← The Dr. Gabrielle Lyon Show
The Dr. Gabrielle Lyon Show
Dr. Peter Hotez - 1 in 20 Americans Has This Parasite and Doesn't Know It!
00:45:38
Loading summary
Transcript131 lines
- [00:00]
Dr. Peter Hotez
Parasitic infections and related tropical diseases are widespread in the US Most of them are being missed and not being diagnosed.
- [00:08]
Dr. Gabrielle Lyon
Do you think that it's more important now than ever to be able to identify these things early and often?
- [00:15]
Dr. Peter Hotez
The other problem with a lot of these parasitic diseases, the diagnostic tests for those, which we'd love to do, but we don't have the funding. And the other problem is the specialty test tests are not done every week. Physicians also just don't bother because it's a lot of extra work.
- [00:31]
Dr. Gabrielle Lyon
How are we in this position at this stage of medicine?
- [00:37]
Dr. Peter Hotez
Our vaccine, which is quite innovative, works on the fact that we, over decades, worked out the pathway by which hookworms degrade the hemoglobin. We could take the protein components involved that the worm uses to feed, make a vaccine out of that. It induces an antibody response. And now we can make our vaccine, we think, for probably two to three dollars a dose.
- [00:59]
Dr. Gabrielle Lyon
There's a recognition that science is imperfect and always evolving and that we can change the hypotheses and things get proven right and things that get proven wrong. But there was a respect. There is a lot of frustration with this, the idea of experts and the level of distrust. Do you think there's a way to restore trust?
- [01:17]
Dr. Peter Hotez
This has become a big issue right now, and unfortunately, it's going to get worse before it gets better because.
- [01:31]
Dr. Gabrielle Lyon
Doctor Hotez, welcome to the show.
- [01:33]
Dr. Peter Hotez
Thank you, Dr. Lyons, great to see you.
- [01:35]
Dr. Gabrielle Lyon
Great to see you, too.
- [01:36]
Dr. Peter Hotez
And feel free to call me Peter.
- [01:38]
Dr. Gabrielle Lyon
You know, I have been thinking a lot about your work, and as I was preparing for this episode, I called my mentor Don, and I said, don, okay, so we're going to be talking about this. And he said, you know, my question is, is that when he was growing up, so he's in his 70s, he said, we had three or four vaccines, and now by the time a child is no longer a child, they've had, what, 75?
- [02:03]
Dr. Peter Hotez
When I was a house officer resident in Boston in the 1980s, we vaccinated kids against eight illnesses. Okay? It was diphtheria, pertussis, tetanus, polio, measles, mumps, rubella. And I believe we were giving influenza vaccines at that time on an annual basis. So we were vaccinating against eight diseases. Right. And so what was my worst nightmare as a house officer, as a resident in Boston at that time, it was admitting kids with bacterial meningitis either Hib meningitis. They call it haemophilus influenza, type B. It was pneumococcal meningitis, and it was two forms of meningococcal meningitis. And I can't tell you how much time I spent with parents after doing the lumbar puncture, the spinal tap, and doing the gram stain and seeing the bacteria under the microscope and getting a confirmatory diagnosis in the lab and admitting them to the pediatric ICU and knowing that a significant number of those kids will die, a significant number of those kids, even if they survive a permanent neurologic injury. And one of the better outcomes is deafness. Right. And then what happened, though? We added the four vaccines for the four forms of bacterial meningitis, and now that those diseases are gone, so are those the ones you want to add back? So now that brings us from eight to 12 diseases. Okay. And then we started vaccinating against two forms of cancer, cervical cancer caused by human papilloma virus. And now Australia is actually going to eliminate cervical cancer by 2035 because the uptake is so high. And we're gonna vaccinate against liver cancer from hepatitis B. So that brought us to 14. And then we added the rotavirus vaccine that was a leading cause of hospitalization in the winter. We added varicella vaccine, and I think it was hepatitis A. So that brought us to 17. So we went from eight to 17 diseases. And you could say, okay, which one do you want to take out? So it's not 75. Right. And right off the bat, you know that 75 number comes from assuming you do an influenza vaccine every year for 20 years. So that brings you right down what they would say is 50, but in fact, it's about 25 to 30 immunizations.
- [04:32]
Dr. Gabrielle Lyon
Okay. So thank you for clearing that up. I love it when Don's wrong. Did the speed at which the vaccine come to market with COVID Was that too fast?
- [04:39]
Dr. Peter Hotez
I think, you know, when operation Warp Speed came along, there were no restraints on how the companies could communicate. But the fact is, the timeframe, the timeline of MRNA vaccines for Covid, like our recombinant protein vaccine, is about the same as every other. But again, it was the way it was communicated that was. That was a big faux pas.
- [05:06]
Dr. Gabrielle Lyon
You know, if nothing else, science, communication is a skill, and it's more important now than ever before. And again, I don't want to spend all the time here because there's so much about this parasitic infection, which, if I had done it over, I would have gone into infectious disease or tropical medicine. I just think it's so fascinating because you're an academic we are talking about, you're talking about hookworm. And but the reality is there's a whole bunch of different helmets. I have over here 2 billion people globally. And then there's also roundworm, hookworm, whipworm.
