Dr. Peter Hotez - 1 in 20 Americans Has This Parasite and Doesn't Know It!

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23:20Dr. Gabrielle Lyon:But we do have a global food system, right? I, 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? Well, that parasite, Clinorchus, used to be highly endemic, for instance, in Chinatown in New York. Why? Because the first wave of Chinese immigrants to the U.S. came from Canton, Guangdong province, where at that time, and this was when China was still a very poor country, had very high rates of that Clinorchus parasite.

24:13And so it was pretty common in Chinatown in lower Manhattan.

24:16Dr. Gabrielle Lyon:But we 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. 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 I think probably the rates of Clonarchus are probably way down there. Well, one of 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.

24:55Dr. Gabrielle Lyon: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. 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 was very successful doing a lot of advocacy for what we were calling neglected tropical disease. There are NTDs in low-income countries and Africa and elsewhere. And I was able to get funds appropriated through USAID for mass treatment programs.

25:32And 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 STOP 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 gone very far. But there's no question parasitic infections and related tropical diseases are widespread in the U.S., particularly in this part of the country.

26:15And most of them are being missed and not being diagnosed. I would absolutely agree with you.

26:23Dr. Gabrielle Lyon: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 mine and those various co-infections? Have you studied that, mine? Which we have, well, Lyme, but also, you know, now we're seeing a big rise. And a lot, of course, is transmitted by ticks. But now we're starting to see a big rise in illnesses from soft ticks 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 George and Cynthia Mitchell Foundation to do it in Galveston and for Harris County from an anonymous foundation.

27:11And 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 reduvid 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.

27:57So the old way of doing it, and 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 and 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 other vulnerable areas. And we're not.

28:35So we're basically not doing that. 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 in both summers. And they were missed. Why? Because a patient comes in initially with nonspecific findings, right? You've seen it, right? Fever, rash, and headache, right? Okay, a patient comes in with fever, rash, and headache. What is it? Well, it could be 100 different things. Now, through this metagenomics project that we call it, we can have a list for what's in every county or even cut it even finer into a district.

29:15So 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. Either the patient is very sick or fine. And so I'm hoping this will be a new approach to really doing a deep dive on these illnesses.

29:38Dr. 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 anymore, but it seems as if individuals, there's this neurocognitive component of Lyme and whether it's later life, they're just, again, and a whole host of this kind of cognitive impairment is not the right word, but maybe they have mood issues or they have gait. Well, remember when COVID happened, one of the big surprises was long COVID, right?

30:23People 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. We're, you know, 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.

31:10But 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.

31:43Dr. Gabrielle Lyon:In the 70s, there was the McGovern Committee. 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. He 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.

32:26Dr. Gabrielle Lyon:What about the biomedical science? Yeah, I think, you know, it's really interesting because I can't tell you, Dr. Lyle and Gabrielle, 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-wringing, okay, what did we do to screw up, you know, with other scientists? 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 get proven wrong.

33:07Dr. Gabrielle Lyon: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, right? But even myself, as someone who is what I would consider evidence-based, it's challenging. Answering all the questions that they would really want to know. Again, trying to get it right of going to some depth in the science and not being condescending about it as well. So that was really important. And the answer is, well, I think, Gabrielle, I think people like you are part of the answer because I can go on CNN and MSNBC till I'm blue in the face.

33:57And I do. And it's great to have that opportunity to go on. 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 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 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 important public service.

34:34Dr. Gabrielle Lyon:To help the general public understand that scientists, we can argue, and 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, 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. 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.

35:20Dr. Gabrielle Lyon:There is a lot of frustration with this, the idea of experts and the level of distrust. You know, even physicians in practice, you know, are often a number of years outside their first year 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. We all remember what a freshly cleaned room smells like.

36:00Dr. Gabrielle Lyon: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, 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.

36:39Dr. Gabrielle Lyon: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 to different is if it would actually clean itself, but it doesn't. Branch Basics is available at Target, Amazon, and branchbasics.com.

37:25Dr. Gabrielle Lyon:You can get 15 % off the premium starter kit with code Dr. Lion at branchbasics.com. That code is DrLion for 15 % off. 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. The reality is if you look at the information that's being spoken about, there's like a bunch of smokescreens. For example, you said concrete examples are best. I'm going to give you a handful. That cows are killing the planet. The reality is for greenhouse gas, agriculture, especially in the U.S., makes up about 9%.

38:07Dr. Gabrielle Lyon: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. 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 or less than 30 % of your nutrients come from animal-based products, you're probably going to 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.

38:49Well, but this is why, you know, if you're going to take 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 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, you know, Howard. And so I don't. So that is certainly not going to help the situation.

39:36Dr. Gabrielle Lyon: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 schistomaniasis or Helmuth disease, and then there are your top 10 experts in nutritional sciences? Do you think that there is, you know, just from 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 it's non-biased and we can all understand.

40:20You've become an exception. You always remain evidence-based and you don't feel the need to attack mainstream medicals. But, you know, so we just need to multiply you times 100, you know.

40:32Dr. 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. Right, right. It would be a non-negotiable. I really appreciate your work. And I think that you are just a great scientist, truly. Oh, thank you. You're doing a lot of important work. What are you working on now in your lab currently? 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?

41:19Dr. Gabrielle Lyon:Out of curiosity, what kind of support are we talking about financially? You know, for us, a few million dollars goes a long way. You know, Novavax got$1.6 billion, and we got about$7,$8 million. That's 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, you know, 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.

42:04That's cool. People don't realize how epidemics had been. 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.

42:18Dr. 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. 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're 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. And it's hard. You know, one of the things, and 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?

43:08And I declined because 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 or Vin Gupta or what you're doing because it means keeping up with so many areas. I don't do it alone.

43:27Dr. Gabrielle Lyon:I don't do it alone. I know what I'm good at. Right. And then I get analysts and help. But it's work, right? It's work. I mean, to really do that. And, you know, I didn't want to be out of the lab that much and wanted to write my books. And at the end of the day, I'm an academic, and this is what I'm doing. And we need that. It's so important. Thanks. 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. Right, right. 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 ridiculous.

44:11Dr. Gabrielle Lyon:And it's dangerous. I'm worried. I'm worried, especially, you know, for our 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 things are dark right now, but it's really important. I mean, we have fewer and fewer physicians, scientists. is we're graduating fewer and fewer PhDs that want to have careers where they're spending their life solving problems. And so I am worried about the future of this country from that standpoint. 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, which I think is, I think that's important.

44:56Dr. Gabrielle Lyon:and I think that there's a level of respect that you earn it. And if it's earned, then there is this mutual respect. And if the ultimate goal is to provide information, the ultimate goal is actually to move the needle for health and wellness for the population, then that's done collaboratively. It's not done individually or collaboratively. I totally agree. So thank you so much. And I'm very excited about your hookworm vaccine. Sign me up. Myself will be the first and my team will be second. Thank you.