Latest / Daniel and Kelly’s Extraordinary Universe / Rat lungworm (featuring Dr. Chelsea Wood)

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Rat lungworm (featuring Dr. Chelsea Wood) · Daniel and Kelly’s Extraordinary Universe

• 0:00
  Speaker 1: Howdy extraordinaries. Today we are talking about a somewhat unpleasant parasite.
• 0:05
  Speaker 1: And it's not just because I have a morbid fascination
• 0:08
  Speaker 1: with parasites. We had a couple listener requests to talk
• 0:11
  Speaker 1: about rat lungworm in particular, and this is a parasite
• 0:15
  Speaker 1: that is spreading in its range and it's an important
• 0:18
  Speaker 1: human health concern and I think more of us should
• 0:20
  Speaker 1: be aware of it.
• 0:21
  Speaker 2: So that's why we're talking about it today. Thanks.
• 0:32
  Speaker 1: Trade and travel are transporting organisms all over the world.
• 0:36
  Speaker 1: Here in Virginia. On my walk today, I came across
• 0:39
  Speaker 1: a variety of different species that are native to Asia
• 0:42
  Speaker 1: and are just absolutely ubiquitous on my property. For example,
• 0:45
  Speaker 1: we have the Tree of Heaven, we have Japanese stilt grass,
• 0:50
  Speaker 1: and recently we've acquired.
• 0:51
  Speaker 2: The spotted lantern fly.
• 0:53
  Speaker 1: And don't get me wrong, no doubt people in Asia
• 0:55
  Speaker 1: can rattle off a list of American species that now
• 0:58
  Speaker 1: dominate their landscape as well. Well.
• 1:00
  Speaker 2: This goes both ways.
• 1:02
  Speaker 1: And it's Kelly talking here, so you've got to know
• 1:04
  Speaker 1: that I'm going to be bringing it back to parasites.
• 1:06
  Speaker 1: Trade and travel are moving parasites around as well.
• 1:10
  Speaker 2: In my area.
• 1:11
  Speaker 1: The local cattle folks are struggling with what to do
• 1:14
  Speaker 1: about the invasive Asian longhorn tick. And on today's show,
• 1:18
  Speaker 1: we're talking about a parasite that's spreading far and wide
• 1:21
  Speaker 1: imposes a risk to human health. In particular, that parasite
• 1:25
  Speaker 1: is a nematode known as rat lungworm. And we have
• 1:28
  Speaker 1: parasite expert doctor Chelsea Wood on the show today to
• 1:31
  Speaker 1: tell us all about it. Welcome to Daniel and Kelly's
• 1:34
  Speaker 1: Invaded Universe.
• 1:49
  Speaker 3: Hi.
• 1:49
  Speaker 4: I'm Daniel. I study particles and aliens. And my favorite
• 1:52
  Speaker 4: parasite is no parasite.
• 1:55
  Speaker 1: Oh, I mean I do have a favorite parasite, but
• 1:58
  Speaker 1: my favorite parasite is people.
• 2:01
  Speaker 2: Is no parasite.
• 2:02
  Speaker 4: Yeah, I'll give you yeah, we can agree on that
• 2:05
  Speaker 4: at least.
• 2:06
  Speaker 2: Yes, yes.
• 2:08
  Speaker 5: Oh.
• 2:08
  Speaker 1: And I'm Kelly, Kelly Waiter Smith, who usually loves parasites.
• 2:12
  Speaker 1: But the parasite we're talking about today, well, I'm not a.
• 2:15
  Speaker 4: Huge fan of It's hard to be a fan of
• 2:17
  Speaker 4: this one, especially if you like salads or California or both.
• 2:21
  Speaker 1: That's right, that's right, And this is a parasite that
• 2:24
  Speaker 1: you know, like, it's been on my radar because we
• 2:27
  Speaker 1: grow leafy greens in Virginia on our farm, and every
• 2:31
  Speaker 1: time I see a slug or a snail, I think
• 2:33
  Speaker 1: to myself, how much longer before I might have to
• 2:35
  Speaker 1: worry that one of those slugs or the snails could
• 2:37
  Speaker 1: be transmitting a parasite to me, and in particular this
• 2:40
  Speaker 1: rat lune warm parasite. But the real reason we're talking
• 2:44
  Speaker 1: about it today is because we have two different listeners
• 2:46
  Speaker 1: who have asked about this parasite. One of them is
• 2:49
  Speaker 1: a man named Scott who's been working on trying to
• 2:52
  Speaker 1: get people in Hawaii more aware of the presence of
• 2:55
  Speaker 1: this parasite because it's pretty common there.
• 2:57
  Speaker 2: Good on you, Scott, Good on you, Scott.
• 2:59
  Speaker 1: And another is Haul from New Hampshire, who is generally
• 3:02
  Speaker 1: interested in slugs and snails.
• 3:04
  Speaker 4: And as one is as what is well.
• 3:07
  Speaker 1: And as y'all will notice, throughout like about a month
• 3:10
  Speaker 1: long period, I've been sort of sprinkling in slug and
• 3:13
  Speaker 1: snail stories. But at the end of a listener question request,
• 3:17
  Speaker 1: Scott mentioned and you know, there are probably some interesting
• 3:21
  Speaker 1: parasites in snails and slugs, like rat lungworm, and so
• 3:26
  Speaker 1: as part of my quest to answer Paul's question, We've
• 3:29
  Speaker 1: got a whole episode on rahet lungworm today, and at
• 3:31
  Speaker 1: the end we're going to give Scott some time to
• 3:33
  Speaker 1: tell us about what he's been working on in terms
• 3:36
  Speaker 1: of trying to get the word out about this parasite.
• 3:39
  Speaker 4: And this is really valuable. I had never even heard
• 3:41
  Speaker 4: of rat lungworm until today, So despite my cringing on
• 3:45
  Speaker 4: today's episode, I do think it is valuable to learn
• 3:49
  Speaker 4: all about this. Plus, of course there are fascinating scientific
• 3:52
  Speaker 4: mysteries for those scientists among us who enjoy studying human misery.
• 3:57
  Speaker 1: I don't know if we enjoying human misery, but would
• 4:01
  Speaker 1: like to understand and alleviate human misery. But so on
• 4:04
  Speaker 1: today's show, we are bringing my roommate from grad school
• 4:09
  Speaker 1: onto the show.
• 4:10
  Speaker 2: We didn't live together for all of grad school, but
• 4:12
  Speaker 2: some of it.
• 4:12
  Speaker 1: And she has ended up being like an absolute superstar
• 4:16
  Speaker 1: in the world of parasitology. And so I was like,
• 4:18
  Speaker 1: you know what, we of course have to have Chelsea
• 4:20
  Speaker 1: on to tell everybody about rat lungworm.
• 4:23
  Speaker 4: And you should hear the admiration in her voice when
• 4:25
  Speaker 4: she describes these terrible creatures.
• 4:27
  Speaker 2: Well, let's jump right in.
• 4:30
  Speaker 1: Doctor Chelsea Wood is an Associate Professor in the School
• 4:33
  Speaker 1: of Aquatic and Fishery Sciences at the University of Washington.
• 4:36
  Speaker 1: Her research program explores the ecology of infectious disease in
• 4:40
  Speaker 1: a changing world. And we would run out of time
• 4:42
  Speaker 1: if I went through all of her honors, so I'll
• 4:44
  Speaker 1: just pick two. She's been named a Sloan Research Fellow
• 4:47
  Speaker 1: and a Caveley Fellow. She is also the author of
• 4:51
  Speaker 1: a kid's book for kids ages eight to twelve on parasites.
• 4:54
  Speaker 1: That's right, you can get kids books about parasites. And
• 4:57
  Speaker 1: the book is called Power to the Parasites. Everything you
• 5:00
  Speaker 1: ever never wanted to know about the creepy Crawley's hidden
• 5:04
  Speaker 1: in your home, your food, your pets, and maybe even
• 5:07
  Speaker 1: in you.
• 5:08
  Speaker 2: And she has an.
• 5:08
  Speaker 1: Adult book about parasites, which sounds a little dirtier than
• 5:12
  Speaker 1: I meant it to, a book about parasites that's not
• 5:15
  Speaker 1: meant for children, that's coming out early next year through
• 5:19
  Speaker 1: Basic Books.
• 5:19
  Speaker 2: Hashit.
• 5:20
  Speaker 5: So welcome, Chelsea, Thank you Kelly, and thank you Daniel
• 5:23
  Speaker 5: for having me. I'm so excited to talk to you.
• 5:25
  Speaker 4: Are your books about explaining parasites or are they about
• 5:28
  Speaker 4: inducing nightmares?
• 5:30
  Speaker 5: Like a little bit from Calm a a little bit
• 5:32
  Speaker 5: from Colomby. The hope is that the nightmares turn into dreams.
• 5:37
  Speaker 5: I love parasites, just like Kelly, and the goal of
• 5:41
  Speaker 5: the books is to help people get to know them
• 5:44
  Speaker 5: face to face the way that we know them.
• 5:46
  Speaker 1: And so I would love for you to explain how
• 5:49
  Speaker 1: you became a person who will say the words I
• 5:51
  Speaker 1: love parasites un ironically, like without having been you know,
• 5:55
  Speaker 1: dropped on your head multiple times. Help the audience underst
• 6:00
  Speaker 1: stand me better by explaining how you got here.
