Sawbones: A Marital Tour of Misguided Medicine - Update: Malaria

Episode Date: July 11, 2023

Now that there have been malaria cases popping up in the United States, we bring the full episode about the disease from 2015. So learn all about malaria in the past, and Dr. Sydnee will have an update about malaria in the present. Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/

Hey, everybody, it's Justin McRoy here and Sydney McRoy. We are going to be Recessitating an episode from 2015 about malaria. Can you believe we've been doing the show that long? No, I can't Sydney But we are going to be bringing that episode to you. I forget it's old enough that a lot of people may not even heard of it We have an update to this We have an update to this episode that you'll find at the end of the episode, but you need the context first. Right, so learn all about malaria from us in the past, and then we'll tell you the update from us in the present. Perfect. Saabones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun.

Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. All right. Tommy is about to books. worth it. We came across a pharmacy with the two in that's lost it out. We were shot through the broken glass and had ourselves on like our own. Some medicines, some medicines, the escalant, my cop, for the mouth.

Wow! Hello everybody and welcome to Sobo and Seminal Tour of Miss Guy of Medicine. I'm Yerko who's just a macaroid. And I'm Sydney Macaroy. Sydney? I'm tired of something. You're tired of something? I'm tired of something and I would like to broach the subject with you now. Right now. You know what? You and I really picked the best time to have these kind of disputes. Well, that's kind of what I'm asking. That's kind of what I want to talk to you about.

This is like our 80th episode, I think, somewhere around there, 80 episodes. And in every episode, we try to come up with a reason, like a conversation that we might have been having that would lead us into the topic of the subject that we're discussing. Yeah, it's like a bit that we do. It's like a bit and you know. And you're really messing this one up. Yeah, well, it's exhausting.

We spent dear friends, we spent the last three minutes trying to figure out how we might have a conversation. Three whole minutes of our precious time. Three minutes. Now, I would say upwards of four minutes discussing what conversation we would be having that would lead us into malaria. Friends. Now you've given it away.

Now it's not a surprise. Now they know we're talking about malaria. Well, that's my intro there. Now, that's the conversation we had that led us into malaria. Friends, we talk about a lot of things here between the two of us and Most of which are are

Charlie centric, but you would be shocked the just a wide breadth of topics very rarely are we say are we having any conversations that would take us Into malaria Just like a net well, okay more more so being married to you, I would say I and that, wow, okay, more so being married to you, I would say. I tried it, but those aren't so much conversations as like one-sided monologues. Like I tell Justin things and he tries not to look like glazed over and...

Sobbing. Sobbing. The podcast. Hey. Hey, I'm just kidding. So we're gonna talk about malaria. If you have a big problem with us leaving out our bits. Our classic bits.

Let us know. Otherwise, we'll spare you. I just imagine people at home like, at home like, yeah, I get it. I get what you guys are going for. But if you like that, if you like that. I don't know, maybe you would say, I guess. That would be me like, oh, they're gonna get into this. Yeah. If you like that part of the show, please let us know,

but also like write a bunch of them for us because they're, I know it seems weird that those took effort, but like they do. Anyway, sorry. Sydney, the thing that made this hard is like, I don't know, I don't know, the layer is real funny. Like that's the where we get into trouble is like,

what are some good, what are some good, I was sitting my head here thinking like I was sitting like bang my head is a table thing. What are some good malaria jokes? There are Danny and good malaria jokes. No, I there aren't I mean malaria is not I don't think it's funny I think it's a fun disease to talk about like people enjoy talking about malaria. It's interesting I should say it's got a long history. And it's a parasite, which we don't talk about a lot, and people always get a little...

Remind me. What is a parasite? Well, it's a some sort of small, well, doesn't have to be small. In this case, we're talking about tiny little organisms that use something from your system, your nutrients to survive. They wheeze off your juice. Right, so they're not giving you anything, they're not providing you anything, they're just taking from you. And they don't have to be small,

but usually when we're talking about parasitology and human parasites, we're talking about small things. Now they can be big, there are big giant worms that can come out of your butt, but we're not talking about that today. And monkeys, monkeys might fly to your butt too. Nope, that's another concern. Nope, not a concern.

Did somebody suggest the topic? Yes, a lot of people have suggested malaria, because like I said, a lot of people like to talk about malaria. Don David, Lehman, Jean, Jose, Nicholas, all suggested the topic. Thanks, y'all. If you, by the way, people ask about this.

