Peter Jay Hotez 00:00

Anymore, what was interesting about them was they weren’t otherwise delusional, but they were sort of fixed delusion about that. Yeah, we see elevated

Dr. Gabrielle Lyon 00:09

eosinophils. Oh, that, yeah. Well, that increase.. well, that’s

Peter Jay Hotez 00:14

probably toxic hair infections, and we can talk about there’s a lot. Okay, in US,

Dr. Gabrielle Lyon 00:18

I would love to. Yeah, and it

Peter Jay Hotez 00:20

gets under nobody diagnose how to diagnose, no, what is it called? It’s called tox, not toxoplasmosis, but toxicoriasis. So, when you walk around low-income neighborhoods, more low-income neighbors than high income neighborhoods, like we did a survey of all the boroughs in New York, and of course, it’s highest in the Bronx, but what you find is you see these stray dogs and cats that are defecating everywhere, and they’re teeming with 1000s of these parasite eggs that then you know are ubiquitous in the ground, kids come into contact with them, and the larval stages migrate through the brain to cause developmental delays, through the lungs to cause wheezing and asthma, but it’s so, and it’s quite common, you know, maybe five 6% of the population has it, and I think it’s an important environmental trigger for asthma and things like that. But do you

Dr. Gabrielle Lyon 01:12

think it’s only five to 6% I was looking at some data, it was whenever

Speaker 1 01:16

you’re ready for recording. Okay, okay,

Dr. Gabrielle Lyon 01:21

so I’m ready. Am I okay?

Peter Jay Hotez 01:25

And what should I call you, Dr. Line? Gabriel, Dr. Lyon. Okay,

Dr. Gabrielle Lyon 01:29

you know what? If you say something that you really are like, ‘Oh, I didn’t want to say that, and I did it out.

Peter Jay Hotez 01:33

Okay,

Dr. Gabrielle Lyon 01:33

yeah.

Peter Jay Hotez 01:35

How long do we go for?

Dr. Gabrielle Lyon 01:36

We have a hard stop at 145 so about an hour 50. Yes.

Peter Jay Hotez 01:40

Okay.

Dr. Gabrielle Lyon 01:42

Okay. yes. Dr. Hotez, welcome to the show.

Peter Jay Hotez 01:52

Thank you, Dr. Lyons. Great to see you.

Dr. Gabrielle Lyon 01:54

Great to see you too. And

Peter Jay Hotez 01:55

feel free to call me Peter. Okay,

Dr. Gabrielle Lyon 01:57

Peter. Peter, you know, I have been thinking a lot about your work, and in the same vein, I was thinking about nutritional sciences, and here’s what I mean by that. In the 70s, there was the McGovern committee, and the McGovern committee is the committee that really influenced the dietary guidelines. It was written by a young staff writer at the time who was trained in agriculture, knew nothing about nutrition, and then these guidelines came out. Since that time, it has perpetuated forward. We know that they are not ideal. For example, it’s just they’ve still hung on the fact that saturated fat is bad, even though we don’t have a number, and I see that that’s probably very similar, or there’s veins of that when it comes to public mistrust in the science, because there’s mistrust in the nutritional science. What about the biomedical science?

Peter Jay Hotez 02:54

Yeah, I think you know it’s really interesting, because I can’t tell you, Dr. Lyon Gabrielle, how many times I’ve been on Zoom calls and meetings, things like that, about trust in science, you know, and it’s all about people hand-wringing. Okay, what did we do to screw up with other scientists? And one of the things that I say to them is, look, you know, the communication during the COVID pandemic was imperfect, and I can, and we can go through it. I can say you chapter and verse of the things that should have been said differently, but the real truth is overall the communication was not that bad. It was imperfect, as will always be during a pandemic, but it wasn’t terrible. The problem, and I can even go into how you know CDC and others could have communicated differently, compared, for instance, the way that I would do it, but the real problem was that you had a group that was specifically seeking to undermine the science and speaking to undermine the scientists for both their political gain and their financial gain, right? They were pushing snake oil, ivermectin, hydroxychloroquine, and they needed, you know, part of the business model for them was to discredit not only the science but the scientists and portrays as public enemies that

Dr. Gabrielle Lyon 04:11

thought out. Do you think that?

Peter Jay Hotez 04:12

Yeah, well, it’s clear. I mean, when you look at, and I talk about it, we talk about it in the new book, Science Under Siege, that there was this whole group, we call them pro, the pros and the propagandists, who many of them have medical degrees and medical credentials, even some of them are at medical, you know, important medical schools, really sought to online in their podcast, really sought to discredit mainstream scientists, and what were they doing? They were selling hydroxychloroquine and all these supplements, and ivermectin and fenbendazole. Have you ever wondered why they’re all anti-parasitic drugs? Because there’s a bucket of them you can buy them. In bulk at low cost, you can repackage it, jack up the price, and you sell it with a $1,600 telehealth visit. And this has been well documented, and they do absolutely nothing for Covid, and they probably don’t do anything for cancer either. But the model then says, well, if they’re really going to push the snake oil, meaning push the hydroxychloroquine and ivermectin, they’ve got to discredit the mainstream science that’s advocating for use of vaccines and other proven interventions. So there was a lot of that. Now, what about this, the science communication? Yeah, but there was an open

Dr. Gabrielle Lyon 05:39

space for mistrust, that’s the part that’s so confusing, is that you know, you and I were chatting before I graduated med school in 2006 that’s you know, quite a while ago, almost 20 years ago, there was, it’s almost like a swing when I was in medical school, and then even in fellowship, there is a trust in the institution that we believe that obviously there’s a recognition that science is imperfect and always evolving, and that we can change the hypotheses and things get proven right and things that get proven wrong, but there was a respect and there was an earned respect, and then it just seemed almost out of nowhere that as social media became more pervasive. It doesn’t matter that I did seven years of postgraduate training. If there’s an influencer online that has 5 million follows, somehow their word can go against, and again, it’s not me, just me, it’s all of this kind of medical knowledge. Well,

Peter Jay Hotez 06:43

let me give you, let me give you a couple of concrete examples on how things could have been communicated better, and then how the bad actors weaponized. So, because I think you know, working with specific examples is for me is a great way to kind of bring it home. So, for instance, if you remember when the mRNA COVID vaccines were rolled out, it was, you know, the Pfizer vaccine three weeks apart, Moderna four weeks apart, right. And then, you know, then then you’re going to be protected against severe illness from COVID, and, and, and that’s it. And, and I was always concerned about that, because I said, look, as you know, as a pediatrician scientist who makes vaccines, that’s usually not how the way it works. What you usually do is you give a series of primary immunizations, you wait six months to a year, and then you boost. So, it from the beginning I said, don’t be surprised if the CDC comes back six months to a year later and recommends a boost, and you know, and then it happened, the Delta wave, and that’s exactly what happened, and you know, I was looking like the smartest kid in the room, but even I was surprised by the limited durability of mRNA, I didn’t think we would need this, this many boosters, but the point is, I communicated my underlying assumptions, and I think the weakness of the way the federal agencies communicated. They had this kind of old school way of communicating, which was what a lot of the comms people would tell me in the beginning, which is you have to talk to the American people like they’re in the fourth grade or the sixth grade, and I found that didn’t work for me. I would actually go into a fair amount of complexity in detail, trying not to lapse into too much jargon, but at least being able to do that, and people tended to appreciate that. So, I think that was kind of a mistake the CDC made, and others, that they would just say, you know, this kind of this top-down, we know what we’re doing, get your vaccine, and then, and then, but without saying all the other stuff, then why you need a booster, or another example, when the the COVID vaccines were rolled out, if you remember, it was based on protecting against symptomatic illness, they said 95% protection against symptomatic illness, and that’s that was our understanding, but then in Israel they did some extraordinary studies with the Pfizer vaccine, showing that wait a minute, the level of virus-neutralizing antibody is so high that it’s actually getting into the mucosa of your of your nasal passages in your throat and it’s stopping virus shedding and transmission, and that was the reason why the CDC said masks can come off, but they didn’t articulate that was the reason, and so when the virus mutated to the delta wave, the level of virus-neutralizing antibody was still pretty high, but not so much that it was stopping virus shedding as much, and so it wasn’t, it was still some protective protection against transmission, but not as much, and therefore that was the recommendation. The masks have to come back on, but I would articulate CDC would just say masks off, masks on. People are like, what’s going on here? And then you had the bad actors sort of weaponizing that. I think if the bad actors weren’t weaponizing it and trying. Undermine trust in the CDC, and everything else, we wouldn’t have been in that same situation.

