a thousand years. Although
Speaker 1: side note, some people believe that the mysterious sweating sickness
Speaker 1: that plagued England and continental Europe during the fifteenth and
Speaker 1: sixteenth centuries might have been caused by a haunt of virus.
Speaker 1: Really yeah, so apparently the symptoms were fairly similar. There
Speaker 1: was this seasonal pattern and in these irregular intervals. Oh,
Speaker 1: but it's still.
Speaker 2: Far from conclusive.
Speaker 1: So, for one thing, this sweating sickness seemed to be
Speaker 1: transmitted person to person, which is rarely or never seen
Speaker 1: in hantavirus outbreaks. And for another, outbreaks appeared sudden and
Speaker 1: disappeared suddenly without any mention of previous cases or reports
Speaker 1: of rodent population increases. But just in case, we should
Speaker 1: probably do a full episode on sweating sickness, just to
Speaker 1: you know, cover the basics.
Speaker 3: It's only, yeah, it is, it is.
Speaker 1: In any case, it's not really until the eighteen sixties
Speaker 1: that we get a clearer sense of hauntavirus outbreaks in humans.
Speaker 1: In the US. In the eighteen sixties, the essa's were
Speaker 1: not very u what in the US, I was so
Speaker 1: dorky erin.
Speaker 2: I liked it.
Speaker 1: It's pretty dorky.
Speaker 3: It's good, okay, So the s's aren't so you.
Speaker 1: The American Civil War was raging, as were cases of
Speaker 1: what was being called war nephritis or trench nephritis. The
Speaker 1: outbreak reached its peak between eighteen sixty two and eighteen
Speaker 1: sixty three, and an estimated fourteen thousand soldiers came down
Speaker 1: with this disease, whose symptoms strongly resembled that of the
Speaker 1: hantavirus caused field nephritis experienced by troops in Flanders during
Speaker 1: World War I. Hantavirus infections make another appearance again in Wars,
Speaker 1: this time a little more global, when the Japanese military
Speaker 1: invaded Manchuria, and also during World War II in Finnish
Speaker 1: and German soldiers. These outbreaks prompted modern descriptions of the disease,
Speaker 1: though the link between the European and Asian infections was
Speaker 1: yet to be discovered. Scientists investigating these diseases had plenty
Speaker 1: to keep them occupied and maybe a bit too much license.
Speaker 1: At this point, you may have noticed the link between
Speaker 1: these infections and war conditions. The disease was seen most
Speaker 1: commonly in soldiers, and not just any soldiers, but ones
Speaker 1: who were huddled in trenches for long bouts of time.
Speaker 1: Researchers in the nineteen thirties and forties also picked up
Speaker 1: on this, and they started looking for the root of transmission.
Speaker 1: Rodents were immediately implicated, as were arthropods such as mites
Speaker 1: and ticks, which were also common and crowded conditions like that, right,
Speaker 1: But how to test?
Speaker 2: How to test?
Speaker 1: How about human experimentation? Of course, great choice, not really,
Speaker 1: but it is the choice that some Japanese scientists opted
Speaker 1: for during World War II, the most notorious of these
Speaker 1: programs being Unit seven hundred and thirty one, whose official
Speaker 1: innocuous title was the Epidemic Prevention and Water Purification Department.
Speaker 1: Throughout the eight year existence of this program, over three
Speaker 1: thousand men women in CHLDREN, both prisoners of war as
Speaker 1: well as civilians, were experimented on, with death being the
Speaker 1: most common outcome. There was frostbite testing, vivisection with no
Speaker 1: anesthetic injections with various infectious diseases, including hantavirus material even
Speaker 1: though they didn't know exactly what that was yet. This
Speaker 1: is world's weapons, he's testing. Yes, Oh my god, Oh
Speaker 1: just wait, it gets so much worse.
Speaker 3: I know it's just humans, man.
Speaker 1: Yeah, weapons testing, starvation and dehydration. Really, the list goes
Speaker 1: on and on and on. The Results of many of
Speaker 1: these experiments were published in peer reviewed journals, with any
Speaker 1: mention of human subjects changed to a non human primate species.
Speaker 3: WHOA are you serious? So they fully It's not like
Speaker 3: they were just like, oh, it's fine. They were like,
Speaker 3: we know this is not fine. We're just gonna do
Speaker 3: it anyway and pretend like we did it on a monkey.
Speaker 1: Yeah.
Speaker 3: Cool, cool, cool cool cool right cool cool.
