In the Season one finale of our show, hosts Dr. Vivian Vega and Dr. Jackie Sherbuk reflect on the evolving landscape of infectious diseases and public health. Yet rather than linger on setbacks, they look ahead, posing the critical question: “What are the future pandemic threats?”

To explore what transforms a simple pathogen into a global threat, they examine three key characteristics: transmission, virulence, and available countermeasures.

Transmission, it turns out, must strike a delicate balance. A virus must spread efficiently—fast enough to infect large populations, but not so aggressively that it incapacitates or kills its host before passing to the next person. Similarly, a pathogen that is too virulent may burn out quickly, unable to spread widely before its hosts succumb. As for countermeasures, their availability and effectiveness vary. Influenza, for instance, can be treated with antivirals, while diseases like Nipah virus remain without effective therapies.

At the time of this recording, H5N1 avian influenza stands out as a pressing concern. Dr. Vega reveals a startling fact: domestic cats may serve as an unexpected intermediary host, offering a new pathway for H5N1 to bridge the gap to humans. It’s a reminder of how creatively and unpredictably pathogens can bypass traditional barriers.

Dr. Sherbuk turns to Ebola as a striking example of how sheer virulence can catapult a disease to global attention. Past outbreaks in Africa overwhelmed health systems, exploiting cultural practices like burial rituals to fuel its spread. Even the limited number of U.S. cases during the 2014 outbreak stirred widespread public fear, driven by the virus’s high mortality rate abroad.

Not all dangerous pathogens are highly lethal. Some, like Zika virus, pose serious risks in specific populations—such as fetal abnormalities in pregnant women. Others, like HTLV-1, may cause chronic illnesses like leukemia and lymphoma.

While many pathogens naturally evolve to become less lethal—thereby enhancing their chances of transmission—some mutate unpredictably, becoming more dangerous. This is the ongoing concern with influenza: a seemingly mild strain could shift into something far deadlier.

The importance of countermeasures cannot be overstated. Yet in the aftermath of COVID-19, global readiness has been undermined by pandemic fatigue and the politicization of public health. Mistrust in vaccines, fractured health policy, and diminished international cooperation all threaten our capacity to respond to the next crisis.

But what if the next pandemic comes from a direction we didn’t anticipate?

Scientists have a name for this uncertainty: “Disease X.” The World Health Organization coined the term as a placeholder for the unknown. COVID-19 was once Disease X—until it had a name. The next one could emerge from zoonotic spillovers like HIV or Nipah, climate change, laboratory accidents, or even bioterrorism.

Whatever its origin, our best defense lies in robust surveillance, scientific agility, and global collaboration. Because the question isn’t if Disease X will come—but whether we’ll be ready when it does.

Dr Vega would like to thank her friend Job Meiller for his musical contribution to our segment breaks. Thank you Job!

Thanks also to Dr. Ana Velez, our artistic contributor, for her painting, "The Multivirus Pandemic Explosion," used in our episode thumbnail.

It felt inevitable. Years of declining childhood vaccination rates were bound to have consequences. In early 2025, those consequences became alarmingly real as a measles outbreak emerged in West Texas and Eastern New Mexico.

Before the introduction of the measles vaccine in 1963, the U.S. Centers for Disease Control and Prevention (CDC) estimated that measles infected three to four million Americans annually, causing 48,000 hospitalizations and 400 to 500 deaths each year. The introduction of the MMR (measles, mumps, and rubella) vaccine marked a turning point. The two-dose regimen—first administered between 12 and 15 months of age, with a second dose between 4 and 6 years—was remarkably effective. By 2000, measles was declared eliminated in the United States.

But in recent years, progress has unraveled. A dramatic drop in vaccination rates—fueled largely by the discredited claim linking the MMR vaccine to autism—has allowed this once-vanquished virus to resurge.

