Three More Eponymous Diseases: Arthropod Bites

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Speaker 1: Welcome to Stuff You Missed in History Class, a production of iHeartRadio.

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Speaker 2: Hello, and welcome to the podcast. I'm Tracy V.

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Speaker 1: Wilson and I'm Holly Frye.

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Speaker 2: A little more than a year ago, we did an episode on eponymous diseases, which I kind of thought might only be interesting to me, but we got some emails from folks in the audience who seem to really like it, so we are doing another one.

00:00:32
Speaker 1: Last time, we talked.

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Speaker 2: About three diseases that were all named for the place where a notable outbreak happened, which led to their being identified and named, and today's really similar. These are named after places again, but this time these are all diseases that you get after being bitten by something specifically mosquitoes and tics, and since both of those feed on blood, this also feels just a little bit like a precursor to October episodes. The diseases that we are going to talk about our West Nile virus, lime disease, and Rocky Mountain spotted fever. I was originally going to put them in chronological order, but the Rocky Mountain spotted fever story turned out to have a couple of twists in it. That made it feel like putting anything after that would seem a little anti climactic. Also, just to note, there is various animal experimentation in this episode.

00:01:33
Speaker 1: So first we have West Nile virus. West Nile virus is part of a large family of viruses, many of which cause disease in humans, including dengey fever, zica, and Japanese encephalitis, and the story of how it was discovered and named is pretty straightforward, although it happened during research into a different disease, that being yellow fever. This research was conducted through the Yellow Fever Institute, which was established by the Rockefeller Foundation's International Division in nineteen thirty six. By the late nineteen thirties, researchers had isolated the virus that causes yellow fever, and they had determined that there were multiple strains of it circulating in parts of Africa and South America, and they also knew that people who recovered from yellow fever were typically immune to it afterward, and in a large region of Central and western Africa, a lot of people had this post infection immunity. The Institute was conducting research along the edges of this endemic zone, where people were less likely to already have immunity, so they could try to isolate and study different strains of the yellow fever virus. In December of nineteen thirty seven, a physician from the institute named A. W. Burke saw a woman from the West Nile district of Northern Uganda. She had a fever of one hundred point six degrees fahrenheit that's about thirty eight point one degree celsius, but she said she wasn't having any other symptoms. Her blood was drawn and three months later she returned to have another blood draw and at this follow up she said she hadn't had any other signs of illness around the time of her prior visit. Researchers isolated a different virus from the blood they drew at her first visit, and she had antibodies to that virus at her follow up three months later. Yeah, so they were looking for yellow fever, but this was something else. The researchers did a bunch of experiments with this virus that involved inoculating mice with it. They ultimately found that it was lethal one hundred percent of the time when a mouse's brain was exposed to it, but it was a lot less lethal in exposure through the skin. They also did research on other animals. Rhesei's monkeys developed encephalitis when they were exposed through their brains or their noses, but they had milder illness when they were given a subcutaneous inoculation. Other monkeys had only a mild illness no matter how they were exposed to the virus, and rabbits didn't develop any signs of illness at all. This was similar to research that was being conducted with the various strains of yellow fever virus that the institute had isolated from other patients. The team published their research on this newly isolated virus in the American Journal of Tropical Medicine and Hygiene in nineteen forty. In their paper, they named it the West Nile virus, after the district of Uganda where they encountered this patient.

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Speaker 2: So at this point, it really doesn't seem like this virus was causing a lot of illness in humans. If it was, it wasn't causing illnesses that really stood out. It's not completely clear whether it made that first patient feel sick. The paper's authors speculated that she might have said she wasn't having any symptoms because she did didn't want to be hospitalized, which in my opinion is pretty reasonable, and they also stated that quote she was not altogether cooperative, and it is possible that she withheld pertinent facts. It is reasonable to have some skepticism about this characterization of her, but it is also possible that she might have had symptoms that she chose not to tell the doctors about.

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Speaker 1: More than a decade passed between the identification of the virus and the next time it was isolated in patients. This involved three apparently healthy children in Egypt, and it wasn't until the nineteen fifties and sixties that there were large enough outbreaks for researchers to really study the virus in human patients rather than in lab animals. Most of these outbreaks were in places around the Mediterranean. Symptoms included fever, headache, muscle pain, rashes, abdominal pain, and vomiting. Smaller numbers of patients had swollen lymph nodes, chest pain, and diarrhea.