Speaker 1: Okay, but I haven't even gotten to one of the
Speaker 1: most outrageous parts of this okay, which is that when
Speaker 1: the US found out about this human experimentation, instead of
Speaker 1: prosecuting any of the researchers or leaders involved in Unit
Speaker 1: seven three to one, the US granted them complete immunity
Speaker 1: as long as they provided all of their results to
Speaker 1: the US and none of the other allies, namely the
Speaker 1: Soviet Union.
Speaker 3: It is zero percent surprising, quite honestly.
Speaker 1: I know, which is also very sad.
Speaker 3: It's very sad, not surprising.
Speaker 1: Yeah, but you should, really like if you have time,
Speaker 1: just check out the Wikipedia page, even with just a skims.
Speaker 1: It is shocking and just something that deserves a lot
Speaker 1: more attention than I'm giving it right now. So maybe
Speaker 1: another episode anyway. But yeah, Unit seven three to one
Speaker 1: was unsuccessful in determining the causative agent of the war
Speaker 1: associated hemorrhagic fever, and they still didn't have a conclusive
Speaker 1: answer for how it was transmitted. And they weren't alone
Speaker 1: both in their human experimentation and in their failure. The
Speaker 1: Soviet Union had their own experiments running around at the
Speaker 1: same time, in which they injected human quote volunteers with
Speaker 1: various materials to try to bring about infection. By nineteen fifty,
Speaker 1: various European and Asian countries were familiar with hauntavirus caused
Speaker 1: infections and their association with rodents, even if they still
Speaker 1: didn't know what a hauntavirus was. It's going to take
Speaker 1: another war to get the interest in funding to solve
Speaker 1: that problem. In this case the Korean War. Tensions had
Speaker 1: been running high between North and South Korea for a
Speaker 1: long time, and it came to a head in June
Speaker 1: of nineteen fifty when North Korean troops invaded South Korea,
Speaker 1: seeking complete control of the divided country. UN forces, largely
Speaker 1: comprised of US military, were sent to South Korea to
Speaker 1: stop this offensive. The war lasted three years and resulted
Speaker 1: in casualties ranging in the tens of thousands to over
Speaker 1: a million dead. As in all wars, combat is just
Speaker 1: one of the leading causes of death, often going hand
Speaker 1: in hand with things like starvation and disease, and with
Speaker 1: so much of this war fought in the trenches and
Speaker 1: the frontline barely moving from the thirty eighth Parallel Trench,
Speaker 1: nephritis or hemorrhagic fever with renal syndrome was one of
Speaker 1: those diseases. In general case estimates of hemorrhagic fever aren't
Speaker 1: very good for this conflict, but we do know that
Speaker 1: approximately thirty two hundred UN soldiers came down with the
Speaker 1: illness and a hundred and twenty one died. Obviously, this
Speaker 1: got people searching for the source of the infection. Ticks
Speaker 1: and fleas and mites were once again investigated and ruled out,
Speaker 1: and rodents were found to be the likely culprit, and
Speaker 1: not just any rodent, Epidemus agrarius the Asian striped field mouse.
Speaker 1: Similar disease ecology research was being done in fenaes Gandia
Speaker 1: to narrow down which rodent might be responsible for disease
Speaker 1: outbreaks there. In that case, a totally different species was implicated,
Speaker 1: as you mentioned Myoti's Gleriolus the bank full. But if
Speaker 1: there was any hope of lessening the suffering caused by
Speaker 1: this disease, the causative agent still had to be identified,
Speaker 1: and that's where doctor Ho Wang Lee comes in. A physician, epidemiologist,
Speaker 1: and virologists from South Korea. Doctor Lee had set his
Speaker 1: sights on discovering what was hiding in these rodents that
Speaker 1: caused illness and humans, and in nineteen seventy six he
Speaker 1: achieved his goal when he found evidence of viral anti
Speaker 1: predominantly in lung tissue of an Asian striped field mouse.
Speaker 1: So it's in the lungs of these guys. Yeah. He
Speaker 1: would go on to develop a diagnostic test for hemorrhagic
Speaker 1: fever with renal syndrome and a vaccine for a strain
Speaker 1: of hantavirus, as well as a lot of other really
Speaker 1: important ecological and medical research on hantaviruses and side note, actually,
Speaker 1: according to Wikipedia, he is the first person in the
Speaker 1: history of medicine to identify a virus that causes human disease,
Speaker 1: develop a diagnostic tool for the disease, and develop a
Speaker 1: vaccine for it as well.
Speaker 2: To do all three.
Speaker 1: That's cool. Yeah, isn't that amazing?
Speaker 2: It's really cool. Okay, we're at.