Dr. Gabrielle Lyon 10:05

Do you think there’s a way to restore trust, and how for the people that are growing up now, for the generation that is watching this, as opposed to the generation that has never seen anything like this before? Right, you’ve spent, you’re up for Nobel Prize, you’ve spent your entire career researching, but for this next generation, this is their first experience with really seeing this. I don’t want to say this division, but really this division between the scientists within themselves and then the science and then social media. How, how do we begin to even repair that, or even make sense of it? Because I had said to you, I read your first one of your earlier books, which is it was a book about your daughter, about how vaccines are not, and when I had my first daughter, I was very concerned, and again, I’m a fellowship-trained physician from WashU, a very academic place.

Peter Jay Hotez 11:05

It’s a great place. I

Peter Jay Hotez 11:06

have a lot of good colleagues,

Dr. Gabrielle Lyon 11:09

but I was very concerned about vaccines in this way again, and I’m not a vaccine expert, but my husband then got me this book that you had written about. Again, this is a great book. I encourage people to read it, but even myself, as someone who is what I would consider evidence-based, it’s challenging.

Peter Jay Hotez 11:29

Well, it’s funny, I wrote that book after a year discussion with Robert F. Kennedy Jr. Look, and you know, debunking all of his stuff, but that my target audience was my wife, Anne. I figured I’d wrote it, you know, you know, smart college, Smith College-educated lady, and, and you know, wrote it was someone who’s very educated, but answering all the questions that they would really want to know, again, you know, trying to get it right, of going in, going to some depth in the science, but and not being, you know, condescending about it as well, so that was, that was really important, and the answer is, well, I think, you know, you know, Gabriel, I think people like you are part of the answer, because you know, I can go on CNN and MSNBC till I’m blue in the face, and I do, and it’s great to have that opportunity to God, but I’m not reaching all the people I need to, right, and I think you know this is why your podcast is so important, because it’s, it’s, it’s a safe space for a lot of people in reaching audiences that I would never have access to otherwise, and unfortunately, you know, I was going on Fox News in the beginning of, of the pandemic, and I was even going on Sean Hannity and Tucker Carlson, and then I wouldn’t go along with the hydroxychloroquine nonsense that was coming out of the West Wing of the White House in 2020 because it did nothing for COVID, and then they basically cut me out, and and that was unfortunate, because those are the people I really were needing to reach, who were refusing COVID vaccines, because, as one of my books says, 200,000 people died because they refused COVID vaccines during the pandemic. So it was really frustrating not to be able to go back on. So, what’s the answer? I think people like you are part of the answer, and I, that’s it. But I also think the academic health centers need to be more proactive in encouraging their docs and scientists to be out there. I mean, you should be in an academic health center, being encouraged to do what you’re doing, because it’s a really important public service. So, my colleagues at Research America do these surveys every year, they’re a great policy group based in DC, and they ask the American people, they do this every few years, and they always get the same answer, but they keep doing it. They ask the American people two questions: one is, Can you name a living scientist? Question number one. Question number two: Can you name an institution where biomedical research is conducted? And the numbers are pretty constant. Turns out 75% of Americans cannot name a living scientist, and, and of those who can, who they’ll name, you know, Bill Nye or Neil deGrasse Tyson, who are great, but they’re not doing the kinds of things I’m doing, revising manuscripts and for scientific publications, or revising, you know, getting grants, and what goes on at a scientific meeting, so, so we’re invisible, and and that makes it easy for the bad actors to weaponize people like myself and portray us as sort of shadowy figures in white coats plotting terrible things, and so I think that, and then, and then the other question is, Can you name an institution where biomedical research is conducted, and that comes up total, total deer in the headlights. People don’t know institutions, so you know they think St. Jude’s a little bit, because they do so much advertising, but you know, for instance, none of the institutions in our Texas Medical Center here in Houston are. Are are named, and, but that’s by design, because you know the academic health centers don’t appreciate the importance of communicating science and medicine to the public, and again, you know, I keep saying it, but this is why what you do is so important,

Dr. Gabrielle Lyon 15:15

and I think that to help the general public understand that scientists, we can argue, and you know, at least in the nutrition space, there’s a level of respect, for sure. Debates are not done on a public forum, they’re not done openly, it’s not this highlight reel, you know, kind of what we’re seeing in the landscape. There’s a lot of respect for the individuals that have been in there and been doing these things, and there’s again people don’t agree, but it’s not quite as divisive as it is now, but the problem is,

Peter Jay Hotez 15:53

is well, the, you know, yeah, you’re absolutely right, and the way that, and the way they frame it, so if you remember, a couple of years ago I got under a lot of pressure, I had, you know Joe Rogan and Elon Musk and Robert F. Kennedy Jr. all piling on, telling me I have to debate him in public about vaccines on the Joe Rogan show, and but that’s not how science is done, right? I mean, science is done through peer-reviewed papers and and discussions between colleagues, really trying to figure out some hard things. It’s not.. I can’t.. I can’t think of a single example where science was advanced through scientific debate, especially with someone who’s completely unqualified or uninterested in the science, like Alfred Jr. What this was all about is they wanted me to, you know, platform him and show him as a serious person, because he was running for president at the time, and I didn’t want to help him do that, but I also thought it would send the wrong message, I mean, that’s not how we do science, right, with debating with people that have no interest in the science and have other agendas, and, and, and it was important for young people to understand that too, that, that you know, historically, I mean, yes, we had had public discussions between Einstein and Niels Bohr about quantum physics, but those were public discussions between two valued colleagues with expertise, but you know, debating in public with a Robert F. Kennedy Jr. or some of these other crackpots. No, I mean, that’s not how we do this,

Dr. Gabrielle Lyon 17:23

and I will say that there was a period of time that people thought Einstein was crazy, and you know, I’m, I’m sure that Robert F. Kennedy feels that there’s, you know, that there’s.. he’s doing a lot of good in terms of reducing processed food.

Peter Jay Hotez 17:41

Well, and with Einstein, you know, in Weimar Germany, he was there, was also that element of anti-Semitism. They called Einstein’s relativity the Jewish fraud in Weimar Germany, which is

Dr. Gabrielle Lyon 17:53

again apparently he was right, and also, side note, the earth is round, but there’s a lot of frustration with this, the idea of experts and the level of distrust, and I’m wondering, is there a way, do you think, to get back there to have some kind of trust, and not a hierarchy, but you know, in my mind, influencers are important, but they should be informed by experts.

