WEBVTT
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This is a podcast about one health.
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The idea that the health of humans, animals, plants, and the environment that we all share are intrinsically linked.
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Coming to you from the University of Texas Medical Branch and the Galveston National Laboratory.
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This is Infectious Science, where enthusiasm for science is contagious.
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Hello, welcome back to the infectious science podcast.
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We are now completely online.
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We are calling in from different places.
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We haven't seen each other in a while.
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Christina, I haven't seen you in like months.
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How are you?
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It's been a really long time.
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Where are you?
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How are you doing?
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How's med school treating you after you just completely disappeared?
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What's going on in your life?
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So third year started basically.
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We took our first licensing test, step one, and then moved on to third year.
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And third year is typically just like the most rigorous year of med school.
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So you're working full time, but you're also studying full time, and it's just it's a lot after a while.
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So just hanging in there.
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But that's why I've disappeared off the face of the earth this year.
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I do apologize, but it's so good to be back.
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It's so good to see you guys too, and to get to record this and also just learn from you guys and have fun and catch up.
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So I'm excited to be here.
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I thought people always say that med school gets easier the further you get through the coursework, no?
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I would say like first two years, I would say that's consistent just because you develop study habits that really get you through the rest of the pre-clinical years.
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But then clinical years, third year is definitely the hardest year, and I would say that's typically the hardest year of the entire medical school curriculum, just because of the balance between working and studying.
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Yeah.
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And your studio looks a little studioed.
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Your uh desk looks a little different.
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Are you calling in from Galveston?
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Uh where are you currently?
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I am.
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I'm calling in from my home, which is in League City.
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But I always just say Galveston because I don't think a lot of people know where League City is.
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Yeah.
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But yeah, I'm still local, but I know Miss Camille is not.
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She got up and left.
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Where are you at, girl?
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I am in upstate New York, which is beautiful.
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It's autumn right now.
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We're recording this towards the end of October, and it's absolutely gorgeous.
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The leaves are falling, and every time I step outside, I just inhale the smell of falling leaves.
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It's so good.
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Yeah, I'm doing good.
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And I'm loving that I have access to apple orchards and like apple cider again because I miss those things in Texas.
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That sounds so wholesome as a Texanite.
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I could not imagine that.
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So Texanite.
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You've got to explore the north.
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You've got to explore the north.
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It's so gorgeous.
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And I love being in the mountains again.
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I miss the mountains when I was in Texas.
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I could never go hiking in Texas.
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I could only go like walking, at least where I lived in Texas, because it was just like so flat.
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That's something that's been so important about the state.
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I used to go hiking all the time when I was back in Reno in Nevada because we were so close to the Sierra Nevada and Lake Tahoe, all those hiking trails around there.
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Around here, if you get an elevation gain of more than 17 feet, I'll call it good.
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That is true.
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Yeah, the most elevation you gain in Galveston is like going up a set of stairs.
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That's it.
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Very fair.
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Agree.
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Very true.
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Alex, were you in Galveston right now?
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Yes, I'm on Island.
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So yeah, just in ensconced in my apartment at the moment.
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And I must say, I I think I've had a chance to see you a little more in recent weeks, considering now that I've been collaborating with Dr.
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Benta, which I've really enjoyed.
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So I ended up moving in a bit of a different direction after my qualifying exams.
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And so now I'm working with Dr.
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Caitlin Cotter and Dr.
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Courtney Wolsey.
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And I am proud to say that Dr.
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Benta is going to be on my committee indeed.
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So I've got to be able to do that.
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Oh exciting.
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Oh, I know.
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Have you nailed on your topic yet?
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Can you talk about it at this point?
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At this point, we're settling on the topic.
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I still need to work on getting my candidates sleep proposal all in order, but I think that the broad scope of it at this point is going to be a project that's uh looking at the intersection between loss of virus disease and pregnancy, and looking at that from an epidemiological perspective, right?
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And also uh looking at that using actual patient serum samples from Nigeria and looking at some of the biomarkers that are associated with severe disease in the pregnant individuals.
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Yeah, but still a work in progress.
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Yeah, cool.
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All right.
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So today's topic is one of my favorites.
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It's climate change.
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Can we say this word out loud?
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Do you think we're gonna get like immediately No?
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I it's I it is peppered throughout my notes for this episode.
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So we start us off with yeah, absolutely.
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So I think it's really important to begin this episode by defining the anthropocene.
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This is a period of time that we're currently living in.
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So we're living in the Anthropocene right now, and it's characterized by humans being the most influential species on our planet.
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And so it's really widely accepted that we, and by we I mean humanity, have really deeply impacted our planet, right?
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So, particularly in the past 60 years.
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In the course of natural history, humanity's actions are pretty unnatural in how we've affected the world that we live in.