Speaker 1: The point in the story where I tell you the
Speaker 1: etymology of our pathogen or disease. While in general the
Speaker 1: trend has been going away from using things like the
Speaker 1: name of a country or city in naming off and
Speaker 1: other geographical markers are still used, doctor Lee chose to
Speaker 1: name the virus after the Hantan River. This river flows
Speaker 1: near the third eighth parallel, which divides north from South Korea.
Speaker 1: This area was a hotspot for hemorrhagic fever with renal
Speaker 1: syndrome during the Korean War, and continued to be an
Speaker 1: endemic region for the disease after the war had ended.
Speaker 1: But in his book, doctor Lee explains that he didn't
Speaker 1: just name the virus for the river's association with the disease,
Speaker 1: but also because to him it represented the tragic history
Speaker 1: of the country and hopes for reunification. The name, as
Speaker 1: you know, stuck. The virus plagued that part of the
Speaker 1: world would be known as the Hanton virus and it
Speaker 1: would soon gain many relatives. So earlier when you mentioned that,
Speaker 1: is that hantaviruses are transmitted by through rodent excrement, whereas
Speaker 1: all the other bunevide are transmitted through arthropods. So some
Speaker 1: researchers believe that it could indicate that huntaviruses are actually older.
Speaker 1: They are a more basal subgroup within Bunia verde.
Speaker 2: Oh cool, yeah, Okay.
Speaker 1: Anyway, with this diagnostic test that doctor Lee had developed,
Speaker 1: it was now possible to test patients from all over
Speaker 1: the world, particularly in those regions where a similar hamorrhagic
Speaker 1: fever or renal syndrome of unknown origin was known to
Speaker 1: pop up. This led to the discovery of pumaa virus,
Speaker 1: soul virus, prospectil virus, etc. You know, all these other viruses,
Speaker 1: and these viruses were all similar but not identical, and
Speaker 1: their discovery hinted at the enormous diversity that this group
Speaker 1: of viruses would later be found to have.
Speaker 3: So cool.
Speaker 1: On that note, let's travel to the American Southwest, May
Speaker 1: nineteen ninety three.
Speaker 3: Yes, I've been waiting for this.
Speaker 1: Bill Clinton as president. Beanie babies have just hit the
Speaker 1: shelves for the first time. Oh my god, the sandlot
Speaker 1: is in theaters. Two Princes by the spin Doctors, is
Speaker 1: on the radio. And in the Four Corners region of
Speaker 1: the US, which is where Colorado, Utah, Arizona, and New
Speaker 1: Mexico meet, is in the early stages of a terrifying
Speaker 1: and tragic outbreak of unknown origin. A twenty one year
Speaker 1: old Navaja woman named Florena Woody, mother to a five
Speaker 1: month old son, started feeling achy and feverish. Within a
Speaker 1: couple of days, her symptoms progressed into pneumonia, and she
Speaker 1: began to have difficulty breathing. At the hospital where she
Speaker 1: was admitted, the doctors tried in vain to keep her
Speaker 1: oxygen levels high and her lung fluid levels low. Eleven
Speaker 1: days after the first symptoms appeared, Florina died on Mother's
Speaker 1: Day in nineteen ninety three. Her fiance, a nineteen year
Speaker 1: old Navajo man named Meryl Bahee, a terrific athlete, felt
Speaker 1: too sick to attend her funeral, and some of his
Speaker 1: relatives decided to drive him to the hospital. As his
Speaker 1: condition rapidly deteriorated. On the drive to the hospital, Merrill
Speaker 1: began gasping for air and collapsed. He was pronounced dead
Speaker 1: on arrival, five days after the death of Florina. It's
Speaker 1: five months, so baby, heartbreaking.
Speaker 2: Yeah, it's horrible.
Speaker 1: It's horrible, and the deaths of these two otherwise healthy
Speaker 1: young individuals threw up red flags for the attending physician,
Speaker 1: who alerted the state Medical Examiner's office and the Indian
Speaker 1: Health Service IHS. Epidemiologist. Autopsies revealed that Florina and Meryl
Speaker 1: had essentially drowned as their lungs filled up with fluid,
Speaker 1: and the medical examiner realized she had seen a similar
Speaker 1: case just a month prior.
Speaker 3: Huh.