Peter Jay Hotez 18:23

That’s right, that’s right. And, unfortunately, you know, the what’s happening now is there’s this whole cadre of talking heads that are actively putting out this information that’s easily debunked, but what’s really interesting about what they’re doing is they’re getting more sophisticated in how they’re doing it and becoming more sort of sciencey sounding in it, so it’s getting harder to debunk. So, let me give you an example. We had our Florida Surgeon General, Dr. Latipo, right, who’s an ardent anti-vaccine activist in university, says mRNA vaccines are the antichrist, and okay, and then he says, and what’s happening is they’re causing turbo cancers because they’re contaminated with DNA that’s integrating next to oncogenes. It sounds very sciency, right? Except it’s all bs. So, first of all, and

Dr. Gabrielle Lyon 19:18

do we know that to be true,

Peter Jay Hotez 19:21

that’s all bs, yeah. Here’s why. First of all, there’s no such thing as a turbo cancer, it’s a made-up term, they made it up. Second, the lipid nanoparticles that have the ability to deliver nucleic acid, even if there is some contaminating DNA in the RNA, gets it past the cell membrane and into the cytoplasm, but to get things past the nuclear membrane that requires a process called electroporation, which is not easy to do, and that’s why we have no licensed DNA vaccines, because those do have to get into the nucleus, and it’s a very complicated process. Next, even if by chance some foreign nucleic acid were to get past. The nuclear membrane into the nucleus, we have interferon-inducible elements of our innate immune system that block integration of foreign DNA into our genome. Otherwise, every time we get a hamburger, we’d have cow DNA in our genome, and that doesn’t happen, and the likelihood it’s going to happen next to an oncogene is even more remote, but here’s here’s here, but this generates the problems. So, first of all, they, it sounds sort of sciency, so people tend to believe it. Second, you know, even physicians in practice, you know, are pretty often a number of years outside their first year biochemistry course, and they don’t have time to look up this stuff, and there’s no, you know, single website that’s out there that provides that information, and so patients, or the parents of patients, will come into the doctor’s office, and they make the doctor feel like they’re not keeping up with the literature, they are, they’re just not keeping up with with the fake stuff, and as I say, they’re getting more sophisticated on their use of of rhetoric. So, what did I do again? Same thing as always, you know. I went on, I think it was Ali Velshi and MSNBC, who’s wonderful, and I think I went on, you know, maybe Mehdi Hassan and a couple of others, but again, I didn’t reach the people I needed to reach, you know, watching Fox News, and hearing this stuff, or or Joe Rogan podcasts, and, and, and there were, they’re sort of insulated, or walled off, and I, and so this has been part of the problem as well,

Dr. Gabrielle Lyon 21:33

and also, I mean, do you think, and this will be kind of my, I’ll wrap up this question, because there’s so much that I, I want to talk to you about as well. Do you think that there’s going to be a way where we come back in terms of, you know, I’ll give you an example from my perspective: veganism. If someone wants to be vegan, I don’t care, good for you. But the reality is, if you look at the information that’s being spoken about, there’s like a bunch of smoke screens, for example. You said concrete examples are best. I’m going to give you a handful that cows are killing the planet, but the reality is for greenhouse gas agriculture, especially in the US, makes up about 9% The rest is industry, electricity, and transportation, 80 plus percent.

Peter Jay Hotez 22:19

If

Dr. Gabrielle Lyon 22:19

you stop eating meat for a year, you take one transatlantic flight, and it’s equal,

Peter Jay Hotez 22:25

sure,

Dr. Gabrielle Lyon 22:26

but if you go online, you should go vegans forever for the planet, and this is perpetuated from my perspective by both science-ish people, and these are some of the bigger institutions, which is shocking, because they’ve built a career believing this, and then perpetuated by influencers, and I bring this up because I think it’s just important to look at two sides of the coin, so sometimes they’re wrong, you know, if you have a diet where less than 30% of your nutrients come from animal-based products, you’re probably not going to miss, you’re probably going to miss B 12, zinc folate, all the things that are necessary for a growing child, and hopefully I’m making myself clear that it’s like they are wrong, and so somewhere there is sometimes science is wrong. Is it knowingly wrong? I don’t know.

Peter Jay Hotez 23:27

Well, but this is why you know if you’re going to take it, you know, extreme measures in your diet, do it in collaboration with a physician who knows something about nutrition, right? I mean, that’s that’s that’s clearly part of, part of the answer. Yeah, so no, this is this, this is become a big issue right now, and, and how we can communicate bona fide science to people, and and do it in a very straightforward way, I think, is, you know, one of the great challenges, and unfortunately it’s going to get worse before it gets better, because you know it’s the CDC and the FDA and NIH were imperfect communicators, but now it’s it’s run by ideologues, and the stuff coming out of CDC and FDA, you can’t, and often NIH, you can’t rely on anymore, so you can’t even now, now it’s a real problem that you can’t rely on the federal government with all of the, you know, the Maha movement has been so tied in with the most corrupt elements of the wellness and influencer industry, and, and you know how it, and so I don’t, so that is certainly not going to help the situation. Do you think the respective

Dr. Gabrielle Lyon 24:41

colleagues will be helpful, for example, if there are collaborative groups? Right, so I’m sure you know the best infectious tropical medicine disease doctors, right, because they’ve been around publishing for a long time. Do you think that there’s a way to say, okay. Potentially, here are your top 10 experts in schistomasis or helmet disease, and then there are your top 10 experts in nutritional sciences. Do you think that there is, you know, just from a solution-oriented standpoint? Because I, honestly, I don’t know, but I would love to think that there is some way where we can get to a place where there’s it’s non-biased and we can all understand, because

Peter Jay Hotez 25:32

you know, a clearinghouse of experts you can trust. In other words, I mean, I mean, for years or decades it happens informally, right? I was just in, I was just in Boston. They asked me to give a lecture at Mass General Hospital, one of the great hospitals, and, and there I, and I talked for an hour with the head of tropical medicine at Mass General, Ed Ryan, who I’ve known and loved for years. Right. So, and so, informally that happens, but you know, I think that would be interesting as well, if you could create something that people would, but of course, once you do that, then you put a target on any everyone’s back on the list, because a lot, unfortunately, you know, there’s a component of the wellness and influencer industry, you know, that’s pushing the snake oil, and it’s, and to do this effectively, they feel they have to denigrate mainstream biomedical science and scientists, and then that’s why they go after people like myself and try to portray us as public enemies or cartoon villains, because it’s become, it’s become incorporated into part of the business model, so if we could even get that practice to stop, it would be great difference, right? That would

Dr. Gabrielle Lyon 26:42

be great,

Peter Jay Hotez 26:43

but easier said than done. Yeah,

Dr. Gabrielle Lyon 26:45

that would be great. Again, when I.. when I mean, I mean, you’re..

Peter Jay Hotez 26:50

you’ve become an exception, unfortunately, and that is someone who really seeks to understand nutrition at a deep level will have a profile in the wellness and influencer industry, but you’re you always remain evidence-based, and you don’t feel the need to attack mainstream, but you know, so we just need to multiply you times 100 you know. Well,

Dr. Gabrielle Lyon 27:16

I have, so I am still mentored by my longtime mentor of 20 years, and he’s actually working on the dietary guidelines now, and he would absolutely kill me if I didn’t practice scientific integrity, right? Right, it would be a non-negotiable. Again, this is someone who’s trained me for 20 plus years. We’re working on some papers right now, and it’s.. but it is, it’s, but you know, it’s, you

Peter Jay Hotez 27:42

know,

Dr. Gabrielle Lyon 27:42

important and interesting, you know. I

Peter Jay Hotez 27:44

understand the importance of academic freedom in medical schools, but we also have this thing called ethics and professionalism, and that was so damaging during the pandemic. You’ve got these guys from Fox, you know, going on Fox News as talking heads, and many of them came from prestigious medical schools, and the Chiron on the bottom would name the medical school, but they were talking about fields that they knew nothing about. That’s very important, and, and you wouldn’t do that. I mean, you don’t, you would never go on and try to portray yourself as an expert in pandemic threats and infections, and I wouldn’t, wouldn’t dream in a million years of going on talking about nutrition, but, but they did, and and they didn’t care if they got it right or got it wrong, it was ever that whatever met with their ideology, and that created a lot of problems, and

Dr. Gabrielle Lyon 28:33

we’re still here in that way, right, which I’m hoping that there is a solution to this over time, there has to be, because I was listening to, you know, I lived in New York, which we were talking about, and I remember being pregnant and taking the subway, so my husband’s active duty, I’m alone, I’m taking the subway, I need to get somewhere, and I was concerned because it was in my pregnancy where I couldn’t take an active vaccine at the time, because again, it just, I was outside of that window,

Peter Jay Hotez 29:06

you couldn’t take a live virus vaccine, right,

Dr. Gabrielle Lyon 29:08

and I was concerned being on a subway with other people, this was, and then the measles, like the measles broke out, and I was really concerned, and I just thought to myself, How, how am I in this position? How are we in this position at this stage of medicine? And it was at that moment I realized that things have just kind of swung.