Today, vaccination rates in many states have dipped below the 95% threshold needed for herd immunity, and the current outbreak offers a grim reminder of what’s at stake. In Gaines County, Texas, where vaccine exemptions are especially high among the local Mennonite population, hundreds of measles cases have been reported—resulting in at least two deaths in Texas and New Mexico.

In this episode, hosts Dr. Vivian Vega and Dr. Jackie Sherbuk trace the recent history of measles in the U.S., focusing on the current outbreak in Texas and New Mexico. They tackle the question: Why is measles still so dangerous? The discussion includes common complications of the disease, current vaccination guidelines, and a thorough debunking of the alleged MMR-autism connection. They also highlight a growing concern: cases of vitamin A toxicity in children, stemming from widespread misconceptions about its role in measles treatment.

Dr Vega would like to thank her friend Job Meiller for his musical contribution to our segment breaks. Thank you Job!

Thanks also to Dr. Ana Velez, our artistic contributor, for her painting, "SSPE-Subacute Sclerosing Panencephalitis," used in our episode thumbnail.

Virology vanguard Dr. Bob Gallo is far from ready to slow down. Now in his seventh decade as one of America's top scientists, he could easily sit back and enjoy the fruits of his numerous and pioneering achievements. His groundbreaking work began in the 1970s with research into human retroviruses, including the discovery of the T-cell growth factor (IL-2) and the identification of the Human T-Cell Lymphotropic Virus (HTLV-1) in 1980, earning him his first Lasker Award, often referred to as “America’s Nobel Prize.” His subsequent research led to the identification of HIV-1 as the cause of AIDS, securing him a second Lasker Award. In the 1980s, he was the world’s most cited scientist. Along with his team, he developed the first HIV blood test, crucial for understanding the spread of AIDS and managing HIV patients. In the mid 1990's Gallo and his collaborators discovered chemokines, naturally occurring compounds that were essential for understanding how HIV infects cells. Dr. Gallo later founded the Institute of Human Virology at the University of Maryland School of Medicine in 1996 and co-founded the Global Virus Network (GVN) in 2011 to enhance global virus detection and management. Recently, Dr. Gallo and his team moved to Tampa, the new global headquarters for GVN, where he now serves as director of the University of South Florida (USF) Virology Institute and Head of the Microbial Oncogenesis Program at the Cancer Institute at Tampa General Hospital (TGH).

In the first part of this wide-ranging interview, Dr. Gallo shares insights into his entry into virology and his initial research into the etiology of certain cancers. This work included crucial discoveries around T cell growth factors, paving the way for identifying HTLV-1. He discusses his collaboration with CDC epidemiologists, which led to recognizing AIDS as being caused by a retrovirus. Once the HIV virus was identified as the cause, creating the first blood test for HIV had profound impacts on the epidemic and patient care.

In the second segment, Dr. Gallo discusses the origins of the HIV virus and its early global spread. He also reflects on the COVID-19 pandemic, why the focus on its origins is irrelevant and reflects on how to rebuild public trust in science and medicine, which may have been damaged during the pandemic.

In the concluding segment, Dr. Gallo talks about his reasons for joining USF Health and TGH and the research areas he finds most promising going forward. He speculates on the prospects for an HIV vaccine, the impact of artificial intelligence on virology, and why he doesn’t necessarily worry about the threat of the next global pandemic. Finally, Dr. Gallo opens up about how the early loss of his young sister deeply affected his life and his desired legacy.

Dr Vega would like to thank her friend Job Meiller, her YES Man, for the wonderful musical contributions and coming through on every idea she has. This time he contributes his renditions of Bruce Springsteen's "Streets of Philadelphia" and "Your Song," by Elton John. Thank you Job!

Thanks also to Dr. Ana Velez, our artistic contributor, for her painting, "HIV," used in our episode thumbnail.