Speaker 1: More calls followed, and as different branches of the IHS
Speaker 1: learned of the mysterious deaths, A couple other similar cases
Speaker 1: came to light. In total, five severe illnesses with respiratory
Speaker 1: symptoms were put in a report which was distributed to
Speaker 1: hospitals all over the Four Corners area, asking physicians to
Speaker 1: look for similar cases. Within a few weeks, twenty four
Speaker 1: suspected cases had been identified, mostly adults or young adults,
Speaker 1: mostly otherwise healthy. The hunt for the cause had begun
Speaker 1: and it was all hands on deck. The CDC showed
Speaker 1: up in full force with EIS agents decked out in
Speaker 1: their spacesuits, and every lead was followed. Could it be
Speaker 1: pneumonic plague? This region is endemic for plague and neumonic
Speaker 1: plague carries a high mortality rate, but that form was
Speaker 1: rare there and screening quickly ruled it out. What about
Speaker 1: a nineteen eighteen like influenza? There were some striking similarities,
Speaker 1: the health and youth of most of the victims, the drowning,
Speaker 1: and the lungs. It seemed plausible another influenza outbreak like
Speaker 1: the nineteen eighteen one would be well horrible. Yeah, yeah,
Speaker 1: you know, especially if you've listened to our first episode. Yeah,
Speaker 1: but again, Tests came back negative. Maybe it wasn't an
Speaker 1: infectious disease at all. Maybe it was a poison, which
Speaker 1: is another common cause of acute respiratory distress. But testing
Speaker 1: of homes revealed no potential poisons. The usual suspects were out.
Speaker 1: It was time to widen the search. Tissue samples from
Speaker 1: those killed by the infection were sent to the CDC
Speaker 1: in Atlanta, Georgia to screen against their enormous database of pathogens.
Speaker 1: Several different types of viruses were selected for the first
Speaker 1: run due to the way they caused disease. Among these
Speaker 1: were hauntaviruses, fortunately, which matched the tissue samples. There it
Speaker 1: was the first piece of this puzzle. Ah, But in
Speaker 1: some ways this clue raised a lot more questions, like
Speaker 1: is this a virus we've seen before or is this
Speaker 1: a brand new species of hantavirus? And if it's a
Speaker 1: brand new, where did it come from? And why are
Speaker 1: we only seeing it now?
Speaker 3: Yeah nineteen ninety three? Like where did this just pop about?
Speaker 3: Of nowhere from?
Speaker 1: Yeah?
Speaker 3: Tell me.
Speaker 1: By this time, the press had picked up on this
Speaker 1: apparent outbreak, and as per usual, began wild speculations as
Speaker 1: to the cause of the disease. They also gave it
Speaker 1: a name, initially Navajo flew terrible. Yeah. Yeah when they
Speaker 1: gave it this name because the first several people who
Speaker 1: were infected with the virus were a Navajo. But this
Speaker 1: name was both stigmatizing and inaccurate. Since this was a hantavirus,
Speaker 1: close association with rodents was undoubtedly implicated as a risk
Speaker 1: for infection, and in popular media it was implied that
Speaker 1: living in poverty or unsanitary conditions greatly increase that risk,
Speaker 1: which simply wasn't true. Yeah, both rodents and the infection
Speaker 1: were not limited to any particular ethnicity or income level. Yeah,
Speaker 1: but the damage was done. Associating a diagnosis with shame
Speaker 1: often makes people less willing to come forward to either
Speaker 1: seek treatment or discuss any aspect of their disease, and
Speaker 1: with a case fatality rate of seventy five percent, this
Speaker 1: was not in the best interest of anyone. When it
Speaker 1: came time to name the virus, which had been confirmed
Speaker 1: to be a new species of huntavirus, there was an
Speaker 1: effort to be more judicious with the naming. The names
Speaker 1: of nearby geographical features were put forth and ultimately sinnombre,
Speaker 1: meaning without name, was chosen supposedly after a canyon named Sinnombre,
Speaker 1: but apparently no one has been able to find it
Speaker 1: on a map.
Speaker 3: I did not know that about the canyon. But I
Speaker 3: love the name Sinnombre virus. I think it is the
Speaker 3: most ba it is. It's so fitting for a virus
Speaker 3: that is this scary.
Speaker 1: Yeah, well it was. It was so contentious. The naming
Speaker 1: was so contentious because like the CDC wanted to name
Speaker 1: it one thing, and someone else wanted to name it
Speaker 1: someone else, and it was just like, you know what,
Speaker 1: it is the perfect name.
Speaker 3: It's a really name.
Speaker 1: It's a shame that it can only be used once.