Peter Jay Hotez 29:31

What’s interesting is one of the arguments that people, that people politicize vaccines is because they talk about health freedom or medical freedom, and you can’t tell me what to do with about my child, right? And then, but what about people like yourself who are now worried about, I mean, if you have a six month old child who’s not yet old enough to get their measles vaccine, now you have to be terrified of going into Costco or going into. It, you know, to go into Target or whatever, because you’re worried you’re gonna have your child, and so, where’s so what about your health freedom and medical freedom? But then

Dr. Gabrielle Lyon 30:10

I also worry about when I, my child was born, so I have two, I have a four and a six year old, you’re lucky enough to not meet them right now, because they would terrorize you, but that’s besides the point. I was so

Peter Jay Hotez 30:21

board-certified pediatric, and I have four kids now. They’re adults. Mine will

Dr. Gabrielle Lyon 30:26

definitely want, make you want to change your mind, but I was concerned, and I’m still concerned when I think about, for example, hepatitis B, and again, this is not my area, even if I’m a fellowship-trained physician. I was concerned, thinking, okay, so I’m going to give my child a hep b vaccine when I don’t have it, and I know that there’s no way my child is going to get hepatitis B, but perhaps that’s an incorrect way of thinking about it. Well,

Peter Jay Hotez 30:52

here’s how you have to think about it. So, first of all, you know the, you had that fact-free ACIP committee meeting, which has now been stacked with anti-vaccine activists, and you know what they’re saying is that all of the transmission is occurring vertically, right from from mom to baby, but in fact, and I actually put it up on my social media, when you go through the scientific papers, a significant number of babies, if they become infected with hepatitis B is from vertical transmission from mom, but an equal number are infected by either being in daycare or being in household contact. So it’s not enough to screen the mom, you have to screen every caregiver in the family, and of course we don’t do that, and it’s very easy to have it fall through the cracks, for what’s actually a very safe and effective vaccine, which is basically, if we continue, we’ll eliminate most of liver cancer as a consequence, and so I think that’s the part that people don’t talk about as well,

Dr. Gabrielle Lyon 31:56

and then you know, as I was preparing for this episode, I called my mentor, Don, and I said, “Don, okay, so we’re going to be talking about this, and he said, “You know, my question is, is that when he was growing up, so he’s in the 70s, he said we had three or four vaccines, and now by the time a child is no longer a child, they’ve had what, 75

Peter Jay Hotez 32:18

but it’s not okay, good, so let’s go through this, because,

Speaker 2 32:22

and I said, and this is

Peter Jay Hotez 32:23

also, you know, the disinformation. Okay, so when I was, I’m dating myself now, so when I look great for 25 I’m 67 So when I was a house officer resident in Boston in the 1980s we’ve vaccinated kids against eight illnesses. Okay, it was diphtheria, pertussis, tetanus, polio, measles, mumps, rubella, and I believe we were giving influenza vaccines at that time on an annual basis. We were vaccinated against eight diseases, right. And so, what was my worst nightmare as a house officer, as a resident in Boston at that time? It was admitting kids with bacterial meningitis, either Hib meningitis, they called Haemophilus influenza type B, it was pneumococcal meningitis, and it was two forms of meningococcal meningitis, and, and, and I can’t tell you how much time I spent with parents, you know, after doing the lumbar puncture, the spinal tap, and doing the gram stain, and seeing the bacteria under the microscope, and getting a confirmatory diagnosis in the lab, admitting them to the pediatric ICU, and knowing that a significant number of those kids will die, a significant number of those kids, even if they survive, will have permanent neurologic injury, and, and one of the better outcomes is deafness, right. So, and then what happened, as though we had, we added the four vaccines for the four forms of bacterial meningitis, and now we now that those diseases are gone. So, are those the ones you want to add back? So now that brings us from eight to 12 diseases. Okay, and then we started vaccinating against two forms of cancer, cervical cancer caused by human papillomavirus, and now Australia is actually going to eliminate cervical cancer by 2035 because the uptake is so high and and we’re going to vaccinate against liver cancer from hepatitis B, so that brought us to 14, and then we added the rotavirus vaccine that was a leading cause of hospitalization in the winter, we added varicella vaccine, and I think it was hepatitis A, so that brought us to 17, so we went from eight to 17 diseases, and you could say, okay, which one do you want to take out, so it’s not 75 right? And there you know, right off the bat, you know that 75 number comes from assuming you do an influenza vaccine every year for. 20 years, so that brings you right down what they would say is 50, but in fact it’s about 25 to 30 immunizations.

Dr. Gabrielle Lyon 35:06

Did we? Okay, so thank you for clearing that up. I love it when Don’s wrong. Happens once every 10 years.

Peter Jay Hotez 35:12

Well, no, but again, but that’s that’s what the disinformation machine would have you believe. And

Dr. Gabrielle Lyon 35:19

what about, and again, I don’t want to spend all the time here, because there’s so much about this parasitic infection, which, if I had done it over, I would have gone into infectious disease or tropical medicine. I just think it’s so fascinating. Did we, did the speed at which we, or did the speed at which the vaccine came, come to market with COVID was that too fast,

Peter Jay Hotez 35:42

so that’s a great question. And I spent a lot of time talking about this, so you know this idea. First of all, we made a low-cost COVID vaccine, recombinant protein COVID vaccine, using an older technology, microbial fermentation in yeast. By the way, it’s a vegan technology, so it became our vaccine, became the first halal certified. That is actually

Dr. Gabrielle Lyon 36:05

very funny.

Peter Jay Hotez 36:06

Could be kosher also, but Indonesia, so we wound up 100 million people got vaccinated at two to $3 a dose. But why were we able to do that? We were able to do that because we had been researching coronaviruses for more than 15 years, so the COVID COVID 19 is caused by what’s called SARS two and severe acute respiratory syndrome virus two, but SARS one was started in 2002 so when SARS two started, there was a huge effort, because they recognized there was going to be others that followed. This, the coronaviruses come from bats, and with warming climate, climate change, the bats are now coming into closer contact with people. So, after SARS two, after SARS came out in 2002 came out of southern China, affected Toronto. We knew other coronaviruses were going to follow, so then Middle Eastern respiratory syndrome came out of the Arabian Peninsula, and then, then finally, COVID 19. By the way, there’s going to be a fourth one, and because that’s what’s happening. Do you think they’ll shut

Dr. Gabrielle Lyon 37:11

down everything like they did last?

Peter Jay Hotez 37:13

Well, let me, let me finish that. This train of folks, I gotta get my gyms in order. So, the point is, coronavirus vaccine research have been going on since 2002 and including, including our, so it wasn’t a year, it was 20 years. Okay, then the mRNA technology was also being studied for that period of time. So, the Nobel Prize for the mRNA vaccine was given to a group at the University of Pennsylvania because they had been working on it for that long, so this idea that these vaccines came suddenly out of nowhere wasn’t true. It’s based on 20 years of research, which is about the same timeframe as other vaccines. Here was part of the problem, the I think you know when Operation Warp Speed came along. There were no restraints on on how the companies could communicate, and you know when, when a pharma company writes a press release, they’re not writing it for you, they’re not writing it for me, they’re writing it for their shareholders, so they could jack up the price right of their stock, and and so what was the messaging, the messaging was, oh, aren’t we miracle makers? Look at what we did, you know, poof, we made, we’re so amazing, we made an mRNA vaccine for COVID,

Dr. Gabrielle Lyon 38:29

just like that,

Peter Jay Hotez 38:30

and, and, and I was like, oh my god, this is gonna create such a backlash. What are they doing? And sure enough, it did, but the fact is, the timeframe, the timeline of mRNA for XV vaccines for COVID, like our recombinant protein vaccine, is about the same as every other, but again, it was the way it was communicated that was, that was a big faux pas,

Dr. Gabrielle Lyon 38:57

you know. If nothing else, science communication is a skill, and it’s more important now than ever before, and I think that because of the velocity at which information spreads, you know, I think about Atkins, this Dr. Atkins, he spent his entire career, took him 40 years to develop a nutrition plan, to develop an entity, 40 years, and then