If you'd like to suggest the topic, you can email solbones at maximumfun.org. So malaria comes from the Italian word for bad air, mal air. Um, and that was, that was because, and we'll talk about this more, but a lot of people thought for a long time that the way you got malaria was by inhaling something in the air. It was like kind of, we've talked about before, like the measma, theory of disease, like that it's like, there's some kind of illness

that's floating around you and you might breathe it in accidentally and get sick, which sometimes is kind of right, but not with malaria. Right. No, not in this case. So, like I said, it's caused by a parasite, which we don't talk about a lot, and I think it's because in the US, we don't get us, or we think we don't get as many parasites.

But there are parasites endemic to the US. Malaria used to be, really. You used to get malaria in the US. You used to get malaria everywhere. Malaria was a big deal in pretty much, not every country on earth, but almost every country on earth for many years, but the change in kind of our sanitation and the big thing is whether

or not you have a lot of standing water for the mosquitoes to lay their eggs in. If you don't, you don't have a lot of these mosquitoes and then you don't get a lot of malaria and so as kind of things changed in the US, malaria got pushed further and further south and now we see it Mostly in Africa, although it still exists other places. What does it do? So let's talk about malaria the parasite and what it does. Okay, so is it single-celled or is it like bigger than that? It's a little teeny Plasmodium. Okay, so Yes, yes, okay. No, no, no, it's not okay. So, yes? Yes. Okay.

No? No. No, it's not. Okay. No. No. I'm going to go with no. Official no.

I don't know. I'm a doctor. Okay. It's a plasmodium. I know all the names. I know what it does to you. Okay. So there are several different flavors of malaria that people get. Depending on which make mine rocky road, which plasma

is modium infects you. There's phalciparum malaria, vivax of valley. There's a couple others. It's carried by a certain kind of mosquito as I've already alluded to the anophiliz mosquito. So anywhere that you have an awful these mosquitoes, conceivably, you could have malaria. It gets into your bloodstream when the mosquito bites you,

so that's why I said it's not really from inhaling toxic air. It's specifically from a mosquito bite. And then initially the parasite will go infect your liver cells, but from there it's released into your bloodstream and that's when you start really getting sick. And that's also when we tend to see and diagnose malaria. And there's a lot of like if you are the kind of person who likes to look at microscopy pictures. And who is that? Like of of things you might see if you looked at blood under microscope. You can see a lot of little shapes like ring forms and little banana shaped things that under the microscope

when somebody's blood who has malaria. Some forms can live in your liver for a long time. Like the Vivext and a Valley, they can have these little things called hypnosygoids, these little secret things like surprise. I don't know, timed. What am I thinking of? Timed minds.

What? They're like, you know, timed. I love time bombs. Yeah. Okay, yeah, I'm not saying. You like, you know. Time bombs? Yeah. Okay. Yeah. I'm not saying. You know, time bombs. You know, time bombs.

The word I couldn't come up with. They lived. But where somehow many things to say the two components of, you just didn't. I said mines. I was thinking like, golden-eye. Like, instead of proximity mines. Well, they had remote mines, but that I don't think. I'm thinking of remote mines. Well, no, because you don't, they're just there.

And then they just, let's go with time, Bob. Yeah. And then they explode out of your liver later on after you think you've already gotten over the malaria and you get sick again. You spread them to another person, only you like them a mosquito bites you and then bite somebody else.

So you tend to see the kind of outbreaks of it in areas, but it's not person to person so much as mosquito to person, mosquito to person. The symptoms of malaria, the classic are these cyclical fevers. And this is why, as I'll talk about, we think we've had malaria around for a really long time, is because there aren't a lot of illnesses

that have this kind of pattern of like, you get this really high fever, you get really sick, and then it starts to abate, you feel better, almost to the point where you seem like you're totally fine, and then you go through the cycle again. And that's been written about all through antiquity, and so that's why we think malaria has been around so long. You also get a riger, so these really awful chills and shakes. You get anemic, you get headaches, you feel really, really lousy when you have malaria.

And then there are like really severe complications that can happen not to everybody, but especially if you get the falsyparum variety, you can get fluid in your lungs like pulmonary demon. Your spleen can get really big, it can even rupture. You can go into renal failure, which kidney failure, you can go into shock. It's really bad for pregnant women to get malaria. There are lots of complications. So malaria can be something that just makes you feel really rotten or it can turn into a really big deal. What changes that? Like what determines what, it just the different, as you said, varietals of malaria.

