The Necessity of Patient Zero

fever and a scratchy throat. I had it a couple of weeks ago and even took it with me to Disney World, uh or right before entering Disness Forward Disney World, I didn't actually enter the park, uh with with the illness, and you went to Disney World the same time. I went to Seattle and I caught I don't know if I got it from you or Jonathan Strickland, our colleague had laryngite this last week and he sits across from me.

But sure enough, the day I got on the plane, I came down with something and I had a horrible fever by the time I got to Seattle for my vacation and was just shivering and Luckily I had three days. I ended up getting better before I attended Emerald City Comic Con last week. Otherwise I would have been patient

zero at an Emerald City and infected everybody. The nomenclature that's usually used at big conventions like that is concruct because you just bound to pick something up with that many people breathing on each other and touching each other. I know people who just have like hand sanitizer in their pockets at all time, and they're just constantly like rubbing their hands within their face. But you know what, like, you're gonna just get it no matter what. Well it's

you're you're combining several different things here. You have to the convention where like you said, a lot of people type space, um you know, sometimes physical interaction. And then on top of that, if you were flying there, then you're in and you're on that in the airplane vironment. So you're in this this sealed tube with all of these coughing, hacking, breathing people, and it's just gonna the

illnesses are gonna be passed around. Like I think, I look back on the times when when I've gotten sick with something you know, notable, and I usually don't don't get that sick, but it's it generally follows international travel um or at least like a long journey by plane. This is no joke. Every single year I get sick one time, like like a major way, and it's always when I go on a vacation. Always, it always happens. Last year I went to Portland, got sick the minute

I got there. And it's it's either airplanes or maybe it's like I'm relaxing and I'm letting my immune system drop or something. But I'll say this what you're just talking about with the coughing. Has anybody ever been on an airplane where somebody isn't hacking. Yeah, it's it's it's like there's always gonna be someone hacking. Theres always gonna be that crying child. Yeah, exactly, It's just part of traveling.

But so we're circling around this. But our topic for today is actually the idea of a patient zero, of the first patient, the first victim bringing a disease to the human populace. Yeah, or if not to the human populace as a whole, then at least to a center of population um. These are also known as index cases, that's really the more official title, uh, the patient zero is the sexier sort of media word for for this type of individual. And it's really misleading. It's a it's

a it's a misnomer, and it's misleading. We're gonna talk about why. Yeah, And and in order to discuss why, I think it's important that we we also isolate some of the mythic and fictional variations of this trope, because we're talking about the idea here that some illness or some flaw and character, and these two are often intermingled, and myth can be traced back to a single individual, And then how are we supposed to feel about that single individual and being humans and doing what we do.

We usually look upon them with the stain and and write a narrative in which they're somehow the bad guy forgetting us all sick. And we know we've talked about mythology on this podcast a lot in the past, and about how how powerful these uh, these mythological ideas are even if we're not consciously invoking them. So I thought it might be a good idea to just look at some of these mythic examples and and see how they

are reflected in our modern view of the patient zero. Okay, so let's let's start with what we can think of as you know, like original sinners or o G sinners. Uh. One of the most famous is, of course Pandora. Pandora's the first woman created by the gods. She opens a jar or a box depending on on on on your reading, and in doing this she unleashes all the sort of non specific evils of the world. So thanks a lot, Pandora. Now we have evil in and Uh it's very easy

to see that is a gendered narrative. Certainly our our friends who used to do stuff. Mom never told you. You You probably have an episode on a Pandora somewhere about the myth of the It's all Pandora's fall or it's all Eve's fault. Yeah, even is the other big one, right? Um?

Eve the first woman? And uh and and as encountered in the Old Testament, Uh, she makes the mistake of listening to a talking snake was of course Satan, who convinces her to disobey the creator guide and eat of the tree of the knowledge of good and evil, and this transmission only leads to their expulsion from the earthly paradise, our mortal legacy of having to work and wear clothes and experience painful childbirth. So again, a very gender to

blame game going on here. This one uh, primordial woman made a mistake aired in judgment listen to a talking snake, which is really a bit unfair, right because I've always looked back on that story and it's like, what is there as talking snake? You really threw a curveball here while having a talking snake? I think didn't all animals talk? I don't know my Bible that well, Joe should be, but I'm pretty sure that in the Garden of Eden

all animals talked. But maybe here's what I don't remember that, but maybe that's from the Disney version that well, that's where I was going was I was thinking, like, is the talking snake the same snake from from the Jungle Book? Like an ancient relative? Yeah, exactly, maybe some cub uh, but certainly a Pandora eve. These are both examples of of of of a essentially a patient zero for human suffering. Another big one from from from the Old Testament is

of course Kane. Uh. He's the first born son and his crime is a bit more complicated because you get into this issue of his sacrifice versus abel sacrifice able being his brother. But however you want to attribute it, He's remembered as being the first murder of his brother Abel. So God punished Kane to a life of wandering and set a mark on him so that no man would

kill him. Yeah, that that is actually a bit of mythos is popping up in a lot of popular culture fictional lately, the mark of Kine and the idea of

bearing that that that mark of the first murderer. It's a little different than disease, but I think that in Kane's case, it's definitely one of those like this is why humanity is so burdened, right, Yeah, And all three of these are examples to where the idea that the stain never watches away, right, humans are always going to be stained with original sin and or uh, females are always gonna have some degree of blame. Right. Or in the case of Kine, it it's carried on through through