Peter Jay Hotez 39:18

so my hookworm, our hookworm anemia vaccine, okay? We got it’s a leading cause of nutritional iron deficiency anemia. I started that as an MD PhD student at Rockefeller University in Weill Cornell Medical College in the 1980s Now, 40 years later, we finally get it to the point where it’s really working. So, so hopefully that will follow. You know, our COVID vaccines reached 100 million people. The difference was with COVID, the deal was you make it, you show it works. The Indian government, the Indonesian government was willing to guarantee the advanced purchase of 100 million doses, or 300 million doses. With hookworm, we don’t quite have that, so there isn’t that same sense of urgency. So this is one of the things we’re. Struggling with is to, you know, figuring out the sustainable finance plan, and I say finance plan in parentheses, and with quotations, because it’s one of the most common causes of nutritional deficiency and anemia in the world, but it only occurs in the world’s poorest countries. Is that

Dr. Gabrielle Lyon 40:18

true? Because I’m going to give you some statistics,

Peter Jay Hotez 40:20

although now there’s, it’s clear that there is hookworm in the southern United States, but nobody looks for

Dr. Gabrielle Lyon 40:26

it, because you’re an academic, we are talking about, you’re talking about hookworm, but the reality is, there’s a whole bunch of different helmets, I have over here 2 billion people globally, and then there’s also roundworm, hookworm, whip worm, just the worms just just keep getting better, and these are not the kind of worms that show up. Well, when it rains, one

Peter Jay Hotez 40:46

of the worms that’s in the United States that I’ve spent a lot of time trying to raise awareness about, but so far not with not much luck, it’s called Toxo Koriasis, T O X O C A R I A S I S, not Toxoplasmosis, but Toxo Koriasis, and what happens is this is a worm in the intestines of stray dogs and cats. So, remember, you’re supposed to deworm your pet. Well, the reason is because they all have Toxicara, and so when you go into low-income neighborhoods, especially, you see these stray dogs and cats, about 100% are infected with that worm, and they’re shedding the eggs in their stool and their feces on the ground, and unfortunately, that will, those eggs can become viable after a week, and kids come into contact with them, and they swallow the eggs, and then the larvae hatch, you know, in the stomach and the intestine, and they migrate through the lungs. They cause wheezing and asthma. They’ll migrate through the brain and cause developmental delays. And these are not rare conditions. They’re maybe high as five, 6% of the US population has it, but it’s been under investigated as environmental cause of asthma and an environmental cause of developmental delay, so my only paper I’ve ever published in a psychiatric journal was in JAMA Psychiatry, because I wrote about this and they thought it was interesting enough to,

Dr. Gabrielle Lyon 42:14

what about it, is actually, and it’s treatable, the

Peter Jay Hotez 42:17

problem is it’s even, even the pediatricians tend not to get educated about this illness, so we actually give a diploma in tropical medicine for medical professionals. A lot of it’s online, still taking

Dr. Gabrielle Lyon 42:32

applicants. Yeah, we’d love to have to do it,

Peter Jay Hotez 42:36

and we did it because, you know, we actually find these tropical infections are not rare in the especially here in Texas and the Gulf Coast, they’re actually accelerating due to climate change and urbanization. We have dengue, we have tick-borne illnesses, but the physicians are not trained how to recognize them because they don’t teach it in medical school anymore. So,

Dr. Gabrielle Lyon 42:53

can I also share what we, our experience has been over the last 10 years of trying to treat this, because we acknowledge it’s a problem. I started my career taking care of special operations, and these guys would go to all these different places, swim in all these weird things, and they would go to the Mayo Clinic, they would go to Cleveland Clinic, they would get all PCR testing, and they, to this day, the majority of parasitic infection testing, if it’s not tropical medicine, which I would love to talk about. What is now in the forefront? These tests come back negative. They’re negative when clearly this person has an elevated eosinophil count, they have iron deficiency anemia, there seems they’re having GI distress, which is cyclical, and yet every test that they do comes back quote negative.

Peter Jay Hotez 43:50

Yeah, so this is one of the reasons why we set up our National School of Tropical Medicine at Baylor College of Medicine, Texas Children’s Hospital, and the Texas Medical Center. They gave me the opportunity to do that because there’s a lot of illness that’s going undiagnosed. One of the things that we found, if you don’t look, you don’t find it. How do

Dr. Gabrielle Lyon 44:08

people test for it? If, for example, the available testing to clinicians is PCR, it’s gold standard, or, like, for

Peter Jay Hotez 44:16

instance, Toxicara. You know, that’s the other problem with a lot of these parasitic diseases. The diagnostic tests for those were all developed in the Pleistocene era, right? Then, when, and you know this, I’m just joking, I’m saying it’s an, you know, 100, they’ll, you know, 100 year, this is 100 year old diagnostic diagnostic tests, and their opportunities to develop improved diagnostic kits, which we’d love to do, but we don’t have the funding to

Dr. Gabrielle Lyon 44:44

just be microscopy.

Peter Jay Hotez 44:46

It depends. In other words, for instance, with Toxic Hera, the one that’s associated with asthma, developmental delays, what happens is you swallow the eggs, but the larvae don’t become full-blown adults producing eggs, so the larvae are migrating through the tissues, so there’s a lot of the. Presentation, and they’ll have, and you can have antibodies to it, but you have to know the antibody test. It’s

Dr. Gabrielle Lyon 45:05

no longer shedding in the stool.

Peter Jay Hotez 45:06

Yeah, and the other problem is the specialty tests are not done everywhere, that could be done at the CDC or our place, and you know it’s not like you can, you know, when you go for blood work, you know, you get the lab slip from Quest Diagnostics, and it’s got all the boxes to check, you know, for your complete blood count and your blood chemistries, that just a box for toxic. Well, not

Dr. Gabrielle Lyon 45:29

toxic care, but can send three days out. There is three day sampling for

Peter Jay Hotez 45:35

right, but a lot of physicians also just don’t bother, because it’s a lot of extra work, and to keep track, and you have to follow it, so these diseases often get undiagnosed. I

Dr. Gabrielle Lyon 45:44

was reading rural Alabama, I mean,

Peter Jay Hotez 45:46

we should have, for instance, a point of care diagnostic for Toxicara, and it would not be hard to create, but you need some funding for it to do it,

Dr. Gabrielle Lyon 45:57

but point, but for that point of care, what about, for example, hookworm? This was rural Alabama. It says 34% of stools. That was our study. That was our study. Yeah, tested positive. Also, Stromloides, you know, Sarcas. And I’ve seen all these, but it’s the reason I saw these was when I had my practice in New York City. There was an infectious disease doctor who studied tropical medicine. Dr. Cahill.

Peter Jay Hotez 46:25

Oh, yeah, sure. I haven’t seen him in years. Well, he

Dr. Gabrielle Lyon 46:28

passed away, unfortunately, during Covid. I would go to Dr. Cahill. We had adjacent practices. I would send all my patients to Cahill, and he did. You know, he’s kind of like a little bit of an odd bird, but he would come back, so I would say Cahill, all of these tests are negative, these guys are symptomatic in platoons,

Speaker 3 46:50

and one

Dr. Gabrielle Lyon 46:51

guy came back with his demoniasis, the other entamovi histolytica, elevated liver enzymes, and when he passed away, because he was so specialized, it’s very difficult. For example, for myself, we have a telemedicine clinic. We, we do this now. It’s very difficult for providers to get answers. Yeah.

Peter Jay Hotez 47:14

No, absolutely.

Dr. Gabrielle Lyon 47:15

And what is the solution? Because, well,

Peter Jay Hotez 47:17

one of the things we’re trying to do is train physicians how to diagnose these illnesses and treat them. So, we’ve created this diploma in tropical medicine, as I say, which is online. And, well,

Dr. Gabrielle Lyon 47:27

I’m going to take it,

Peter Jay Hotez 47:28

but you know, our most recent

Dr. Gabrielle Lyon 47:29

graduate, but,

Peter Jay Hotez 47:30

but it’s, you know, not a lot of doctors are doing that. So, that’s what is the

Dr. Gabrielle Lyon 47:35

testing? Is it stool? Is it microscopy? What depends,

Peter Jay Hotez 47:39

for which. So, each one is different? The

Dr. Gabrielle Lyon 47:42

helmets, number one. Well,

Peter Jay Hotez 47:43

you can’t generalize raw helmets, so some, you know, there’s a fecal exam, others you could do fecal PCR, others it’s a blood test, right? And sometimes it’s testing sputum, even. So it really depends on the individual. What are the most

Dr. Gabrielle Lyon 47:58

common? If you know, what would be the most presenting, the most common presentation for the most ubiquitous?