• 6:03
  Speaker 5: Yeah, I mean, I don't think anyone's born a parasitologist.
• 6:06
  Speaker 5: It's not like something kids dream about doing when they're
• 6:11
  Speaker 5: very little. When I was growing up, I wanted to
• 6:13
  Speaker 5: be a marine biologist. I wanted to swim with whales
• 6:16
  Speaker 5: and dolphins naturally, lots of people do naturally. And I
• 6:20
  Speaker 5: went to college with that intention and got through a
• 6:24
  Speaker 5: lot of my bachelor's degree planning on being a dolphin
• 6:28
  Speaker 5: trainer whale scientist when I grew up. And then I
• 6:32
  Speaker 5: tried to do research while I was an undergraduate, and
• 6:36
  Speaker 5: I was in a college that didn't have a lot
• 6:38
  Speaker 5: of marine biology, and I didn't have a lot of
• 6:40
  Speaker 5: marine biology. I mean it had no marine biology. Not
• 6:45
  Speaker 5: the best career choice for someone who was bound and
• 6:48
  Speaker 5: determined to be a marine biologist. But I made the
• 6:51
  Speaker 5: best of it, and I worked in an engineering lab.
• 6:54
  Speaker 5: I studied lake zoplankton for a while, I ground up
• 6:57
  Speaker 5: bark beetles. It was all fun, but I want the dolphins,
• 7:01
  Speaker 5: and so I asked my academic advisor to set me
• 7:04
  Speaker 5: up with an internship anywhere in the world with any
• 7:07
  Speaker 5: marine biologists she knew, and she happened to connect me
• 7:10
  Speaker 5: with a person who used to be her office mate,
• 7:13
  Speaker 5: who was a marine biologist but also studied parasites. I
• 7:18
  Speaker 5: went into his lab just like totally grossed out, pretty
• 7:22
  Speaker 5: disappointed that I was going to be working on worms
• 7:25
  Speaker 5: instead of dolphins, but like a little marine biology mercenary,
• 7:29
  Speaker 5: wanting to get my foot in the door. And I
• 7:32
  Speaker 5: worked for him for a quarter and I fell in love.
• 7:36
  Speaker 5: I found that the truematodes, the flatworms that I was
• 7:39
  Speaker 5: working on, were just so fascinating, and it took me
• 7:42
  Speaker 5: a little while to kind of like change course, to
• 7:45
  Speaker 5: like re envision what my future would be without snuggling dolphins.
• 7:50
  Speaker 5: But now I get to snuggle worms, which is way.
• 7:52
  Speaker 1: Better way better. I mean, they don't smell good, but
• 7:56
  Speaker 1: like dolphins don't smell.
• 7:57
  Speaker 5: Great, you know, they don't they smell terrible.
• 8:01
  Speaker 2: Yeah, there you go.
• 8:02
  Speaker 4: But was your initial attraction to whales and dolphins because
• 8:06
  Speaker 4: of their dignity and their grace and the idea of
• 8:09
  Speaker 4: like swimming alongside of them, or was it about the
• 8:11
  Speaker 4: research questions or did you then discover like, wow, I
• 8:15
  Speaker 4: want to swim alongside worms or worms have a grace
• 8:18
  Speaker 4: all of their own. I mean, is this a change
• 8:20
  Speaker 4: in you or is this a change in what you
• 8:23
  Speaker 4: were looking for?
• 8:24
  Speaker 5: When I was interested in marine mammals, it was about
• 8:29
  Speaker 5: wanting to swim with them. It wasn't about the research questions.
• 8:33
  Speaker 5: And you know, like with any scientists, you go through
• 8:35
  Speaker 5: phases of development, and your interests mature and change, and
• 8:39
  Speaker 5: you become less attracted to the superficial beauty of an
• 8:44
  Speaker 5: organism and more attracted to the interesting questions that you
• 8:50
  Speaker 5: have about what that organism is up to in nature.
• 8:53
  Speaker 5: And so I underwent that evolution, and as I did,
• 8:56
  Speaker 5: realized that the questions that were really excited to me,
• 9:00
  Speaker 5: we're not about whales and dolphins, but what lives inside
• 9:03
  Speaker 5: of them.
• 9:04
  Speaker 4: And you can also swim with dolphins and whales without
• 9:07
  Speaker 4: being a marine biologist, right, you sure.
• 9:09
  Speaker 2: Can, yeah, yeah, but they don't like it.
• 9:12
  Speaker 1: If in the middle of those like experiences that you
• 9:14
  Speaker 1: pay a bunch of money for, you like then open
• 9:16
  Speaker 1: the dolphin up to check its parasites, you know, they
• 9:18
  Speaker 1: crown on that.
• 9:19
  Speaker 2: So Chelsea and I don't go to places like that.
• 9:22
  Speaker 2: Probably very often we're not allowed. Yeah, no, so I might.
• 9:25
  Speaker 1: I had a similar trajectory, but it was charismatic African
• 9:29
  Speaker 1: megafauna that I wanted to study, but instead parasites. Way better,
• 9:33
  Speaker 1: way better, way better. Well, we've had quite a few
• 9:38
  Speaker 1: listeners ask about rat lungworm and I was like, all right,
• 9:42
  Speaker 1: I could cover that, but I know Chelsea has like
• 9:45
  Speaker 1: amazing stories about rat lungworms, so she's got to be
• 9:47
  Speaker 1: the one who does it for us. And so rat
• 9:50
  Speaker 1: lungworm it is. Let's start with, like, what kind of
• 9:53
  Speaker 1: animal is rat lungworm?
• 9:56
  Speaker 5: Rat lung worm? Its scientific name is Angiostrongelus cantonensa, and
• 10:00
  Speaker 5: it is a nematode, a round worm. It's parasitic and
• 10:04
  Speaker 5: it normally cycles between snails and slugs and rodents, but
• 10:09
  Speaker 5: it can get into people, and that's where the trouble starts.
• 10:13
  Speaker 4: So how big is this thing or we're talking like
• 10:14
  Speaker 4: a super tiny little worm or like a some megaworm.
• 10:18
  Speaker 5: Depends on the life stage. The nematodes go through a
• 10:21
  Speaker 5: series of molts from you know, juveniles or larvae into adults.
• 10:27
  Speaker 5: The larvae are super tiny, you can only see them
• 10:29
  Speaker 5: under a microscope. The adults are quite big. You'll find them,
• 10:34
  Speaker 5: you know, if you dissect an infected mouse, for example,
• 10:36
  Speaker 5: you'll find them either in the brain tissues or in
• 10:39
  Speaker 5: the lungs, and they are easily visible to the naked eye,
• 10:43
  Speaker 5: like about the length of a thumbnail.
• 10:45
  Speaker 2: Yikes, how do you feel when you see that?
• 10:49
  Speaker 5: The first time I saw rat lungworm larvae, it was
• 10:53
  Speaker 5: like a moment in my parasitology career because I've seen
• 10:57
  Speaker 5: a lot of worms under the microscope, you know, dissect
• 10:59
  Speaker 5: it and snails and fish and all kinds of different vertebrates,
• 11:04
  Speaker 5: and like, I've seen a lot of stuff, but I
• 11:07
  Speaker 5: have never seen so many larvae as the rat lungworm
• 11:13
  Speaker 5: larvae we pulled out of some snails and slugs in
• 11:16
  Speaker 5: Honolulu a couple of years ago. It was just hundreds
• 11:20
  Speaker 5: of thousands of tiny roiling larvae. Under the microscope. You
• 11:25
  Speaker 5: could roll the stage in any direction and you'd be
• 11:29
  Speaker 5: going for like what felt like miles and miles a
• 11:33
  Speaker 5: carpet of baby nematodes.
• 11:36
  Speaker 4: It was que the nightmares.
• 11:38
  Speaker 5: It was staggering. I actually did dream about them for
• 11:41
  Speaker 5: a couple of days after I saw them.
• 11:45
  Speaker 4: And why are they called rat lungworm? Are they found
• 11:48
  Speaker 4: in the lungs of rats? So you're talking about snails
• 11:51
  Speaker 4: and slugs here, so I'm confused.
• 11:52
  Speaker 5: Yeah, they have a really interesting life cycle. Their larval
• 11:55
  Speaker 5: stages are in snails and slugs. The snails and slugs
• 11:59
  Speaker 5: get eaten by road and the larvae, which are now
• 12:02
  Speaker 5: in the rodent's gut, bust through the lining of the
• 12:05
  Speaker 5: gut and find their way into the central nervous system
• 12:09
  Speaker 5: of the rat or mouse.
• 12:10
  Speaker 4: What does that feel like? Do you think bad?
• 12:12
  Speaker 6: Not?
• 12:12
  Speaker 5: Good?
• 12:16
  Speaker 2: Straightened to the point?
• 12:17
  Speaker 5: I like it. If it's anything like what humans experience,
• 12:21
  Speaker 5: probably like fever flu like symptoms as the worms are
• 12:25
  Speaker 5: migrating from the gut into the central nervous system. But
• 12:28
  Speaker 5: then once they're in the central nervous system, they ride
• 12:32
  Speaker 5: up the spinal column and into the brain. And then
• 12:35
  Speaker 5: they start literally consuming the brain tissue of the rodent hosts,
• 12:41
  Speaker 5: burrowing holes, burrowing tunnels through the brain tissue, and they
• 12:46
  Speaker 5: get fat on this brain tissue. Obviously, brain is really nutritious,
• 12:49
  Speaker 5: so as a parasite, it's a smart place to go.