Having just survived the calorie-fest of the Thanksgiving Holiday, show hosts Drs. Vivian Vega and Jackie Sherbuk reflect on the changing seasons--and that has them thinking NOT just about the weather, but about the climate. Here to discuss the impact of a changing climate on infectious diseases, they welcome Dr. Lauren Rybolt, Chief Infectious Diseases Fellow at the University of South Florida Morsani College of Medicine. Dr. Rybolt mentions that in the Tampa Bay Area, especially after the recent hurricane season, we are already seeing the effects of climate on infectious diseases occuring in real time. The direct effects of two rapidly intensifying hurricanes, Helene and Milton, that impacted Florida in late September and October have led to increased outbreaks of vibrio vulnificus and other waterborne infections, subjects which were highlighted in our very first episode.

Dr. Rybolt explains that the effects of climate change are not singular, but are the results of many interconnected processes. For instance, how warming oceans affect precipitation patterns over the U.S., leading to flooding in some areas and drier conditions in others. Flooding can pollute streams and rivers and contaminate water supplies, while displacing people and increasing exposure to mosquito-borne disease; whereas drought can lead to water insecurity and the health consequences of extreme heat on vulnerable populations. Man made deforestation and land development can worsen the effects of flooding, and at the same time exacerbate climate change due to the loss of ecosystems and carbon-absorbing vegetation, for instance.

Dr. Rybolt goes on to describe how the changing climate is producing an expanding zone of tropical infectious diseases in areas where they never occurred. More cases of Malaria and Dengue have been reported in Florida in recent years, for example. Tick-borne infections such as Lyme disease can expand to non-endemic regions due to climate change, but in Florida, we have been protected by a certain ubiquitous reptile. Certain fungal infections such as Candida auris have also spread beyond their typical "endemic areas" as well.

Lastly, during their "ID News" segment, Vivian and Jackie discuss World AIDS Day, trends in vaccination and respiratory virus season, as well as the recent discovery of Bird Flu in raw milk.

Thanks to Dr. Lauren Rybolt for appearing on this episode to share her knowledge about the infectious diseases impacts of climate change.

Dr Vega would like to thank her friend Job Meiller, her YES Man, for the wonderful musical contributions and coming through on every idea she has. This time he is joined by his daughter, Isabelle Meiller, for a moving rendition of "Big Yellow Taxi." Thank you Job!

Thanks also to Dr. Ana Velez, our artistic contributor, for her painting used in our episode thumbnail.

They're back! Infectious Diseases Clinicians and show hosts Drs. Vivian Vega and Jackie Sherbuk reflect on the last few weeks since Episode 4. In the face of devastating storm surge from Hurricane Helene, and severe wind and flooding from Hurricane Milton, the Tampa Bay Area and its medical centers experienced a back to back punch, separated by only two weeks. This left some hospitals flooded, beaches seriously eroded, streets filled with debris, power outages lasting as much as 5-7 days, and countless people with immersed or damaged homes. Vivian and Jackie open the show by discussing how their lives were affected by evacuation orders, "hurricane call," and the stress of--in the words of a local weatherman--"stalking the turtle." That is, stressfully following daily hurricane forecasts without knowing if its slowly changing track would take it over the Tampa Bay Area. Now that the storms have passed, the recovery will likely take weeks to months. And diseases directly related to storm waters and flooding, such as Vibrio vulnificus and mosquito-borne illnesses, will likely be on the rise.

Next, as Florida begins to experience cooler weather in the wake of the storms, the duo go on to discuss the coming respiratory virus season. First, acknowledging the renewed thread of COVID-19, Vivian reviews the "alphabet soup" of influenza virus strains, how to decipher the H's and N's of flu season, and what is meant by "antigenic shift" and "angenic drift."