- [05:38]
Dr. Peter Hotez
One of the worms that's in the United States that I've spent a lot of time trying to raise awareness about. But so far with not much luck. It's called toxocariasis. T O X O C A R I A S I s not toxoplasmosis, but toxocariasis. And what happens is this is a worm in the intestines of stray dogs and cats. So remember, you're supposed to deworm your pet. Well, the reason is because they all have toxic hera. And so when you go into low income neighborhoods, especially you see these stray dogs and cats, about 100% are infected with that worm. And they're shedding the eggs in their stool and their feces on the ground. And, and unfortunately those eggs can become viable after a week and kids come into contact with them and they swallow the eggs and then the larvae hatch, you know, in the stomach and the intestine and they migrate through the lungs. They cause wheezing and asthma. They'll migrate through the brain and cause developmental delays. And these are not rare conditions. They're maybe as high as 5, 6% of the US population has it, but it's been under investigated as an environmental cause of asthma and an environmental cause of developmental delay. So my only paper I've ever published in the psychiatric journal was in JAMA psychiatry. Even the pediatricians tend not to get educated about this illness. So we actually give a diploma in tropical medicine for medical professionals, especially here in Texas and the Gulf coast. And they're actually accelerating due to climate change and urbanization. We have dengue, we have tick borne illnesses, but the physicians are not trained how to recognize them because they don't teach it in medical school anymore.
- [07:26]
Dr. Gabrielle Lyon
So what we, our experience has been over the last 10 years of trying to treat this because we acknowledge it's a problem. I started my career taking care of special operations and these guys would go to all these different places, swim in all these weird things and they would go to the Mayo Clinic, they would go to Cleveland Clinic, they would get all PCR testing and to this day the majority of parasitic infection testing. If it's not tropical medicine, which I would love to talk about what is now on the forefront, these tests come back negative. They're negative. When clearly this person has an elevated eosinophil count. They have iron deficiency anemia. They have, there seems to, they're having GI distress, which is cyclical. And yet every test that they do comes back, quote, negative.
- [08:20]
Dr. Peter Hotez
Yeah. So this is one of the reasons why we set up our National School of Tropical Medicine at Baylor College of Medicine, Texas Children's Hospital and the Texas Medical Center. They gave me the opportunity to do that because there's a lot of illness that's going undiagnosed. One of the things that we found, if you don't look, you don't find it.
- [08:38]
Dr. Gabrielle Lyon
How do people test for it? If, for example, the available testing to clinicians is pcr, it's gold standard.
- [08:45]
Dr. Peter Hotez
You know, that's the other problem with a lot of these parasitic diseases, the diagnostic tests for those, which we'd love to do, but we don't have the funding.
- [08:53]
Dr. Gabrielle Lyon
Could it just be microscopy?
- [08:56]
Dr. Peter Hotez
It depends. In other words, for instance, with toxic hera, the one that's associated with asthma, developmental delays, what happens is you swallow the eggs, but the larvae don't become full blown adults producing eggs. So the larvae are migrating through the tissues. So there's a lot of antigen presentation and they'll have, and you can have antibodies to it, but you have to know the antibody test, it's no longer
- [09:16]
Dr. Gabrielle Lyon
shedding in the stool.
- [09:17]
Dr. Peter Hotez
Yeah. And the other problem is the specialty tests are not done everywhere. They have to be done at the CDC or at our place. And you know, it's not like you can, you know, when you go for blood work, you know, you get the lab slip from Quest Diagnostics and it's got all the boxes to check. But a lot of physicians also just don't bother because it's a lot of extra work and to keep track and you have to follow it. So these diseases often get undiagnosed.
- [09:42]
Sponsor/Advertisement Voice
As a physician, I spend a lot of time talking to patients about healthy aging and one of the most important factors is maintaining skeletal muscle. I know it sounds simple, but simple isn't the same as easy. And many people struggle to consistently consume enough high quality protein to support muscle health, recovery and long term metabolic function. And thank you to one of the sponsors of the show, Perfect Amino. That's one reason why I personally use and recommend Perfect Amino by Body Health. Perfect Amino provides all of the essential amino acids your body needs for protein synthesis and beyond. It is a highly bioavailable form of amino acid detection, easy to take and can be a practical option for individuals looking to support muscle health, especially when meeting protein goals. Are difficult. Remember, muscle is the organ of longevity. Whether you're training hard in the gym or simply focused on staying strong and independent as you age, giving your body the building blocks it needs is an absolute non negotiable. For your long term health. Go to bodyhealth.com and use the code Lion20 for 20 off your first order. That's bodyhealth.com code Lion20.
- [11:06]
Dr. Gabrielle Lyon
But for that point of care, what about, for example, hookworm? This was rural Alabama. It says 34% of stool.
- [11:14]
Dr. Peter Hotez
That was our study. That was our study, yeah.