Speaker 1: But still, even though this name existed, the question why
Speaker 1: now remained. Yeah. The first step to answering that was
Speaker 1: to determine which animal was responsible for the outbreak. Since
Speaker 1: it was a haunt of virus, it had to be
Speaker 1: a rodent, so individuals of twelve different rodent species were
Speaker 1: rounded up and tested. The culprit Paramiscus maniculatis. The deer
Speaker 1: mouse A little babe, so cute, You're so cute. But
Speaker 1: it wasn't like deer mouse had suddenly moved move to
Speaker 1: the Four Corners region. The species actually had an enormous distribution,
Speaker 1: covering most of North America. So why was this the
Speaker 1: first time we were seeing a disease associated with it.
Speaker 1: The short answer is that deer mouse population levels in
Speaker 1: nineteen ninety three were high. Yeah. In other parts of
Speaker 1: the world, peaks of hantavirus cases were known to follow
Speaker 1: peaks and rodent populations, and this pattern has been well
Speaker 1: established in Fenescandia, for instance, where the carrier of Pumla virus,
Speaker 1: the bank Fowle, has about this three year population cycle.
Speaker 3: You guys, if you don't know, Aaron Welsh is studying
Speaker 3: voles and disease in Finland right now during the post doc,
Speaker 3: so she hal cover. She has an extra smile on
Speaker 3: her face describing the life cycle of a vol to
Speaker 3: you right now.
Speaker 1: I am very thrilled about this. I love it. I'm
Speaker 1: very thrilled. But trying to fake figure out what is
Speaker 1: driving those cycles is pretty dang complicated because it often
Speaker 1: ends up being a mixture of many things, including resource availability,
Speaker 1: predator abundance, competition within species and among different species.
Speaker 2: I mean, the list goes.
Speaker 3: On ecology, man ecology.
Speaker 1: And this means an ecology also means Long term monitoring
Speaker 1: of these rodent populations is necessary if you want to
Speaker 1: understand the cycle, especially if you want to understand the
Speaker 1: cycle enough to predict it. Unfortunately, in the Four Corners
Speaker 1: region there wasn't really extensive long term monitoring, so while
Speaker 1: anecdotal reports of high rodent populations in nineteen ninety three
Speaker 1: were plentiful, any empirical evidence of population increase was hard
Speaker 1: to come by.
Speaker 2: But there were a few clues, and El.
Speaker 1: Nino year in nineteen ninety two meant increased rainfall to
Speaker 1: the Four Corners region. This increase and rainfall meant a
Speaker 1: huge harvest year for pinion pines, which produced nuts that
Speaker 1: act as a favorite food source for our little deer
Speaker 1: mouse friends. These plentiful food resources and a relatively mild
Speaker 1: winter allowed the rodents to a survive and b throw
Speaker 1: in an extra breeding cycle which increased their population quite
Speaker 1: a bit. So researchers turn their focus to the past.
Speaker 1: This may be a newly described virus, but it wasn't
Speaker 1: new to the deer mice that carried it. In fact,
Speaker 1: it had probably been around for millions of years, adapting
Speaker 1: alongside its host, and for their scrutiny of past medical
Speaker 1: records and examination of preserved tissue showed that sinnombree virus
Speaker 1: had actually struck in the US decades before, not as
Speaker 1: extremely as it did in nineteen ninety three, but it
Speaker 1: has been around. Why it was only recognized in nineteen
Speaker 1: ninety three was probably a combination of a lot of things,
Speaker 1: like the observant eye of healthcare practitioners, rodent population dynamics,
Speaker 1: el Nino blame it on al Nino, and.
Speaker 2: Other factors.
Speaker 1: Since the nineteen ninety three outbreak of synombree virus, there
Speaker 1: has been an explosion of other hauntaviruses coming to light
Speaker 1: all over the world, some with worrying traits like is
Speaker 1: that one in South America? Possibly the andes virus? Is
Speaker 1: that transmitted person to person?
Speaker 3: Right?
Speaker 1: Who knows?
Speaker 3: Terrifying if it is.
Speaker 1: But yeah, and if that's the case, how would we
Speaker 1: even begin to control that? It's very Yeah, it is
Speaker 1: an alarming thing.
Speaker 3: Yeah, because, by the way, there is no treatment for this.
Speaker 1: No spoilers.
Speaker 3: Sorry, I should have said it in the biology.
Speaker 1: I should have asked it in the biology. But yeah,
Speaker 1: like I said, the history of hantaviruses is still ongoing,
Speaker 1: and I'm super curious to hear where we stand in
Speaker 1: terms of treatments, which apparently is nil, vaccines, et cetera. Aaron,
Speaker 1: tell me about hauntaviruses today.
Speaker 3: Please, Okay, so what part of hauntaviruses do you want
Speaker 3: to talk about the most?