Kane's children. Uh. It indeed, like as if it's an infectious agent. Yeah. Absolutely, Now, we also have plenty of examples of monster patriarchs and matriarchs we have a kidna the Greek from Greek myth, so this is the mate of the giant Typhon, and she gave birth to such monsters as Cerebus, the Hydra, the Chimera, the Sphinx, the gorgon, um,

uh Cilia, et cetera. I have just been reading Chuck Wendig's book Zeros, and it's um not at all about mythology, but it is about cyberculture and artificial intelligence, and they heavily play off of the ecodnah Typhon mythology within the

sort of classifications of AI. Yeah, there's also lilith the First, a wife of Adam according to Jewish mythology, and you see later treatments, especially in fiction and vampire fiction, where lilith Is is held up as this demon or the first vambuire and uh to to to draw in a less mythic and certainly more pop cultural example, I'm I was always a big fan of Blade two lad to the Fantastiermo de Toro movie, and that has a wonderful

patient zero plot in it. Yes it does. Yeah, The whole plot line here is there's a patient zero for a new strain of vampiresm when it turns the vamps into reapers who feed on the blood of vampires. And so you have this character Jared Nomack who's the sort of tragic supervillain of the of the film. Yeah, and that's an interesting take on it because, like you can look at vampiresm mythology in general as being about disease, right, but then this sort of flips it on its head.

It's a disease for the disease carriers in a situation where the disease changes, there's something is tweaked in the illness and suddenly it becomes all the more dangerous. And that kind of mutation is is actually very real and part of what we're going to talk about today with

these ideas of patient zeros in major epidemic breakouts. Yeah, now, what are a few more here We've recently been talking about the expanse Yeah, and there's the character Juliet mal on that show who's infected with the protomolecule and that becomes a major plot point in the first book, in the first couple of seasons of the show. In Stephen King's The Stand. Uh, some of some of you King fans that they might remember that there's a there's a

one individual, Charles Campion, I believe. Is he the security guard who like ends up like leaving the base when he's not supposed to believe, so he becomes eight. He becomes the patient zero for Captain Trips super flu the stand is truly like the epidemic story of our time. I I anytime I get a really bad flu. I referred to it his Captain Trips. Yeah, And there's this movie that came out maybe two or three years ago that I thought of. It's called Contracted. They've made a

sequel to it as well. It's a zombie movie technically, but it's about, uh. The whole thing is about a woman who contracts zombie ism I guess as a sexually transmitted disease from a patient zero, and it's a slow burn of her basically like going through the initial stages of the disease. The movie ending with her turning into

a zombie. But apparently Contracted, to which I have not seen, is about finding the patient zero, and this is kind of a familiar trope to some of these films, such as The Ring and potentially even it follows like I've understand, I've understood that if they do a follow up film, that's going to be what it deals with is kind of blaming the agent, I mean, the patient zero there is, Yeah, there is sort of an element of that in the

in the original. It follows if they ever come out of the sequel that kind of h I kind of hope they believe it where it is. But but yeah, the idea that they need to find out whoever the first person is, who's contracted this curse, because that's our human tendency, right, we want to find out where did

it begin? Uh? Who can we blame? Um? And it's it becomes this complicated game that is both both that that has certainly elements of of of important science to it, uh, and in terms of containing and figuring out how the illness works, that also draws in all of these less scientific mythic ideas. So let's unravel this a little bit. What what is exactly a patient zero or an index case? So as we've been discussing it, we're essentially talking about

the first known patient to exhibit symptoms of a given illness. Uh. And yeah, it's one that plays out into so many of our dramas about infectious disease. Some of the examples we didn't touch on that have been mentioned in some of our sources, or contagion that came out in twenty eleven, twelve Monkeys and twenty eight days later came out in twenty in two thousand and two, and the outbreak was in a lot of my notes. Yeah yeah, yeah, um.

But as Robert mentioned earlier, scientists prefer the term index case. The reason why is identifying a single person as the patient zero both gives an incorrect impression about how a disease might emerge, and it insinuates that somebody should be blamed for the outbreak right. Um. At the same time, it's important to find out what's going on with these cases because then if you know their history, you can

help researchers determine how and when the upbreak started. So some refer to this as detective work, or actually start referred to as shoe leather epidemiology in one of the articles.