Peter Jay Hotez 48:05

I think toxic hair, as a worm, is probably the most common helminth in the United States, and which,

Dr. Gabrielle Lyon 48:11

by the way, I’m shocked to hear this,

Peter Jay Hotez 48:13

and it presents with eosinophilia often

Dr. Gabrielle Lyon 48:17

in blood or in the esophagus.

Peter Jay Hotez 48:19

Well, it can be, it’s, it’s in the lungs also, but it’s typically a diagnosis by seeing a blood eosinophilia

Dr. Gabrielle Lyon 48:27

by what

Peter Jay Hotez 48:28

number it, well, you know, if you have, you know, elevated white count and a significant percentage, you know, about 5% or eosinophils, that

Dr. Gabrielle Lyon 48:36

which is not, if you look at the, for example, lab core quest, or whatever it is, 5%

Peter Jay Hotez 48:44

but also in terms of the symptoms, so you know someone who gets into the lungs that causes wheezing and asthma-like symptoms, but sometimes can be very subtle. There’s something called covert toxic psoriasis, where it could present with developmental delays, and the problem is, pediatricians are not really educated about that illness so much, and so, you know, what percent is what I wrote about in general psychiatry. What percentage of kids diagnosed with developmental delays are getting sent for specialty testing for toxic psis? I said probably rounds off to zero, right? So, so we need more awareness.

Dr. Gabrielle Lyon 49:21

What is the main way of testing? Is it a blood test? It’s

Peter Jay Hotez 49:23

an antibody test, an

Dr. Gabrielle Lyon 49:24

antibody test. What about treatments? I was reading one of your.. it’s actually

Peter Jay Hotez 49:29

not that hard to treat you, actually albendazole.

Dr. Gabrielle Lyon 49:32

Yes, I was reading about that. I think it was something that you had published. It was mass treatment of albendazole or membendazole, potentially.

Peter Jay Hotez 49:40

Well, maybe Bendasol doesn’t get absorbed as well through the tissues, so maybe Bendasol would work for something like Ascaris in the gut, in the lumen of the gut, but less so for that.

Dr. Gabrielle Lyon 49:50

It is so fascinating because what is also out there, and I don’t know if you’ve seen this, but there is some. And again I’m curious, as I feel, if you’ll say this is pseudoscience, or whatever this is, but this was there are some treatment again that people will give. Have you heard of this? Give parasitic worms, or that those that have parasitic infections actually have an improvement in autoimmune conditions.

Peter Jay Hotez 50:21

Yeah, there’s a lot of that out there on the internet. I think the evidence for it is extremely weak, and, and again, you know, it kind of.. it’s, and it’s based on some erroneous assumptions. So, it’s based on the idea that said, well, you know, God gave us our allergic responses to fight parasites, and now that parasites have vanished here in developed countries like the US, you know, the allergic responses are turning on themselves, but again it ignores the fact that we’ve got significant level of parasitic disease in the US. It’s just that it goes undiagnosed, and in fact, these worms themselves are causes of allergic illness, right? They can cause asthma and wheezing. They can cause what’s the one of the leading causes of inflammatory bowel disease in the world? It’s whipworm infection, right? Tricheras. What’s the one of the leading causes of asthma? It’s ascaris, and toxic era.

Dr. Gabrielle Lyon 51:18

But people don’t know that. Would you say that’s the same in the US,

Peter Jay Hotez 51:23

probably not so much asker and trickiers, but toxic hair is, I think, significant

Dr. Gabrielle Lyon 51:27

inflammatory bowel disease for every single patient that we have who presents with inflammatory bowel disease. Every single patient that we’ve had has some kind of co-infection.

Peter Jay Hotez 51:38

I’m not surprised. Yeah, so this is

Dr. Gabrielle Lyon 51:40

not the so so the the

Peter Jay Hotez 51:43

idea of this hygiene hypothesis is sometimes called is they’re going to treat with worms, not really understanding that it’s quite the the problem is the opposite. The worms themselves are part of the problem.

Dr. Gabrielle Lyon 51:55

They are, what about in terms of when you said there are changes, let me move this over here. When you said that there are, they can potentially, can they all potentially cause cognitive delay because of, say, for example, anemia.

Peter Jay Hotez 52:16

So, so, in case of toxic Hera, the larvae are actually migrating through the brain, parenchyma, right? They’re using cerebritis, it sometimes, but oftentimes it’s because the remember the larvae are maybe a couple of 100 microns in length, so super tiny, right? So that, that’s that’s a problem in the case of hookworm, the cognitive deficits from hookworm are a consequence of the

Dr. Gabrielle Lyon 52:44

anemia, the anemia, and then, yeah, and

Peter Jay Hotez 52:47

the iron deficiency, the

Dr. Gabrielle Lyon 52:47

iron deficiency, which again you compound, and from what I understand, the reason that anemia happens is because there’s a lot of micro bleeding that happens in the case

Peter Jay Hotez 52:58

of hook worms, the though the larvae grow into adult worms in the intestine. They get to be about that big, a centimeter long, and they extract blood out of the intestine. And our vaccine, which is quite innovative, works on the fact that we, over decades, worked out the pathway by which hookworms degrade the hemoglobin, so that’s what they’re interested in, is the nutrient source, they, they, they ingest the red blood cells, they break it open and digest the hemoglobin, and we find that if we could take the protein components involved that the worm uses to feed on hemoglobin, make a vaccine out of that, it induces an antibody response, so that when the worm is taking up blood, the antibody gets taken up like a Trojan horse. I love it, and kills the horses. Very innovative mechanism. And, and now, our, you know, we can make our vaccine, we think, for probably two to $3 a dose, just like our COVID vaccines, the similar technology.

Dr. Gabrielle Lyon 53:56

But is it available to the general public

Peter Jay Hotez 53:57

right now? No. So, our COVID vaccine was only available, you know, in places like India and Indonesia, our hookworm vaccine is not available anywhere, because we haven’t found a vaccine producer willingness. We’ve made it at the small scale, but for clinical trials, but we have not found a major vaccine producer that wants to take it on. Why? Because they don’t proceed as a big money making operation,

Dr. Gabrielle Lyon 54:19

man. If they knew what I saw in clinic routinely, and then what I see is that families get it. I don’t know if there’s evidence to support this, because it seems like it isn’t studied in this way, but there seems to be transmission from family member to family member. I don’t know if it’s just oral feather just talking about hookworm, but I had this guy, he was in the Air Force, he was asymptomatic, and his wife got it, and also their dog had it. It was just this kind of trifecta, and their dog was sleeping in the bed, kissing the face, this whole thing. But if you were to say, okay, if you want to avoid infection, would it be fair? To say don’t sit on toilets, don’t let your dog kiss you in the face. How, how would we begin to think about

Peter Jay Hotez 55:08

well, in the case of Toxicara, the dogs have it in their intestines, so the best way to do it is to take your dog to, or, and cats have it also, so, but, but take, make sure you take your cat regularly to the veterinarian and get them dewormed.

Dr. Gabrielle Lyon 55:26

Could we deworm humans regularly, routinely?

Peter Jay Hotez 55:29

You could, but it may not be necessary, because

Dr. Gabrielle Lyon 55:34

they’re not self-limiting. For am I understand that correctly? Hook worm, if someone has persistent anemia or elevated liver enzymes,

Peter Jay Hotez 55:41

well, hookworm, adult hookworms can live five years in the intestinal tract. Toxic care can go on for a number of years, but I think you know I’d be careful about just indiscriminately taking what are called an helmet drugs, because you know every drug has a risk, right? So it’s it’s good to only, only be strategic, right, and use it only when you’re diagnosed.