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Speaker 2: Research in the Upper Nile Delta in nineteen fifty one started looking for signs of West Nile in non human animals in the wild, as well as evidence of whether it could be transmitted by insects. The virus was found to be capable of infecting a wide range of animals, and it seemed to be particularly fatal in horses and other equines. The virus was first identified in birds in nineteen fifty three, and today birds are considered to be the virus's primary host. The research also found that West Nile could be isolated from mosquitoes, but not from some other insects, and today we know that it is transmitted mostly through mosquito bites.

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Speaker 1: Until the late nineteen fifties, cases of West Nile were usually relatively mild and self limiting. In some places, the majority of children had evidence of being infected at some point, and it seemed almost like a routine childhood illness. Research that first identified the virus had suggested that it could cause encephalitis, and it's related to other viruses that do, but that wasn't really happening in human patients.

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Speaker 2: That started to change in nineteen fifty seven, when an outbreak in Israel affected several elderly people, and many of them developed severe neurological symptoms. After this outbreak, it became more common for people with West Nile virus to develop encephalitis, meningitis, or some other kind of serious neurological issue, and to die from the disease.

00:07:36
Speaker 1: There was another shift in nineteen ninety six with an outbreak in Bucharest, Romania, which was the first major outbreak in a primarily urban area. Most people in Bucharest did not have air conditioning, so they kept the windows open, and many of those windows did not have screens. Another factor was that many people were living in apartment buildings that had flooded basements, and of course that created a breeding ground for mosquitoes. A lot of patients in this outbreak had some kind of involvement of their central nervous system. This was also the first outbreak in which one particular mosquito, the common house mosquito or qlex pipions, became recognized as a vector.

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Speaker 2: After this outbreak in Romania, outbreaks of West Nile virus disease started happening in more places far away from Equatorial Africa and the Mediterranean, with a greater proportion of the patients having more severe symptoms. For example, an outbreak in Russia in nineteen ninety nine had one hundred and eighty three confirmed cases, with more than half of those people developing acute meningo encephalitis, and there were forty deaths. More than seventy five percent of the deaths were in people sixty years old and older.

00:08:54
Speaker 1: That same year, West Nile virus was reported in North America for the first time. This was in New York City, and it was initially suspected to be Saint Louis encephalitis that is also related to West Nile virus. The strain of West Nile virus that was isolated in this outbreak was similar to one that was circulating in and around Israel at the time. It is not definitively known exactly how the virus arrived in New York, but two possibilities are mosquitoes that found their way onto international flights and illegally imported birds. It was not spread by sick humans. While humans can get West Nile virus, it doesn't reach a high enough level in our blood to infect a mosquito, and it doesn't spread from person to person except very rarely through things like blood transfusion and organ donation.

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Speaker 2: Within three years of its arrival in New York, West now virus had been detected in forty four states and the district of Columbia, and it has since spread to Mexico and Central and South America. A subtype of West Nole virus called Kungen virus was first isolated in Australia in nineteen sixty, but it was not classified as a strain of West Nile until a lot later.

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Speaker 1: Today, most people who contract West Nile virus have minor symptoms or even no symptoms at all, but about one percent of patients develop West Nile virus neuroinvasive disease, which is a severe and serious illness that can involve meningitis, encephalitis, or acute flaccid paralysis, and it can be deadly. There is no treatment for the virus itself, only for some of the symptoms and issues that it can cause.

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Speaker 2: There are some veterinary vaccines for West Nile virus, including one for horses, but there's not a human vaccine yet. Part of that has to do with the virus itself and how it mutates, but it's also connected to the fact that West Nile virus outbreaks in humans can be kind of random in their size and severity and location. Ideally, if someone was doing efficacy testing for a vaccine, they would be able to administer it to a population before an outbreak actually started, so they could see whether that population was protected. But the unpredictability and seasonality of major outbreaks makes that hard to do with this specific illness, so prevention is largely based on avoiding mosquito bites and on mosquito control and health authorities taking screening steps for blood and organ donation when there is an outbreak. We have more fun disease talk coming up, but first we're going to pause for a sponsor break. In May of twenty fourteen, research was published in the journal Historical Biology that described fossilized tics preserved in Dominican amber that had spirrokeat like cells in their digestive tracks. The size and shape of these cells strongly resembled bacteria from today's Brellia species. Burrellia borgdorferi is one of the bacteria that caused lime disease, and, according to research published in the journal Nature Ecology and Evolution in twenty seventeen, its family tree is at least sixty thousand years old. Research on the fifty three hundred year old mummy known as Utsy the Iceman who has made many appearances on our show and on installments of Unearthed, also found DNA evidence of Borellia bacteria in his bone marrow.