• 12:52
  Speaker 4: Sorry, obviously brain is really nutritious. This is not obvious
• 12:55
  Speaker 4: to me. What is nutritious about the brain?
• 12:58
  Speaker 5: Lots of protein, lots of fats, the things that parasites
• 13:02
  Speaker 5: are looking for. And once they've finished maturing inside the brain,
• 13:08
  Speaker 5: they will then migrate down into the lungs of the
• 13:11
  Speaker 5: rodent host. Because they can't just hang out in one
• 13:13
  Speaker 5: rodent for the rest of their lives. They need to
• 13:15
  Speaker 5: get their babies into the outside world, so they have
• 13:21
  Speaker 5: their larvae in the lungs of the rodent host. The
• 13:24
  Speaker 5: rodent then.
• 13:25
  Speaker 6: Coughs the larvae up wwllows them down, passages them through
• 13:31
  Speaker 6: the gut tract, and the larvae come out in rat poop,
• 13:34
  Speaker 6: which is eaten by snails or slugs, thus completing the
• 13:36
  Speaker 6: life cycle.
• 13:37
  Speaker 4: Now I want something to crawl through my brain and
• 13:39
  Speaker 4: eat the parts of it that remember this conversation so
• 13:41
  Speaker 4: I don't have naemers about it.
• 13:43
  Speaker 1: Later. And is it bad for the snails and the
• 13:47
  Speaker 1: slugs too, because it sounds like it's pretty miserable for
• 13:49
  Speaker 1: the rats.
• 13:50
  Speaker 5: Great question. I don't know if anyone's ever tackled that.
• 13:53
  Speaker 5: Ratlo worm is a pretty understudied parasite, especially with respect
• 13:58
  Speaker 5: to its impact on human hood. I'm not aware of
• 14:01
  Speaker 5: any studies that have looked at what impact parasitic infection
• 14:05
  Speaker 5: has on the snails. People are too busy worrying about
• 14:07
  Speaker 5: what's happened into the vertebrates.
• 14:09
  Speaker 1: Do they get like castrated with the trematodes or we
• 14:12
  Speaker 1: have no idea.
• 14:12
  Speaker 5: I don't know. They're not a castrating parasite.
• 14:14
  Speaker 4: And so you're describing a life cycle with slugs and
• 14:16
  Speaker 4: snails and then rats where they have this horrible thing
• 14:19
  Speaker 4: that goes in their brain and then in their lungs
• 14:21
  Speaker 4: they cough it up and then it forces them to
• 14:22
  Speaker 4: swallow that nightmare. But it can also happen in humans, right,
• 14:26
  Speaker 4: Is there a sort of similar life cycle there, just
• 14:28
  Speaker 4: go through the human brain and into the human lungs,
• 14:30
  Speaker 4: different trajectory.
• 14:31
  Speaker 5: Yeah. Wow, People accidentally or sometimes purposefully eat snails and slugs.
• 14:37
  Speaker 5: It's easier than you think because these snails and slugs
• 14:40
  Speaker 5: can be super tiny, and kale has lots of little
• 14:44
  Speaker 5: crevices in it, So if you accidentally eat one of
• 14:48
  Speaker 5: these snails or slugs, winds up in your gut, busts
• 14:51
  Speaker 5: through the gut wall, gets into the central nervous system
• 14:53
  Speaker 5: up to the brain, and then it burrows lots of tunnels.
• 14:57
  Speaker 5: We don't think that the parasite is capable of mature
• 15:00
  Speaker 5: in a human host, so we think that it either
• 15:04
  Speaker 5: does not or it has trouble getting from the brain
• 15:07
  Speaker 5: to the lungs. But that's kind of irrelevant from the
• 15:10
  Speaker 5: perspective of the patient because the real impact of infection
• 15:14
  Speaker 5: is on having a worm tunneling through your brain. So
• 15:17
  Speaker 5: people who are infected will start by experiencing flu like symptoms.
• 15:21
  Speaker 5: That's when the worms are moving from the gut into
• 15:23
  Speaker 5: the central nervous system, and that's the only moment when
• 15:26
  Speaker 5: the disease is treatable. You can get those worms with
• 15:30
  Speaker 5: an anti parasitic drug at that stage before it gets
• 15:33
  Speaker 5: into what we call the immune privileged site of the
• 15:36
  Speaker 5: central nervous system. Getting drugs into the central nervous system
• 15:39
  Speaker 5: is really difficult, and so treating the worms once they
• 15:43
  Speaker 5: get in there is essentially we can only deal with
• 15:46
  Speaker 5: the symptoms. We can't actually kill them, so flu like
• 15:49
  Speaker 5: symptoms as you enter this two week period when the
• 15:52
  Speaker 5: worms are moving from the gut into the central nervous system,
• 15:54
  Speaker 5: and then literally any symptom that can be produced by
• 15:57
  Speaker 5: the brain can be produced buy these worms, depending on
• 16:02
  Speaker 5: what they decide to eat. As they're up in your
• 16:04
  Speaker 5: brain case, people describe feeling like their body's full of electricity.
• 16:09
  Speaker 5: They describe not being able to wear clothes because just
• 16:13
  Speaker 5: the touch of fabric on their skin is painful. They
• 16:17
  Speaker 5: will say that they feel like they're being stabbed or
• 16:19
  Speaker 5: frozen or burned. And there is literally nothing that doctors
• 16:25
  Speaker 5: can do for those patients other than try to manage
• 16:27
  Speaker 5: the inflammation that the worms are causing.
• 16:29
  Speaker 4: Doesn't it ever do anything good? I mean, brains could
• 16:31
  Speaker 4: also make you feel good. Is there nobody out there
• 16:33
  Speaker 4: who's just, like, constantly experiencing ice cream or something?
• 16:38
  Speaker 5: I am not aware of any reports of people constantly
• 16:40
  Speaker 5: experiencing ice cream.
• 16:45
  Speaker 2: I like your optimism, though, Daniel.
• 16:47
  Speaker 4: I'm struggling here, man, this is nightmare material.
• 16:50
  Speaker 1: I kind of wish we could release your video because
• 16:52
  Speaker 1: the series of faces that you're making because the episode
• 16:55
  Speaker 1: goes on is pretty fantastic. But so so the doctors
• 16:58
  Speaker 1: can't do anything. How long does the parasite live? How
• 17:01
  Speaker 1: long does this go on?
• 17:03
  Speaker 5: We know in rats the parasite can live for years.
• 17:06
  Speaker 5: We don't know for sure what goes on in people. Typically,
• 17:10
  Speaker 5: the initial period of severe neurological problems can last for
• 17:17
  Speaker 5: weeks to months, and sometimes the lingering effects go on
• 17:21
  Speaker 5: for years. Sometimes people die. That's rare, but it does happen.
• 17:25
  Speaker 5: I have a friend here in Seattle who had rat lungworm.
• 17:29
  Speaker 5: She contracted it on a vacation on the Big Island
• 17:32
  Speaker 5: of Hawaii, and she got sick within days of eating
• 17:36
  Speaker 5: a veggie wrap, which is how she thinks she was infected,
• 17:40
  Speaker 5: And it took her a couple of weeks to get diagnosed,
• 17:42
  Speaker 5: and then she was incapacitated by her infection for months. Wow.
• 17:47
  Speaker 5: She lost her ability to speak and understand speech, Her
• 17:51
  Speaker 5: vision was affected, her motor skills were affected. She used
• 17:54
  Speaker 5: a walker for a period of time, and it took
• 17:57
  Speaker 5: her years of physical fare and steroids and other drugs
• 18:04
  Speaker 5: to come back to some semblance of normal, and very
• 18:07
  Speaker 5: luckily she is healthy and healed. Now, But she was
• 18:12
  Speaker 5: infected years ago and it took her years to recover,
• 18:15
  Speaker 5: and that's it seems to be pretty typical.
• 18:17
  Speaker 4: And when you say recover, the brain doesn't like repair
• 18:20
  Speaker 4: those holes. You're talking about like retraining yourself to learn
• 18:24
  Speaker 4: those skills.
• 18:24
  Speaker 5: Again, I'm not sure about the neurobiology of the healing process.
• 18:29
  Speaker 5: I don't think those those holes get filled in. I
• 18:32
  Speaker 5: do think you retrain yourself to use the neurons and
• 18:37
  Speaker 5: synapses that remain. But you'd have to ask a neurologist
• 18:41
  Speaker 5: about the details.
• 18:42
  Speaker 1: How do we figure out if somebody is infected? Is
• 18:45
  Speaker 1: it like brain scans or blood tests?
• 18:48
  Speaker 3: Yeah?
• 18:48
  Speaker 2: How do you figure that out?
• 18:49
  Speaker 5: A definitive diagnosis can only be reached with a spinal
• 18:53
  Speaker 5: tap and then identification of the worms in the cerebro
• 18:57
  Speaker 5: spinal fluid. Spinal taps are not fun. They are procedures
• 19:03
  Speaker 5: that doctors really hesitate to perform unless they're in really
• 19:08
  Speaker 5: exigent circumstances. And even then you've got to get the
• 19:11
  Speaker 5: worms in the CSF in order to know for sure.