Uh So, basically, the idea here is you backtrack the disease and once patient zero is identified, you try to figure out how they got sick, So were they in contact with a certain species of animal or what kind of activities did they do right before they got sick, or how exposed were they, Like do they have open wounds or did they breathe something in did they ingest

something or was it just something in the air. So, what today's research is really going to ask us to consider is that this is a state of harnessing scientific authority to enact coercive measures while drawing upon contemporary beliefs that either race or class or sexuality could lend to

the patient zero's propensity for disease. Because when patient zero is defined as someone with distinguishing traits, whether that's behavior or sexuality or race, it makes it easier for those of us with different characteristics to reassure ourselves that we're not at risk. This doesn't have to do with us, right, Uh. And they typically locate disease origins as being in quote

pre modern parts of the world. So there's a concern that this narrative deflects attention away from the structural factors that can affect transmission and health health outcomes. Um so, yeah, I mean, and it's it's also incredibly difficult to nail down a patient zero. Yeah, yeah, it's it's it's one of these ideas that certainly works better in fiction than

it does in reality. Yeah, absolutely, it seems right, like, uh, twenty eight days later, it's really easy to say, like, oh, the monkey bit this person and then this person spreading you know what I mean, Like like, it's it's very easy to do it that way. That's not how the real world works, right, I mean, it's it's irresistible from a fiction all standpoint because it invokes those myths. But

but yeah, actually finding that individual there. We're going to discuss some cases of alleged patient zeros, but for the most part, it's a rather difficult ansercise, Yeah, because the thing here is that infectious agents can percolate in the environment for years, sometimes even decades without being detected, and when they do enter the human population, it could be through more than just one person. Also, some people are

more capable of spreading disease than others. So one argument is basically, well, instead of thinking of it in terms of patients zeros, maybe we should be thinking of super spreaders. And there's also a terminology for people who are referred to as super shedders as well, and these are the people who shed many more types of the virus into an environment. So yeah, so we've got a lot to unpack here. I think we're gonna see more of it

when we look at the examples. Now, you might well ask yourself, well, how does one become the first carry or of a particular illness. Well, the answer here, of course, is that that they mutate, They leap from a non human host to a human when they adapt and sustain. So for many zoonotic infectious diseases, the first step involves the species jump. All right, We've seen this, and you've seen this in a number of examples that have propped up in the news over the years, you know, bird flu,

swine flu. The idea that these these are strains of influenza that have thus far been isolated to a non human animal, but through close proximity, this thing is able to jump to us and then sustain itself in this new host. Yeah, and we're gonna see in some of these examples that bats are actually a huge factor in zooonotic infections. Uh. The other thing that I was going to mention too is this reminds me of our episode on the guinea worm, where it was the other way around,

and that the guinea worm jumped to dogs from humans. Yeah, it isn't. Essentially, we thought we had it wiped out and then we found out it it had jumped to dogs as a as a new hiding place, thus complicating our efforts to eradicate it. Uh and uh, you know, so anyway they get into a human they can they can spread through the human population. And to put that in perspective, about six of all existing human infectious diseases are zooonotic. So it's not a it's not a case

where oh this is this. This is a strange situation where this this illness jump from one species to another. This seems to largely be how how they work like this is this is a common factor in in in studying, preventing, and fighting infectious disease. So why then, why is it important for science to be able to attribute a patient zero. Well, there are two main factors here, of course, One is

the chance to better contain the outbreak. If you can pinpoint who brought it, then you can you can follow the chain, you can try and contain it. You can you can do everything you can to prevent the further spread of the illness. Uh. And then second, it's the chance to determine where and when the outbreak started based

on the patient's personal history. It gets one closer, one step closer to the to the source because essentially you're you're you're condensing the history of the illness to the history of the person, right and that can conceivably be easier to to to track down Now. An example of this in action would be uh when medical professionals traced the two thousand fourteen West African outbreak of Ebola back to a two year old child who died on December six,

two thou thirteen. By January one, the child's mother, three year old sister, and grandmother had died as well. So this this was a town in Guiana, which sits adjacent to the borders of Liberia and Sierra Leone, so there's easy access for it to spread into different regions, which explains how it managed to spread through three countries within

a matter of months. Isolating the patients zero in this case allowed researchers to map the trammission of the virus and better understood stand how and where it was spreading. But as we'll explore, this helpful concept can also spin out of control thanks to the complications of of human prejudice and just the power of this mythic idea that that there's a single individual to blame, there's something as complex as the mutation and spread of an infectious disease.

In fact, I believe in that UH particular Ebola case,

I believe that there were some factors of witchcraft being blamed. Um. So it's important to see, you know, patient zero not only works in a medical situation and that like we need to apply it so that we can try to contain the upbreak figure out what's origins are, but it also works from the human cultural perspective of trying to understand what's going on, right, right, Why don't we take a quick break and when we get back, what we're going to take a look at some patient zeros of

note throughout history. Alright, we're back, So, yeah, we're gonna talk about some patient zeros here. And this first one I'm particularly fond of because the story actually comes up in the first season of The Nick, which was was It is a fabulous Cinemax uh TV series starring Clive Owen about the just the rapid advances in the medical profession UH in the early twentieth century and it's a

really rough story for this particular individual. I'm sure most of you have been thinking about her as we've been talking about patients zero. Of course we mean typhoid Mary. Yeah, the name itself has become synonymous with someone who unknowingly spreads a disease. Yeah, and so typhoid Mary was actually a woman named Mary Malone or Malan. She was an Irish immigrant and she was forcibly quarantined after officials determined that she was spreading disease to unsuspecting families that she