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And our current lifestyles really rely on things like natural resource extraction, and that disrupts ecosystems.
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We've seen unprecedented carbon dioxide emissions, global warming, acidification of our oceans, and habitat destruction, as well as massive extinctions.
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And what we really want to focus on today in this episode, against this really urgent change is needed backdrop, is the impact of the Anthropocene on multiple classes of pathogens.
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So we're gonna talk about fungi, we're gonna talk about viruses, bacteria, parasites.
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But just super quickly before we jump into that, as many of them are a really big reader and post-PHD, I am like reading even more because I actually have like more brain space for reading.
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And I recently came across this erasure poem of a news piece that was documenting a funeral that was held for a glacier in Iceland.
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And this is gonna be like relevant later because I do talk a lot about permafrost.
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But what's really interesting is that there was a plaque dedicated during this funeral for the glacier, and on it was inscribed this.
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So this is a direct quote: a letter to the future.
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Okay is the first Icelandic glacier to lose its status as a glacier.
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In the next 200 years, all our glaciers are expected to follow the same path.
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This monument is to acknowledge that we know what is happening and what needs to be done.
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Only you know if we did it.
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I find that super poignant in the current moment because the undercurrent to all the concerns we're going to discuss in this episode is that we really do know what environmental problems we have created.
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And for the most part, we really do know how to resolve them.
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And so I was actually recently reading a Natural History Museum article, and it really outlines what steps do we have that we've agreed on to like move towards a better future.
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And it's things like stopping the mining of fossil fuels and transitioning to reliance on sustainable alternatives.
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That's something we urgently need.
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So is reducing emission of air pollutants, right?
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And those things can go hand in hand.
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We also really concur that we need to protect at-risk ecosystems.
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Those are things like wetlands and coral reefs.
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And we know that things like eating less meat reduces environmental strain.
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And I say that as a kid who grew up on a beef farm.
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So I don't know if anyone has questions about that.
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And also, we know that shifting economic goals and reducing inequality and stabilizing the world's population will also help us move towards a better future.
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So I just want to note before we jump into everything in this episode, these aren't easy changes to make, and so a lot of them have not been made, because the systems, there aren't really systems designed to support people during these shifts that we know need to be made so that no one gets really unequitable or punishing treatment as the changes we need to avert disaster are being made.
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And so I just want to start off with the anthropocene, and we know what needs to be done because we know these are the solutions we need to rapidly enact.
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And there just really isn't enough being done in like a corporate or a government or necessarily an internationally collaborative scale, which is often where change is most needed.
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So then individual change can sort of gather weight within a system that's already designed to reinforce it.
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So that's the current crisis.
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And maybe if an if I can jump in and just make an announcement to our listeners as well, right?
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This is a very complex topic.
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And if you've listened to the previous episodes, we always take the lens of focusing on pathogens and not necessarily only from the perspective of pathogens, but this topic climate change is obviously much broader than that, right?
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There's an influence on plants, on humans.
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It's just so broad.
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I think we would have to have a whole season just to cover these topics.
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Now I want to uh do a quick plug here, I guess.
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I took a class, an online class that Yale offers.
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It's called Health and Climate.
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And it's an online course that you take, it's over a few months, and I took so much away from that.
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And I think probably the key message for me is just how complex and how interconnected everything is, and from heat stress to losing water and so on.
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So I just wanted to preface this episode by saying we're taking a snapshot of certain aspects, but obviously this whole topic is much, much broader.
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Oh, yeah, absolutely.
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I for sure echo that.
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And everything we're talking about today, these are things that come up and we can just scratch the surface of.
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But there's so much more to this topic, and it can be hard to engage with, right?
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Because it can feel very hopeless.
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But I guess I wanted to preface it the way that I did because we do know what needs to be done, and there are actions we can take.
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And so I think that's just always an important thing to me to set up when you talk about climate change, is that we do know what needs to be done, and there are actions we can take, and then get into like, all right, so what problems are we facing?
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So then we can think about how do we move forward and why does it matter that we do move forward.
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Alex, do you want to jump in?
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Absolutely, yeah.
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Well, to that end, so I think I'll start out by talking a bit about the genus of parasite responsible for causing malaria and how your human-driven climate change has ultimately impacted malaria prevalence and incidence.
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So, just to give at first just a brief introduction about malaria, so it's obviously caused by an infection with parasites of the genus Plasmodium and the spread through the bites of mosquitoes of the genus Anophiles.
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And so there are 249 million cases annually and about 608,000 deaths annually per the World Health Organization as of 2022.
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The vast majority of these were concentrated in sub-Saharan Africa and were as a result of infection with Plasmodium falciparum, which is the most virulent of the Plasmodium pathogens in general.
