This Podcast Will Kill You

“Let’s do Bartonella next,” we said. “It’ll be straightforward and fun,” we promised ourselves. Turns out we were half right. In this fun but not quite straightforward episode, we tackle not one, not two, but three different species of Bartonella bacteria that can cause disease in humans: Bartonella bacilliformis (Carrión’s disease), B. quintana (trench fever), B. henselae (cat scratch disease). Essentially, we’re giving you three mini-turned-maxisodes for the price of one! For each pathogen, we review its surprisingly strange biology, take a brief tour of its history, and wrap up with a look at its current status across the globe, comparing and contrasting along the way. By the end of this ride, you’ll be bursting with Bartonella trivia, in awe of dental pulp, and scratching your head about the transmission of cat scratch fever.

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Celebration wasn’t the only thing in the air in Philadelphia in July of 1976. Over the course of several days during the 58th Annual Convention of the American Legion, a killer mist spewed out of the air conditioning units throughout the building and into the sidewalks nearby. The result was a large outbreak of unexplained febrile pneumonia, often fatal, that would acquire the name Legionnaires’ Disease. What was causing this terrifying disease and how could it be stopped? In this episode, we walk through the massive investigation into this outbreak that would lead to the discovery of the causative agent, Legionella pneumophila, and explore the biology of this mysterious pathogen. We wrap up the episode with a look at the current status of Legionnaires’ Disease and a potentially grim forecast for its prevalence as the world slowly gets back to normal.

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Ah, chickenpox, that pesky old childhood illness. And that’s all it is, right? Just a mild, routine infection that we all used to catch until the vaccine came around? Not quite. In this episode, we learn that, when it comes to the varicella-zoster virus, not everything is as it seems. We explore the complex nature of this virus, how it can make you kinda sick and then how it can make you really, really sick. After that, we dive into the evolutionary origins of this virus and the different infections it causes (spoiler alert: shingles as a viral survival strategy?!). And finally we trace its human history from discovery to vaccine to where we stand with chickenpox and shingles today.

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When you think of mercury, what springs to mind? Is it the entrancing drop of shimmery liquid that flows from a broken thermometer, giving the metal the name quicksilver? Or is it the warnings of overconsumption of fish and bioaccumulation? Or perhaps it’s the Mad Hatter from Alice in Wonderland? The story of mercury, in both its biology as well as its history, is vast and varied, and in this episode, we attempt to piece together a picture of this heavy metal. We first delve into the pathophysiological effects of the different forms of mercury exposure on the body, and then take a narrow tour of the metal’s history, focusing primarily on Minamata disease, before wrapping it all up with a look at just how widespread mercury contamination is today. Although the relationship between humans and mercury is as old as history itself, there are still so many lessons to be learned from it, especially “what is the true cost of progress?”.

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Over the past year and a half, we have learned so much about this virus, but there is still more to know. There always will be. We have seen the widespread impacts that the pandemic has had on all facets of society, but there is still more to see. There always will be. The COVID-19 pandemic is not over, and its effects will continue to be felt for years to come. What can we expect in a post-pandemic future? Frankly, no one knows. But we can make some guesses based on what we have already seen. Throughout the COVID-19 pandemic, one of our best reference points for comparison has been, of course, the deadly and devastating 1918 influenza pandemic. What can that pandemic tell us about our own uncertain future, and where do comparisons simply fall short? Did the lessons learned from the 1918 pandemic change the course of COVID-19? Or were we doomed to repeat history? To help us look forward by looking back, we are so excited to be joined by John Barry, award-winning and New York Times best-selling author of books such as The Great Influenza: The story of the deadliest pandemic in history (interview recorded May 25, 2021).

This marks the tentative final episode in our Anatomy of a Pandemic series on the COVID-19 pandemic. There is still more ground to cover (there always will be), and it’s entirely possible we’ll produce additional episodes in the future, but this is it for now. Thank you to everyone who has been interviewed, who has sent in their firsthand account, and who has listened. We appreciate all of you so very much.

To wrap up this episode as we always do, we discuss the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we’ve listed the questions below: 

1. Can you remind us of some of the similarities as well as some of the differences between the COVID-19 pandemic and the 1918 influenza pandemic?
2. The COVID-19 pandemic has been highly politicized, both in the US and elsewhere. Did we see a similar intersection of politics and public health in 1918, and if so, how did that affect both the way that pandemic played out as well as the aftermath?
3. You wrote that the single most important thing for our society and our governments to do in this pandemic was to tell the truth. How did countries fail to tell the truth in 1918? And how would you rate our honesty during this present pandemic?
4. How do today’s methods of science communication differ from the ways the public got their public health information back in 1918? Was there a similar issue with rampant disinformation campaigns?
5. How did the 1918 influenza affect the public health infrastructure in the US? Did it change the general perception of the role of public health?
6. During the 1918 pandemic did we see countries working together to try and solve the influenza crisis, or did we see intense nationalism due to the ongoing war?
7. After the 1918 pandemic came the Roaring Twenties, with its dramatic lifestyle change and economic growth. Could you talk about what this period looked like and how much of it came as a reaction to the end of the 1918 influenza pandemic and WWI? 
8. How long did the 1918 pandemic live in our collective consciousness as a vivid reality? Given its scale and duration, do you think this pandemic will live in our collective consciousness more vividly?
9. Can you talk about some of the limitations in applying lessons learned from the 1918 influenza pandemic to today’s reality?
10. What are some things that you hope we keep from this pandemic, either personally or as a society?