worked for as a cook. Now, the idea here was basically that she worked in these homes and members of the homes they would develop typhoid fever. They would get it from salmonilla ty fi. So they quarantined her on two occasions for a total of twenty six years, and she subsequently even sued the New York Department of Health because she was basically imprisoned, but she was unsuccessful. Is that what they cover in the neck? Do they talk about her quarantining They the quarantine is kind of set

up at the end. It basically there's a character in the show who's who inspects outbreaks and tries to get to the bottom of it. And there's a strong, uh you know, immigrant um aspect of the plot as well. But you have a couple of the characters who were

investigating this outbreak and trying to determine what's causing it. Yeah, So I mean we can see here not only was she a woman and it made it gendered, but she was also Irish and at the time there was a lot of prejudice against Irish immigrants, so of course it worked very well for them to say, well, this is the person who this whole thing broke out with. It's it's her that's responsible for this. She's actually not technically

what we would refer to as a patient zero though. Yeah, I guess she might qualify as a as a as a what a super shudder, Yeah, either a super spreader or a super shredder. Uh. That sounds like some kind of teenage mutant Ninja Turtles. There was super Shredder and the second one. I believe it's that they're shredding them mutate, but her case, it's actually similar to um that movie twenty eight weeks later. So the idea here is it's somebody who can spread the disease, but they're also immune

to it. So she didn't get sick herself, but she she was supposedly spreading it to all these other people. Yeah, she was an asymptomatic carrier, so which means that she carried the disease, she transmitted it, but she exhibited no symptoms herself. And that that's what made her inadvertently so so dangerous because she didn't seem like a sick person, but she was carrying this this this deadly infection and made it very easy for them to basically lock her

up for half of her life. Yeah, I think she died in president Actually, Yeah, it's uh, it's interesting that we bring this up a course on the week of St. Patrick's Day because I think for a lot of modern listeners it's it's especially given you know the importance of of people of Irish descent in our country and uh, and you know, the celebration of St. Patrick's Day and that, etcetera.

It's easy to forget that that that Irish immigrants had kind of a second class class, a second class citizen classification um in in these in these times, not too long ago, not very long ago at all. Yeah, And of course, another another case is with Chinese Americans, and we have an example of that that comes up. This was from a similar, similar time period. This was back in nineteen d public health officials discovered the corpse of a forty one year old Chinese man named a Wing

Chung ging in the basement of the Globe Hotel. So this was in San Francisco, and signs pointed to bubonic plague, and indeed this was the start of the San Francisco plague. Of that that that there was an issue from nineteen o four. So if officials responded to this by ordering a complete quarantine of Chinatown, they ordered all white residents to evacuate and had mandatory a house by house fumigation

and vaccination for all of the residents. So it's another case in which, yes, on one level, there's a rational attempt here to contain the spread of an infectious disease, but there's also this element of race and social standing that's playing into it. You know, the idea, well, let's get let's get all the white people out and let's deal with the problem here, which are the Chinese people. And just how ridiculous and ultimately grotesque that notion is

and and potentially ineffective in containing the the the illness. Yeah. You see how in these American examples, and we're going to talk about HIV a lot later, uh, that they they're immigration scares essentially, right, and in the case of

HIV it's a scare of sexuality. But I mean, I could very easily see, given our current situation with immigration here in the United States, that it would be very easy to latch onto a narrative that somebody who is either Latino or Middle Eastern was a patient zero of

some kind in the coming years. Right, that would be a very similar uh storyline to what we saw with typhoid marry and wing chun ging, uh, basically like demonizing them, so that the predominant narrative is, Oh, it's not me, I'm okay, I'll be fine as long as I stay away from those people, right, I mean, well, you see, Amain, there's been a lot of discussion in the media, uh recently about the idea that we see the exact same

thing with with acts of violence and terrorism. Right, that the idea is that we end up focusing on individuals who are mothered in some respect, so it's individual was from a from a predominantly Muslim nation or or a nation that that is has some connection to these, uh, these these cases of violent extremism, and then saying well, this is where it's coming from, and then you're just missing other fonts of violence, other fonts of terrorism that

occurred domestically or in other nations that for various reasons are not receiving the same level of scrutiny. Right, But it happens in other nations too. It's not just the United States was certainly was. This is a human wide phenomenon. So another example of a of a patient zero here or an allegation zero was a a Chinese doctor by the name of doctor lu Jeen Loon. This is a sixty four year old He was from Guangdong Province. This is a home to to Guangzhou for anyone who's trying

to piece it together in a map. And he spent the night in a Hong Kong hotel and according to a report from CNN, he may have transferred um his virus to at least sixteen other guests staying on the same floor, that virus being stars. Yeah, so the idea here, this definitely seems to be a case of what they call super spreading. It's thought that Lou acquired the disease from a hospital that he worked in. So a farmer in Guangdong first developed STARS after coming into contact with

an animal. So we've talked about this already. This is zoonotic infectious disease that jumps from one species to another. Uh. So it's believed that Stars originated in bats actually and then spread to other animals like civit cats before infecting humans. Uh. And so when the genetic material from two or more other viruses infect a single human or really any animal, the host itself is referred to as a reassortment event, right, And so that that is what is assumed to have

happened here. A lot of deadly diseases are linked to bats in this way, and we'll we'll give you some more examples later, but a bowl uh hepatitis, se stars, and perhaps mers are all linked to bats. In the case of Stars, it's thought that it first spread to humans actually in by bats that were infecting horses in Brisbane, Australia. Then two people caught the virus from the horses, and they think it was possibly from scratches that were exposed

to infected horse blood. Both of these people died horrible deaths. UH. In other diseases, pigs have become infected by eating saliva covered fruit that's dropped by bats, and then that subsequently infects the humans who eat the pigs. Uh. People can also be directly infected by drinking juice from date palms that have been contaminated by bats. It's interesting to bring bats up because you know, we've been talking about typhog Mary.