- [11:15]
Dr. Gabrielle Lyon
Tested positive. Also stromvyloides. And I've seen all these. But it's. The reason I saw these was when I had my practice in New York City, there was a infectious disease doctor who studied tropical medicine. Dr. Cahill?
- [11:30]
Dr. Peter Hotez
Oh yeah, sure. I've, I haven't seen him in years.
- [11:32]
Dr. Gabrielle Lyon
I would go to Dr. Cahill. We had adjacent practices. I would send all my patients to Cahill. He would come back. So I would say, cahill, all of these tests are negative. These guys are symptomatic in place platoons. And one guy came back with schistominiasis, the other, entamoeba histolytica, Elevated liver enzymes. And when he passed away because he was so specialized, it's very difficult. For example, for myself, we have a telemedicine clinic. We do this now. It's very difficult for providers to get answers.
- [12:09]
Dr. Peter Hotez
Yeah, no, absolutely.
- [12:11]
Dr. Gabrielle Lyon
And what is the solution? Because.
- [12:12]
Dr. Peter Hotez
Well, one of the things we're trying to do is train physicians how to diagnose these illnesses and treat them. So we've created this diploma in tropical medicine, as I say, which is online and sometimes it's testing sputum even. So it really depends on the individual.
- [12:28]
Dr. Gabrielle Lyon
What would be the most common presentation for the most ubiquitous.
- [12:33]
Dr. Peter Hotez
I think toxic hair as a worm is probably the most common ailment in the United States, which, by the way,
- [12:40]
Dr. Gabrielle Lyon
I'm shocked to hear this.
- [12:41]
Dr. Peter Hotez
And it presents with eosinophilia, often in
- [12:45]
Dr. Gabrielle Lyon
blood or in the esophagus or both.
- [12:48]
Dr. Peter Hotez
Well, it can be. It's. It's in the lungs also. But it's. You typically you would diagnose this by seeing a bloody eosinophilia. By what number it. Well, you know, if you have a, you know, elevated white count and a significant percentage. No, also in terms of the symptoms. So you know, if someone gets into the lungs, it causes wheezing and asthma like symptoms. But sometimes it can be very subtle. There's something called covert toxic parasis where it could present with developmental delays. Problem is, pediatricians are not really educated about that illness so much. And so, you know, what percent. This is what I wrote about in JAMA psychiatry. What percentage of kids diagnosed with developmental delays are getting sent for specialty testing for toxicarias?
- [13:32]
Dr. Gabrielle Lyon
What about treatments?
- [13:34]
Dr. Peter Hotez
It's actually not that hard to treat, actually. Albendazole.
- [13:37]
Dr. Gabrielle Lyon
Yes, I was reading about that. I think it was something that you had published. It was mass treatment of albendazole or membendazole potentially.
- [13:45]
Dr. Peter Hotez
Well, maybendazole doesn't get absorbed as well through the tissues. So maybendazole would work for something like ascaris in the gut, in the lumen of the gut, but less so for
- [13:54]
Dr. Gabrielle Lyon
that are some treatment again that people will give. Have you heard of this give parasitic worms or that those that have parasitic infections actually have an improvement in autoimmune conditions?
- [14:09]
Dr. Peter Hotez
Yeah, there's a lot of that out there on the Internet. I think the evidence for it is extremely weak. And, and again, you know, it kind of, it's. And it's based on some erroneous assumptions. So it's based on the idea that said, well, you know, God gave us our allergic responses to fight parasites and now that parasites have vanished here in developed countries like the U.S. you know, the allergic responses are turning on themselves. But again, it ignores the fact that we've got significant level of parasitic disease in the U.S. it's just that it goes undiagnosed. And in fact, these worms themselves are causes of allergic illness. Right. What's the one of the leading causes of asthma? It's ascaris and toxicara.
- [14:56]
Dr. Gabrielle Lyon
But people don't know that. Would you say that's the same in
- [14:58]
Dr. Peter Hotez
the U.S. probably not so much ascaris and tracheirus, but toxic hera is I
- [15:02]
Dr. Gabrielle Lyon
think, significant inflammatory bowel disease. For every single patient that we have who presents with inflammatory bowel disease, every single patient that we have had has some kind of co infection.
- [15:14]
Dr. Peter Hotez
I'm not surprised. Yeah. The idea of this hygiene hypothesis is sometimes called is they're going to treat with worms. Not really understanding that it's quite the. The problem is the opposite. The worms themselves are part of the problem.
- [15:26]
Dr. Gabrielle Lyon
Can they all potentially cause cognitive delay because of say, for example, anemia?
- [15:33]
Dr. Peter Hotez
So in case of toxic hera, the larvae are actually migrating through the brain. Remember, the larvae are maybe a couple of hundred microns in length. So super tiny. Right. So that's a problem in the case of hookworm. The cognitive deficits from hookworm are a Consequence of the anemia.
- [15:54]
Dr. Gabrielle Lyon
The anemia and the iron deficiency.
- [15:57]
Sponsor/Advertisement Voice
And the iron deficiency, which again, you compound.
