My name is Catherine Hughes, and five years ago I gave birth to the most beautiful, gorgeous little boy. His name was Riley, and he had soft blonde hair and gorgeous, piercing blue eyes. But when Riley was about three weeks old, he started to get sick. I really thought it was just a cold. At first, it was just a bit of a runny nose, a bit of a sniffle, and I wasn't too worried. But then a couple of days later, I heard this tiny little cough and I'll never forget
the sound it made. It was so small, so innocuous, but it was really a sign of what was to come. My husband was way for work, so I decided to call out a locum doctor to come visit our house one evening. Riley was about four weeks old at the time, and Riley appeared perfectly healthy. He was sound asleep and you just couldn't tell that there was anything wrong with him in between the coughing bouts. So the doctor looked at Riley reassured me that I was probably worrying too much,
that Riley seemed to be perfectly okay. That evening, Riley slept and slept and slept and just did not want a breastfeed. He didn't want to wake up. He was so sleepy. I was feeling really uncomfortable at that stage, so my husband flew back in from work and we took him to hospital the next morning, and at hospital, he was admitted overnight because they were just a bit worried that he was not interested in breastfeeding anymore. But
Riley didn't go home the next day. Each day that he stayed in hospital, he just seemed to grow worse and worse, and the coughing got more severe. It felt like every day there were just more tubes and wires and more doctors. Everything just got worse and worse. On his fourth day in hospital, we were moved into the pediatric intensive care unit. The doctors were concerned that he had developed pneumonia, and they were pretty confident at this
stage that he had hooping cough. When the doctors diagnosed Riley with hooping cough, I actually felt a bit relieved because I thought that there'd be able to cure him. But there is no cure for hooping cough. You just kind of hope and pray that they get better as they are cared for in hospital, and Riley didn't get better. His organs started to shut down. By day five, his heart was under a lot of strain, and on day five, which was his last day in hospital, he was unconscious.
They'd put him in a on life support and they tried to use echmo to save his life, and I just remember looking at his body on the bed. It was a big bed, a tiny little four week old baby on there, but he was so swollen and just covered in so many wires and tubes. It was really the most traumatic thing to say. And that afternoon we watched as this pink, foamy stuff started coming out of his lungs, and the doctors told us that there was
nothing more that they could do. We'd asked about organ donation, but unfortunately, I think his organs were just too ravaged from the toxins released by the hooping cough bacteria. So at two in the afternoon, after five days in hospital, we took Riley off life support and he was just hot and swollen and so sick, and they took all the tubes and wires out and we had to say goodbye to our little baby or because he caught this horrible preventable hooping cough, and he was too young to
be vaccinated. He was only thirty two days old when he died, and at the time, pregnancy vaccination hadn't been routinely recommended or funded in Australia, so newborn babies up Riley were extremely vulnerable to hooping cough and it cost him his life.
Hi, I'm Aaron Welsh and I'm Erin Oman Updike and this is this podcast will kill you? Yeah, today it is today it is. Yeah. So you just heard from Catherine Hughes who was kind enough to come onto the podcast and share with you her story, and you're gonna hear a little bit more from her later on in the episode as well. So thanks again, Catherine. That was yeah.
Yeah, it's a horribly depressing story that unfortunately isn't the only one out there. So today we're obviously talking about protessis whoopin cough.
To get us to this episode, we are drinking.
A very strong quarantine.
Yes, it's basically all alcohol. It is call Three Women and a Baby and it's called that because the first really successful vaccine and that was in widespread use, was developed by three awesome women Woo woo girl power. Yeah, so what is in three Women and a Baby.
Well, it's rye whiskey, of course, because whiskey, as we all know, is the cure for all children's ailments.
Of course, don't do that at home. It's not not evaluated by the FDA or podcast. We're not being serious.
No.
It also has luxardo liqueur and chinar which is an artichoke liqueur which.
Sounds weird, but it's quite tasty in context.
It's bitter and delicious. Also my band name.
Bitter. Yeah, that's a good band name actually.
Garnish with a cherry and enjoy.
And we'll post the full recipe for this quarantini as well as our non outcoholic plasy Burta on our website, this podcast will kill you dot Com and all of our social media channels.
Making the plasy burrita is going to be a challenge for this one.
But you'll you'll figure it out up with total faith, glad to do like I say, you'll figure it out. I'll just be nice jobs.