For some historical context, the Drs. Vega and Sherbuk review the 1918 outbreak of the "Spanish Flu" in Philadelphia related to a War Bonds parade. And they then move on to discuss the impact of RSV in both babies and adults during the fall respiratory virus season. Fortunately, an RSV vaccine is available. Also covered are non-pharmacologic interventions to avoid the spread of respiratory infections, such as mask wearing, handwashing, and isolating yourself if you are sick. Lastly, the show closes with some recent ID news about Pertussis (Whooping cough), continuing Listeria outbreaks from meat products, and the McDonalds Quarter Pounder outbreak related to slivered onions.

Dr. Vega would like to give a special thank you to her good friend Mr Job Meiller for his musical contributions for our podcast.

Thanks also to Dr. Ana Velez, our artistic contributor, for her painting used in our episode thumbnail.

For our fourth episode, show hosts Dr. Vivian Vega and Dr. Jackie Sherbuk candidly admit that they've been spending a LOT of time thinking about "not-so-forgotten infectious diseases." These are syndromes that the public may not hear about everyday, but that are still very important to the medical community and to the public at large. Although it was the first human contagion ever successfully eradicated, Smallpox as a disease still looms large, not just as a potential agent of bioterrorism, but as a cousin (orthopoxvirus) to Monkeypox (Mpox), which is currently experiencing a deadly outbreak in Africa. In fact, the American Mpox vaccine given to many at-risk U.S. individuals in the 2022 outbreak was originally created as a Smallpox vaccine. Vivian shares the fascinating tale of the last ever case of Smallpox which unexpectedly took the life of an unlikely victim. Both hosts share information on the typical presentation of Smallpox in its victims and its distinct characteristics. The eradication of Smallpox still is considered one of the great accomplishments of Medicine.

Next, Vivian and Jackie discuss another feared but not forgotten infectious illness, Polio. Once endemic, this waterborne illness once affected tens of thousands of victims across the U.S., and led to the closure of parks, swimming pools, schools, and other public places. This devastating illness was vanquished by the discovery of effective, easy to administer, and inexpensive vaccines. Even so, many victims lived out their lives in an iron lung, including Paul Alexander, a courageous American man who lived out the remaining 72 years of his life in such a device, passing away earlier this year. Despite the great accomplishments in the eradication of Polio, this small RNA virus is still endemic in a handful of countries, and a case prompting the mass vaccination of children was just reported in Gaza in late August 2024.

In their ID news segment, there is plenty to discuss, including more information about the Listeria outbreak involving Boar's Head meat products, the Mpox Public Health Emergency declared by the WHO in Africa, and "Triple-E" (Eastern Equine Encephalitis) and West Nile virus cases being reported in areas of the U.S.

Dr. Vega would like to give a special thank you to her good friend Mr Job Meiller for his musical contributions for our podcast.

Thanks also to Dr. Ana Velez, our artistic contributor, for her painting used in our episode thumbnail.

In our third episode, show hosts Dr. Vivian Vega and Dr. Jackie Sherbuk kick things off by discussing the latest news from the world of infectious diseases. Important topics highlighted include a Listeria outbreak linked to deli meat, a progress report on long acting medications for HIV prevention, and an update on bird flu (H5N1 Influenza) associated with poultry and dairy cattle.

With summer clearly in full swing, our main topic this episode is Primary Amoebic Meningoencephalitis, or PAM. Guest expert and Infectious Diseases clinician Dr. Sandra Gompf, Professor of Medicine at the University of South Florida, shares her experiences as head of Amoeba-Season.com. For more than 10 years, her organization has been dedicated to raising awareness about amoebic brain infections associated with fresh water exposure. Dr. Gompf identifies the organism that causes most infections--Naegleria fowleri, and the risk factors, recreational situations, and mechanisms by which most victims (mainly young children) are exposed. Although, as our episode title suggests, PAM is 99% fatal--encouraging stories of survival have emerged from cases where early diagnosis of the disease permitted prompt treatment. Our guest provides important information sites for parents and clinicians and how some communities and health care facilities are being proactive in making sure diagnostic and therapeutic resources are in place during the warmest summer months. Dr. Gompf also shares her own personal story about PAM, and offers information on treatment options and the simple and inexpensive ways for families to enjoy aquatic activities while making this condition 100% preventable.