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And so, to give a basic overview in terms of how malaria's pathogenicity works exactly, there are various stages of life of the malarial parasite that it goes through.
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And those stages can have differing impacts on both the human immune system as well as they're intrinsically tied to a replication within the Anopheles mosquitoes themselves.
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You gave such a great overview of basically plasmodium and malaria and how it infects people and how it, I guess, evolves within the body.
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So just to synthesize what you said, malaria is, and correct me if I'm wrong, okay?
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I want to understand.
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But basically, malaria is a parasitic infection that is spread by the anophiles mosquito.
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And so the mosquito bites, and it basically gives the parasites to the victim of the bite, and these parasites go to the liver, right?
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And that's where they mature, and then from the liver, they go and they spread throughout the body or and infect red blood cells.
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And so that's why malaria is really dangerous, is because not only are red blood cells necessary for carrying oxygen throughout the body, but these parasites essentially cause the death of the red blood cells.
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And so with fewer red blood cells in the body, there's less oxygen being sent throughout the body, and there's also this inflammatory reaction within the body that can cause a lot of other detrimental side effects.
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Is that correct?
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Absolutely, yes.
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That's a perfect summary.
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Okay, cool.
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I just wanted to make sure, yeah.
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Alex, why did you pick malaria, just that of interest as a disease?
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Is it because of its global impact, or is it was it just a disease of interest for you in general, or why did you pick that as the topic?
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A bit of both, a bit of both.
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Because it was something that when I was an undergrad, my research had been characterizing the interactions of this crystalline toxin produced by Bacillus therogensis, known as Cryfor B, which had these insecticidal interactions with the caterin receptor inside of the mid-gut of Anopheles gambiae, which is the principal vector for plasmodium falciparum, which is the most lethal of the malarial agents.
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And so I've always been interested in malaria for some time after going and doing some of that research in undergrad, but the scope of my research, of course, never really touched the parasite itself.
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So I figured it'd be fun to uh learn some more and talk about it here.
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But also, it's just, yeah, just something that absolutely, as you mentioned, the global health significance of it is just something that's worth noting.
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And so I figured may as well call attention to it and for that too.
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Alex, before I interrupted you, sorry, you were getting towards the whole topic of global warming and climate change and how malaria is potentially becoming more prevalent because of the change that we're seeing within our global climate, is that correct?
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Absolutely, yes.
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There have been significant issues when it comes to, yeah, deforestation and forest degradation being these really big drivers of climate change.
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They're ultimately estimated to constitute about 12 to 20 percent of global greenhouse gas emissions annually.
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And because you know, as you're releasing and removing these carbon sinks rather from the global ecosystem, right, you're releasing CO2 into the atmosphere, which can be deeply problematic.
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And a number of these changes, of course, are linked to changes in land use, right?
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Clearance of forest lands for subsistence agriculture, as well as for industrial farming.
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And so these can help to, in some ways, resolve perhaps issues of local food insecurity that in and of themselves are driven by climate change indirectly or may contribute to global markets, right?
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But the issue though with deforestation is that it has a significant impact on also then warming these environments that enable anophthalese mosquitoes to then better thrive, right?
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So there was this 2006 study that found that in these deforested areas in the Kenyan Highlands, that these areas were about 1.2 degrees Celsius warmer in the dry season and 0.7 degrees Celsius warmer in the wet season.
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And that doesn't sound like much, but these mosquitoes were found to have considerable increases then in their net reproductive rate and in their populational intrinsic growth rate in these areas, which thus enabled an increase overall in the vectorial capacity of these mosquitoes to go about being vectors of the malarial parasites themselves, thus increasing the likelihood of transmission to humans, right?
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Because you have more mosquitoes and they reproduce at a higher rate, you're just going to have a greater propensity for potential mosquito-human interactions that could lead to malarial infection, which is particularly problematic.
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Yeah, if I could jump in, speaking of this kind of interaction between humans and vector species, I don't know if you found anything on this, but something that just popped into my head as you're talking about this, because it's really interesting, is not only may we be changing how land is being used or the microclimates that are available, but also if it's really hot out, people might be going outside to do work in times where it's cooler parts of the day, like morning or evening, where they might be more likely to come in contact with mosquitoes.
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So I don't necessarily know that I did not dive into malaria for this episode, but this idea that, you know, as things get hotter, not only do microclimates change and not only do land use change, but also people are trying to adapt to that to do the work that they need to do, right?
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If they're outside doing agricultural work in a prime time when they might be bitten by mosquitoes, they might be more likely to be exposed to malaria.
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No, that's a that's an excellent point.
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And Camille also, I think, raised a very good point there in terms of just, yeah, changes in human behavior when it comes to these warming environments and then potentially participating in some of these outdoor activities at points in the day when they are more likely to be bitten by these anophily mosquitoes is definitely a significant factor as well.