We talked about how she was an asymptomatic carrier. Of course, bats are asymptomatic carriers of rabies. Uh. They don't display the rabies of uh, you know, they're not foaming at the mouth, but they can be carriers of it. And that's why we is. Everyone I think has heard if you're bitten by a bat, you have to you have to act accordingly. Um as if you've contracted great. Yeah, it's a different episode for another time, but I would love for us to tackle bats in their immune systems

and and and just their anatomy in general. We did a how stuff works video and it was like three years ago where we went to dragon Con and we interviewed a woman who was a specialist in bats and viral spreading, and it was just really interesting. The idea basically being that they have these crazy fast metabolisms that just process things right out of them. Um, but on the other hand, they're also super susceptible to spreading these diseases.

The other thing is that, in the case of Stars, it's thought that a few wild civets were infected by bats, and then these civets were caught and taken to the market and the virus jumped to humans. You know what I immediately think of, here, have you heard about this coffee that's made from civit? Oh? Yeah, I have never

had it, but I haven't familiar with it. But so if nobody out there has heard of this, apparently, I think in l A it's kind of a thing you can buy like a cup of coffee that costs like what it's like eighty bucks or something crazy like that for one cup of coffee. It's supposed to be like the best coffee in the world. So the idea here, I think is that, uh, these civits eat coffee beans, they digest them, and then when it comes out the other end, they're able to somehow process it into coffee,

not the civits people. It's not coffee itself, just poured directly out of there right exactly. They process it and it and it supposedly has like this amazing fruity flavor. But my first thought was, well, what if these civits are bitten by bats and you're drinking this eighty dollar coffee, do you then get stars from your coffee? Yeah? I can imagine the selling. Look, this is gonna be the

best cup of coffee you ever have. You're you're gonna catch stars probably, but just just just give it a try. I meant it. I doubt that's the case. Otherwise people would probably be warned about this super expensive coffee. But still,

it just kind of made me think about that whole thing. Now, Dr lu John Lune here Again, he wouldn't have been patient zero per se, but it was still a critical factor in the spread of the disease because people from that hotel traveled and in less than four months, about four thousand cases and five fifty deaths from stars could be traced back to his stay in Hong Kong. And this just makes me think back to our stories about traveling while sick, Like when when we have these tales

of patient zeros or alleged patient zeros. It's really easy to apply blame and say, oh, that was so irresponsible that person to travel while they were sick and got all these other people sick. And yet this is something we all do. We all know that if you're sick, you should you should probably not travel. We know that if your kids sick, you shouldn't send them to school.

And yet this happens all the time because we had we make our plans, we spend money, we have our jobs to do, we have our lives to uh uh. You all planned out, and then illnesses come along and we're generally we generally just try and plow through it if we possibly can exactly. I mean, like, so in both of our cases, you and I had both invested a lot of money and going on these vacations. It's not like you're just gonna you can't just cancel those plans,

because that's a huge you know wash essentially. Now, yeah, you know some of you out there are probably saying, well, you should have for the for the betterment of mankind, for everybody around you. I mean, for my part, like I would I think try to wear one of those masks or something, or honestly, after this last week, I would recommend that everybody just wear one of those masks when you're on a plane from now on. Uh. Those first really got popularized with stars, right I remember that. Yeah.

I mean, of course in um, in much of Asia, you still see them all the time in any kind of like a public gathering and sporting event. Uh so much so that they're like they've they've kind of like gotten some like aesthetic designs to them, right, you see logos and emblazoned on the Yeah. But uh, you know, I think that's probably the smart way to go. I remember seeing people like that on the train or whatever and being like, what a germophobe? And now I'm like

it makes sense, like the German is not sick. Yeah, exactly. Okay, here's a couple other examples. So. Um there was a six year old and I don't think this is his real name, but he was referred to as Captain boonemanuk Uh and he was a tai boy who was the first confirmed casualty of Avian influenza, or as we more commonly call it, bird flu. In two thousand four. He fell ill and his family reported that he had recently scooped up a chicken and that chicken was thought to

have had the virus. So he's referred to as the patient zero for that. We've also got Edgar Hernandez, who is a five year old living in the Mexican town of Le Gloria, when doctors identified him as the earliest documented case of swine flew in two thousand nine. There you go with a an example of somebody of Latino descent who's blamed as a patient zero. But yeah, he was. He was called the earliest documented case of swine flu.