• 19:15
  Speaker 5: Other indicators are the proportion of eosinophils in the cerebro fluid,
• 19:20
  Speaker 5: the immune cells that respond to parasitic infection, and that's
• 19:24
  Speaker 5: the only way that you know for sure. It's a
• 19:26
  Speaker 5: challenging disease to diagnose because it looks like flu in
• 19:30
  Speaker 5: the period when it's treatable, and after that your only
• 19:34
  Speaker 5: option is to perform a spinal tap. Doctors don't have
• 19:37
  Speaker 5: a lot of good training on rat lungworm, and so
• 19:39
  Speaker 5: many patients go completely undiagnosed and might never know why.
• 19:44
  Speaker 5: There's some suffering from neurological symptoms.
• 19:47
  Speaker 1: And so where is this thing native and how big
• 19:50
  Speaker 1: of a problem is it in its native range?
• 19:52
  Speaker 5: It is native to East and Southeast Asia. It was
• 19:56
  Speaker 5: first described from China in the thirties, and while that's
• 20:01
  Speaker 5: its native range, it is now broadly distributed across the world.
• 20:06
  Speaker 5: It's been introduced. No sorry, sorry to report.
• 20:11
  Speaker 4: We're going to end with some good news in this episode,
• 20:13
  Speaker 4: right right.
• 20:16
  Speaker 1: What happens when you talk to parasitologists such your expectations slow.
• 20:23
  Speaker 5: It's now it's present all throughout the Equatorial Pacific. It's
• 20:28
  Speaker 5: in Hawaii obviously. It was first reported there in nineteen
• 20:33
  Speaker 5: sixty one, and we know it's been there since nineteen
• 20:36
  Speaker 5: fifty nine because that is when one very sick man
• 20:40
  Speaker 5: wound up in Hawaii State Mental Facility and he had
• 20:45
  Speaker 5: rat lung. Roman was the first patient described from Hawaii.
• 20:48
  Speaker 5: It's also in parts of Europe, Jamaica, South Africa, Brazil.
• 20:54
  Speaker 5: It's been reported from the southeastern US, and there have
• 20:56
  Speaker 5: been human cases from the southeastern US, and the couple
• 21:00
  Speaker 5: of months ago it was reported for the first time
• 21:03
  Speaker 5: in zoo animals in San Diego. No, so now it's
• 21:06
  Speaker 5: in California.
• 21:07
  Speaker 4: What the last line of defensive in breached people.
• 21:10
  Speaker 1: That's all right, let's take a break and when we
• 21:13
  Speaker 1: get back, we'll talk a little bit about how this
• 21:15
  Speaker 1: parasite is getting from place to place.
• 21:37
  Speaker 2: Okay, and we're back.
• 21:39
  Speaker 1: Daniel and I took a little bit of time to
• 21:40
  Speaker 1: try to get that yuck out and we are doing
• 21:44
  Speaker 1: our best to not make Yeah, we're doing our best
• 21:46
  Speaker 1: to not make too many faces, as Chelsea describes this.
• 21:49
  Speaker 1: So the people who live in Hawaii must be particularly
• 21:51
  Speaker 1: frustrated to have this parasite because they also didn't originally
• 21:54
  Speaker 1: have rats, right, and so like, how much of this
• 21:57
  Speaker 1: system has been introduced into Hawaii and like how did
• 22:01
  Speaker 1: it get there?
• 22:02
  Speaker 5: Almost all of it rodents are not native to Hawaii.
• 22:07
  Speaker 5: The Polynesian rat was introduced by Polynesian voyagers about eleven
• 22:11
  Speaker 5: hundred years ago, and then European colonists introduced the black rat,
• 22:16
  Speaker 5: dorway rat, and house mouse. So those rodents are now
• 22:20
  Speaker 5: all extremely common across the Hawaiian islands. Most of the
• 22:24
  Speaker 5: snails and slugs that are host to rat lungworm are
• 22:28
  Speaker 5: also non native to Hawaii. Oh, come on, and the
• 22:32
  Speaker 5: word non native. Yeah, it is an entirely novel ecosystem
• 22:39
  Speaker 5: that's been assembled to support the transmission of this parasite.
• 22:43
  Speaker 4: And you said it was first described in the thirties,
• 22:45
  Speaker 4: but it must have been around a long time, right.
• 22:47
  Speaker 5: Yeah, this is this worm isn't new. It has evolved
• 22:51
  Speaker 5: from a large tree of other nematodes. And while we
• 22:58
  Speaker 5: obviously don't want to be infected by it, it is
• 23:00
  Speaker 5: natural and normal in East and Southeast Asia. What's not
• 23:05
  Speaker 5: natural or normal is the fact that it's now been
• 23:06
  Speaker 5: imported into ecosystems all around the world.
• 23:09
  Speaker 1: And so if you live in Southeast Asia, are people
• 23:12
  Speaker 1: just regularly getting like is it as big a problem
• 23:16
  Speaker 1: in its native range as it is in like Hawaii,
• 23:18
  Speaker 1: for example.
• 23:19
  Speaker 5: It doesn't appear to be. And this is this is
• 23:21
  Speaker 5: a frontier area of research, so you know, this is
• 23:24
  Speaker 5: something that we still have some uncertainty about. We think
• 23:27
  Speaker 5: that early life exposure to the worms protects against catastrophic
• 23:34
  Speaker 5: infection later in life. So people who have no exposure
• 23:38
  Speaker 5: to rat lungworm and then suddenly get a big dose
• 23:41
  Speaker 5: of it are the ones who are winding up with
• 23:43
  Speaker 5: really severe neurological problems. But this is this is an
• 23:46
  Speaker 5: emerging area of research, and that's not a solidified hypothesis yet.
• 23:52
  Speaker 4: How would that work? Your immune system is somehow trained,
• 23:55
  Speaker 4: and then when they're burrowing through your body looking for
• 23:58
  Speaker 4: the brain, they get attacked by the immune system precisely. Yeah, wow, gosh.
• 24:02
  Speaker 1: So I can imagine maybe one day there'd be like
• 24:04
  Speaker 1: a vaccine before you go to Hawaii, or a vaccine
• 24:07
  Speaker 1: for everybody living in Hawaii, which would at least make
• 24:10
  Speaker 1: it less bad.
• 24:11
  Speaker 5: If we could develop a vaccine against a.
• 24:13
  Speaker 1: Worm, yeah, right, which we haven't done yet, right. I
• 24:16
  Speaker 1: know they're working on it for hookworm, but we've not
• 24:18
  Speaker 1: had any success, right, not yet.
• 24:19
  Speaker 4: But remind me, and I know we did a whole
• 24:21
  Speaker 4: episode on why it's hard to get vaccines from parasites,
• 24:24
  Speaker 4: But this is something where your immune system can be
• 24:26
  Speaker 4: trained to respond. What's the challenge in developing the vaccine?
• 24:31
  Speaker 5: Okay, I don't develop vaccines, so I'm way out of
• 24:34
  Speaker 5: my depth here, and Kelly, you should step in and
• 24:36
  Speaker 5: correct me. My understanding is that worms are so closely
• 24:40
  Speaker 5: related to us that biochemically we have so many similarities
• 24:44
  Speaker 5: that things that hurt them also hurt us. And that's
• 24:47
  Speaker 5: why it's just logistically much more challenging to develop a
• 24:50
  Speaker 5: vaccine without unacceptable side effects for a worm relative to
• 24:54
  Speaker 5: something like a virus.
• 24:56
  Speaker 1: We had John Howden on the show and he talked
• 24:58
  Speaker 1: about this for like an hour, and he he said
• 25:00
  Speaker 1: a lot of what you said. He also said that
• 25:01
  Speaker 1: part of the problem is just that, like worms are
• 25:03
  Speaker 1: really big, and like nema toads for example, the outside
• 25:07
  Speaker 1: of them has this like you know, hard outer coating,
• 25:09
  Speaker 1: and so it's hard for the immune system to do
• 25:11
  Speaker 1: much of anything to them. And so you have to
• 25:14
  Speaker 1: try to find a way to, like I don't know,
• 25:15
  Speaker 1: get inside of the nematod and then attack it from within.
• 25:18
  Speaker 1: And it's just really complicated for lots of reasons.
• 25:21
  Speaker 4: But the immune system knows how to do it. Because
• 25:24
  Speaker 4: in Southeast Asia, people who are exposed as children have protection.
• 25:27
  Speaker 4: I'm just reaching here for some optimism.
• 25:30
  Speaker 1: Help me out, mate, Let's go with maybe, which is
• 25:33
  Speaker 1: about Does that seem reasonable?
• 25:36
  Speaker 2: Chelsea?
• 25:36
  Speaker 5: The solution to worms is more worms?
• 25:40
  Speaker 4: No, we need more worms to eat these worms? Is
• 25:43
  Speaker 4: that what you're saying?
• 25:44
  Speaker 5: No more worms for us earlier in life to provide
• 25:48
  Speaker 5: immune protection against later catastrophic infection. I'm not actually advocating
• 25:52
  Speaker 5: for this, by the way, No one go out and
• 25:54
  Speaker 5: get worms.
• 25:55
  Speaker 4: Do not take medical advice from this show. But maybe
• 25:57
  Speaker 4: take your baby to Hawaii?
• 26:01
  Speaker 1: So how is this changing the lives of people who
• 26:04
  Speaker 1: live in Hawaii? Has it changed their diet? What is yeah?