Now now this feels like a group project again.
I also want to give a quick shout out and thank you to a Kia and I'm sorry that we might have just pronounced your name wrong, but for sending us the most adorable gift package from Texas.
Y'all.
Oh my gosh, it's adorable. So many great things there.
Did you guys know something called Techsaroni existed. It's macaroni in the shape of Texas. Okay, It's everything I needed in life, and I feel like.
That should be sold in stores across the US. But Techsarroni version not like you know, Illinois, Illinois. No, I wouldn't eat that. Texas is a great shape for pasta. Whow it really is?
I can't wait. We need to make mac and cheese together or something arin.
Oh my gosh. Yeah.
Anyways, thank you so much. That was really sweet of you, and sorry it took forever for me to check our po box.
We should post pictures, yeah, we.
Should of us eating macaroni and cheese.
Yes, okay, cool?
Cool? Okay?
All right?
Shall we jump right in.
Let's do it. Should we take a quick break first?
I think we need a breather, right, yeah, So protestis aka whooping cough. Let's talk about what these symptoms are. So protessis is caused by a bacterium and the name of the disease, a colloquial name whooping cough, tells you the most characteristic part of these symptoms, and that is this very distinctive whooping sound that is not actually during the cough, but it's as people try and take a breath of air in after an episode of coughing.
And so is the whoop. Is that all ages that have whooping cough? Or is that mostly younger children?
Good question. We'll talk a little bit more in a bit about the differences in symptoms. It can happen in people of any age, but it's most typical in younger age groups. Okay, and we'll talk about why in a bit. That's a really good question though. All right. So the bacterium that causes protessis is called Bordodella protessis. It's a little gram negative rod so again the gram negative means
it's pink when we stain it. However, while Borddella protessis is the most common cause of whooping cough, there are a couple of other very closely related bacteria species, including Bordodella paraprotessis and Bordodella bronchosseptica that can in some cases cause a very clinically similar disease. But Borddella pertessis is the one that, for example, we have a vaccine four and kind of the most important of these species.
Are you ready for questions? I feel like this is the aady Okay, So about these different bacterial species. Are they as globally prevalent as just Bordetella protessas good question.
I know that Paraprotesis is pretty widespread globally. I would guess that bronchosseptica is as well. One of the big differences is that these other species are found in many other species of animals as well, whereas Bordadella pertessis is a human specific disease. Side note, though, Bordetella bronco septica causes kennel cough in dogs. Interesting huh So anyways, protestis
is transmitted via respiratory droplets. I've seen estimates that the are not which, if you'll remember from previous episodes, is the number of secondary infections that a primary infection can cause. I've seen estimates ranging anywhere from five to fifteen.
Wait, I know.
That's bigger than measles. I was gonna say it, which doesn't seem right. Well, but I guess the r like the are not is it's an average Yeah.
But anyways, in any case, this is a highly highly infectious disease. It spreads very easily.
Yeah.
In general, the incubation period, so the time between when you first get exposed and when you start to show symptoms, on average is about a week maybe ten days, but it can be quite a bit longer. And I think the reason that the range can be longer is twofold.
Partly it has to do with infectious dose how much are you exposed to at the outset, But also it's very difficult to pinpoint when exposure might be in relation to symptoms because the onset of symptoms for this disease is kind of insidious, which means it's slow and you might not recognize at first, for like a week or more that what you're dealing with is actually protessis oh yeah, okay, so let's talk about how this little bacterium gets into
you and causes disease, Okay, and then we'll talk about those insidious that's one of my favorite words, insidious symptoms.
Yeah. Also it's going to end up convincing a lot of people that they have whooping cough.
Probably, I mean, I mean I convinced myself that my baby had whooping cough. So you're not alone if this convinces you that you have whooping cough.
Okay, we just apologize in advance, Yeah, we do.
Uh So, Unlike many of the other diseases that we've talked about recently, including like syphilis and E. Coli, even dengay, this is a highly highly specific bacterium, So it doesn't just go throughout your whole body wreaking havoc. Bordetella. Protessis replicates only in association with the cciliated epithelium of your lungs.
How does it only reproduce there?
How it has? Okay, So protessis has a lot of different virulence factors on its surface, Yeah, that allow it to colonize our body and then cause the symptoms that it causes. It also has a number of different talks which are really ultimately responsible for a lot of the symptoms that we see. And so these virulence factors very specifically allow it to bind to the epithelium of our respiratory tract.