They believe this came from again a reassortment event. The idea here was that the H one N one strain was mixed inside pigs and that created new combinations that were more likely to infect people. Edgar Hernandez was the first one that they documented. Now for this next one, this is the individual that uh, we referenced already when we're talking about that ebola case, that two year old.

But you have some additional information here. Yeah, so it looks like and I'm probably butchering this name, but the name is a meal U Muno uh and like Robert had earlier said, it was a toddler living in the village of Milandou when he developed a bola uh. So Robert mentioned how quickly that spread and that basically it was because the town that this happened in it was on the intersection of three different countries, so the virus

spread really easily. This showed researchers just how transmissible uh ebola can be and that specifically dealing with the sick is a higher risk event for acquiring the affection. Now in this case, they were saying, like, look, whether or not it's like a medicine man type figure of shaman type figure, or even if it's just some kind of a medical doctor, that they're basically putting themselves into these

high risk scenarios where they can then subsequently become super spreaders. Uh. In addition to the detective work that the researchers did, they were also able to sequence the genomes of nine BOWLA viruses that were found in samples taken from seventy eight patients and Sierra leone. Uh. This led them to believe that the virus was brought to West Africa in the past decade by an animal. And so, like we

said earlier, you know this could this could have been bats. Uh. It's also thought ebola can be transmitted through monkeys and forest antelope as well. And we've also got a patient here who is a sixty eight year old South Korean man. Uh. He's thought to be the so called patient zero for MERS or Middle East Respiratory syndome syndrome. UH. He was an extensive traveler and he had been in Bahrain, the United Arab Emirates, Saudi Arabia, and Qatar before returning to

South Korea. Now, MERS can take two to fourteen days before symptoms begin to show, so it's thought that he may have transmitted it to twenty eight other people before he even arrived at a hospital. That's an important note to make because even if you're not a purely an asymptomatic carrier of a disease, so many different diseases and anonymosis have an asymptomatic period. Uh. This is the case in a number of STDs as well, where one is carrying the STD, but you're not displaying a lesions or

you know, or swelling or rashes or whatever. The symptoms are of like a full, full blown outbreak. Yeah. And and so speaking of STDs, now we've we've got the big term for patient zero. We're gonna take a break. When we come back, we're going to talk about the redemption of the man who was first designated patient zero, or the first man supposedly to have HIV. Alright, we're back. So we're talking here about Gaeton Dog. Yeah. He is often attributed as being the patient zero for the HIV crisis.

He was a Canadian flight attendant that was accused of introducing the virus to North America after he picked it up in either Haiti or Europe and do God was said to have infected hundreds of sexual partners before his death in Now this is where the term patient zero was popularized. This shocked me. I thought that that term had been around for a very long time, at least as far back as typhoid Mary. But it turns out it's it's relatively re within our lifetimes. Yeah, I mean,

this was a This was a major publication. They did a TV movie based on it that had the Matthew Moods starring. Yeah, stuff to blow your mind. Favorite Matthew Modine. He's played the doctor I believe not do different doctor from the one who plays and stranger things. Well who knows, but yeah, so this the term was popularized in a book that was by a game named Randy Schiltz. And this book is called in the Band Played On. It came out in and it documented the early years of

the AIDS crisis. Schiltz took the medical term patient oh, that's the letter oh and turned it into zero in the book, describing Dog as a person who continually had sex with partners without regard for their health, even after his physicians told him to stop. The book also says that Dog would purposely show partners his sarcoma legions after sex and say things like I've got gay cancer, I'm going to die and so are you? H Now the reason why the letter oh was misinterpreted as a zero

this turned into the provocative term patient zero. It actually meant oh for outside of California. Uh. And the book, but as we said, was made into a film. Now. One thing to keep in mind about about Randy Schiltz here, and I bring this up because not everyone's problem may not be familiar with the book, um and what his background is, especially when we're talking so much about mothering here and discussing the the outsider as the source of

an illness. Now, Schiltz himself was a homosexual man, uh and he had did. He also eventually died of of HIV, though he he held off on finding out for sure if he had the illness until he had completed the book because he didn't want it to to influence just to color his prose um. Again, he was a you know, acclaimed journalist in his life, like prior to writing the book. So so I want everyone to have the like, the proper impression of him before we keep going. Yeah, exactly.

I mean, so what we're going to discover here is that, well, Schultz was wrong about dog. But that doesn't mean that Schultz necessarily was a bad person. Right now, in terms of dogad we talk a bit about the redemption of of him as a carrier of the illness. Um it he still allegedly boasted of two dred and fifty partners a year after he learned of his condition. Um. He was highly vilified, as is certainly following this book coming out. Many Canadians apparently saw it as a shame on the nation.