Dr. Gabrielle Lyon 56:08

Do you think it’s something that perhaps routinely should be thought of when children have low appetites? Often they are not eating, I mean, you know, my son, I saw him yesterday, he was going into the freezer trying to eat ice. I’m like, pick up, you kind of better stop eating ice, right? Whether that’s or he’s just eating ice, he’s just a weirdo. But when we think about our nutritional quality, has really decreased. Do you think that it’s more important now than ever to be able to identify these things early and often.

Peter Jay Hotez 56:45

Yeah, I mean, this is why you know you want to follow what the American Academy of Pediatrics recommends, which is regular pediatrician visits, and, and if you have a concern, this is something to bring up with your pediatric got

Dr. Gabrielle Lyon 56:58

it.

Peter Jay Hotez 57:01

Yeah, we’re trying to get the word out. Let’s go, Peter. This is where..

Dr. Gabrielle Lyon 57:05

listen, COVID.. that’s passe. Let’s talk about worm infection, helmet infection, because I.. again. And then liver fluke. Can you talk to me about.. is that something that you see often? Not so much

Peter Jay Hotez 57:19

in the US. It’s. it’s a big problem in parts of Asia, far east, yeah. So, in northern Thailand, and it’s actually a helminth cause of cancer. So, liver fluke, what it’s, the, there’s two different species. One is called Clonorcus sinensis, that’s found more in China and Korea, and then there’s Opisthorchis vivarini, which is in Thailand, Laos, and Cambodia. What happens is it’s in the.. it’s acquired by eating uncooked fish, not so much as sushi, but what happens is the.. in these small fish that the locals use to grind it up, make a fish paste out of it, and they put all sorts of condiments on, and things like that, but it

Dr. Gabrielle Lyon 58:00

never. it’s like a

Peter Jay Hotez 58:01

ceviche, right, but they, but it doesn’t kill the parasites, and it’s really ingrained in the food habits of those populations. The it contains the cysts of those worms of Opus Orcus or Clinorcus, they come out and then they go into the bile duct, and they spend years migrating through the bile duct, where they’ll cause fibrosis and cholangitis, but then they cause neoplastic changes in bile duct, and so it’s so, if you look, the rates of bile duct cancer in Thailand are really high because of that parasite. Is

Dr. Gabrielle Lyon 58:37

that why when we think about gastric cancer or gastric cancer in certain populations seems to be higher. Is it related to, say, H. pylori or something? That’s

Peter Jay Hotez 58:48

that’s what’s often said. So, as opposed to what we’re just talking about, bile duct cancer, stomach cancer, probably their combination. I think you know what it is. Also, it’s not only the pathogen and, like, helicobacter pylori. or Opistorkas, this worm, it tends to be also the diet, which could be very high in what are called nitroso amines, which are carcinogenic. So, for instance, there’s you can actually reproduce that bile duct cancer in laboratory animals, you give them the parasite Opistorus, and you give them a diet high in nitrosamines, not one two punch,

Dr. Gabrielle Lyon 59:23

but we do have a global food system, right? I, you know, if I was a betting woman, I would say, while we think about it in certain locations, for example, in Thailand, or wherever, but because food supply seems to be so global that I would assume these things are coming here, whether they travel to Thailand or not. But have you thought much about that?

Peter Jay Hotez 59:53

Well, this, that parasite, Clinorcus, used to be highly endemic. Instance in Chinatown in New York. Why? Because the first wave of Chinese immigrants to the US came from Canton, Guangdong Province, where at that time there were.. then this was when China was still a very poor country, had very high rates of that Clonorchis parasite, and so it was pretty common in Chinatown in lower Manhattan, now not so much, so it might be

Dr. Gabrielle Lyon 1:00:24

right, but we’re, we wouldn’t necessarily have the evidence to test, and again, do you think that it’s still there? Because I just think that we’re not testing for these things routinely.

Peter Jay Hotez 1:00:36

Yeah, I think it’s probably less so. Well, one, because Chinatown, they’re coming from all over different parts of Asia now, but also, you know, Guangdong now has got a pretty advanced economy now, so I think probably the rates of clonorcas are probably way down there as well. One

Dr. Gabrielle Lyon 1:00:52

of the things that I think has been really important about your works, especially around tropical diseases, is that there seems to be the stigma about low sanitation, but you’ve also said that it’s not just about the low sanitation, that we’ve kind of.. there’s a new way that we can reframe these.. yeah, I

Peter Jay Hotez 1:01:11

think a lot of this climate change that’s a big factor, also urbanization too, so people are living in more crowded areas, and it’s been really tough to get the word out about parasitic diseases in the US, you know. I did. I was very successful doing a lot of advocacy for what we were calling neglected tropical diseases, or NTDs, in low-income countries in Africa and elsewhere, and was able to get funds appropriated through USAID for mass treatment programs. And then in 2000 that was in the early 2002 1008 I wrote a paper called Neglected Infections of Poverty in the United States of America, and I thought, wow, when I write this, you know, everyone’s gonna pay attention. It was the opposite, right? It was, I couldn’t get any traction on it, and I even bet at that time I went back to the White House, because I, a lot of success in getting under the George W. Bush administration, mass treatment package for neglected tropical diseases abroad, and they said, “Yeah, but Peter, now you’re telling a more complicated story, it’s not just a quick fix of mass treatment, you’re saying we have to go into communities that we think are infected, the laboratory tests that you want to do are more complicated, and the modes of prevention are a little more problematic, and well, yeah, but that’s the reality, and finally I got Senator Cory Booker interested in it, and he put in legislation in the Senate called the Stop Stop, Neglected Tropical Disease Act, Stop NTDs Act, which included mandates that we actually do active surveillance for these diseases, and he couldn’t get a co-sponsor, and it’s kind of.. I don’t think it’s gotten.. it’s been a few years now. I don’t think it’s gone very far, but there’s no question parasitic infections and related tropical diseases are widespread in the US, particularly in this part of the country, and most of them are being missed and not being diagnosed.

Dr. Gabrielle Lyon 1:03:16

I would absolutely agree with you, and people are symptomatic, even beyond wheezing, we see it manifest in skin conditions, we see it manifest in all kinds of IBS. What about Lyme, and those various co-infections? Have you studied that much? We

Peter Jay Hotez 1:03:33

have, well, Lyme, but also, you know, now we’re seeing a big rise in a live, of course, transmitted by ticks, low

Dr. Gabrielle Lyon 1:03:41

star tick,

Peter Jay Hotez 1:03:42

well, especially Lyme disease, especially Ixodes, the which is, which is a heart tick, but now we’re starting to see a big rise in illnesses from soft ticks and others, and they’re not being diagnosed. So one of the things that we’ve done now, we’ve gotten some support from here in Texas, from the Lyda Hill Foundation, and they’re based in Dallas, and, and now the George and Cynthia Mitchell Foundation, for to do it in Galveston, and for Harris County, from an anonymous foundation, and what we’re doing now, which is quite interesting, is we’re collect, you know, collecting the ticks, which transmit things like relapsing fever, mosquitoes that can transmit dengue, or chikungunya, or zika, God forbid, yellow fever, as well as fleas that transmit typhus. Now we have typhus transmission here, as well as the Reduvid bugs that transmit Chagas disease, and we’re doing their full genomic sequence, and so by doing that, you not only get the genome of the the vector, the the the with the arthropod that’s doing this, but also you get the viruses that are inside.

Dr. Gabrielle Lyon 1:04:54

How easy is it to happen,

Peter Jay Hotez 1:04:56

and and what we’re finding is a whole new. Set of pathogens that people didn’t realize, that’s a

Dr. Gabrielle Lyon 1:05:02

bummer.

Peter Jay Hotez 1:05:03

Yeah, so the old way of doing it in Harris County, here in Texas, does this, and they’re one of the few that even do this, which is they’ll collect pools of mosquitoes, and they’ll design PCR primers to look for what they think is there. What this does by doing the whole genome is, we can actually get the full ecology of all the infectious diseases that are popping up, and now we’re doing this for Harris County, Houston, and Galveston. The problems now, we love to do this for, we should be doing this for the whole country, right? And, or at least the Gulf Coast, and, and, and, and other vulnerable areas, and we’re not, so we’re basically not doing that. We’re not using the most modern methods of genomics to really detect these pathogens, and we should be doing that.