Part of it is that, which one is more likely to cause problems, but just like felsipram is classically what we think of as the worst. But just because you get felsipram doesn't mean you're gonna get that sick. It depends one on either more complications, sometimes the more times you have malaria. Man, that's rotten.

I know, I know. I didn't mean to laugh. It's just like, ugh. Like to me, the idea of getting a malaria is so like, just so unfathomable. Like it breaks my heart to think that there are people who get it and are like, ugh, again. Again with this.

For a lot of people, it really is like that. Like another science infection. Like the, the, in certain parts of the world it really is like that. Another time is infection. In certain parts of the world, people get malaria that often. It can cause, if it's not treated appropriately and you're not getting an address, then it can cause chronic problems from that. Or just sometimes, it's either your first time getting malaria or who knows, and you have one of these catastrophic complications.

Certainly, people who are already sick would be more likely to have these problems, but Part of it is just bad luck as well We have found evidence that the parasite the plasmodium that causes malaria Has been around for 30 million years and we found it in mosquitoes trapped in amber Which I think Along with some dinosaur DNA. I knew you were going to go down the street. It's fun as I found this information and I thought, now we're going to have a Jurassic Park conversation.

The bad thing is we thought it was just malaria, but then we crossed it with a DNA of a frog. And that's why malaria is so bad today. Because it's because we crossed it with a DNA of a frog. And that's why malaria is so bad today. Because it's because it's the cross that with, because it's frog malaria and it's reproducing asexually. If it was frog malaria, it probably wouldn't infect humans. Probably, I mean, that might not be so bad. Dinosaur.

There was suggested that maybe some dinosaurs got malaria. Oh, really? Yeah. That is because there's been evidence that it was in reptiles. So maybe. So this is not one of our new diseases that we've talked about before. This is an old one.

No. We likely first got it as it evolved over time from chimpanzees and, depending on what strain and gorillas who passed it on to humans, like again, from mosquitoes. And malaria is interesting because it's probably evolved alongside us, with us adapted to us and we have adapted to malaria. It's actually shaped some of the other chronic blood disorders that we see. For instance, sickle selenemia, thalassemia, there's another called G6PD deficiency.

These people are less likely to be infected by malaria. And so there's a thought that when you, the reason that we still see these blood disorders, the reason that when they arose, you weren't selected against evolutionarily. Do you understand what I'm saying? Yeah. It's because they provided a selective advantage

because you were less likely to get malaria if you had them. Right, that makes sense. So that's why, that's part of why we see the prevalence of these diseases. In addition to our evolutionary history, malaria has changed the course of history in a lot of like our social and political history. Sort of like, well, what do we talk about last time?

Ciflis had it in that way. To work elosis has had that impact. But malaria certainly, because at times, if there would be an outbreak in certain parts of the world, it would destroy a whole city-states. Armies were decimated by malaria at various points in different wars and history. Specifically, when we talk about the civil war, there were as many people sick in bed with malaria as there were fighting and being injured in the war. It's depressed economies.

Every time there would be a big outbreak of malaria, it was very hard on the economic situation. And there were theories that there were parts of countries that were uninhabited, especially coastal lands, for decades because people knew that it had something to do with water, and they didn't know what specifically. So they stayed away from bodies of water. So there were areas that it was thought,

and nobody lives there, and it's probably because of malaria. We tend to think of it, like I kind of said, we tend to think of it as like a tropical disease now, but it was everywhere for a long time. But like I said, you need some, you need standing water. That's one of the big things that you,

when you're trying to address the malaria problem to eliminate sources of standing water, can be a big help. And we've seen malaria kind of recede from, at least from the U.S. and, you know, the UK and Europe. There is evidence that the ancient Egyptians had malaria. Yeah, I would think so if the dinosaurs hadn't. We found DNA evidence in mummies.

And there's also evidence that they at least had some ideas that they didn't want to be around mosquitoes. Oh, really? Yes. The pharaohs, Nefarro used to use bednets, Cleopatra slept with a bednet. And I mean, maybe they just don't like getting bitten by mosquitoes.

But still, I mean, that's, yeah. But I mean, if you do that every single night, you have to begin to wander like, I don't know. Do you know, do you know something? Do you suspect something? Well, yeah, but like, yeah. But, I mean, if you do that every single night, you have to begin to wander like, I don't know. Do you know, do you know something? Do you suspect something? Well, yeah, but like, at the same time, who would have nights where like, maybe I'd like to get a bit by mosquitoes tonight?