- [16:01]
Dr. Gabrielle Lyon
And from what I understand, the reason that anemia happens is because there's a lot of microbleeding that happens.
- [16:08]
Dr. Peter Hotez
In the case of hookworms, the larvae grow into adult worms in the intestine. They get to be about that big, a centimeter long, and they extract blood out of the intestine. And our vaccine, which is quite innovative, works on the fact that we over decades worked out the pathway by which hookworms degrade the hemoglobin. So that's what they're interested in, is the nutrient source. They ingest the red blood cells, they break it open and they ingest the hemoglobin. And we find that if we could take the protein components involved that the worm uses to feed on hemoglobin, make a vaccine out of that, it induces an antibody response. And now we can make our vaccine, we think, for probably two to three dollars a dose, just like our Covid vaccines. The.
- [16:57]
Dr. Gabrielle Lyon
But is it available to the general public right now?
- [16:59]
Dr. Peter Hotez
No. So our COVID vaccine was only available in places like India and Indonesia. Our hookworm vaccine's not available anywhere because we haven't found a vaccine producer willing to. We've made it at the small scale but for clinical trials, but we have not found a major vaccine producer that wants to take it on. Why? Because they don't proceed as a big money making operation.
- [17:20]
Dr. Gabrielle Lyon
Man, if they knew what I saw in clinic routinely. And then what I see is that families get it. I don't know if there's evidence to support this because it seems like it isn't studied in this way, but there seems to be transmission from family member to family member. I don't know if it's just oral fecal, if we're just talking about hookworm, but I had this guy, he was in the Air Force, he was asymptomatic and his wife got it and also their dog had it. It was just this kind of trifecta and their dog was sleeping in the bed kissing faces. But if you were to say, okay, if you want to avoid infection, would it be fair to say, don't sit on toilets, don't let your dog kiss you in the face. How, how would we begin to think about.
- [18:08]
Dr. Peter Hotez
Well, in the case of Toxicara, the dogs have it in their intestines. So the best way to do it is to take your dog to the.
- [18:15]
Dr. Gabrielle Lyon
Don't the dog.
- [18:17]
Dr. Peter Hotez
Well, or, or. And cats have it also. So. But, but make sure you take your cat regularly to the veterinarian and get them dewormed.
- [18:26]
Dr. Gabrielle Lyon
Could we deworm humans regularly, routinely?
- [18:29]
Dr. Peter Hotez
You could, but it may not be
- [18:31]
Dr. Gabrielle Lyon
necessary because they're not self limiting. Am I understanding that correctly? Hookworm, if someone has persistent anemia or elevated liver enzymes.
- [18:41]
Dr. Peter Hotez
Well, hookworm, adult hookworms can live five years in the intestinal tract. Toxicara can go on for a number of years. But I think I'd be careful about just indiscriminately taking what are called anhelmetic drugs because every drug has a risk. Right. So it's good to only be strategic. Right. And use it only when you're diagnosed.
- [19:07]
Dr. Gabrielle Lyon
Do you think it's something that perhaps routinely should be thought of when children have low appetites? Often when we think about our nutritional quality has really decreased. Do you think that it's more important now than ever to be able to identify these things early and often?
- [19:28]
Dr. Peter Hotez
Yeah, I mean, this is why, you know, you want to follow what the American Academy of Pediatrics recommends, which is regular pediatrician visits. And if you have a concern this is something to bring up with your
- [19:40]
Dr. Gabrielle Lyon
pediatrician or test for it, they don't open.
- [19:43]
Dr. Peter Hotez
Well, they got it.
- [19:44]
Dr. Gabrielle Lyon
Let's talk about worm infection, helmet infection, because I again. And then liver fluke. Can you talk to me about. Is that something that you see often?
- [19:55]
Dr. Peter Hotez
Not so much in the U.S. it's, it's a big problem in parts of Asia Far East. Yeah. So in northern Thailand. And it's actually a helminth cause of cancer. So liver fluke, what it's the. There's two different species. One is called Clinorcus sinensis, that's found more in China and Korea. And then there's Opisthoricus vivarini, which is in Thailand, Laos and Cambodia. What happens is it's in the. It's acquired by eating uncooked fish, not so much as sushi. But what happens is the, in these small fish that the locals use to grind it up, make a fish paste out of it, and they put all sorts of condiments on and things like that, but it doesn't kill the parasites. And it's really ingrained in the food habits of those populations. It contains the cysts of those worms of Opisthorchus or Clinoricus. They come out and then they go into the bile duct and they spend years migrating through the bile duct where they'll cause fibrosis and cholangitis, but then they cause neoplastic changes in the bile duct. And so it's A so if you look, the rates of bile duct cancer in Thailand are really high because of that parasite.
- [21:10]
Dr. Gabrielle Lyon
Is that why when we think about gastric cancer or gastric cancer in certain populations seems to be higher, is it related to say H. Pylori or something?