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Speaker 1: Written descriptions of symptoms that are associated with lime disease started in the late nineteenth and early twentieth centuries. In eighteen eighty three, German physician Alfred Buchwald described a chronic skin condition typically affecting the hands and feet, that sounds like something that can happen in a late stage untreated lime disease. Almost forty years later, Swedish dermatologist Arvidovzelius described a rash that frequently occurs in lime disease, which can be shaped like a bullseye. In the nineteen twenties, two doctors in France, Ce Garrin and A Bougeadou described a patient who developed a rash in neurological symptoms after a tick bite, which is sometimes described as the first clinical description of lime disease, but the patient also had other symptoms that were not consistent with lime.

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Speaker 2: But the name lime disease today also known as lime boreliosis, is way newer than any of that It is only fifty years old. In nineteen seventy five, Polly Murray and Judith Mensch, who lived in Lime, Connecticut, each contacted the State Department of Health in Hartford, Connecticut. Polly Murray's husband and two of her children were having recurring issues with raw rush's headaches, muscle pain, and swollen joints. Judith Minch's daughter had been diagnosed with osteomyelitis after experiencing severe knee swelling, and then that diagnosis was changed to rheumatoid arthritis after it didn't resolve with antibiotics. In addition to what was going on in both of these women's families, they knew about and had heard about other people, including other children in their neighborhoods, who had been diagnosed with rheumatoid arthritis or with a similar condition. That was enough that it seemed unusual and concerning, and both women wanted answers. Murray and Minsch were not the only people to notice a cluster of this kind of disease. There were also reports from Cape Cod in the nineteen sixties, and researchers on Long Island in New York were studying what was locally called Montak knee. But Murray and Mensch's advocacy led to a surveillance study in the communities of Old Lime, Lime and East Hadda, Connecticut, which ultimately led to the disease being identified and named. These three communities had a combined population of about twelve thousand people, and researchers found thirty nine children and twelve adults who had symptoms that were similar to rheumatoid arthritis. But that was an unusually large percentage of the population to have RA, especially when it came to juvenile RA. But beyond that, the cases were not spread out evenly among these three communities. They were very heavily concentrated in specific areas. A lot of them were in people who lived in wooded areas along the same few roads. On some roads, as many as ten percent of the children were affected. The state Department of Public Health and Yale University worked together to try to work out what was going on, including running blood work and getting family medical histories from the people who were affected. It seemed like most people's symptoms started in the late summer or early fall. About a quarter of the patients remembered having a rash that was shaped like a bullseye. There rheumatoid arthritis like symptoms also seemed similar to a collection of symptoms that were being reported in Europe. Soon, a hypothesis emerged that this might be an illness that followed some kind of bite. In August of nineteen seventy six, Connecticut Commissioner of Public Health Douglas S. Lloyd issued a circular to the States Directors of Health that set, in part quote the seasonal and geographic distribution of cases and the association with a skin lesion suggests that a virus carried by a biting insect may be responsible for this disease. By that point, researchers were calling the disease lime arthritis, and they had pointed to the bulls eye rash, which is known as eurhythmia migrants, or EM, as a leading symptom. Over the next few years, other cases were documented elsewhere in the United States. Most of these cases were still clustered together in the northeastern US, in Wisconsin and in California, Oregon. By nineteen seventy eight, the search for the diseases vector was focused not on insects but on arachnids, specifically ticks, among other things. Researchers in Connecticut started noticing that this disease seemed to be more prevalent in areas that had more tics.

00:17:33
Speaker 1: Swiss American medical entomologist Wilhelm Bergdorfer, known as Willie, worked out of Rocky Mountain Laboratories, which had been established to study Rocky Mountain spotted fever and later became part of the National Institute of Allergy and Infectious Diseases. He and his team were studying Rocky Mountain spotted fever on Long Island. Ticks can carry.