Like, I mean, I think that once you decided you would rather not be a bit by mosquitoes, that's probably a life decision you're gonna live with. Maybe you just fall asleep first, and you're like, oh, I don't wanna wake back up and get my bed net out. But my bed net out. I think if you're Cleopatra, odds are pretty good. You're not hanging up here in bed net, but like, oh, I don't want to wake back up and get my bed net out. But my bed net out. I think if you're Cleopatra, odds are pretty good.

You're not hanging up here in bed net, but maybe. I don't know. It's kind of, I mean, like, you know how every night you get in bed and try not to brush your teeth and then I have to convince you to get back out of bed and brush your teeth. Yeah, yeah, yeah, yeah, yeah, I remember that. Maybe it's like that.

Same principle. The builders of the pyramids were given a lot of garlic and that's thought that it was an attempt to protect them from malaria. Again, not sure that they knew any connection between what was going to give them malaria, just that somehow garlic would kind of like the strong smells, fight strong smells, push away the bad air. Like I said, these cyclical fevers are really what make us think that this has existed so long because hypocrite's wrote about this, that there was an illness and that you would

have these horrible, horrible high temperatures and then you would get better and then it would come again and then it could be deadly. But we think this is malaria, we're pretty sure that ancient Chinese physicians wrote about this as well and also wrote about the fact that patients who would get these high Fever's tended to have large splines often. So again more evidence that we think this probably is malaria The Romans called it the Roman fever We think that when they reference that their time at malaria, which I think is a little conceited Yeah, it's very showy And also dinosaur fevers better.

Dinosaur fevers would be, if they had like, A, called it with dinosaurs and B, called it dinosaur feaver, I would be slightly less concerned about catching malaria, I think. If it was called dinosaur feaver. Yeah, because I, honestly, there was a period when I was like, five or six where I did have dinosaur feaver a did have dinosaur fever a lot I think a lot of little kids go through that phase. Yeah, like a dinosaur fever phase. Not malaria No, I was just really into dinosaurs The Pope Gregory the fourth actually in response to the Roman fever being more prevalent and warmer times of the year

actually moved all Saints day in response to the Roman fever being more prevalent and warmer times of the year actually moved all Saints day from May to November and in part it was because of malaria. All Saints day November first, all hellos. It's not what I know about, is that a Catholic thing? It's the day after Halloween, all Saints day. Oh, okay. I know about all Saints, the girl group. Is it the same thing? Not at all. Okay. I thought Halloween all saints, the girl group. So the same thing? Not at all.

Okay. I thought we had a nice, I think it's a nice day. I think it's a nice that all saints has a day in their honor though. They made only a minor impact on the music landscape, but I'm glad that we're still remembering their contribution. It's nothing like all spice day.

I expected more from that one. Yeah. No, but it's a day after. All spice day. I expected more from that one. Yeah. No, but it's a day after. Yeah. What was the joke? All spice. It's a spice. All saints, all spice. I thought you were going for a spice girl's thing because we have all saints. Okay. No, I was talking about the season. Sure. Yeah. Anyway, no, it's the day after how all halos eve is Halloween and then the next day is it's must be the day of the Hallows of the Saints, the Holy people are only the day after Halloween is the day that I have diarrhea from eating too much candy. So that's not I didn't know it was a holiday. Well, I It's also a day where we celebrate all the Saints when I was younger. I dress up as one of the same don't do that. We all did. We all had to do that in mind. I don't know what to tell you, Sydney. Okay. Anyway, we don't do that. We didn't do that when I was little. We did

have saints. So there's some belief that maybe part of the reason we moved all science data in November is because of malaria. The Romans also believe that it came from the air and specifically swamp air. So one of the solutions was move away from the swaps, don't be close to the swaps. Which again, isn't a bad idea. If you're looking for a place where mosquitoes are. It's nice that they figured out the water thing. Did they know it was from mosquitoes or did it?

It was just the water. Nope, just something to do with the swamp air. Throughout Shakespeare's time, Shakespeare wrote about malaria quite a bit, like seven or eight of his plays. He mentions malaria. At this point, it would have been called Marsh fever or the Tertian Agu. The Agu is a name we hear a lot for malaria. And as I kind of mentioned, it just ravaged different wars in our history, specifically the Revolutionary War and the Civil War. A lot of people had malaria. Congress, specifically the Revolutionary War and the Civil War, a lot of people

had malaria. Congress actually during the Revolutionary War bought Sincona bark, which is we're going to talk about, was one of the old and current treatments for malaria, from South America during the Revolutionary War in an attempt to combat malaria. I know about Sincona bark from a signature of all things. Yeah. And then World War I and World War II, there were certainly many people sick with malaria, although not as many people were dying from malaria

at this point. The bigger point is that it made a lot of soldiers sick, and that was obviously a huge impact on many, many different battles in the war. By the 1890s, we figured out that it was spread by parasite. We'd isolated the parasite. It was actually two medical students helped in this effort finding the parasite, like reproducing inside mosquitoes and figuring out what was going on.