- [21:21]
Dr. Peter Hotez
That's what's often said. So as opposed to what we're just talking about bile duct cancer, stomach cancer, probably their combination. I think you know what it is also it's not only the pathogen and like Helicobacter pylori or opus dorcasis worm, it tends to be also the diet which could be very high in what are called nitrosoamines which are carcinogenic. So for instance there's, you can actually reproduce that bile duct cancer in laboratory animals. You give them the parasite Opus thoracus and you give them a diet high in nitrosoamines, not one two punch.
- [21:56]
Sponsor/Advertisement Voice
Are you concerned about what you cook and store your food in? Well, as we learn more about traditional cookware, I'm concerned for myself and my family. Our place is coated with ceramic and or their titanium pro line. They have an entire line. They're one of the sponsors of the show and they have accessories like spatulas and steamers. Their always pan is non toxic, non stick. It's made without PFAS, lead or microplastics. It serves 10 functions in one pan. You can strain, saute, fry, boil and it's oven safe for up to to 450 degrees. Their wonder oven pro is another one of my favorite multi tool appliances. It can air fry, it can bake, it can roast, it can reheat. And they have a special infusion steam feature making things crispy without, you know
- [22:47]
Dr. Gabrielle Lyon
what I'm talking about, the smell of burning chemicals.
- [22:50]
Sponsor/Advertisement Voice
We've been doing this rotisserie chicken thing in our family and this wonder oven preheats 60% faster than a traditional oven and more importantly, it's completely free of the forever chemicals. So if you want to upgrade your kitchen, Visit from our place.com use the code Dr. Lion for 10% off site wide. That's from our place.com code Dr. Lion for 10% off and you can try it risk free for 100 days.
- [23:21]
Dr. Gabrielle Lyon
But we do have a global food system, right? I, you know, if I was a betting woman, I would say while we think about it in certain locations, for example in Thailand or wherever, but because food supply seems to be so global that I would assume these things are coming here whether they travel to Thailand or not. But have you thought much about that?
- [23:48]
Dr. Peter Hotez
Well, this, that parasite Clinorcus used to be highly endemic, for instance in Chinatown in New York. Why? Because the first wave of Chinese immigrants to the US came from Canton, Guangdong province, where at that time there were then, this was when China was still a very poor country, had very high rates of that Clinoricus parasite. And so it was pretty common in Chinatown in lower Manhattan, but where we
- [24:18]
Dr. Gabrielle Lyon
wouldn't necessarily have the evidence to test. And again, do you think that it's still there? Because I just think that we're not testing for these things routinely.
- [24:29]
Dr. Peter Hotez
Yeah, I think it's probably less so. Well one, because Chinatown, they're coming from all over different parts of Asia now. But also, you know, Guangdong now has got a pretty advanced economy now. So. So I think probably the rates of Clinorcos are probably way down there as well.
- [24:44]
Dr. Gabrielle Lyon
One of the, the things that I think has been really important about your works, especially around tropical diseases, is that there seems to be this stigma about low sanitation. But you've also said that it's not just about the low sanitation that we've kind of. There's a new way that we can reframe these.
- [25:04]
Dr. Peter Hotez
Yeah, I think a lot of it is climate change. That's a big factor. Also urbanization too. So people are living in more crowded areas. And it's been really tough to get the word out about parasitic diseases in the U.S. you know, I did, I was very successful doing a lot of advocacy for what we were calling neglected tropical disease near NTDs in low income countries in Africa and elsewhere. And where I was able to get funds appropriated through USAID for mass treatment programs. And the modes of prevention are a little more problematic and. Well, yeah, but that's the reality. And finally I got Senator Cory Booker interested in it and he put in legislation in the Senate called the STOP ST O P Neglected Tropical Disease Act, STOP NTDS act, which included mandates that we actually do active surveillance for these diseases. And he couldn't get a co sponsor. And it's kind of. I don't think it's gone. It's been a few years now. I don't think it's, it's gone very far. But there's no question parasitic infections and related tropical diseases are widespread in the US Particularly in this part of the country. And most of them are being missed and not being diagnosed.
- [26:20]
Dr. Gabrielle Lyon
I would absolutely agree with you. And people are symptomatic, even beyond wheezing. We see it manifest in skin conditions. We see it manifest in all kinds of ibs. What about Lyme and those various co infections. Have you studied that much?