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Every summer, when the warm weather rolls around and the local ponds and lakes heat up enough for a tempting dip, remember that there may be something else lurking in those waters besides the people looking to cool off. Naegleria fowleri, the topic of today’s episode, makes its home in warm, fresh waters, and that’s mostly where it stays, until a chance encounter between human and amoeba introduces it to a new locale: the brain. In this episode, we explore the brutal biology of the so-called ‘brain-eating amoeba’, walk through its recent but global history, and discuss the possible future of this pathogen, both good (e.g. treatments, awareness) and bad (e.g. climate change, land-use change). 

Even though this is a very rare disease, its deadly potential is deeply felt by those impacted by it. We are very grateful to Dr. Sandra Gompf, who shares her story of how her son Philip’s fatal encounter with Naegleria fowleri led her to create Amoeba Season, a Philip T Gompf Memorial Fund for Infectious Disease Research project. You can learn more about Dr. Gompf’s story on her website, amoeba-season.com, where you can also find many helpful links for raising awareness, fact sheets on amoebic meningitis, and a wonderful set of resources for healthcare professionals. As Dr. Gompf says, amoebic meningitis is 99% fatal but 100% preventable, and the best method of prevention is knowledge - Amoeba Season is a great place to start.

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From virology to vaccines, from education to economics, and from disparities to disease, our Anatomy of a Pandemic series has covered many different aspects of the COVID-19 pandemic. With such a broad range of topics and an often birds-eye view of the situation, it can be easy to forget that this is a large-scale event happening to individual people. The impacts of the COVID-19 pandemic are widespread but also deeply personal and absolutely unique. In this episode, we wanted to take this opportunity to recognize this aspect by featuring firsthand accounts that we have received from listeners over the last several months sharing their pandemic experiences. We have no expert to feature for this episode because, by this point, we are all experts in our own COVID-19 stories. Which stories resonate with you? Which ones surprise you? Let us know! And a huge thank you again to everyone who has shared their firsthand accounts with us - we feel so honored to hear them.

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Our sign-off, “wash your hands, ya filthy animals”, has never been more appropriate than with this episode on puerperal or childbed fever, now known as maternal peripartum infections. It took us over seventy episodes to get here, but today we finally tell the tragic story of Ignác Semmelweis, the “father of hand hygiene” and “savior of mothers”, whose keen observations and devotion to his patients earned him ridicule in his time and respect in ours. But the tragedy of this episode’s topic doesn’t reside solely in the past. Today maternal peripartum infections are still a major contributor to maternal morbidity and mortality worldwide, and, surprise surprise, the impact is not equally felt across racial, ethnic, and socioeconomic groups. Join us as we dive into this historically rich, medically complicated, and still appallingly prevalent group of infections.

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The COVID-19 pandemic has touched all of our lives in incredibly varied ways, with no two experiences exactly alike. Despite this, we all probably share the same thought: how can we stop this from happening again? In this episode of our Anatomy of a Pandemic series, we ask that question in the context of wildlife conservation. Why is protecting biodiversity synonymous with protecting our own health? If spillover events themselves are inevitable, how can we limit the likelihood that they will become epidemics or pandemics? Where do commercial wildlife markets and subsistence hunting fit into the equation? To help us answer these questions and more, we are thrilled to be joined by Dr. Chris Walzer, Executive Director of Health at the Wildlife Conservation Society (interview recorded April 6, 2021). And for more information on the topics discussed, check out the WCS’s COVID-19 News and Information page and read a recent Op-Ed piece by Dr. Susan Lieberman and Dr. Christian Walzer about why biodiversity is crucial for preventing pandemics. 

As always, we wrap up the episode by discussing the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we’ve listed the questions below:

1. Now that we are over a year into this pandemic, what do we know about the sequence of events that led to this pandemic? 
2. People have been studying spillovers and the emergence of novel viruses for a long time and have been saying that a pandemic like this was inevitable. So what did we do wrong on a national or international level?
3. What things did we do right, or what things did we adequately prepare for during this pandemic? 
4. What are the ways in which we’ve made scientific progress or the ways in which the world has fundamentally changed that have allowed this pandemic to play out differently than it could have 20 years ago? 
5. Can you talk us through some of the nuance in the interactions between commercial wildlife markets, spillover events, and wildlife hunting for subsistence purposes?
6. How predictable are spillover events themselves? Or perhaps, how predictable are the scenarios that would increase risks for spillover and how predictable are the events that follow?
7. Since another spillover event could happen at almost any time, what measures do we have in place to prevent these events from turning into another pandemic? Where does wildlife and forest conservation fit into this equation? 
8. Pandemic preparedness and pandemic response are two different things. How do these two aspects of dealing with a pandemic differ and who is involved in each of these efforts?
9. What are people who study this the most concerned about when it comes to the next pandemic? What are the areas in which we still have big improvements to make in how we prepare for or predict or try to prevent pandemics based on what we’ve learned during this one?
10. What do you hope we keep or learn from this pandemic, either personally or as a society?

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A fluffy white fungus and a little brown bat. A deafening silence and an uncertain future. In this episode, we explore one of the most devastating wildlife diseases in recent times, white-nose syndrome. Since its debut in North America in 2006, this fungal pathogen has spread across much of the continent, leaving millions of dead bats in its wake. Why is it so deadly? Which bats are at risk? Where did it come from? And most importantly, what can we do about it? We attempt to answer these questions and more about this pernicious pathogen, and we are so delighted to be joined by Dr. Winifred Frick, Chief Scientist at Bat Conservation International and Associate Research Professor at UC Santa Cruz, who helps us take a closer look at the ecology and impact of this disease on North American bat populations.

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