And then, of course, that it was spread by mosquitoes, we figured out after that. Excellent. I should mention, we just randomly mention single-triple things. That's a great novel by our friend Elizabeth Gilbert. If you like our show, you will probably like single-triple things. I think you will.

It's a wonderful book. I would highly recommend it. Sydney, I just did that little plug for Liz Gilbert's book, and now I'm got the urge to promote more things. Can you help me out? Yeah, let me show you the way to the Billion Department. Let's go. The medicines, the medicines,

the ask you let my God before the mouth. Hey, Max von listeners, this is Cameron Esposito. I'm a stand-up comic actor, writer, best-selling author, and podcaster. I got a great show called Queerie where I interview LGBTQ plus luminaries across a bunch of fields. People in entertainment, astronauts, musicians, rock stars.

I am bringing the show to Maximum Fun. You can listen right now, and I am so happy to be on this network. We have new episodes out every Monday. You can listen at maximumfund.org or wherever you get your podcast. [♪ OUTRO MUSIC PLAYING [♪ It's official.

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That's maximumfund.org slash COOP. So why don't we talk about some treatments for malaria? Yeah. Now that we've kind of gone over the history. Let's start digging out of this as well. Okay. So first of all, what's interesting about the history of malaria treatments is that we kind of got it right a couple times without really intending to. Hey, go us.

As far back when we go into like the ancient Chinese writings about malaria, you find them recommending a certain herb, the Artemisia herb. What is so interesting about that is that that is the basis of some of the treatments we still use today for malaria. So this was not wrong. I don't know if soaking it in cold water and then eating it raw would work, but I know that they were on the right track. And what I love the most is that the recommendation of using this herb is from a book called

Emergency Prescriptions kept in one sleeve. That's a great title. I bet that was flying off the shelves. I don't recommend to my patients to keep any prescriptions in their sleeve, but I'm going to start, I guess. Your sleeves look really baggy. Well, I've been feeling under the weather lately. I've got some emergency in here. I've got some cough drops. I've got some brambleberry essence. Be careful what you carry in your sleeves, though. It's a crazy world out there now. A lot of sleeve thieves. You have to be careful. People are said, you notice somebody eyeing your sleeves, you just head on down the road. They're up to no

good. They're after your blood pressure medication. You're a bark, depending on what error. Or the bark you have in your sleeve. There was an early understanding, we kind of talked about that people knew that water had something to do with it and like swamps. So rice patties came under fire in China. And so there were some recommendations like- Oh, I bet those things are just like rife with mosquitoes. Yeah, and so there were some thoughts like, maybe we should stop doing this,

but of course that was a huge economic problem. So it wasn't stopped, but there was debate, you know, like what do we do? Because we need, the rice was a big, you know, still, I imagine, a big feature of the economy. Yeah. so there was some question as to whether that should be stopped. Similarly, draining swamps was something that we suggested at various times, at various places in history.

Like, I don't know if we drain all the swamps, will people start getting sick? I don't know that a lot of good comes from swamps, like from a human being point of view, it's a secret. There are people in Florida right now who are losing their mind and you know well no what they're thinking is like you know what Justin that offended me but then I realized like the only thing that happens is swamps is alligators are there and sometimes people have bodies there those are the two things that happens in swamps and those sweet airboats but I don't

know where you get those okay I I will tell you that I went to many school trips when I was younger and lived in my cross Georgia to the Okie-Fonokis swamp. And it was very cool. One guy's like, yeah, yeah, Okie-Fonokis represent. I loved going to the Okie-Fonokis swamp because you saw all the others, you wrote a bow, and then there were these leaves that you would like, they would pull off plants and rub together and soap, there would be soap would happen from the leaves. I loved going to those. That sounds fun.

I don't know, that sounds fun. So be careful when you did swaps. Sorry swaps. I used to like swaps, but I show so late I swap. In the middle ages, they tried all kinds of weird, bad ideas for treating malaria. As we did for everything, right? Yeah, middle ages was really bad.