• 26:08
  Speaker 1: What are their lives like?
• 26:09
  Speaker 5: Well, public health outreach about rat lungworm is pretty minimal
• 26:13
  Speaker 5: in Hawaii, so a lot of people are totally unaware
• 26:16
  Speaker 5: that it's being transmitted locally, that it's a risk. There's
• 26:19
  Speaker 5: a tremendous amount of agriculture locally in Hawaii because otherwise
• 26:25
  Speaker 5: food needs to transit over these huge distances in order
• 26:28
  Speaker 5: to reach the Hawaiian islands. So there's lots of lettuce
• 26:31
  Speaker 5: and kale and other leafy greens being grown locally that
• 26:34
  Speaker 5: people are eating without any awareness that there could be
• 26:36
  Speaker 5: snails or slugs that represent a risk to them. That's
• 26:39
  Speaker 5: a problem. People who are aware are trying to be careful,
• 26:44
  Speaker 5: but there's only so much you can do. And actually
• 26:47
  Speaker 5: I met one patient who is also a professor at
• 26:50
  Speaker 5: the University of Hawaii, Manoa. She's an ecologist. She was
• 26:54
  Speaker 5: aware of rat lungworm when she went to a farmer's
• 26:57
  Speaker 5: market and bought kale, and she washed it very thoroughly,
• 27:00
  Speaker 5: and nonetheless, she was infected and nearly died of her infection,
• 27:04
  Speaker 5: was hospitalized for a month and still suffers the after
• 27:08
  Speaker 5: effects of her infection. Wow. So people try, but there
• 27:11
  Speaker 5: are limits. You can't check every kale crevice. There's no
• 27:15
  Speaker 5: way to ensure that your leafy greens are completely safe.
• 27:20
  Speaker 4: What if we irradiate the kale particle physics to the rescue.
• 27:25
  Speaker 5: I'll leave that to you, Daniel. That can be your
• 27:27
  Speaker 5: next project.
• 27:28
  Speaker 4: Bring your salad to the large hadron collider and I
• 27:31
  Speaker 4: will kill those worms.
• 27:34
  Speaker 1: We And you mentioned, you know, like someone had a
• 27:36
  Speaker 1: veggie wrap and in some writing of yours that I'm
• 27:40
  Speaker 1: familiar with that folks can find in early twenty twenty seven,
• 27:44
  Speaker 1: like you mentioned that you can get it in a smoothie,
• 27:46
  Speaker 1: Like you know, you put like kale in a smoothie,
• 27:48
  Speaker 1: you don't even think about it, and now you've got
• 27:50
  Speaker 1: parasites that way. Like, there's so many different routes that
• 27:53
  Speaker 1: you might not even think about to get it, which
• 27:55
  Speaker 1: is why none of us are going to sleep tonight.
• 27:57
  Speaker 4: And why we're never getting kale advertisers after this episode.
• 28:01
  Speaker 2: Yeah, that's right, Big kale is gonna shun us.
• 28:05
  Speaker 1: Oh wait, so you went to Hawaii to meet people
• 28:08
  Speaker 1: who study this and to like sort of find out
• 28:10
  Speaker 1: what it's like for people in Hawaii.
• 28:12
  Speaker 2: And so you and I when we.
• 28:14
  Speaker 1: Used to be roommates, we'd go out for sushi and
• 28:16
  Speaker 1: you would eat all kinds of sushi, right, so you
• 28:19
  Speaker 1: don't seem like a kind of person who is worried
• 28:21
  Speaker 1: about parasites in their food, although I know sushi's usually
• 28:25
  Speaker 1: frozen beforehand, But like, did this change your eating habits
• 28:31
  Speaker 1: when you were in an area where you knew that
• 28:33
  Speaker 1: it was.
• 28:33
  Speaker 5: One hundred percent There's a big difference between going out
• 28:37
  Speaker 5: for sushi and eating a salad. In Hawaiian rat lung
• 28:40
  Speaker 5: worom is a catastrophic infection, potentially life ending, certainly life altering.
• 28:47
  Speaker 5: It is not a parasite that I would touch with
• 28:50
  Speaker 5: a ten foot pole. It's very, very dangerous and probably
• 28:53
  Speaker 5: you know, of all the parasites that I have encountered
• 28:56
  Speaker 5: in my career, the one I at least like to
• 28:58
  Speaker 5: be infected with myself.
• 29:00
  Speaker 4: You have a ranking like most to leave, I sure do.
• 29:03
  Speaker 2: Wow, where is loa looa?
• 29:08
  Speaker 5: I would one hundred percent take loo looa? Absolutely?
• 29:12
  Speaker 4: What's a loaaloa?
• 29:13
  Speaker 6: Oh?
• 29:13
  Speaker 1: That was We did the list of the three parasites
• 29:16
  Speaker 1: that creep Kelly out the most, and loa loa was
• 29:19
  Speaker 1: on there because it moves around the inside of your
• 29:22
  Speaker 1: eye and people can see it moving in your eye.
• 29:24
  Speaker 2: And I thought that was pretty gross, But.
• 29:26
  Speaker 4: That sounds cool to you, Chelsea.
• 29:28
  Speaker 5: It's gross for sure, but it's really low pathogenicity. You know,
• 29:32
  Speaker 5: there's very few effects of being infected with looaloa. And
• 29:37
  Speaker 5: then you get to like have a little pet that
• 29:39
  Speaker 5: you keep with you all the time.
• 29:42
  Speaker 2: You're never alone, never alone.
• 29:46
  Speaker 1: So what do we know about how this parasite gets
• 29:48
  Speaker 1: from one place to another? Like do we know how
• 29:51
  Speaker 1: it got to Hawaii or how it got to Louisiana?
• 29:54
  Speaker 5: We have no idea how it got to Hawaii, which
• 29:57
  Speaker 5: is a question that I find really interesting because there
• 30:00
  Speaker 5: are several very different potential answers. It seems pretty likely
• 30:05
  Speaker 5: that it could have arrived from Southeast Asia during World
• 30:08
  Speaker 5: War II or the Korean War, because there was a
• 30:11
  Speaker 5: tremendous amount of movement of material between those regions, and
• 30:16
  Speaker 5: we know that rodents came and went. It's also possible
• 30:19
  Speaker 5: that snails and slugs came and went in things like
• 30:21
  Speaker 5: tires or vehicles that were being moved from one place
• 30:24
  Speaker 5: to the next, so that's really reasonable. But it's also
• 30:28
  Speaker 5: entirely possible that the parazite arrived with Polynesian rats when
• 30:33
  Speaker 5: they were introduced eleven hundred years ago by Polynesian voyagers.
• 30:37
  Speaker 5: So those are two very different answers that question. And
• 30:42
  Speaker 5: I find it really interesting that we don't know how
• 30:46
  Speaker 5: it arrived, given how much impact it's had, and how
• 30:51
  Speaker 5: that information would really help us better understand how to
• 30:55
  Speaker 5: move materials responsibly across the face of the moving forward,
• 30:58
  Speaker 5: given that we don't want rat long room to continue
• 31:00
  Speaker 5: to expand in its range.
• 31:02
  Speaker 4: Can I ask a question about that comment you made.
• 31:04
  Speaker 4: You said that Polynesians introduced Polynesian rats where the Polynesian
• 31:08
  Speaker 4: ships large enough for the rats to hide on them,
• 31:11
  Speaker 4: or intentional that I.
• 31:13
  Speaker 5: Don't I don't know whether it was intentional or not,
• 31:16
  Speaker 5: but I've always just assumed that they were still always
• 31:19
  Speaker 5: like in any other ship.
• 31:20
  Speaker 1: Wow, because in Moana it's just a raft. That's why
• 31:25
  Speaker 1: it's confusing.
• 31:26
  Speaker 4: Kelly is revealing the depth of my research on this topic. Yes,
• 31:31
  Speaker 4: I've actually had rats in the home, so thank you
• 31:33
  Speaker 4: very much. I have a little bit of experience. I'm
• 31:35
  Speaker 4: grateful they didn't have rat lungworm though, hopefully.
• 31:39
  Speaker 2: Yeah.
• 31:39
  Speaker 1: So now when you travel to other parts of the world,
• 31:44
  Speaker 1: like I don't know it's in Louisiana and Florida, for example,
• 31:47
  Speaker 1: do you like, are you totally off salads now?
• 31:50
  Speaker 2: Is what I'm asking?
• 31:51
  Speaker 1: How do you how do you balance this risk when
• 31:54
  Speaker 1: you go from place to place.
• 31:55
  Speaker 5: I'm really really careful about fresh leafy greens when I
• 31:59
  Speaker 5: travel in a place that has rat lungworm. I did
• 32:02
  Speaker 5: not eat anything green while I was in Hawaii. The
• 32:05
  Speaker 5: only exception is I was hanging out with Rob Cowie,
• 32:09
  Speaker 5: who's a malacologist a snail researcher at the University of
• 32:13
  Speaker 5: Hawaii and one of the folks there who's studying rat lungworm,
• 32:17
  Speaker 5: and he had my husband and me over for dinner
• 32:20
  Speaker 5: one night and served us a salad. And I looked
• 32:24
  Speaker 5: at him and I was like, you have to be joking.