You know, the idea that here's this this guy who who played such a pivotal role in spreading this this disease. And he was one of us, he was Canadian, and how are we supposed to feel about that? Uh? And and still as sensational as all of this was at the time and is vilified as he was following the band played on, not everyone at the time was really

into this sensation. When the book came out in the late eighties, pioneering age researcher Professor Marcus Connat of the University of California at San Francisco told Time magazine quote, if it hadn't been this man, it would have been some other. So it's much even though one is, you know, instantly inclined to say, oh, this guy's patient zero. Look how reckless he was. Look, Look look how terrible he was. He should have he should have cared more for his

for his fellow humans. Uh. If it hadn't have been him, it would have been someone else like these. When you're dealing with an infectious disease, it's it's not a thing of that is born out of human choice. It's not something as simple as uh as Pandora opening that box. And even then you could say, well, if Pandora didn't open it. Someone would have opened you have a box setting around. You can't just leave a box with a lid on it and expect that nobody's ever going to

try it out and see what's inside. Yeah, and as we're going to find out, you know, not only would it have been somebody else if it wasn't Duga, but it was. It was already out there. It was already in the world. It was already in the human populace. It just wasn't in the United States yet. And that's the thing here too, right, is that, like the narrative is, oh, this guy, this is the guy who brought it to the United States, but we didn't care about the people

who were infected with this in the Caribbean or in Africa. Yeah, it's the idea that that that that everyone in the US was somehow, you know, situated in this just on another planet, essentially, was completely removed from the threats of it via this station in the world. Um. Like, one example that comes to mind when discussing all this is another case of destructive introduction of an infectious disease, and that's uh uh Spanish explorers bringing a smallpox influenza and

measles into the New World. Now, this of course played a huge role in uh and you really can't um overestimate the role that's played. It gave them the the ability to exert military dominance, uh, certainly with more ease. It Uh, it was. It was just a vital factor in this this this population coming into the New World. And you can easily ask, well, what if what if this hadn't have happened, what if they hadn't introduced uh

uh these illnesses. Well, it's hard to envision a situation where it wouldn't have, right, I mean, because people were traveling across the world, that the world was getting smaller, we were these were some of the you know, the first contact between these these these two human populations. It was gonna happen. Now you can say, well, maybe it would there there are scenarios where you can imagine it happening uh uh in a way that wasn't so destructive.

But but but but these these illnesses were going to spread into the New World. There's there's really no way to imagine an alternative scenario. I mean unless there was some sort of you know, Star Trek prime directive scenario involved. Story. Yeah, yeah, I don't think that the early colonists had any prime directives in mind. What what this makes me think of is just from from my you know, local history growing

up in New England. Uh So, Amherst, Massachusetts is a town that my family is just generally from around that area, and my mother lives there. It's named after Lord Jeffrey Amherst. What a lot of people don't know, even who live in the town, is that Lord Jeffrey Amherst purposely gave smallpox blankets to the Native American population in the area, you know, subsequently killing a lot of people. Uh. Yet you know, this is one of the larger towns in

New England. It's also uh sort of a celebrated bastion of liberalism today, which is ironic. And yet here's this figure who was essentially engaging in biological warfare via these infected blankets. Now, in the case of Douga, there was a recent article in Nature that found that HIV in fact entered the US several years before he even did.

They determined this through a genetic analysis of stored blood samples, and what they found was that the virus entered the US from the Caribbean somewhere around one, and they think it was possibly through contaminated blood products like blood plasma. It wasn't even human to human interaction. Yeah, this was of course a big deal. And in a lot of the early HIV transmissions. If you're any science fiction fans, so they probably remember that Isaac Asimov contracted HIV this way.

He'd uh, I did not know that because some heart surgery, I believe, and uh he ended up contracting HIV from the transfusion. But it was so it was so scandalous at the time. It was I think ten years after his death. Before that that fact was made public by his family where they said, yeah, this is this is what happened. The same thing happened in my family. My grandfather contracted HIV through heart surgery. Uh. But this is interesting, I've never heard about this about Isaac Asimo. But yeah,

same thing. My grandfather was a doctor, uh, and he contracted HIV when he had heart surgery. Uh. And of course, because he was a doctor, he didn't want to lash out of the medical community or the hospital where he was treated at. And so you know, it was just something that we dealt with now in in in the case of figuring out what went on with Douga. What's really interesting here is they used similar techniques to those that are used to decipher the badly degraded ancient DNA

from fossils. So what they did was they found that the viral DNA was so genetically diverse that the viruses must have been circulating in cities for years prior to nineteen seventy eight, which is how they picked up all these variations. So the researchers believe that HIV first jump to United States from Haiti somewhere around nineteen seventy or

nineteen seventy one. The samples that they looked at all came from the same family tree of HIV and these were all the same as the one from the Caribbeans. So that suggests that the HIV virus spread from Africa to the Caribbean and then to the United States. But then again because of some specific markers, they think New York was where it specifically went to from the Caribbean

somehow through these blood plasma products. You know, it's it's interesting here because we've discussed the you know, the idea that these are these are things that emerge from less civilized places. They emerge in the wild right in the rural areas, but at the same time large centers of population, including places like New York Um. You know, certainly one of the more the more famous metro metropolitan areas in

the world. Like a modern city of there there ever was one like these are classic incubation sites for the illnesses and disease. When you look back at the history of infectious disease, uh, for for human beings like this is that we see this time and time again. People come together, they create these cities. And certainly cities are great for for enterprise, for for economics, for cultural ideas, but they are also places where diseases uh pick up stain.