Okay, And so those are the only.
Cells that they bind to. Now, Borditella does not invade our cells, but it binds to these respiratory cells and then it replicates in association with those cells, So like next to those cells.
What this is so weird? Okay, I know, isn't it?
So this is a very like I don't know how much you're going to talk about the evolution of this pathogen. Yeah, but it seems to me like based on this, we've had a long association with this pathogen. Am I right?
I'm going to withhold comment until okay the history that would be excellent.
That would be my guess based on the fact that this is a bacterium that is highly specialized to these cells in our respiratory tract, and it's it's a human space pathogen, so it's not found in a bunch of other animals. Right, Okay, cool?
But so are our human respiratory cells that much different than any other mammal respiratory cells?
Oh than any other mammal I have absolutely no idea. I mean, I guess they're specific enough that the virulence factors that Bordetella protests has doesn't allow them to easily colonize other animals.
Yeah, I'm just wondering what it is about the specificity.
That's like a great question. I mean, it makes sense like that it would if it's going to specify on any cells. Respiratory epithelia are great because it's going to cause you to cough and sneeze and that's going to spread the pathogen really far. So from that perspective it makes sense. But the specificity to humans, I don't know, man, how does that ever happen?
Right?
And again, Bordtella has a number of different toxins that it releases that result in a lot of the damage and symptoms that we see. So in addition to like PILLI which we've talked about before, those sticky things that allow it to attach to the respiratory tract, two of the important toxins that it has are number one, a toxin called protessis toxin. It's a really good name for it. That actually blocks the ability of our white blood cells
to get back into our lymph system. Ooh, So what that means is that you have white blood cells coming because they recognize bacteria. Right, they're like, oh man, we need to come in and help out. But then what those white blood cells want to do is then go back to our lymph nodes and regroup so that they can like figure out a plan of attack kind of
m hm. So Protessa's toxin blocks their ability to do that, So you end up with a ton of white blood cells in the blood stream because they've all come out to try and figure out what's going on with these bacteria, but then they can't get back where they want to be.
Oh my gosh. Yeah, okay, that's really interesting.
It is, and it's one of the only systemic symptoms of a Bordetella protestis infection. Is this what we call lymphocytosis, A lot of white blood cells in your bloodstream?
Okay?
Because it is? Yeah, I mean you can get that in tons of other diseases, so it's certainly not specific at all, but it's one of the only like systemic manifestations because this is a very respiratory specific pathogen. And then it has other toxins which I forgot to write the name of down. Of course, I think tracheal toxin is one of them. Actually, that damage directly caused direct damage to the scillia of our respiratory epithelia and so ccilia.
Are these little what do you call this aeron fingers like undulating?
Undulating?
Yeah, exactly, little projections on these cells that help to weep mucus and debris up and out of our respiratory track. We talked a lot about them in our cystic fibrosis episode.
Yeah.
Anyways, So these other toxins, trichial toxins and others that Bordetella produce caused damage to that system. So you're gonna get a build up of gunk in your lungs when you get infected with protessis. Now we know what it does in your body, how it's infecting you. So what does it look like when you get infected?
M h, not good.
It's not good. So there are three main phases to protessis what's called the catarrhal stage, I think that's how you pronounce it, the paroxysmal stage, and then the convalescent stage aka recovery. So the catarrhal stage is this very insidious, nondescript illness, and this is what can make it difficult to pinpoint exactly when you might have started showing symptoms. And what I think is worst about this phase is that the symptoms are quite mild in a lot of cases.