- [26:37]
Dr. Peter Hotez
We haven't. Well, Lyme, but also, you know, now we're seeing a big rise and Lyme of course, is transmitted by ticks, but now we're starting to see a big rise in illnesses from soft tics and others, and they're not being diagnosed. So one of the things that we've done now, we've gotten some support from here in Texas from the Lida Hill foundation and they're based in Dallas, and now the Georgia and Cynthia Mitchell foundation to do it in Galveston and for Harris county from an anonymous foundation. And what we're doing now, which is quite interesting, is we're collecting the ticks which transmit things like relapsing fever, mosquitoes that can transmit dengue or chikungunya or Zika, God forbid, yellow fever, as well as fleas that transmit typhus. Now we have typhus transmission here, as well as the raduvid bugs that transmit Chagas disease. And we're doing their full genomic sequence. And so by doing that, you not only get the genome of the vector, the arthropod that's doing this, but also you get the viruses that are inside. And what we're finding is a whole new set of pathogens that people didn't realize. So the old way of doing it in Harris county here in Texas does this. And they're one of the few that even do this, which is they'll collect pools of mosquitoes and they'll design PCR primers to look for what they think is there. What this does by doing the whole genome is we can actually get the full ecology of all the infectious diseases that are popping up. And now we're doing this for Harris county in Houston and Galveston. The problem is now we'd love to do this for. We should be doing this for the whole country, right? Or at least the Gulf coast and, and other vulnerable areas. And we're not. So we're basically not doing the. We're not using the most modern methods of genomics to really detect these pathogens. And we should be doing that. In 2003, 2004, Houston had a dengue epidemic both summers and they were missed.
- [28:52]
Dr. Gabrielle Lyon
Why?
- [28:52]
Dr. Peter Hotez
Because, you know, a patient comes in initially with non specific findings. Right. You know, you've seen it, right? Fever, rash and headache. Right. Okay, patient goes with a fever ration. Headache. What is it? Well, it could be a hundred different things. Now, through this metagenomics project that we call it, we can have a list for what's in every county or even, you know, cut it even finer into a district. So then the physician can actually be better informed of what's actually in their community because now it's their best guess. And they have to send off specialty tests that take two weeks to come back. You know, either the patient is very sick or. Or fine. And so I'm hoping this will be a new approach to really doing a deep dive on these illnesses.
- [29:38]
Dr. Gabrielle Lyon
It makes me think of the patients that we have in our practice. There are. We do get a fair number of Lyme patients that have been all over, and it's more of dealing with this kind of sequelae. Have you seen that? I mean, because I know that as a pediatrician, probably after 18, they don't come to see pediatrics any anymore. But it seems as if individuals, there's this neurocognitive component of Lyme and whether it's later life, they're just again, a whole host of this kind of cognitive. Cognitive impairment is not the right word, but maybe they have mood issues or they have gait, just.
- [30:17]
Dr. Peter Hotez
Well, remember when Covid happened, one of the big surprises was long Covid, right. People didn't know that there could be such a thing as long Covid. Well, it turns out long term sequelae from infections are actually more common than you think. They occur with influenza, West Nile virus. It turns out one of the things that our scientists have found at the national school of Tropical Medicine are these long term cognitive effects and neurologic effects of Lyme disease, even kidney disease, you know, years after they've had it. And I think that's another important new frontier for infectious diseases is recognizing these long sequelae. You know, when we talk about influenza virus or the coronavirus causing Covid, the SARS 2, we always couch it as a respiratory pathogen, but they are as much cardiovascular pathogens as they are respiratory pathogens. And so the SARS 2 coronavirus that causes COVID 19 is a thromboembolic virus that causes clots to form in your coronary artery and the blood vessels going to your brain and the cerebrovascular system is causing heart attacks and strokes. So it turns out one of the best ways to protect your heart health is to stay up, keep up with your Covid vaccines. Same with influenza. Influenza causes heart attacks, and people are not aware of that.
- [31:44]
Dr. Gabrielle Lyon
In the 70s, there was the McGovern Committee, and the McGovern Committee is the committee that really influenced the dietary guidelines. It was written by a young staff writer at the time who was Trained in agriculture, knew nothing about nutrition. And then these guidelines came out. Since that time, it has perpetuated forward. We know that they are not ideal, for example, it's just they've still hung on the fact that saturated fat is bad, even though we don't have a number. And I see that that's probably very similar or there's veins of that when it comes to public mistrust in the science, because there's mistrust in the nutritional science. What about the biomedical science?
- [32:30]
Dr. Peter Hotez
Yeah, I think, you know, it's really interesting because I can't tell you, Dr. Lyon, Gabrielle, how, how many times I've been on zoom calls and meetings, things like that, about trust in science, you know, and it's all about people hand reading. Okay, what did we do to screw up, you know, with other scientists?
- [32:48]
Dr. Gabrielle Lyon
It's almost like a swing. When I was in medical school, and then even in fellowship, there is a trust in the institution that we believe that obviously there's a recognition that science is imperfect and always evolving and that we can change the hypotheses and things get proven right and things that get proven wrong. But there was a respect and there was an earned respect. Do you think there's a way to restore trust and how for the people that are growing up now, for the generation that is watching this, as opposed to the generation that has never seen anything like this before.
- [33:22]
Sponsor/Advertisement Voice
Right.