We tried blood-leaning. We tried blood-leaning. We tried blood-leaning. We tried blood-leaning. We tried blood-leaning. We tried blood-leaning. We tried blood-leaning. We tried blood-leaning.

We tried blood-leaning. We tried blood-leaning. We tried blood-leaning. We tried blood-leaning. We tried blood-leaning. We tried blood-leaning. We tried blood-leaning. We tried blood-leaning. We tried blood which we tell you not to. Like every time. Like, but people did that. Amputated limb. It's like they're not even listening to our podcast. Try some witchcraft, take some belladonna. That won't

help. I'll hold a sword out of a rock. Like, what are you guys doing? No. Let's, let's work out your nativity chart with astrology and then tell you what, what plan is causing your malaria. I don't know how that fixes it. Middle ages was really bad. At least before that, we're like, I don't know how to me. Figure it out or something or don't. I don't know. We don't know anything. The most interesting and Justin, you probably know part of this because you read the signature of all things. Be it first. Is the story of the synconetry. So it's funny because if you read about how did we figure out this synconatry, which has also been called the fever tree because it cures

feverish, the way that we figured out like how do we ever think this bark might help us against this horrible disease. The story is that there was an earthquake that caused a bunch of synconatries to fall into a lake and that the water and the lake was really bitter after that, flavored by the syncona. And nobody wanted to drink it, except there was one guy who was really sick, and so he had a fever, he was really thirsty, so he drank it, because he needed water, he was very thirsty,

and he got better, and that's how we figured out that syncona bark. That story is just wild enough to make total sense. It's interesting. Everything that adds up. I don't have a better thought as to how we would have ever thought to get tree bark. I don't know how we figure out any of this stuff, right? There's gotta be some story like that for all of these things, right?

Yeah. Some just random happenstance. You're making metal springs for weapons and one of them gets knocked off of a shelf You see a very pleasingly coil off the shelf onto the floor and you think that's a toy slinky born That's and this is on the same level. I think it's the slinky basically It's kind of like Sean Connery and medicine man, you know, it was the ants. Mm-hmm. Sorry spoilers and medicine man, you know, it was the ants. Sorry, spoilers. Spirits for medicine. Stayed to your spoiling, remitting the stone necks. The miners also took this when they had to go into like cold damp mines because it would stop,

they thought it stopped shivering, which is probably a reference to the fact that it stopped the rigors that are associated with malaria. It was used by the native, the people native to Peru and then the Spanish missionaries found it when they came to Peru and started noticing that people would use this local tree bark to treat this awful fever that everybody got and it worked and so they started exporting it all over the world. And it does work because it has the alkaloid quinine in it, which quinine is still used to treat malaria two day. So that's pretty cool.

That is cool. Yeah. And so that this bark was sent, Jezwit bark was the same name or, you know, fever tree, all kinds of the same thing was sent all over the world to treat malaria because it was a big problem. It's interesting because there's one of the other big treatments you read about is Warburg's tincture, which was created in 1834 by a German doctor, which also contained quinine. So it kind of took over for a while as the big treatment for malaria, but I mean it had quinine in it as well. So we're still using quinine, but it was used hugely

by the British and Austrian empires. Also, this is in tonic water quinine in it as well. So we're still using quinine. But it was used hugely by the British and Austrian empires. Also, this is in tonic water, quinine. Oh, yeah. Just as a side note. So. Because you were drinking it along when you were pregnant for your leg, restless leg. Yes.

I was tonic water. That's unrelated to the layer. Yes, quinine has been used for leg cramps and restless leg and that kind of thing. Although, I would, if you're considering that, talk to your doctor, be very careful. Not so, I mean, tonic water, you'd have to drink a whole lot of it to call yourself problems, but there are a lot of supplements over the counter on a side note that have quinoine in them, and you can get too much, and it's called synchonism because of the tree, and you can get poison. So, be careful. Good enough.

Once we figured out the parasite, as I mentioned in the 1890s, throughout the 1900s, we developed all kinds of new medications, and I won't go through all the medications we have today for malaria, but we have quite a few. The biggest problem though is as we have developed new medications, the malaria parasite is wily, and it becomes resistant to them almost as soon as we make them. So that's why if you're traveling somewhere in the world, the first question you should

ask your doctor is do they have malaria there and what medication can I use to prevent it when I go there because it's different everywhere you go in the world. And moving on to today, malaria is still a huge problem. Like I said, we don't think of it that way. I think here because we don't see it in the US. Right. I know for me, it was something that we talked about in medical school. I was interested in it because I had an interest in international medicine. But then I didn't see it until I went to Malawi. And then we had a case here, which is weird. Yeah, that is weird.