Speaker 1: I want to know two things in particular, Okay, One
Speaker 1: is how many people get sick every year all over
Speaker 1: the world with these different pulmonary or hemorrhagic syndromes. And
Speaker 1: then I also want to know how are we actually
Speaker 1: preventing it?
Speaker 3: Yeah, good questions. So in the US, we'll start there.
Speaker 3: That's where we ended with the history. In the US,
Speaker 3: there have been a few outbreaks recently. Probably the most
Speaker 3: famous one that you might have heard about was in
Speaker 3: twenty twelve, there was a relatively large outbreak of HPS
Speaker 3: in Yosemite. There were ten confirmed cases and three fatalities. Yeah, yeah,
Speaker 3: so that happened. There was also in twenty seventeen an
Speaker 3: outbreak of soul virus, so not HPS but HFRS caused
Speaker 3: by soul virus in the US in eleven different states.
Speaker 3: There were sixteen people infected, and they also found thirty
Speaker 3: one infected ratteries. Tell me what's a rattery where they
Speaker 3: bringing rats?
Speaker 1: Is that real?
Speaker 3: Yeah, that's real.
Speaker 1: A rattery is something, it's a.
Speaker 3: I mean, I'm assuming that's what I have what is
Speaker 3: a rattery in my notes? But I'm assuming that's what
Speaker 3: a rattery is.
Speaker 1: It is also a village in Civil Parish in Devon, England.
Speaker 3: Well, there you go. But as of January twenty seventeen,
Speaker 3: in the US, there have been seven hundred and twenty
Speaker 3: eight cases of hantavirus that have been definitively identified across
Speaker 3: thirty six states, mostly New Mexico, Colorado, Arizona, and California. Okay,
Speaker 3: that's in the US, but obviously the US for whatever reason,
Speaker 3: has very very low case numbers. In China there are
Speaker 3: thousands of cases annually, likely between twelve and twenty thousand
Speaker 3: cases every year. In Finland there have been some years
Speaker 3: where up to three thousand cases have been reported, and
Speaker 3: then elsewhere in Europe, in Germany, in Slovenia there can
Speaker 3: be up to one thousand or so cases a year.
Speaker 3: In some areas, they've done testing to try and just
Speaker 3: figure out what serial prevalence is and it's as high
Speaker 3: as two percent, which means that up to two percent
Speaker 3: of the total population has been exposed at some point.
Speaker 3: And then there's also been clusters of cases throughout South
Speaker 3: America as well, in Paraguay, Argentina, Panama, Brazil, Uruguay, and
Speaker 3: most of these are due to Andy's virus.
Speaker 1: That's a lot of Hanta.
Speaker 3: It's a lot of Hanta. It's way more than I
Speaker 3: expected in terms of current research. It's really interesting. So
Speaker 3: there was a vaccine that was developed in the early
Speaker 3: nineties actually so I think as far as I know,
Speaker 3: it was actually before Sinombre virus was discovered. This virus
Speaker 3: was in development in China. It's called Hanta vax. It
Speaker 3: is licensed, I believe, in both China and Korea, and
Speaker 3: it's it's a vaccine. They have it, you can get
Speaker 3: it there. It's only effective for Hantan and soul viruses
Speaker 3: and it hasn't been approved for use in Europe or
Speaker 3: the US, but it's thought that it wouldn't be effective
Speaker 3: against the viruses that circulate in the US and Europe anyways. Okay,
Speaker 3: but by using this vaccine they have pretty substantially decreased
Speaker 3: the number of cases of HFRS in China.
Speaker 1: That was like twenty five years ago. Yeah, basically, so
Speaker 1: are there other vaccines, because it seems like it would
Speaker 1: be if there's already a vaccine for one hanta, it
Speaker 1: wouldn't be that difficult to make vaccines for other ones.
Speaker 3: Yeah, it's very interesting. It's interesting to me that there
Speaker 3: there's definitely a lot of research going on about vaccines.
Speaker 3: So there are various different vaccines that are in development.