• 32:26
  Speaker 5: I am literally here to study rat lung worm with you, Like,
• 32:30
  Speaker 5: there's no way you're feeding me this right now. And
• 32:32
  Speaker 5: he's like, no, no, no, it's totally it's fine. I know
• 32:35
  Speaker 5: that this lettuce came from California, so I know that
• 32:38
  Speaker 5: it's safe, so you can eat it and it's okay.
• 32:40
  Speaker 5: And so I was like, all right, you're the expert.
• 32:43
  Speaker 5: Put some salad on my plate, passed it down the
• 32:45
  Speaker 5: table to another dinner guest, Vernon Ansdell, who's a physician
• 32:50
  Speaker 5: and rat lungworm expert in Hawaii based in Honolulu, and
• 32:54
  Speaker 5: he took that bowl and passed it right on down
• 32:57
  Speaker 5: the table without giving himself any salad. And I just
• 33:01
  Speaker 5: I like was internally panicking. I didn't want to be
• 33:04
  Speaker 5: rude and not eat the salad, so I ate it.
• 33:07
  Speaker 5: Oh and then I didn't sleep for a couple of
• 33:09
  Speaker 5: days after that.
• 33:11
  Speaker 4: Yeah.
• 33:11
  Speaker 5: Yeah, So anyway, I'm very careful about green things when
• 33:14
  Speaker 5: I'm in Hawaii, except for when Rob tricks me into
• 33:18
  Speaker 5: eating a salad. Not cool, it's not cool.
• 33:22
  Speaker 4: Wow, you're peer pressured into parasite roulette there. That's terrifying.
• 33:27
  Speaker 5: And then you know, in the southeastern US, yeah, I
• 33:31
  Speaker 5: avoid leafy greens, especially local ones. The reality is that
• 33:35
  Speaker 5: the vast majority of salad that is eaten in North
• 33:38
  Speaker 5: America comes from the Central Valley of California. So so
• 33:43
  Speaker 5: far that's safe. And that means that salads that you
• 33:47
  Speaker 5: eat anywhere in North America are probably from California and
• 33:51
  Speaker 5: therefore safe. But to me, it's you know, I'll gamble
• 33:54
  Speaker 5: with a lot of different parasites. I eat sushi because
• 33:56
  Speaker 5: I don't care if I get sushi worm. It's fine.
• 33:59
  Speaker 5: It's worth it to me, And.
• 34:00
  Speaker 2: Eat sushi might even be kind of awesome.
• 34:03
  Speaker 5: Might even be kind of awesome.
• 34:05
  Speaker 2: I mean, if you could collect it somehow. All right, Sorry,
• 34:08
  Speaker 2: maybe not. Maybe it's just me speaking alone here.
• 34:10
  Speaker 5: No, no, you're not at all. I mean. And a psychidosis,
• 34:14
  Speaker 5: which is sushi worm disease, not fun, vomiting, diarrhea, abdominal pain.
• 34:20
  Speaker 5: In really severe cases, you're hospitalized and they have to
• 34:23
  Speaker 5: do an endoscopy to actually visualize and remove the worm.
• 34:26
  Speaker 5: Would that be cool? It knows I wouldn't enjoy it
• 34:30
  Speaker 5: in the moment. Would I love to have a picture
• 34:33
  Speaker 5: of a worm from my own gut?
• 34:36
  Speaker 4: Also?
• 34:37
  Speaker 2: No, yep, not gonna lie.
• 34:38
  Speaker 5: It would be pretty amazing.
• 34:40
  Speaker 2: Yeah, that would be pretty cool.
• 34:41
  Speaker 4: No, it would not be pretty amazing. Wow, this is
• 34:44
  Speaker 4: a real litmus test for people's personality.
• 34:46
  Speaker 1: I think I'd rather have a tapeworm though, absolutely like that.
• 34:48
  Speaker 1: I'd rather collect a tapeworm.
• 34:50
  Speaker 5: Yeah, no question.
• 34:51
  Speaker 1: Okay, so you don't worry about salads because most of
• 34:53
  Speaker 1: the salads have come from central California, but you pay
• 34:57
  Speaker 1: attention to where you're going and you change your behavior accordingly.
• 34:59
  Speaker 1: With that be a reasonable summary.
• 35:01
  Speaker 5: Yeah, I don't eat salad in Hawaii. I wouldn't eat
• 35:04
  Speaker 5: leafy greens that are uncooked in East or Southeast Asia,
• 35:09
  Speaker 5: and I'd be cognizant of it in the southeastern US,
• 35:12
  Speaker 5: where salads are most likely sourced from California, but could
• 35:16
  Speaker 5: be from local creams.
• 35:18
  Speaker 4: So you're saying, if somebody served you two salads, one
• 35:20
  Speaker 4: grown in California and one grown in Virginia, you would
• 35:23
  Speaker 4: eat the California salad.
• 35:24
  Speaker 5: So far, Virginia's Okay.
• 35:27
  Speaker 1: Yeah, so Daniel and I have a California verus Virginia
• 35:30
  Speaker 1: thing going on and he was trying to catch.
• 35:34
  Speaker 2: Yeah. Okay, so it's called rat lungwarm.
• 35:37
  Speaker 1: But you've already mentioned that it can get into mice,
• 35:40
  Speaker 1: and now we know it can get into people. So
• 35:43
  Speaker 1: as it gets introduced throughout the world, are there other
• 35:48
  Speaker 1: animal brains it's eating, like other than humans and mice
• 35:51
  Speaker 1: and rats? Like, how bad is this for like the
• 35:53
  Speaker 1: rest of the ecosystem.
• 35:54
  Speaker 5: Yeah, any mammal can be infected and suffer some of
• 35:57
  Speaker 5: the same effects as pea bull and rats. In Hawaii,
• 36:02
  Speaker 5: there are lots of veterinary reports of paralyzed dogs who
• 36:07
  Speaker 5: experience that paralysis as a result of ratlung room infection.
• 36:10
  Speaker 5: Horses too, And often our reports of ratlung room from
• 36:15
  Speaker 5: the continental US are from zoo animals, and that's because
• 36:21
  Speaker 5: they're highly observed by really well trained veterinarians and they're bored,
• 36:27
  Speaker 5: and so if a snail or a slug comes into
• 36:29
  Speaker 5: their enclosure, they're likely to eat it, touch it, mouth it,
• 36:33
  Speaker 5: and become infected themselves. The reports from California that came
• 36:37
  Speaker 5: out of San Diego recently were from zoo animals.
• 36:40
  Speaker 1: All right, well, let's take a break bit of a
• 36:43
  Speaker 1: palate cleanser again, and when we get back, we'll do
• 36:46
  Speaker 1: our best to see if we can find some sort
• 36:49
  Speaker 1: of positive angle to end on for Daniel, and we'll
• 36:52
  Speaker 1: see where that gets us. And we're back. We're talking
• 37:15
  Speaker 1: about the spread of rat lungworm and so, Chelsea, you
• 37:20
  Speaker 1: said something about how if we knew how it got
• 37:23
  Speaker 1: from place to place, there would be something we could
• 37:26
  Speaker 1: do about it. Are there inroads for ways we can
• 37:31
  Speaker 1: keep it from spreading to places that it hasn't gotten
• 37:35
  Speaker 1: to yet.
• 37:36
  Speaker 5: Yeah, So we've talked about war and how war moves
• 37:40
  Speaker 5: materials over these large spans of space and can bring
• 37:43
  Speaker 5: animals that are from one place to another. We haven't
• 37:46
  Speaker 5: talked about yet is trade, and the trade in horticultural
• 37:50
  Speaker 5: products is thought to be one of the pathways by
• 37:53
  Speaker 5: which the worm has made it into the southeastern US. Trees, shrubs,
• 38:00
  Speaker 5: herbaceous plants come in soil. Snails and slugs can be
• 38:04
  Speaker 5: in soil, and that is one pathway by which the
• 38:08
  Speaker 5: parasite is transported from one part of the world to another.
• 38:12
  Speaker 5: The trade and horticultural products is regulated and of course
• 38:16
  Speaker 5: people are trying to prevent the spread of invasive snails
• 38:19
  Speaker 5: and slugs themselves, but our screening procedures are not perfect.
• 38:25
  Speaker 5: Better protections on how biological materials are moved across national
• 38:30
  Speaker 5: boundaries would reduce the likelihood that the worm is going
• 38:34
  Speaker 5: to make it into new places.
• 38:36
  Speaker 4: But if you can't even rinse scale and inspect it
• 38:39
  Speaker 4: in your own sink and be confident that there's nothing
• 38:42
  Speaker 4: in there, how could inspectors check every plant?
• 38:45
  Speaker 5: I don't think they can.
• 38:46
  Speaker 1: Okay, And once it gets established somewhere, is there any
• 38:52
  Speaker 1: hope of kicking it out?
• 38:53
  Speaker 5: It depends on where you are. Eradicating rats and mice
• 38:57
  Speaker 5: is famously difficult, not possible, except in small areas or
• 39:04
  Speaker 5: on small islands. There are some islands where rats have
• 39:08
  Speaker 5: been introduced and later eradicated. It costs a ton of
• 39:12
  Speaker 5: money and it takes a ton of effort, but it
• 39:14
  Speaker 5: is possible. But if we're talking like an area of
• 39:18
  Speaker 5: a large land mass, getting rid of rats or mice
• 39:22
  Speaker 5: or snails or slugs is really just not practical. The
• 39:25
  Speaker 5: best intervention is to make sure that people are taking
• 39:28
  Speaker 5: measures to protect themselves and that the food supply is protected.