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Absolutely.
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So that's a that's a great point.
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So as a result of the warming climate writ large as well, what we've also seen is that some of these areas that have historically been epicenters of valarial incidents, right?
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Some of these equatorial regions that are historically hot and humid and in a position to support a high anophaly's population, is that we're seeing a number of these mosquitoes instead move towards more hospitable environments as those regions grow too hot to support necessarily their reproduction.
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And so what we've seen is over the past 30 years, increases in the incidence of malaria throughout regions in which it had been relatively low or even non-existent, such as in the Ethiopian islands.
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And some of that has to do with geopolitical and conflict issues when it comes to especially Ethiopia in particular, with issues over the past few years in particular, but but also you know, largely have to do with these climate changes, and that's uh a deep problem, absolutely.
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And the listeners are interested in human conflict, uh war and conflict, go back to a couple episodes ago when we talked about the pathogens and war, so go back to that episode.
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But Alex, my question for you is so you were talking about the expansion of the mosquitoes into new regions, northwards and probably southwards as well.
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But what we see with the tick-borne diseases is yes, there's an expansion northwards and southwards into new areas because now they become habitable for ticks.
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But we also see that certain areas that used to be good areas now change their climate so much that they are not suitable anymore for ticks.
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So it's not just a continuous expansion into all areas, but almost like a contraction, right?
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It goes up into a certain area, but like certain other areas will the disease or the vector will disappear.
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Did you read anything about that with malaria?
00:19:13.680 --> 00:19:14.559
Yes, indeed.
00:19:14.720 --> 00:19:33.119
So that's exactly what has followed as well, that there are reductions in and projected to be reductions in incidence of malaria in some of these equatorial regions in which it has grown too hot to necessarily go and support that same high population of Anopheles mosquitoes.
00:19:33.279 --> 00:19:42.319
And so, yes, that's a great point, absolutely, because yeah, it's definitely not a continuous expansion, but it'll contract in some of those historical hotspots as well.
00:19:42.480 --> 00:19:46.160
So it sounded like you've got some stuff for us too, Camille, no?
00:19:46.319 --> 00:19:47.119
Yeah, absolutely.
00:19:47.279 --> 00:19:49.519
But I don't want to cut Dennis off and talking about ticks.
00:19:49.680 --> 00:19:52.880
If you have anything more to add on ticks, now is the thing.
00:19:54.960 --> 00:19:56.240
This is your moment.
00:19:57.599 --> 00:19:59.279
My moment to shine, yes.
00:19:59.519 --> 00:20:05.039
Yeah, I think you know what the other parts, I think there's certain themes that are the same.
00:20:05.440 --> 00:20:10.960
You do see an expansion of ticks into new areas, quite a bit, actually.
00:20:11.200 --> 00:20:15.839
But what the difference is the way mosquitoes and ticks travel.
00:20:16.000 --> 00:20:23.279
Like mosquitoes can fly, they have a range of hundreds of meters, and ticks can only crawl so far.
00:20:23.440 --> 00:20:32.559
They often use animals, cows, for example, imagine like pastoralists, where you have ticks on a cow and they're moving to new areas.
00:20:32.720 --> 00:20:40.880
So they use almost other animals, wild animals, birds, and so on, as tick taxis, basically, where they get to new spaces.
00:20:41.039 --> 00:20:51.279
So the transport into new areas is slightly different than some of mosquitoes, and also the establishment of ticks into new areas is also very different than mosquito species.
00:20:51.359 --> 00:20:54.799
But I think that the tendency, generally speaking, are the same.
00:20:55.039 --> 00:20:57.839
So similar picture with slight differences.
00:20:58.000 --> 00:20:59.759
Does that answer your question, Camille?
00:21:00.000 --> 00:21:01.440
Yeah, yeah, absolutely.
00:21:01.680 --> 00:21:03.759
I just wanted to give you a moment to talk about ticks.
00:21:03.839 --> 00:21:05.279
We know how much you want to know.
00:21:06.319 --> 00:21:08.319
And I never get to talk about ticks here.
00:21:08.880 --> 00:21:11.119
I do like a special tick episode for Dennis.
00:21:11.519 --> 00:21:13.119
Oh no, it's gonna be 99.
00:21:13.519 --> 00:21:15.599
And you can just educate the rest of us.
00:21:20.480 --> 00:21:26.400
I found a tick on me like the other day, like on my jeans, and I immediately thought of you when I saw this tick.
00:21:26.480 --> 00:21:31.599
It was like crawling up the knee of my jeans, and I was immediately like, oh, I was like, Dennis would think that's cool.
00:21:31.920 --> 00:21:34.880
Is this a good thing or a bad thing that you immediately thought of me?
00:21:38.960 --> 00:21:40.000
It's I don't know.