Speaker 3: There aren't any others that are licensed, and from what
Speaker 3: I can tell, it seems like most of them are
Speaker 3: still in rather early phases of development. And I think
Speaker 3: that in part in the US at least, it's likely
Speaker 3: because this causes so few cases every year that there's
Speaker 3: not a lot of incentive, Right, there's not a lot
Speaker 3: of financial incentive to protect against a disease that's only
Speaker 3: caused only quote unquote seven hundred cases over the last
Speaker 3: twenty five years, right, unfortunately, right, Yeah, right, But I
Speaker 3: mean in other parts of Europe it causes a significant
Speaker 3: amount of disease, but it's not that lethal of a disease. So,
Speaker 3: but there are vaccines that are being developed. What's very
Speaker 3: cool is that a lot of the research that's being
Speaker 3: done right now is on DNA vaccines, and I will
Speaker 3: admit I don't know that much about DNA vaccines. Yeah, so, okay,
Speaker 3: most vaccines, what you're injecting is either a whole virus
Speaker 3: or parts of the outside of the virus, like the
Speaker 3: proteins of the virus, or the toxin of the bacteria,
Speaker 3: like inactivated toxoid from bacteria, because that's that's what your
Speaker 3: body is going to generate an immune response against. Are
Speaker 3: those outer proteins. DNA vaccines are vaccines that include DNA
Speaker 3: that codes for those viral proteins rather than the viral
Speaker 3: proteins themselves.
Speaker 1: Why is that an advantage over the proteins.
Speaker 3: So one thing is that it's easier to make multi
Speaker 3: valent vaccines, so you can make one plasmid that has
Speaker 3: proteins for a whole bunch of different hontaviruses.
Speaker 1: Oh m G.
Speaker 3: I'm so glad that worked really well the way that
Speaker 3: you asked that, because it's really good flow, because I
Speaker 3: had it all right there.
Speaker 2: It's good.
Speaker 3: Yeah, So it's pretty cool.
Speaker 1: I that's so cool. It's very cool.
Speaker 3: I don't know a ton about them. I know they're
Speaker 3: kind of one of these hot things in vaccines right now,
Speaker 3: and I'm sure I'll do a lot more research on
Speaker 3: them for our vaccine episode in the future. But it's
Speaker 3: very cool and it's definitely something that's in the works.
Speaker 3: In animal models, they do seem to be effective. They've
Speaker 3: started to test them on humans. But from what I understand,
Speaker 3: one of the biggest issues is the mode of delivery,
Speaker 3: So trying to make sure that the way that you
Speaker 3: deliver this DNA vaccine is going to be the most effective.
Speaker 4: So hmm, okay, yeah, that is fascinating. It's very fascinating.
Speaker 4: So there's very cool research being done right now with
Speaker 4: hantaviruses and with vaccine development. It's it's a cool area.
Speaker 3: Wow.
Speaker 1: Yeah, oh man, my mind is blown open as this
Speaker 1: DNA vaccine situation.
Speaker 2: I'm gonna have to go on a little. It's pretty good.
Speaker 1: It's pretty cool stuff. Does infection with one of the
Speaker 1: hauntaviruses make you immune to subsequent infections or make you
Speaker 1: immune to other infection to other hantavirus infections?
Speaker 3: As far as I know, it definitely does not make
Speaker 3: you immune to infection with other hantaviruses, which is part
Speaker 3: of why the haunted vax vaccine doesn't work. For Yeah,
Speaker 3: I don't know, I would assume that once you've been
Speaker 3: infected with say sin nombrevirus, if you survive, you probably
Speaker 3: won't be infected with sin noo brevirus again. Okay, yeah,
Speaker 3: so probably what everyone wants to know is how to
Speaker 3: not get haunted virus. Yeah, since we don't have a
Speaker 3: vaccine in the US.
Speaker 2: And we have friends who work on mice and voles.
Speaker 3: Yep, including you, so erin, here's how you cannot get
Speaker 3: anti virus in the future. Basically, if you are in
Speaker 3: a place like you're cleaning out your grandma's cabin or something,
Speaker 3: assume that it's invested with rats or mice, because it
Speaker 3: probably is, and first you air things out before you
Speaker 3: clean anything out. You try and get rid of any
Speaker 3: rodent infestation if you can, and don't vacuum up dry
Speaker 3: mouse poop and.
Speaker 2: Stuff or like with a broom or with a broom.
Speaker 3: Yeah, so CDC recommends that you wet everything down with
Speaker 3: ten percent bleach or some other disinfectant and let it
Speaker 3: sit for a while, and then you make sure that
Speaker 3: everything is wet essentially when you clean it up, instead
Speaker 3: of cleaning everything up when it's dry.
Speaker 1: I mean, it's if you're inhaling the particle. So just
Speaker 1: think about how to prevent yourself from inhaling these, you know,
Speaker 1: poop particles, particle, pea particles.
Speaker 3: Pea particles. Yeah, it's like a lot of bleach and
Speaker 3: spray bottles, is what the CDC recommends. They say, where
Speaker 3: protective gear and do this in a well ventilated area.