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Speaker 2: Multiple diseases, and people who regularly encounterticks can wind up with more than one, so this research on Rocky Mountain spotted fever was overlapping with research into other tickborn pathogens, and some of the patients had em This research involved collecting large numbers of tics and studying the microorganisms that were in their bodies. One of the microorganisms that they found was a spirikeat. After finding this spira keet in the bodies of ticks, researchers also spotted it in the blood of patients with lime disease. In nineteen eighty two, the spira keat was named Borellia Burgdorferi in honor of Willie Bergdorfer, so it is epotymous both for Lime Connecticut and for him today. Lime disease is found primarily in North America, Europe, and Asia, and there are multiple species of Burrellia bacteria that can cause it. Different species are prevalent in different parts of the world. It's most often spread by tics in the genus Exodes, with the exact tick again ring from one region to another. In eastern North America is usually the black legged tick, also called the deer tick or Exodies scapularis. Whether these ticks actually transmit lime disease varies from place to place, depending on what animals the ticks are feeding on and whether those animals carry the bacteria. For example, in the northeastern United States, the ticks usually feed on rodents in their larval and nymphal stages, and those rodents often carry the bacteria, but in the Southwest, ticks at those stages of their lives are often feeding on lizards, which do not.

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Speaker 1: In North America, lime disease is also associated with deer, but deer don't contract the disease and they don't pass it on to ticks. Instead, deer are a primary food source for adult tics, with those adults producing the next generation of ticks, which start that psycolope again by picking up Brillia bacteria from infected rodents when they feed as larvae and nymphs.

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Speaker 2: Researchers believe this connection to deer is why lime disease really started to become an issue in the mid twentieth century in North America, and that traces back to the ecological history of the continent. There's evidence that Borellia bacteria existed in North America prior to the arrival of European colonists, and so did rodents and deer and humans, all the ingredients that are needed for lime disease transmission. But it is also likely that there were a lot fewer deer in North America then than there are today, since there were earlier on a lot more large predators like wolves, and more people hunting deer for food and other resources. Indigenous land stewardship practices like controlled burns may have also helped reduce the population of ticks. Then, as Europeans started colonizing the Americas, deer were driven nearly to extinction through overhunting and habitat loss. At the start of the twentieth century, there were as few as three hundred thousand white tailed deer across all of North America. Because of a combination of conservation laws, changes in land use, and changes in hunting patterns, the population of deer rebounded dramatically over the first half of the twentieth century, and it's estimated that they are between thirty and thirty five million white tailed deer in North America today. Warmer winters due to climate change also mean that fewer ticks are dying over the winter, so it's likely that a person living in suburban New England is living in proximity to more deer and more deer ticks than people in the same region were prior to colonization. In the nineteen nineties, a vaccine for lyme disease was introduced in the United States, but it was withdrawn from the market in two thousand and two. This vaccine required a dose roughly every other year, and while it definitely reduced a person's risk for developing lime disease, it was reported to be about seventy five percent effective. There were, of course, people who wanted that number to be higher. There were also some concerns about whether the vaccine could trigger autoimmune arthritis, although an investigation into those concerns could not confirm any kind of connection. Lime disease was also a lot less prevalent in two thousand and two than it is today, so there just was not as much demand for a vaccine, especially one that people felt like didn't give them complete protection like it definitely, as we said, reduced the risk of the disease, but there were people for as sort of consumers wanted it to be one hundred percent. However, there is a new vaccine that is now in phase three clinical trials, with the results of those trials expected by the end of this year. That means prevention for lime disease is all about avoiding tick bites. It's believed to take at least twenty four hours of attachment for a tick to transmit the spirakeat to a person, so people who spend time outdoors are advised to thoroughly check themselves for ticks and immediately remove them. People are also advised to seek medical attention if they are bitten by a tick, regardless of whether they develop that bullseye rash or develop other symptoms. The rash develops in most cases but not all of them, and it is also a lot harder to see on people that have darker skin. Lime disease is treated with antibiotics, most often doxycycline. Okay, my primary care doctor's my chart landing page has a big thing that's like, have you been bitten by a tick? Press this button. A couple of quick notes before we take a break. There is a conspiracy theory that lieme disease escaped from a research facility, but as we have discussed, there is a lot of established evidence that the bacteria that caused lime disease existed in multiple parts of the world for decades or centuries before that could have happened. In addition to what we've already talked about, the bacteria have also been found in nineteenth and early twentieth century rodents and tics in museum collections in North America, which I find a fascinating way to look at that.

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Speaker 1: Let's go back to the tax that.