- [33:22]
Dr. Gabrielle Lyon
But even myself, as someone who is what I would consider evidence based, it's
- [33:28]
Dr. Peter Hotez
challenging and answering all the questions that they would really want to know again, you know, trying to get it right of, of going in, going to some depth in the science, but. And not being, you know, condescending about it as well. So that, that was, that was really important. And the answer is, well, I think, you know, you know, Gabrielle, I think people like you are part of the answer. Because, you know, I can go on CNN and MSNBC till I'm blue in the face, and I do, and it's great to have that opportunity to go out, but I'm not reaching all the people I need to. Right. And I think, you know, this is why your podcast is so important, because it's, it's, it's a safe space for a lot of people and reaching audiences that I would never have access to otherwise. So what's the answer? I think people like you are part of the answer. And I, and I, that's it. But I also think the academic health centers need to be more proactive in encouraging their dogs and scientists to be out there. I mean, you should be in an academic health center being encouraged to doing what you're doing because it's a really
- [34:33]
Dr. Gabrielle Lyon
important public service to help the general public understand that scientists, we can argue and you know, at least in the nutrition space, there's a level of respect for sure. Debates are not done on a public forum. They're not done openly. It's not this highlight reel, you know, kind of what we're seeing in the landscape. There's a lot of respect for the individuals that have been in there and been doing these things. And there's again, people don't agree, but it's not quite as divisive as it is now.
- [35:08]
Dr. Peter Hotez
But that's not how science is done, right? I mean, science is done through peer reviewed papers and discussions between colleagues really trying to figure out some hard things.
- [35:20]
Dr. Gabrielle Lyon
There is a lot of frustration with the idea of experts and the level of distrust.
- [35:26]
Dr. Peter Hotez
Even physicians in practice are often a number of years outside their first year of biochemistry course and they don't have time to look up this stuff. And there's no, you know, single website that's out there that provides that information. And so patients or the parents of patients will come into the doctor's office and they make the doctor feel like they're not keeping up with the literature. And so this has been part of the problem as well.
- [35:57]
Sponsor/Advertisement Voice
We all remember what a freshly cleaned room smells like. Straight chemicals. You know, as I think about it, I used to touch this stuff with my hands directly. And the more we learn, the more we understand the whole body burden of these compounds over time. We all have frankly enough to worry about. Cleaning products should not be one of those things. And I remember when people thought I was crazy because I was really concerned about all of these cleaning products. I get it, the essential oils might not clean everything. But on the other hand, and I'm not sure that we need these very aggressive cleaning products. And typical cleaning products use chemicals that leave synthetic fragrances and other endocrine disruptors as well. There's also harsh organic compounds on your countertop floor, your sheets that kids sleep on. These chemicals accumulate over time, forcing your body to carry that burden. And that's why in our house we use Branch Basics. Their premium starter kit uses one plant and mineral based concentrate to replace every single toxic cleaner in your house. It has zero fragrance and zero endocrine disrupting chemicals. It handles everything from our laundry to our kitchen counter without compromising our health. The only thing I wish it did different is if it would actually clean itself. But it doesn't Branch Basics is available at Target, Amazon and branch basics.com you can get 15% off the premium starter kit with code Dr. Lyon@branch basics.com that code is Dr. Lion for 15% off.
- [37:37]
Dr. Gabrielle Lyon
Do you think that there's going to be a way where we come back in terms of, you know, I'll give you an example from my perspective, veganism. If someone wants to be vegan, I don't care. Good for you. But the reality is if you look at the information that's being spoken about, there's like a bunch of smoke screens, for example. You said concrete examples are best. I'm going to give you a handful that cows are killing the planet. But the reality is for greenhouse gas agriculture, especially in the US makes up about 9%. The rest is industry, electricity and transportation. 80 plus percent. If you stop eating meat for a year, you take one transatlantic flight and it's equal. Sure. I think it's just important to look at two sides of the coin. So sometimes they're wrong. You know, if you have a diet where less than 30% of your nutrients come from animal based products, you're probably gonna miss B12, zinc, folate, all the things that are necessary for a growing child. Hopefully I'm making myself clear that it's like they are wrong. And so somewhere there is sometimes science is wrong. Is it knowingly wrong? I don't know.
- [38:50]
Dr. Peter Hotez
Well, but this is why, you know, if you're going to take, you know, extreme measures in your diet, do it in collaboration with a physician who knows something about nutrition. Right. I mean that's clearly part of the answer. Yeah. So no, this is, this has become a big issue right now and how we can communicate bona fide science to people and do it in a very straightforward way I think is one of the great challenges. And unfortunately it's going to get worse before it gets better because now it's a real problem that you can't rely on the federal government and how. And so that is certainly not going
- [39:34]
Dr. Gabrielle Lyon
to help the situation if there are collaborative groups. Right. So I'm sure you know the best infectious tropical medicine disease doctors. Right. Because they've been around publishing for a long time. Do you think that there's a way to say, okay, potentially here are your top 10 experts in schistomoniasis or Helmuth disease, and then there are your top 10 experts in nutritional science. Is, do you think that there is, you know, just from a, a solution oriented standpoint? Because I honestly I don't know, but I would love to Think that there is some way where we can get to a place where there's. It's non biased and we can all
- [40:20]
Dr. Peter Hotez
understand you've become an exception. You always remain evidence based and you don't feel the need to attack mainstream radicals. But you know, so we just need to multiply you times a hundred, you know.