Speaker 3: Don't just sit in an attic full of ret pee.
Speaker 1: I do have a question, mm hm, how scared should
Speaker 1: we be of haunt of viruses?
Speaker 3: You living in Finland or me living in Illinois or
Speaker 3: everyone who's listening.
Speaker 1: Everyone who's listening, everyone.
Speaker 3: Who's listening, Eh, not so scared. Okay, it's a scary illness,
Speaker 3: but it's not super common and you can protect yourself
Speaker 3: from it. But yeah, I would say, not not super scared.
Speaker 3: Don't let this one keep you up at night.
Speaker 1: Okay, Well, there's plenty else to do exactly to keep
Speaker 1: us up at night.
Speaker 3: There's plenty of things to have anxiety about, versa and preanza. Yeah.
Speaker 3: So we recorded this episode a few weeks ago, and
Speaker 3: since then there have actually been some updates on the
Speaker 3: status of hauntavirus worldwide. Specifically, there have been a couple
Speaker 3: of outbreaks that have been reported since we last recorded,
Speaker 3: so I wanted to give you guys an update so
Speaker 3: that your is up to date. Possible. Number One, there
Speaker 3: have been at least one hundred and three confirmed cases
Speaker 3: that happened in Panama over the course of twenty eighteen,
Speaker 3: including fifty one of those which were classified as hauntavirus
Speaker 3: without pulmonary syndrome and forty eight that were classified as HPS,
Speaker 3: including four deaths. In Argentina, there's actually an outbreak happening
Speaker 3: currently as of January fifteenth, twenty nineteen. The most recent
Speaker 3: numbers that I've found are at least twenty eight people
Speaker 3: in the hospital currently under observation for hauntavirus infection and
Speaker 3: eleven people that have died so far. So this is
Speaker 3: an ongoing outbreak. So we'll try and keep you guys
Speaker 3: updated on Twitter and our social media as to what's
Speaker 3: going on. Update over so sources sources.
Speaker 1: I used a couple of sources. What is a book
Speaker 1: called of Mice, Men and Microbes by Andrea S. Meyer
Speaker 1: and David M. Harper. Another is called Hauntavirus Hunting by
Speaker 1: Ho Wang Lee, and so that is the man who
Speaker 1: discovered the virus did the diagnostic test vaccine, et cetera. Cool,
Speaker 1: and then finally some excerpts from a book titled Hantaviruses
Speaker 1: which is added by C. Schmall, John and st Nickel.
Speaker 1: And then also apparently in the X Files movie it's
Speaker 1: mentioned that hauntaviruses were brought by aliens. I didn't manage
Speaker 1: to watch it to verify, but amazing.
Speaker 3: Yeah, I have a number of articles. We as always
Speaker 3: will post all of our sources, books and articles on
Speaker 3: our website this podcast will kill You dot com, so
Speaker 3: you can find them all there.
Speaker 1: I really enjoyed learning about hantaviruses too.
Speaker 3: It was a fun one to research.
Speaker 2: It really was.
Speaker 3: Thank you to Bloodmobile for providing the music for this
Speaker 3: episode in all of our episodes.
Speaker 1: And thank you to you listeners and to everyone who
Speaker 1: has ever written a message to us. We really appreciate it,
Speaker 1: and we if we haven't responded, we're really sorry. We
Speaker 1: want to and we're going to try to. We're just
Speaker 1: two people and we're doing this like we each have
Speaker 1: full time jobs in addition to doing this.
Speaker 3: And this is our for funds, and it's super fun
Speaker 3: to get to hear from you guys, and we really
Speaker 3: love it, so we apologize if we have ever written
Speaker 3: you back. We've read your message and loved it, and
Speaker 3: we're trying.
Speaker 2: To reply to you all, so keep sending them.
Speaker 1: Yes, okay, okay, well wash your hands.
Speaker 3: You filthy animals.
Speaker 1: Over half a million people with boobs swear by the
Speaker 1: original True Bodybra by trueancode dot com.
Speaker 3: The True Bodybra looks amazing when you put it on,
Speaker 3: with soft fabric that smooths you out in all the
Speaker 3: right places while still giving you the support you need.
Speaker 1: The best part, it has no wires, so it's super
Speaker 1: comfortable for all day wear.
Speaker 3: Try the original True Body Bro from True in code
Speaker 3: today with free and easy returns.
Speaker 1: And say fifteen percent now when you go to trueancode
Speaker 1: dot com, slash this podcast and enter the code this podcast.
Speaker 3: That's t r u e A n d co dot com.
Speaker 3: Slash this podcast