• 39:33
  Speaker 2: Okay, Yeah, that was the most positive we were able
• 39:36
  Speaker 2: to come up with.
• 39:37
  Speaker 5: Sorry, because I am not a beam of light here,
• 39:41
  Speaker 5: and I have to hammer on that a little bit.
• 39:43
  Speaker 4: You're saying protect themselves, but again, what can we do
• 39:46
  Speaker 4: to protect ourselves other than not eat salads?
• 39:49
  Speaker 5: By let us from places that are safe? Californian let
• 39:54
  Speaker 5: us so far is both the easiest to get and
• 39:58
  Speaker 5: the safest. All of your leafy greens extremely thoroughly. Inspect
• 40:04
  Speaker 5: those greens very carefully. If you live in an endemic
• 40:07
  Speaker 5: region and you're growing your own greens, what I'd recommend
• 40:11
  Speaker 5: is like filling up a sink with water and letting
• 40:14
  Speaker 5: the lettuce soak for an hour or so so that
• 40:17
  Speaker 5: any snails or slugs that are on it are dislodged
• 40:21
  Speaker 5: and you can see them more easily, and then rinsing
• 40:24
  Speaker 5: it really really carefully and inspecting all the crevices. And
• 40:27
  Speaker 5: it also means protecting kids from their own curiosity. A
• 40:32
  Speaker 5: lot of pediatric rat lung worm cases in Hawaii are
• 40:36
  Speaker 5: kids who were playing in the backyard and picked up
• 40:39
  Speaker 5: a snail or slug, mouthed it or even just handled it,
• 40:42
  Speaker 5: and then put their hands in their mouths. So watching
• 40:45
  Speaker 5: over kids, especially in places where rat lungworm is known
• 40:48
  Speaker 5: to be transmitted when they're playing in nature or in
• 40:51
  Speaker 5: the backyard.
• 40:53
  Speaker 4: So this doesn't seem very helpful. I mean, in five
• 40:55
  Speaker 4: years and twenty years, in fifty years, is rat lung
• 40:58
  Speaker 4: worm just going to be everywhere? Is care free eating
• 41:01
  Speaker 4: of salads just going to be a historical anecdote.
• 41:05
  Speaker 5: I might have answered this question differently a couple of
• 41:07
  Speaker 5: months ago. It's a subtropical parasite, and I would have
• 41:12
  Speaker 5: expected it to remain only in regions that are very
• 41:16
  Speaker 5: warm and very moist. It made sense to me that
• 41:19
  Speaker 5: it would wind up in the southeastern US. It's like,
• 41:21
  Speaker 5: well within the bounds of the humidity and temperature that
• 41:27
  Speaker 5: the parasite evolved in. The fact that it showed up
• 41:30
  Speaker 5: in San Diego is upsetting, yes, because that is a
• 41:33
  Speaker 5: very different habitat than where the parasite has been found before.
• 41:38
  Speaker 5: And we don't know whether this is really limited or not.
• 41:42
  Speaker 5: Like the first report from San Diego only came in
• 41:44
  Speaker 5: a few months ago, so we don't know the full
• 41:46
  Speaker 5: picture yet. But the fact that it shows up in
• 41:49
  Speaker 5: a place that seems to be outside of the envelope
• 41:54
  Speaker 5: of environments that it's previously been known to in habit.
• 41:59
  Speaker 5: Kind of blows up my expectations about where we should
• 42:01
  Speaker 5: expect to see it in the future.
• 42:03
  Speaker 1: So, what are the lessons from rat lungworm for what
• 42:06
  Speaker 1: we should expect regarding other parasites spreading around the world, Like,
• 42:10
  Speaker 1: is rat lungworm the only parasite that's spreading around the
• 42:13
  Speaker 1: world or is this happening with a lot of different
• 42:14
  Speaker 1: kinds of parasites right now?
• 42:16
  Speaker 5: The answer is all over the map, you know, parasite.
• 42:18
  Speaker 5: When we say the word parasite, we're talking about this
• 42:20
  Speaker 5: like sprawling tree of life. Parasitism has evolved two hundred
• 42:27
  Speaker 5: and twenty three independent times across the animal tree of life. Wow,
• 42:31
  Speaker 5: that's two hundred and twenty three times when a free
• 42:34
  Speaker 5: living ancestor gave rise to a parasitic branch. And that
• 42:39
  Speaker 5: means that there's this like crazy amount of diversity among
• 42:42
  Speaker 5: the parasites. They're not a monolith. They're all doing different stuff.
• 42:46
  Speaker 5: Rat lungworm is a great poster child for those parasites
• 42:50
  Speaker 5: that are benefiting from global change. We're like moving stuff
• 42:54
  Speaker 5: all around the world, and rat lungworm is the beneficiary
• 42:57
  Speaker 5: of all of that movement. It's not the only one.
• 42:59
  Speaker 5: There are lots of parasites that are similarly well positioned
• 43:02
  Speaker 5: to take advantage of the fact that we've now connected
• 43:04
  Speaker 5: these really far flung places. But there are other parasites
• 43:08
  Speaker 5: that are doing the exact opposite thing. We don't pay
• 43:12
  Speaker 5: attention to them because they're not causing outbreaks, right, They're
• 43:16
  Speaker 5: not increasing in abundance, and so we have no reason
• 43:19
  Speaker 5: to encounter them. But they are quietly diminishing, sometimes even
• 43:24
  Speaker 5: to extinction. And that's the other side of the coin
• 43:27
  Speaker 5: that we never see because it doesn't affect us personally.
• 43:31
  Speaker 1: And that seems like a perfect segue into the amazing
• 43:34
  Speaker 1: book that you wrote. Do you want to tell us
• 43:36
  Speaker 1: a bit about it so that folks can immediately go
• 43:39
  Speaker 1: pre order it after listening to this episode.
• 43:42
  Speaker 4: If this was a nightmares.
• 43:43
  Speaker 5: Enough, yeah, there are actually a lot more nightmares in
• 43:47
  Speaker 5: nether world. The Genius of Parasites, which is the book
• 43:51
  Speaker 5: that I've been working on for the past couple of years,
• 43:53
  Speaker 5: which is due to come out on the sixteenth of
• 43:55
  Speaker 5: February twenty twenty seven. Pre Orders should open in mid June.
• 43:59
  Speaker 5: This book is kind of the culmination of my career
• 44:03
  Speaker 5: to date in parasitology. It's what I've learned about the
• 44:06
  Speaker 5: future of parasitism. It's my answer to the question is
• 44:11
  Speaker 5: the world getting wormier or not? And yeah, the book
• 44:15
  Speaker 5: is about how global change is influencing parasites, whether we
• 44:19
  Speaker 5: should expect in the future more parasite outbreaks or fewer
• 44:24
  Speaker 5: parasites in general. And the upshot is these parasites are
• 44:28
  Speaker 5: just so diverse there's no reason to expect them all
• 44:31
  Speaker 5: to do the same thing. And the book covers many
• 44:34
  Speaker 5: examples of parasitic outbreaks like rat lungworm and many others,
• 44:39
  Speaker 5: but it also looks at the other side of that
• 44:41
  Speaker 5: coin and investigates those parasites that are diminishing even into extinction,
• 44:47
  Speaker 5: and asks the question why and does it matter?
• 44:50
  Speaker 4: Should we care and can we do that to rat lungworm.
• 44:55
  Speaker 1: After we wrap up this episode, folks should stay tuned
• 44:58
  Speaker 1: because one of the listeners who reached out to us
• 45:00
  Speaker 1: is a man named Scott who is actually working on
• 45:03
  Speaker 1: trying to get people in Hawaii aware of rat lungworm.
• 45:06
  Speaker 1: So he's like part of a group that's working on that.
• 45:08
  Speaker 1: So we're going to give him some time to tell
• 45:09
  Speaker 1: us about what he's been working on. But before we
• 45:12
  Speaker 1: let you go, I want to know what is your
• 45:15
  Speaker 1: favorite parasite, And if it's not rat lungworm, what is
• 45:19
  Speaker 1: the creepiest parasite?
• 45:21
  Speaker 5: Oh boy, you're like asking me to choose amongst my children.
• 45:25
  Speaker 2: I know now. I knew it was not an easy question.
• 45:28
  Speaker 2: I knew, I.
• 45:28
  Speaker 5: Really I have a lot of favorite parasites, but the
• 45:34
  Speaker 5: most beautiful, in my opinion, are the tapeworms in the
• 45:38
  Speaker 5: order tripinnerenka. And I really love these worms. We come
• 45:42
  Speaker 5: across them a lot in our coral reef Fish project.
• 45:46
  Speaker 5: We dissect lots of coral reefishes and we find these
• 45:48
  Speaker 5: parasites as larvae. And I love them because they are
• 45:54
  Speaker 5: set up perfectly for life inside of a slippery shark gut.
• 46:00
  Speaker 5: Imagine yourself inside a shark gut. It's dark, it's slippery,
• 46:04
  Speaker 5: there's this never ending tide of poop that's trying to
• 46:07
  Speaker 5: sweep you out of the gut and into the environment.