For more information, visit Amoeba-season.com

Vivian would like to express her deep appreciation to Nathalia Estrada and Chrissy Derado for their musical contributions this episode.

Thanks also to Dr. Ana Velez, our artistic contributor, for her painting used in our episode thumbnail.

A preview of our podcast series from our hosts, Drs. Vivian Vega and Dr. Jackie Sherbuk

In 2007, Australian former pro tennis player, former World No. 1 in doubles and US Open singles champion, Sam Stosur was at the top of her game, before succumbing to a mysterious illness that left her unable to play--with prolonged fatigue, severe headaches, chest pains, and weakness. She struggled for months before seeing an infectious diseases (ID) specialist who ultimately diagnosed her with a tick-borne illness. Sam tells her own story to open the episode, and then hosts and ID clinicians, Dr. Vivian Vega and Dr. Jackie Sherbuk, summarize her syndrome and the symptoms she experienced.

Using this as a springboard to discuss other zoonotic (transmitted from animals to humans) infections of the summer, Vivian and Jackie next discuss what are known as vector-borne diseases (VBDs). These are infections that use an intermediary host (such as a blood-sucking insect) to transmit the infection to a human victim. VBDs kill up to a million persons per year, according to the World Health Organization.

Among the most important vectors of summertime infections are ticks. Our hosts explain how ticks attach to their hosts and the factors that make these six-legged creatures so adept and spreading infections to humans.

Lyme disease is a perennial tick-related syndrome in the US and Europe that is a major cause of illness and prolonged complications in endemic areas. Vivian and Jackie review the history of Lyme disease and its different clinical manifestations. Lyme disease diagnosis, treatment strategies, and prevention are explained. As an aside, the duo also discusses alpha-gal syndrome, a fascinating but under-recognized food allergy related to tick exposure.

Next, the duo move on to discuss mosquito-borne illnesses. Important summertime infections of these buzzing pests are described, including West Nile virus, Dengue, and Chikungunya. And demonstrating the power of preventing disease through engineering, they explain the reason behind why there are no mosquitoes in Disney World.

In our last segment, Vivian and Jackie share important Infectious Diseases news stories for the month, including the reporting of even more cases of Avian Influenza and the threat they pose to agriculture and humans. Finally, DoxyPEP (post-exposure prophylaxis) is highlighted, a promising new approach to preventing sexually transmitted infections in vulnerable persons in high risk groups.

Vivian would like to thank her friend Sam Stosur for sharing her story on this episode. She would also like to thank her friend Natalie Buono for putting together the theme song for this episode and vocals. John Ferrell on lead guitar.

Thanks also to Dr. Ana Velez, our artistic contributor, for the custom oil painting and thumbnail art for this episode.

In our inaugural episode, show hosts Drs. Vivian Vega and Jackie Sherbuk discuss the upcoming Summer travel season and important infections spread by contact with water. Vibrio vulnificus is a potentially deadly illness spreading in the U.S. due to climate change that peaks in the hottest summer months. Vivian discusses risk factors for exposure and how vulnerable individuals can stay safe. Next, Jackie shares three limericks tied to specific waterborne infections, and Vivian has to guess the infectious agent tied to hot tubs, aerosolized water, and other recreational aquatic exposures. Next, the duo discuss Leptospirosis, an important zoonoses (human disease acquired from wild animals) associated with adventurous travel. To close the episode, two Infectious Diseases specialists and travel enthusiasts from the USF's Division of Infectious Diseases, Dr. Shylah Moore-Pardo and Dr. Shivan Shah, discuss how they stay safe during their travel adventures.

Dr. Vega would like to give a special thank you to her good friend Dr. Rey Rivera and to Mr Job Meiller for their musical contributions for our podcast.