Dr. Gabrielle Lyon 1:05:51

Do you think that there is?

Peter Jay Hotez 1:05:52

So, I think there was, and here’s why this is important. It turns out one of my faculty, now she’s moved to Emory University, Christy Murray, spelled with a K, did this extraordinary study to find out that in 2003 2004 Houston had a dengue epidemic both summers, and they were missed. Why? Because you know a patient comes in initially with nonspecific findings, right? You know you’ve seen it, right? Fever, ration, headache, right? Okay, patient comes with fever, ration, headache. What is it? Well, it could be 100 different things. Now, through this metagenomics project that we call it, we can have a list for what’s in every county, or even, you know, cut it even finer into a district, so then the physician can actually be better informed of what’s actually in their community, because now it’s their best guess, and they have to send off specialty tests that take two weeks to come back, and by the time they come back, right, it’s, it’s, you know, either the patient is very sick or fine, and so I’m hoping this will be a new approach to really doing a deep dive on these illnesses,

Dr. Gabrielle Lyon 1:07:03

it makes me think of the patients that we have in our practice. There are, we do get a fair number of Lyme patients that have been all over, and it’s more of dealing with this kind of sequelae. Have you seen that? I mean, because I know that as a pediatrician, probably after 18 they don’t come to see pediatrics any anymore, but it seems as if individuals, there’s this neurocognitive component of Lyme, and whether it’s later life, they’re just again a whole host of this kind of cognitive cognitive impairment, is not the right word, but maybe they have mood issues, or they have gait, just well,

Peter Jay Hotez 1:07:43

remember when Covid happened. One of the big surprises was long Covid, right? People didn’t know that there could be such a thing as long Covid. Well, it turns out long-term sequelae from infections are actually more common than you think they occur with influenza, West Nile virus. It turns out we’re, you know, one of the things that our scientists have found that the National School of Tropical Medicine are these long-term cognitive effects and neurologic effects of Lyme disease, even kidney disease, you know, years after they’ve had it, and, and I think that’s another important new frontier for infectious diseases, is recognizing these long sequelae are really important, which, by the way, is another important reason to stay at Keep Up with Your Vaccines, because the COVID vaccine not only can keep you out of the hospital, but it reduces the likelihood of you getting long COVID, and same with flu, and one of the things that the word that I’m trying to get on, especially as we head into the winter season, is you know when we talk about influenza virus or the coronavirus causing COVID, the SARS two, we always couch it as a respiratory pathogen, but they are as much cardiovascular pathogens as they are respiratory pathogens, and so the SARS two coronavirus that causes COVID 19 is a thromboembolic virus that causes clots to form in your coronary artery, and and the blood vessels going to your brain, and the cerebral, the cerebral vascular system is causing heart attacks and strokes. So, it turns out one of the best ways to protect your heart health is to stay up, keep up with your COVID vaccines. Same with influenza. Influenza causes heart attacks, and people are not aware of that. So, I think getting that word out is really important, because I think we would get much better percentage of people, Americans agreeing to get vaccinated if they knew that

Dr. Gabrielle Lyon 1:09:44

well. I really appreciate your work, and I think that you are just a great scientist. Truly, thank you for doing a lot of important work. What are you working on now in your lab currently?

Peter Jay Hotez 1:09:58

So right now. Now we are really trying to get the last mile for our hookworm anemia vaccine. It’s working. I’m

Dr. Gabrielle Lyon 1:10:07

very excited. It’s working. I’ll be the first person to take it.

Peter Jay Hotez 1:10:09

Hopefully, the paper showing that it works will be published soon, and then it’s a matter of trying to find support to actually get this manufactured, and then where is it going to be? Out of

Dr. Gabrielle Lyon 1:10:24

curiosity, what kind of, what kind of support are we talking about financially?

Peter Jay Hotez 1:10:28

You know, for us, a few million dollars goes a long way. You know, Novavax got $1.6 billion and we, and we got about seven $8 million that’s all we know. We needed then, so we don’t even need that much, so I think getting that kind of support would make me huge. The other thing we have a disease, a vaccine for disease called Chagas disease, and then the other is, of course, I like to write books, and you know, I’ve been writing about anti-science movements for the last couple of books, but this new book that I hopefully will announce soon is I’m relooking at a re re looking at the history of Texas through the lens of its epidemics. People don’t realize how epidemics had malaria, cholera, yellow fever, smallpox dramatically changed the whole history of Texas and Anne. So I’m doing a deep dive in the history of Texas, and loving it. That’s,

Dr. Gabrielle Lyon 1:11:23

I mean, it’s fascinating. I’m telling you, if I had had a choice, if I didn’t go in the direction that I did, it would have been infectious disease. Well, you’ve had topical,

Peter Jay Hotez 1:11:31

well, you’ve had an amazing career, and, and I can’t thank you enough for having me, because what you’re doing is, is so important, you know, getting real information out there without, you know, trying to scam people, without trying to push a lot of snake oil, but actually get, you know, meaningful nutritional and health information out to people, and it’s hard, you know, one of the things, another reason I admire you is a couple of times, you know, after going on the cable news channels talking about COVID, infectious diseases, and vaccines. Some of the cable news channels said, “Hey, do you want to be a medical correspondent for us to do all the things that you know people like Sanjay Gupta do or Vin Group to do? And, and I decline, because I find that really hard to one be a generalist, but also do it with integrity, and really take the time to look. So, my hat’s off to people like Sanjay Gupta, Vin Gupta, or what you’re doing, because it means keeping up with so many areas.

Dr. Gabrielle Lyon 1:12:33

I don’t do it alone, I don’t do it alone, I know what I’m good at,

Peter Jay Hotez 1:12:35

right?

Dr. Gabrielle Lyon 1:12:36

And then I get analysts and help, and, but it’s, but it’s work, right? I mean, to

Peter Jay Hotez 1:12:42

really do that, and you know, I, I didn’t want to be out of the lab that much, and wanted to write my books, and the end of the day, I’m an academic, and this is what, and we

Dr. Gabrielle Lyon 1:12:52

need that, it’s so important. Thanks, it’s more valuable now than ever, because it takes a lot of effort, and it’s a lifetime career. It’s very, it’s very much earned. Nothing in academics is given right,

Peter Jay Hotez 1:13:05

right

Dr. Gabrielle Lyon 1:13:06

away. It is a very different landscape now, and we need academics. This idea that we can all be self-taught things of that nature, it’s, it’s ridiculous, and it’s dangerous. But, yeah, no, there’s a way

Peter Jay Hotez 1:13:22

I’m worried, I’m worried, especially, you know, for our young scientist and physician, you know, sometimes they look at me like Moses in the desert, why did you bring us here? And I said, look, you know, I know it’s things are dark right now, but it’s really important, I mean, we have fewer and fewer physician scientists, we’re graduating fewer and fewer PhDs that want to have careers where they’re spending their life solving problems, and so I am worried about the future of this country from that standpoint,

Dr. Gabrielle Lyon 1:13:52

but potentially hopefully we’ll be able to inspire people to begin to think and have transparent conversations, and then go back to this model of deeply respecting colleagues, which I think is, I think that’s important, and I think that there’s a level of respect comes from, you know, that you earn it, and if it’s earned, then there is this mutual respect, and that’s if, if the ultimate goal is to provide information, the ultimate goal is actually to move the needle for health and wellness for the population, and that’s done collaboratively. Absolutely, it’s not done individually. I totally agree. So, thank you so much. And I’m very excited about your hookworm vaccine. Sign me up. Myself will be the first, and my team will be second. Thank you. Thank you. I have a handful of questions very quickly, if you have time.

Peter Jay Hotez 1:14:45

Sure, thank you so much. Let

Speaker 1 1:14:47

me cut the recording.

Dr. Gabrielle Lyon 1:14:50

I could talk to you for all, forever. I’ve so.