• 46:10
  Speaker 5: And you don't want that. No, The trepennaynks avoid that
• 46:14
  Speaker 5: by having these like four tentacles that are on their
• 46:18
  Speaker 5: head end, which we call skolex, and the tentacles are
• 46:21
  Speaker 5: retractable so they can have them kind of like coiled
• 46:24
  Speaker 5: up inside of their head, and whenever they wish, they
• 46:28
  Speaker 5: can eject those tentacles. Each one is armed with thousands
• 46:33
  Speaker 5: of backward facing hooks. So those tentacles, Daniel.
• 46:38
  Speaker 1: Daniel, this is so fascinating, Daniel, and I are having
• 46:41
  Speaker 1: diametric responses right now.
• 46:43
  Speaker 5: This is.
• 46:46
  Speaker 4: All right. I can handle it. I can handle it.
• 46:48
  Speaker 2: Go ahead, you got this, Daniel.
• 46:51
  Speaker 4: It's shooting these tentacles out of its head, all.
• 46:53
  Speaker 5: Right, it's shooting tentacles out of its head. They lay
• 46:57
  Speaker 5: those tentacles down on the intestinal a of the shark,
• 47:01
  Speaker 5: dig in the hooks, and then retract them back into
• 47:04
  Speaker 5: their heads so that they're firmly anchored on the shark's
• 47:07
  Speaker 5: gut wall. And they are.
• 47:09
  Speaker 2: That's amazing.
• 47:10
  Speaker 5: They're amazing. They're also just so beautiful because those tentacles
• 47:14
  Speaker 5: are like curly cued, kind of like the illustrations in
• 47:17
  Speaker 5: the margins of a medieval manuscript. You know, all those
• 47:20
  Speaker 5: like really elaborate ornaments.
• 47:22
  Speaker 1: M h.
• 47:22
  Speaker 5: And they've got all these hooks that refract light when
• 47:25
  Speaker 5: you see them under a microscope. So just like imagine
• 47:28
  Speaker 5: like a bedazzled medieval manuscript and you've got an idea
• 47:32
  Speaker 5: of what the trapen ranks look like. They're just gorgeous.
• 47:37
  Speaker 5: I love the thought of them swimming around with a
• 47:40
  Speaker 5: bunch of sharks, traveling hundreds of miles, with their hosts
• 47:44
  Speaker 5: using these incredibly like well adapted tentacles to get what
• 47:48
  Speaker 5: they want in the world. I just every time I
• 47:50
  Speaker 5: see one, it's a really special moment.
• 47:52
  Speaker 2: I can imagine I'd love to see one in person.
• 47:54
  Speaker 5: Come visit.
• 47:55
  Speaker 4: Okay, you speak of this parasite admiringly, but you also
• 47:59
  Speaker 4: call it beautiful. Are you really thinking it's like attractive?
• 48:02
  Speaker 4: I mean, we you like wear as a piece of jewelry,
• 48:05
  Speaker 4: or are you just like impressed by its ingenuity and
• 48:08
  Speaker 4: its ferociousness? She nearly has one on her finger? All right,
• 48:14
  Speaker 4: all right, right, there we go.
• 48:16
  Speaker 1: It's a different kind of parasite. But yes, right, yeah,
• 48:20
  Speaker 1: it's the haplesson you diplas on. Yeah, those are two
• 48:23
  Speaker 1: trematodes that are permanently connected to each other.
• 48:26
  Speaker 5: Nice monogenes actually monogens.
• 48:28
  Speaker 2: Oh no, I've been embarrassed in public.
• 48:32
  Speaker 1: All right, but I'm feeling like we should probably not
• 48:35
  Speaker 1: get to a creepy parasite. Given Daniel's face, when we
• 48:39
  Speaker 1: were talking about the most beautiful parasite, and so I
• 48:43
  Speaker 1: think maybe we should call it quits here and bid
• 48:46
  Speaker 1: you farewell.
• 48:48
  Speaker 2: Thank you so much for coming on the show. This
• 48:49
  Speaker 2: was amazing.
• 48:50
  Speaker 1: Folks should go out and pre order Nether World. This
• 48:53
  Speaker 1: episode is coming out after the pre orders go live,
• 48:56
  Speaker 1: so you can all go and do that right now,
• 48:57
  Speaker 1: and when the book comes out, we will have Chelsea
• 49:00
  Speaker 1: back to talk more about parasites and their future.
• 49:03
  Speaker 2: Thanks for being on the show.
• 49:04
  Speaker 5: Thank you so much for having me, guys, I really
• 49:06
  Speaker 5: appreciate it.
• 49:07
  Speaker 3: Hi, Daniel and Kelly, thanks for the information on rat lungworm.
• 49:11
  Speaker 3: It was very thorough and answered more questions than I
• 49:14
  Speaker 3: thought I had. I've been on a dietem and told
• 49:17
  Speaker 3: to eat more salad. Well, so much for that. Admittedly
• 49:20
  Speaker 3: I live in New Hampshire where the salad is likely safe,
• 49:23
  Speaker 3: but it still give one pause. And please don't find
• 49:26
  Speaker 3: a chocolate cake parasite anyway. Thanks for the great show.
• 49:31
  Speaker 7: Aloha, Kelly and Daniel. I really enjoyed listening to doctor
• 49:34
  Speaker 7: would share her knowledge of the rat long worm parasite
• 49:37
  Speaker 7: and the disease. It was very informative. Thank you so
• 49:40
  Speaker 7: much for giving me this opportunity to share some about
• 49:43
  Speaker 7: our efforts for disease prevention here in Hawaii. In our
• 49:47
  Speaker 7: rural community of Hanna, Maui. Back in twenty seventeen, we
• 49:50
  Speaker 7: had an outbreak of rat long worm disease and I
• 49:53
  Speaker 7: have friends who are still experiencing some neurological symptoms years later,
• 49:57
  Speaker 7: and there are still cases now. And then you're the
• 50:00
  Speaker 7: Hawaii Farmers Union. We developed an educational outreach campaign aimed
• 50:04
  Speaker 7: at rat lungworm disease prevention, targeting farmers and consumers. While
• 50:10
  Speaker 7: all mollusks can carry ROLW and Hawaii the most high
• 50:14
  Speaker 7: risk vector is called the semi slug due in part
• 50:18
  Speaker 7: to how its habits bring it into contact with human
• 50:20
  Speaker 7: food sources, where it can end up hiding in a
• 50:22
  Speaker 7: lettuce or kale. As doctor Woods mentioned, there is a
• 50:27
  Speaker 7: great need for locally grown food in Hawaii and we
• 50:29
  Speaker 7: want to support our local farmers. So while we don't
• 50:32
  Speaker 7: want anyone to get rat lungworm disease, of course, we
• 50:36
  Speaker 7: also don't want the fear of the disease to discourage
• 50:39
  Speaker 7: people from eating locally grown produce, so we did outreach
• 50:44
  Speaker 7: to local farms to help them reduce the risk of
• 50:46
  Speaker 7: contamination by aggressively going after rodents on their farms, creating
• 50:51
  Speaker 7: buffer zones around their growing areas which semi slugs don't
• 50:54
  Speaker 7: like to cross, putting out non toxic iron phosphate slug bait,
• 50:58
  Speaker 7: and doing manual sets my slug removal. This is especially
• 51:03
  Speaker 7: important during the rainy season when slugs are most active,
• 51:06
  Speaker 7: and taken together, it can have a big impact on
• 51:10
  Speaker 7: the presence of slugs for the consumer. No matter how
• 51:14
  Speaker 7: much we may trust the farmer, we have to take
• 51:16
  Speaker 7: responsibility for our own safety. Cooking or freezing kills the parasite,
• 51:22
  Speaker 7: so for kale and other leafy greens, cooking it will
• 51:25
  Speaker 7: prevent the disease, and if you really want raw kale smoothies,
• 51:28
  Speaker 7: you can freeze the kale first. I do eat local
• 51:32
  Speaker 7: salads still, but I wash every leaf of lettuce in
• 51:36
  Speaker 7: flowing water, which will knock off the semi slug, and
• 51:38
  Speaker 7: I carefully inspect them as I do. The good news
• 51:42
  Speaker 7: Kelly and Daniel is that ratlungworm disease is an entirely
• 51:47
  Speaker 7: preventable disease. By taking proactive measures where produce is grown,
• 51:54
  Speaker 7: we can greatly reduce the risk and by ultimately taking
• 51:57
  Speaker 7: responsibility for our food. As consumers, we can and still
• 52:00
  Speaker 7: enjoy our delicious local greens while keeping ourselves safe from
• 52:04
  Speaker 7: this nasty nematode. As part of our outreach, we created
• 52:07
  Speaker 7: a website with basic, clear information for farmers and consumers
• 52:11
  Speaker 7: as well as patients. So and invite your listeners to
• 52:14
  Speaker 7: visit rat lungworm dot info. Again, thank you so much
• 52:19
  Speaker 7: for spreading awareness about this parasite and the debilitating disease
• 52:22
  Speaker 7: it can cause, and for giving me my chance to
• 52:25
  Speaker 7: add two cents to doctor Wood's excellent information. All of.
• 52:37
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• 52:39
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• 52:42
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• 52:44
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• 52:48
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• 52:49
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• 52:53
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• 52:58
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• 53:01
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• 53:03
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• 53:05
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• 53:09
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• 53:12
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• 53:16
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• 53:20
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• 53:22
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