- [40:33]
Dr. Gabrielle Lyon
So I am still mentored by my longtime mentor of 20 years and he's actually working on the dietary guidelines now. And he would absolutely kill me if I didn't practice scientific integrity.
- [40:47]
Dr. Peter Hotez
Right, right.
- [40:47]
Dr. Gabrielle Lyon
It would be a non negotiable.
- [40:49]
Dr. Peter Hotez
That's.
- [40:49]
Dr. Gabrielle Lyon
I really appreciate your work and I think that you are just a great scientist, truly.
- [40:56]
Sponsor/Advertisement Voice
Thank you.
- [40:56]
Dr. Gabrielle Lyon
You're doing a lot of important work. What are you working on now in your lab currently?
- [41:02]
Dr. Peter Hotez
So right now we are really trying to get the last mile for our hookworm anemia vaccine. Then it's a matter of trying to find support to actually get this manufactured. And where is it going to be manufactured?
- [41:19]
Dr. Gabrielle Lyon
Out of curiosity, what kind of support are we talking about financially?
- [41:24]
Dr. Peter Hotez
You know, for us a few million dollars goes a long way. You know, Novavax got $1.6 billion and we got about seven, $8 million. That's all we need. All we needed then. So we don't even need that much. So I think getting that kind of support would be huge. The other thing, we have a vaccine for disease called Chagas disease. And then the other is of course I like to write books and I've been writing about anti science movements for the last couple of books. But this new book that I hopefully will announce soon is I'm re looking at the history of Texas through the lens of its epidemics.
- [42:05]
Dr. Gabrielle Lyon
That's cool.
- [42:05]
Dr. Peter Hotez
People don't realize how epidemics, malaria, cholera, yellow fever, smallpox dramatically changed the whole history of Texas. And so I'm doing a deep dive in the history of Texas and loving it.
- [42:18]
Dr. Gabrielle Lyon
I mean it's fascinating. I'm telling you, if I had had a choice, if I didn't go in the direction that I did, it would have been infectious disease, tropical.
- [42:26]
Dr. Peter Hotez
Well, you've had an amazing career and I can't thank you enough for having me. Because what you're doing is so important. You know, getting real information out there without, you know, trying to scam people, without trying to push a lot of snake oil but actually get, you know, meaningful nutritional and health information out to people.
- [42:48]
Dr. Gabrielle Lyon
And it's hard.
- [42:49]
Dr. Peter Hotez
You know, one of the things, another reason I admire you is a couple of times, you know, after going on the cable News channels talking about COVID infectious diseases and vaccines. Some of the cable news channels said, hey, do you want to be a medical correspondent for us to do all the things that, you know, people like Sanjay Gupta do or Vin Gupta do? And, and I declined because I, I find that really hard to one, be a generalist, but also do it with integrity and really take the time to look. So my hat's off to people like Sanjay Gupta. Vin Gupta, what you're doing, because it means keeping up with so many areas.
- [43:27]
Dr. Gabrielle Lyon
I don't do it alone. I don't do it alone. I know what I'm good at. And then I get analysts and help.
- [43:36]
Dr. Peter Hotez
But it's work, right? I mean, to really do that. And I didn't want to be out of the lab that much and wanted to write my books. And the end of the day, I'm an academic and this is what I'm.
- [43:47]
Dr. Gabrielle Lyon
And we need that. It's so important.
- [43:48]
Dr. Peter Hotez
Thanks.
- [43:49]
Dr. Gabrielle Lyon
It's more valuable now than ever because it takes a lot of effort and it's a lifetime career. It's very much earned. Nothing in academics has given away. It is a very different landscape now and we need academics. This idea that we can all be self taught, things of that nature, it's, it's ridiculous and it's dangerous.
- [44:13]
Dr. Peter Hotez
I'm worried. I'm worried especially, you know, for young scientists and physicians. You know, sometimes they look at me like Moses in the desert, why did you bring us here? And I said, look, you know, I know it's, things are dark right now, but it's really important. I mean, we have fewer and fewer physicians, scientists, we're graduating fewer and fewer PhDs that want, you know, to have careers where they're spending their life solving problems. And so I, I am worried about the future of this country from that standpoint.
- [44:43]
Dr. Gabrielle Lyon
Potentially, hopefully we'll be able to inspire people to begin to think and have transparent conversations and then go back to this model of deeply respecting colleagues.
- [44:52]
Dr. Peter Hotez
Yeah.
- [44:52]
Dr. Gabrielle Lyon
Which I think is, I think that's important. And I think that there's a level of respect comes from, you know, that you earn it. And if it's earned, then there is this mutual respect. And that's if, if the ultimate goal is to provide information, the ultimate goal is actually to move the needle for health and wellness for the population. And that's done collaboratively. It's not done individually or.
- [45:21]
Dr. Peter Hotez
I totally, totally agree.
- [45:23]
Dr. Gabrielle Lyon
So thank you so much. And I'm, I'm very excited about your hookworm vaccine. Sign me up myself will be the first, and my team will be second. Thank you.