But anyway, there's still like 225 million cases each year. 800,000 people still die of malaria. And there are, there are about a hundred different countries worldwide where it's still in Demic, largely in Africa. It's a huge cause of childhood death as well. And like I said, there are many drugs, but there's still much resistance to them. Bed nets are one of the biggest solutions to this. So simple, but effective.

Just don't get bitten by mosquitoes. And this is important if you're going to travel anywhere in the world, go talk to your doctor, especially if you have somebody who does like a travel clinic, like I offer offer where you can ask about what meds you might need. And you can go donate, go donate some bed nets to help people who are still suffering from this. You could have nothing but nets.net. You can buy some nets and help people out there. Because it's really that simple. I mean, the idea is historically of draining swamps and Cleopatra sleeping under a net, probably was more effective at fighting malaria than just about anything else we could do. So go do that and then feel a little better about the problem because you're helping to combat it.

Well, not so fast, Justin had said, in the year of 2015, with your one-year-old child. You were so young and naive, you're a host of dreams. I'll lay it out in front of you. Malaria has been back in the news recently, Sid. What's happening? Well, Justin, so I think it's important to remember that just because we don't see malaria transmitted in the United States, typically, doesn't mean that it's not possible to get

malaria in the United States. I think a lot of people in this country kind of forget about it. We do have cases of malaria that are diagnosed here every year, but they're almost always people who have traveled somewhere, gotten malaria there. And then when they come back, we figured out and diagnosed them. Prior to the pandemic, it was like 2000 cases a year like that. Because in some parts of the world, it's very common

to get malaria. So if you go there, it's easy to get it. Now, during the COVID years, those numbers dropped dramatically because not a lot of people are traveling. We expect that they're going to jump back up, especially this summer. A lot of experts kind of predicted that this summer, we're going to see a resurgence. Again, in people returning to the US

with malaria because they got it somewhere else. What we haven't seen in the US more or less since 1951 is malaria being actively transmitted in the United States of America. We had a small occurrence of that in 2003. There were like eight cases, I think in Palm Beach, where they found that malaria had been, they actually got it there. Malaria was being transmitted there. And in order for malaria to be transmitted in an area, remember, it's not person to person, right? You don't give it to another person. You give it to a mosquito. Who they are kind enough to pass along to another person. Exactly. Like a career service. So in order for malaria to be transmitted in a community, the mosquitoes in that community

have to be one capable of carrying the parasite and then two infected with it. Well, the anophiliy species of mosquito that can carry malaria has exists in most of the US. So that's not like that. We already know that risk factors there. Then you just have to introduce malaria to that population of mosquitoes. And then there are certain conditions that can foster it. Temperature is a big, you know, mosquitoes like warm climates. Right. And then standing water. If there are large areas of standing water, that's where mosquitoes later edge. You wear a mask, your ponds.

Yes. You know what standing water is. It's not only water. Why I'm explaining it. And these are conditions that will make it easier for malaria to kind of take hold in an area. So what has happened is that we have now identified, as of the most recent count that I'm looking at at this moment,

there have been a cluster of cases in Florida and one in Texas and the cases in Florida. I believe we're up to seven. Where they cannot find that these are not people who traveled and returned, meaning that local transmission of malaria is happening in this area of Florida. People are getting malaria in Florida. As far as I can tell, they've had a case in Texas and we don't really know if there are other cases.

Some of the journalistic outlets that I have looked at are saying that they're reaching out to the Texas Public Health Officials and not really getting a lot of information back. So we don't know for sure are there more. And the problem is you need a robust public health system to track and control outbreaks like this. You need epidemiologists, You need public health professionals. Well,

Florida, the government there has gotten rid of a lot of public health officials, either by firing them, replacing them with people who maybe are not necessarily evidence-based public health professionals, or just, I think, creating an atmosphere where a lot of professionals don't want to work. What I am reading is they're having trouble hiring people for these positions. Because if your boss doesn't believe in science and you're a scientist, it's really hard to want to work there. Yes. It would be my guess.

And if your bosses made it really hard, I remember for the woman that had been tracking COVID in Florida, there was a really bad situation there. Exactly. So if you don't have the scientists you need to go out and sample, first of all, to keep track of malaria cases, you have to inform the public so that they know this could be malaria, I should go get checked out.