Oh yeah, absolutely. I mean I love New York. It's one of my favorite places in the world to be. But anytime I get on the subway and in New York, I've just like it's almost like I get this like special vision where all I'm seeing is just like creepy crawley potential viruses or bacteria just on everything you know, and you just have to go with it, right uh. And And of course that's why New York works so well.

And like apocalyptic disease fiction like the stand right, Like, remember there's that scene in The Stand where the Lincoln Tunnel, I believe it is, is like all completely backed up because everybody just died in their cars and one of the characters has to like crawl through the Lincoln Tunnel on the pitch black dark, surrounded by all these diseased corpses. And it's of course New York makes sense for that setting.

All right, So we've been we've been dancing around this, but yeah, we really come back to this idea, is that, well, why do we why do where are we so drawn to this idea of patient zero? Why is this this trope? Why is this mythic um description? Uh so irresistible? Like even if we were not, even if we don't want to consciously invoke it, we end up thinking about it. And uh and this is this has been a topic of some consideration by a number of authors out there.

There's one piece in particular that came out in Ian magazine recently. Um and this is from Leila me and in the title of the pieces, the Seductive Lie of Patient Zero and the Outbreak Narrative. And I just want to read a quick quote from it because I thought she really summed summed it up rather nicely. The allure of patient zero rests on the ways in which the figure allows us to assign responsibility and blame when an

outbreak occurs. It makes visible the vectors of disease transmission and draws attention to the dangers of human contact, creating distance between the afflicted and the rest of us. When patient zero is defined as someone with distinguishing traits of behavior, sexuality, or race, then those of us with differing characteristics can reassure ourselves that we are not at risk. A patient zero lacks both the capacity for self control and the

moral conviction to avoid placing others in danger. The more he or she strays from established norms, the greater the opportunity for reprobation. Yeah. So basically what she's saying here is when we stray from the status quo, that's when we allow disease to happen. Uh. The idea being that

patient zeros are culpable, that they're responsible for what they've done. Now, the Douga legend of him going around and having sex with two and fifty people and then saying ha ha ha I gave you Aid's plays very well into that.

But as we've seen with a lot of these other cases, that's not always accurate, right, Yeah, and it's I mean, it comes comes back around to to this, this, this trend throughout human culture to confuse illness with some sort of a moral uh disfigurement to I mean, or any kind of disfigurement really like a physical disfigurement, means your soul is twisted in some way, shape or form, right Uh.

And and even no matter how much we try and distance ourselves from that sort of illogical thinking, it has a way of creeping back into our to our judgment um in the narrative. Here this this this agent zero narrative, because this gives us someone to blame off, an escapegoat. Yeah, and other that makes us feel safer because we can always say, well, I'm not Asian, or I'm not poor, I'm not homosexual, I'm not this that or the other.

Whatever makes us feel a little safe. And you know, I I think we all find ourselves engaging in some level of this when dealing with illness, because just the other day I was talking with my wife about about our you know, illness creeping into our own family, and uh, we're saying, well, you know, we we eat really healthily, Like,

how how come this is happening to us? And of course that that's simplistic thinking on our part, because yes, you know, healthy, healthy diet is important that you know, boost t immune uh system, etcetera. But to think of it as this this barrier, as this golden shield against infectious agents that do not work so simplistically. Um, you know that that that that gets in the way of

proper um protection and understanding of these illnesses. Yeah, you also have a four year old who's coming into contact with all these other four ales who are wiping I imagine their their noses or their hands on their mouths or whatever and touching each other and then coming home. Yeah, you want to talk about incubators for illness. Yeah, any pre k kindergarten, first grade scenario is going to be

exactly that. But you know, at at the heart of it that we we want to put a face with a threat and then we want to reassure ourselves that that face is not our own. And I feel as we experience, uh you, we experience some like this when we even say, look at mug shots and we we want to see the victims of crimes. We want to

see what they looked like. We have to know the face of the afflect, afflicted or affected individual so that we can evaluate our own standing in relationship to them, right Yeah, And like with all culture, it's basically us trying to figure out how the world works by creating a story that we can understand, right Uh. And but I think like if you sort of peel the layers away from that story, you see necessary It isn't necessarily

always the case with these quote patient zeros. In fact, the term itself is such a misnomer really, index case seems to be more responsible term. Ye. So you know, as we've just said, over the last two weeks, Robert and I have been battling off illness. It's that time of year. Also, I think a lot of stuff is going around. So maybe those of you out there that

are listening can relate to this. If you want to get in touch with us and you want to let us know your thoughts on the patient zero narrative or just you know, in general, how disease is transmissible, you can always hit us up on social media. We are on Facebook, Twitter, Tumbler, and Instagram. And hey, if you want to you've specifically the discussion of AIDS and HIV was of interest to you and you want to learn more.

UH we do recommend checking out the International AIDS Society or i A S. You can find them at www dot i A Society dot org and if you want to send us an email, just simply shoot us your missive at Blow the Mind at how stuff works dot com for more on this and thousands of other topics. Because at how stuff works dot com, I think they may joint to foot part propos Part FO