00:24:32
Speaker 2: Are made animals and the preserved tics and see what they've gotten their bodies. Also, there are people who continue to have symptoms related to lime disease after going through treatment, including cognitive issues, fatigue, and body aches. For a long time people called this chronic lime, but the current recommended terminology within the medical field is post treatment lime disease syndrome. Because people experiencing these symptoms don't have signs the actual pathogens still in their bodies. There's been a ton of discussion and controversy around these symptoms and the terminology around it for years. It's been called the liemars. That is how contentious it is. This is way beyond what we can really sort through as lay people on a history podcast. But a lot of it has been rooted in the fact that people still have symptoms, but that doctors can't find evidence of what could be causing those symptoms. However, since the COVID nineteen pandemic, in the existence of long COVID, it does seem like there has been more awareness of potential long term symptoms following and infection. We will talk about Rocky Mountain spotted Fever after we have another sponsor break the first reports of the illness that became known as Rocky Mountain spotted fever. We're in bitter Root, Montana in eighteen seventy three. At the time, most of the people living in this region were either white settlers or indigenous people, including the Bitter Root Salish, whose settlers called the Flathead, although head flattening is not a Salish practice. Symptoms of this illness included a fever and a rash, as well as joint pain, nausea, and vomiting, and it was very frequently fatal. People started calling this new disease black measles, and since it seemed to strike in the spring and summer, people thought it might be caused by drinking melt water runoff from the mountains.

00:26:41
Speaker 1: There were tensions and violence between the white newcomers and the Salish during this period, and the Salish would eventually be forcibly removed to the Flathead Indian Reservation, which is also home to the Upper Pendorat and the Coutiny. But white people also recognized that the indigenous peoples of the area might have some knowledge of this disease, so early researchers asked indigenous people as well as white trappers, traders, and missionaries who had had lots of interactions with them, and based on these conversations, it seemed like this illness was something new.

00:27:17
Speaker 2: Over the eighteen eighties and nineties, cases were also reported in the Quinn River Valley in Nevada and in other parts of Montana. In eighteen ninety nine, physician Edward E. Maxey of Boise, Idaho wrote what is regarded as the first clinical description of the disease in a paper titled Some Observations on the so called spotted Fever of Idaho quote a feberal disease characterized clinically by a continuous, moderately high fever and a profuse or pupyhic eruption in the skin, appearing first on ankles, wrists, and forehead, but rapidly spreading to all parts of body. By the early nineteen nineties, the disease had also been reported in Washington, California, Arizona, and New Mexico.

00:28:05
Speaker 1: The prevalence and seriousness of this disease was an influence on the creation of the Montana State Board of Health in nineteen oh one, two years after Montana attained statehood. Understanding and trying to prevent or treat this disease was one of the Board's biggest priorities from its inception. On July first, nineteen oh two, the Board issued a paper authored by W. M. Chowning and LB. Wilson that suggested ground squirrels as a possible host for the disease and tics as a potential vector. The disease appeared and disappeared along with when ticks were most active, and a lot of patients had a tick bite in their history.

00:28:45
Speaker 2: The following year, bacteriologist John F. Anderson studied the epidemiological data that was available and confirmed that most documented cases of this disease were in people who had a tick bite before the star of their symptoms. His paper was also the first written use of the name Rocky Mountain spotted fever. A lot of the places where the disease was being reported were in and around the Rocky Mountains. In nineteen oh six, pathologist Howard Ricketts found infected wood ticks in the Bitter Root Valley and showed that their bites could sicken guinea pigs. In nineteen oh eight, the Rocky Mountain wood tick was named dermaicentor andersonai after John F. Anderson, and in nineteen oh nine, a bacterium that Ricketts isolated from crushed tick bodies, which causes Rocky Mountain spotted fever, was named Ricketzia Ricketsie after him. Like lime disease and West malvirus. Rocky Mountain spotted fever was happening mostly seasonally when the ticks were feeding, so the research into it was really focused on the summer months.

00:29:54
Speaker 1: As the summer of.