Secondly, you've got to do sampling of mosquitoes. You've got to go out and capture mosquitoes and see if they've got malaria. To see if it's out there has it established a presence. You have to do all that leg work to try to track and then control this. And if you don't have the right scientist's employer, you don't put the money and resources behind it,

you're gonna be in trouble. So the things that the CDC has said so far is, one, don't freak out, which is always good advice. There is no matter how dire things are, freaking out, generally is not helpful. Don't panic. Don't panic.

If you live in one of these areas and you develop symptoms that are consistent with malaria, I would be quicker to go get checked out. A lot of us might get a fever, and if we don't feel too bad, we might not go get checked out. Well, if you live in an area where there's malaria and you get a fever, you need to go get checked out.

It could be malaria. So they're advising people, if you're having fevers, if you're feeling sick, go get checked out. That doesn't mean you need to call an ambulance immediately. It just means you need to access your local healthcare resource to get checked out and ensure that it's not something like that. Hopefully it is just a run of the mill, cold or whatever.

So they're advising that. Your risk is just a run of the mill, cold or whatever. So they're advising that your risk of getting malaria in the United States is still extremely low. Again, so we shouldn't panic. But what we should remember is that there was a report issued two years ago to look at the United States preparedness for a malaria outbreak. Would we be ready? Could it happen and would be ready? And what they found is it could happen and we're not ready. Because we don't think about malaria anymore. And the thing is, as the world gets warmer, and areas of the earth that previously had longer, cool periods are now having longer warm periods, they become much more hospitable to the species of mosquito. And it will be easier for these mosquitoes

to hang around more of the year in places further from where we generally expect to see malaria. So if you combine that, that there might be the mosquitoes that can carry malaria, that hang around places longer, plus, maybe malaria is starting to get established in places because we don't have as much public health surveillance. Maybe we're not paying as close attention as we used to to areas of standing water. And you could certainly see a resurgence

of malaria. That doesn't mean it's happening right now. That doesn't mean, again, panic doesn't help anything. Awareness helps, preparedness helps. Seeing these changes and like reacting in a helpful way is what we need to do right now. I think what's worrisome for a lot of public health officials is that it's happening in Florida. And this is no offense to Florida. If you live in Florida, this is not offensive people who live in Okay. I always feel bad saying that because- Some of people live in Florida. Well, but we live in West Virginia and you could level plenty of criticism at our government and our legislature and our governor. We're not talking about all of the people who are, you know who you are.

No, certainly not. Because there are people there who are conscientious and science-minded and don't want to see malaria spread. What I think, though, underneath all this, what you have to remember, is that malaria still kills hundreds of thousands of people across the globe every year. Just because it's not a US problem doesn't mean it's not a problem that deserves our time attention and resources and partnership with other global agencies to solve. It's sad that sometimes it has to affect us for us to wake up and care enough to do something

about it, but it should remind us all that malaria is something that we could see an end to. We could. We could put enough money and resources and brains and will and compassion behind this to see an end to malaria deaths all over the world. And then we wouldn't have to freak out when we see a handful of locally transmitted cases in the US because everybody's life matters, not just if you live in the United States of America. So that's what's up with malaria currently. They'll be continuing to track, hopefully.

All the people so far that I've read about are getting treatment and are, as of my last update from, I checked like 10 different news outlets are in stable condition. There is treatment from malaria, assuming that you are able to access medical care and these people were lucky enough to live in a part of the world where it's a little

easier to access medical care. Well, thank you so much for that update, Sid, and let's head back into the episode. Thank you to theMaximumFun.org network for having us as a part of their family. They've got a lot of great programs that you can go listen to. Thank you to the taxpayers for our theme song, Medicines. And thank you to people tweeting about the show. We're at Saul Bones on Twitter so you can tweet about us and be like Sparkly Pony,

Lana Kay, Maelan Carlson, we are Goose, Foxy Love, Kelly Wardell, Amy, KLM, David Cooper, Mundistius, Ames, Meg Dan and Glinn over,

it came to my play date, Adrian Mecha, Mecha, Mecha, I think Mecha, that sounds right, Adrian Mecha, Dylan Sennott, so many others, thank you so much for tweeting about the show, You can follow us on Twitter if you would like to do so. And thanks to you for listening. Thanks to you Sidney for being here. Really appreciate you.

Thank you Justin for inviting me to your office. Her podcast. Until next time, probably on a Tuesday or Wednesday. I'm just a macro. I'm Sydney Macro. As always, don't jill a hole in your head. Alright!