00:29:55
Speaker 2: Nineteen ten approached, Howard Ricketts was not sure if he was going to get funding that summer, so he went to Mexico City to work on an epidemic typhus outbreak. Typhus is another disease caused by bacteria in the genus Ricketsia that's Ricketzia prasekii, named for Stanislas von Prausek. Sanaslos von Prowsek and his colleague Enrique to Rochelima discovered this bacterium and they both died of typhus, which they both contracted in the course of their work. Howard Ricketts also contracted typhus while working in Mexico City, and he died there on May tenth, nineteen ten, at the age of only thirty nine. With the Rocky Mountain spotted fever bacterium and its vector both identified, the next big focus was on trying to stop the disease. Today, doxycycline is the typical treatment for several diseases in the Ricketzia genus, including both rocky Mountain spotted fever and epidemic typhus, but the first true antibiotic, Pennacia villain, wasn't isolated until nineteen twenty eight, and doxycycline wasn't patented until nineteen fifty seven, so in the early twentieth century, the focus was on trying to control ticks. Researchers had pinpointed a number of animals that were susceptible to Rocky Mountain spotted fever and were often bitten by tick, larvae and nymphs. That included various squirrels, chipmunks, and rats. But the bigger concern from a public health perspective was the animals that were being bitten by adult ticks and also bringing those ticks into close proximity with humans. Those were mostly cattle and other livestock, and this is where.

00:31:44
Speaker 1: Things got wild. Doctor Robert Cooley was head of Montana State College's Department of Entomology and Zoology. He was inspired by the work of Howard Ricketts and two of his colleagues had gotten Rocky Mountain spotted fever in the course of their work and had died. Cooley's proposal was to reduce the number of ticks that humans were exposed to by reducing their numbers in cattle. He worked with the Montana State Board of Entomology to develop a dipping program. Dipping stations would be set up around the affected area and filled with vats of pesticide, and ranchers would drive their cattle to those stations, where they would swim through the liquid in the vats. This effort was funded by the federal government and the state of Montana.

00:32:31
Speaker 2: The solution that the cattle were going to swim through was made from arsenic soap, kerosene, and water. Obviously, since the point was to kill ticks, the solution needed to include substances that would be toxic, and arsenic and kerosene both fit that bill. Today we know that arsenic is a carcinogen, but at the time, the more immediate and the known concern was that if the constant creation of arsenic was too high in this dip, it would burn the cattle. It would especially burn them on parts of their bodies, like their utters that were not as densely covered in hair. Authorities had to work out the best proportions of arsenic through trial and error. Also, Montana ranchers weren't exactly people who were known for being excited about complying with the government. Being ordered to do something that could hurt their cattle made that already existing conflict even worse. Many ranchers refused to have dipping vats located on their land, worried not just about their own cattle, but about ticks being brought in on other ranchers cows who were coming to be dipped. In June of nineteen thirteen, someone smashed the dipping vat in Hamilton, Montana with a sledge hammer, and about a week later someone blew up the vat in Florence, Montana with dynamite. The rancher whose Hamilton proper, the first vaut was on, was tried and acquitted for malicious mischief, and afterward he sued the officials who were running the program. Eventually, authorities did develop a formulation for the dip that seemed safe enough for the cattle, although the arsenic was still a carcinogen, something not really understood until later. Within a few years, there was less resistance to the dipping program and most cattle in the area were being dipped as well as sheep, horses and goats. The number of Rocky Mountain spotted fever cases started to drop, although there was a case of two children who had been helping at the dipping station on their famili's land contracting the disease and dying. The presence of Rocky Mountain spotted fever and the efforts to control it led to the establishment of Rocky Mountain laboratories, which we mentioned earlier in our discussion of lime disease. In nineteen twenty one, the US Public Health Service started venting an unused schoolhouse west of Hamilton, Montana, to function as a laboratory, rather than disease researchers having to work mostly out of tents and sheds. In nineteen twenty six and nineteen twenty seven, a dedicated entomological lab was built in Hamilton, and people in the area were so worried about disease carrying ticks escaping from the facility that it was also surrounded by a moat, although that moat was never filled with water. The decision to build a moat followed a series of lawsuits people filed to try to stop the facility from being built.

00:35:34
Speaker 1: At all.

00:35:36
Speaker 2: By then, doctors Roscoe Spencer and Ralph Parker had developed a vaccine for Rocky Mountain spotted fever using tissue from infected ticks that was then treated with phenol. This vaccine was in use in humans by nineteen twenty seven. It was at least somewhat effective. In nineteen thirty seven, Rocky Mountain Laboratories became part of the National Institutes of Health. That same year, the movie green Light starring Errol Flynn, told the fictionalized story of a surgeon studying Rocky Mountain spotted fever in Montana. Errol Flynn is of course better known for his more swashbuckling roles like Various Pirates and Cowboys and even Robin Hood. Today, as we said earlier, Rocky Mountain Laboratories is part of the National Institute of Allergy and Infectious Diseases. It is today also home to one of the United States Maximum Containment Laboratories, known as a biosafety Level for facility. It no longer has a moat we should bring back moats despite its name. Today in the US, Rocky Mountain spotted fever is most common not in the Rocky Mountains, but in the southern and Central Atlantic states. More than sixty percent of cases are reported in North Carolina, Oklahoma, Arkansas, Tennessee, and Missouri. It's also present in other parts of the world that are home to the various species of ticks that can carry it, and in some of those places it has its own eponyms, including sal pallo fever and Brazilian spotted fever. In Brazil, there is no commercially available vaccine today, and while it can be treated with antibiotics, it can be hard to diagnose, especially if someone doesn't recall being bitten by a tick. As with lime disease, the main method for prevention is avoiding tick bites. That vaccine that had been developed back in the twenties, once antibiotics came on the market, was no longer really made. The tips for avoiding tick and mosquito bites are pretty much the same for all of them. Wear long sleeves and long pants, and use insect repellent that's the big stuff. Try to stay out of very tall grass for ticks. Also, try not to be around outside around dawn and dusk for most breeds of mosquito. Some breeds of mosquito don't really care about that though, and they will come tied about you at any time.

00:37:58
Speaker 1: They don't have watches, they don't know when their schedule begins.

00:38:02
Speaker 2: When I was living in the Atlanta area, my neighborhood had a lot of Asian tiger mosquitos and they were out at all times of the day and they would bite me between getting out of the car and getting into the house after I got home from work. It's a full time job being an Asian tiger mosquito. Yeah, I was not a fan of them. Anyway. We'll talk more about these things on Friday. I have an email for our listener mail from listener Stephanie, and Stephanie wrote, Hello Tracy and Holly. The phrase do your own research is one commonly heard or posted online. This has led me to wonder how, in the age of AI generated responses, crowdsourced Wikipedia pages, and self proclaimed experts on YouTube and TikTok, does one find reliable sources online that provide a factual and supported information. Since so much of your work involves research, I thought you might be able to point me toward some resources. My goal is eventually to take a class or course to learn more about how to conduct proper research from credible sources. My ultimate goal is to teach my young son to differentiate fact from opinion and credible sources from dubious ones. Thank you for the many years you have kept me company during long commutes, sleepless nights, and painful Excel based work projects. As a lifelong learner, I hope to hear your voices for many more years to come. Sincerely, yours, Stephanie. Stephanie did not have pet pictures to share and instead sent a little human made completely from scratch. Unfortunately, little human picture did not come through for whatever reason. I will assume this human is adorable. Thank you for this email, Stephanie. I first want to acknowledge that the rise of large language models and generative AI has made this a lot harder. So much so I'm gonna say thing number one. Currently, I am still using Google to do a lot of searching. There are other search engine options. They all have pros and cons. In Google, if you put minus AI at the end, you should stop getting an AI summary at the top, and I highly encourage this. Do you.

00:40:26
Speaker 1: For clarity? Are you typing out the word minus or are.

00:40:29
Speaker 2: You using the minus sign, the dash, the dash yeah, dash AI to mean minus the AI summary is often wrong. Yeah. Uh And when I have not put that in there, I have had laughably wrong AI summaries in things related to UH to work when I'm doing research. And something I really would like everyone to understand is that when it comes to things like chat, GPT and other generative a I, the process by which they give correct answers is the same as the process by which they generate things that are plausible but wrong. This is not something that AI developers can fix. It is inherent into how these models work. They will always be giving wrong answers that sound right. Do not ask chat GPT for information on stuff, is my opinion, because it might give you the right answer, but it might give you the answer that sounds right and is wrong.

00:41:33
Speaker 1: It's a day troll, it is. It really is.

00:41:38
Speaker 2: Also, on a less serious note, if you like me, play video games and sometimes you need a hint for something because you're stuck. If you don't put in the minus AI at the end, the AI summary is just going to show you the full on answer. It might be the right answer, it might not, but like it's not going to give you it's not going to point you to a page where someone has written a discrete hint that can help you toward the right answer. It's going to show you the right thing in your face. I don't like that. I'm laughing because do you remember for a minute what people were advising before minus AI was to put a swear word at the end of your query. Oh funny, because it wouldn't It would automatically throw that out. Yes, but I ran into the problem where I was ending up on websites that I did not need to be visiting. Sure. Ever, Yeah, and now I'm on the KG part of the internet.

00:42:38
Speaker 1: Yeah.

00:42:40
Speaker 2: There are also plugins that will strip out the AI summaries and other browsers that just don't do AI summaries, but just the circles background don't rely on the AI summaries. A lot of the other tips are the same as they were prior to the evely of generative AI, which is figuring out who is responsible for a piece of content and what their reasoning is for doing it. So, like confirming that the byline on the piece or the name that the person has given in their YouTube or TikTok video, like confirming that is a real person do they work for? For example, a college or a university. When I used to train people on this as part of my job, we talked about the use of government sources. A lot of those government sources are now being deliberately undermined. We've already talked on the show before about like public health expertise being stripped out of the health and medicine related government agencies to be replaced with literal quacks. So I can't really advocate for that anymore the way that I used to. But a good starting point is often to like confer firm who this person is, read their you know, their biography, their brief bio on whatever do they where do they work, what is their background? Why are they writing about this? And over time you can kind of develop list of sources that you trust, who you know if someone has an agenda, that agenda is to get real, factual, accurate information, not to for example, cherry pick badly constructed studies to say that thailanol causes autism. It doesn't. This is actually well established through many years of research that have happened in multiple places around the world, specifically looking at whether thilan al also called acetaminifit. I don't remember what the name is and most of the rest of the world. But like we've already studied this, we know that it does not cause autism. And once again, even if it did cause autism, people are talking about autism as though it is like the worst thing in the world. When autistic people are human beings whose minds work and process information a little differently than people who aren't autistic, and it's also a spectrum. There are bajillion things I feel like we have to say every time this comes up. I know. The other thing, right, is that autism is incredibly complex and there's no one thing.

00:45:31
Speaker 1: That causes it.

00:45:33
Speaker 2: Right, often there are guesses about many layers of things that may have led to it, right, but there's no one thing where you go, no, it's this. We went through this with the vaccine thing a million years ago, and yet here it is again. Yeah, yeah, we know for sure that there is no causal relationship between vaccines and autism or cedamnifin during pregnancy and autism, and yet it's being trotted out again. Also, a cedamnifin during pregnancy is one of the few things you can take for a fever, and a fever that goes unchecked during pregnancy can actually cause some very real problems, and that is studied and documented. Yes, I have very strong feelings about this for someone that neither has nor wants children, right, I really don't like making parents feel like they're doing it all wrong when most parents just want to do the best for their kids, right right, right. So yeahs I don't know. I feel like we are still figuring out what all the best steps to take are regarding how to get information that's accurate in the age of large language models and chat bots and generative AI. But the broad sweeping things are don't trust AI generated stuff, whether it's video or audio or text.

00:47:09
Speaker 1: It is likely to be wrong.

00:47:11
Speaker 2: In the process of coming up with wrong answers is the same process that yields right answers in other cases and destroys.

00:47:18
Speaker 1: The environment in the process. Yeah, it's not.

00:47:21
Speaker 2: It uses a lot of electricity. A lot of places that have data centers for these nearby are really struggling with their energy use and energy bills. And boy do I hate it when there's like an everybody, please don't run your air conditioning so much when it's ninety seven degrees. While we are actually going to give some tax breaks to the giant data center that is causing an inordinate use of electricity. Anyway, that's not actually related to Stephanie's question.

00:47:54
Speaker 1: Stephanie, you've opened pandors.

00:47:56
Speaker 2: Yeah, we're both having a time over here today. So yeah, big, big part of it is just figuring out who wrote something, what is their background, why did they write it? And that continues to be true even as so much more stuff on the Internet and elsewhere is being generated by chatbot of some sort. If you would like to send us a note about this or any other podcast, we're at History Podcasts at iHeartRadio dot com. If your email is about how large language models are great and we should stop being blood heightes, I want you to listen to our episode about blood heightes and what that word really means, and then, better yet, just keep the emails for yourself. You can subscribe to our show also on iHeartRadio app and anywhere else you'd like to get your podcasts. Stuff you missed in History Class is a production of iHeartRadio. For more podcasts from iHeartRadio, visit the ie her radio app, Apple Podcasts, or wherever you listen to your favorite shows.

00:49:07
Speaker 1: H