So these include something like a runny nose, not a gunky nose, just kind of a watery, runny nose chariza, so like tearing from your eyes, like kind of like a like a viral eye infection might be okay, okay, like watery eyes, Maybe your eyes get a little red,
maybe they're itchy, like maybe you think it's allergies. You might have some sneezing, And at first it starts off with a pretty mild cough, and that's how it begins, and in tiny kids actually across the board, if there is a fever, which often there isn't a fever at all. Even if there is a fever, it's usually pretty mild. Like we're talking maybe like one hundred and one, which
is a pretty low grade fever. If you're talking about a kid who's like over age two, you mostly wouldn't even be concerned about a fever that low because kids get fevers from everything. Like every infection is going to give a kid a fever. So if a kid has a very low fever, you probably aren't going to be like, well, this kid is clearly very sick. You'll be like, oh, it's the little fever. They'll get over it, right, but that's it. Those are the symptoms. This lasts for like
one to two weeks. It's super mild. The coughing sort of starts to get worse, but at this phase it's it doesn't have anything that makes it stand out. It's not more frequent at certain times of day, it's not super productive. It's just like a kind of normal cough. Okay, and again no fever. Then comes the paroxysmal phase, and this is the whooping cough of whooping cough. Okay, So the cough that starts out as mild in that catarrhal phase,
it becomes paroxysmal. Paroxysmal means a sudden recurrence, so all of a sudden, out of the blue, people will have a massive coughing attack. These usually are like between five or ten, but they can be up to thirty coughs in a row, and they become also these paroxysms, these coughing attacks become more frequent at night and overall increase in frequency both throughout the day and the night, and each one becomes more severe than the last.
Okay, And it's kind of almost.
Hard to describe how terrible these coughs are so I actually found a paper from nineteen seventy five that's a really nice overview of protesses, and I'm going to just read this. The child possessed of the coughing fit is a pitiful sight, all the more so as the observer is helpless to alleviate or terminate the attack. Each attack consists of ten to thirty forceful coughs per spasm, and into each cough, the patient appears to concentrate all his energy.
He leans forward, or, if standing, stands with legs spread, grasping the nearest object and leaning far forward, tongue protruded to the utmost, saliva and mucus streaming from nose and mouth, eyes bulging with tears streaming, his entire body racked with the total exertion of each cough. The coughing continues in a staccato series. The face becomes more and more cyanotic, which means blue, the neck bulges with venus congestion, and
still the attack continues. Finally, when it seems certain that death is imminent, a final cough appears to clear offending secretions or mucus from the upper airway, and the first opportunity to inspire is offered with a massive effort. Inspiration ensues, air rushes into the lungs against a still narrowed glottis, and the characteristic whoop is produced.
Oh my gosh, yeah, just taking a second to like breathe, right ah wow.
Yeah, And so that's kind of a very classic description of what these paroxysms look like. They're horrible. I don't recommend googling them, but you can find a lot of videos of them online.
Yeah, are the coughs productive? Are you coughing up mucus or gunk from your lungs?
So, yes, and no, there is a lot of mucus in your lungs, and so it's thought that these coughing spasms are because of that mucus. It's like you trying really hard to get that mucus up. But especially because this is often a disease of very young infants, they're not good at coughing stuff up, so they may or may not actually cough anything up, but there is a lot of mucus there that could potentially be coughed up. Yeah, okay, Yeah. One of the sort of other characteristic things that happens
after these paroxysms is what's called post tussive vomiting. So it's really common to cough so hard that you end up vomiting. Oh gosh, Yeah, it's horrific. And these episodes are so exhausting. I mean, imagine you are literally unable to breathe this whole time, which is why that inspiratory whoop is so like, it's so powerful. You're trying so hard to get air back into your lungs. That as these progress and become more and more frequent throughout the
ensuing days and weeks, this can last for weeks. People tend to become very, very exhausted, so they might be sleeping most of the day and only awaken when they have these coughing fits and then fall kind of right back to sleep.
It sounds so utterly exhausting.
Yeah, oh god, and so especially in well in babies and in older children and adults. This can lead to weight loss because people might stop eating because they're just sleeping through like in between every coughing episode.
Right.
You can also get a lot of complications from the actual force of the coughing. You can burst blood vessels in your eyes or under your skin. You can cough out like a hernia. You coughing so hard that you like result in a hernia through your belly button. You can crack ribs, yeah, and often your chest wall will get really sore and tender, even if you don't break a rib, just because you're working those muscles so so
hard to cough so much. And then there are a number kind of a couple of really important complications that can happen on top of this, the most deadly of which is a secondary pneumonia. Okay, so that's like a secondary Usually it's a secondary bacterial infection because you've been sick with protessis for so long, and that often causes
the most deaths. It's not the only way that you can die from protessis, because these paroxysms can be so severe that you can have prolonged hypoxia, which means your brain isn't getting enough oxygen. That can result in encephalopathy, so brain damage, which can cause either long term brain damage or can cause death, especially in young infants.
Yeah.
Yeah, there's a number of other complications that you can get. You can rupture your trichia or your esophagus and get air that goes into like your subcutaneous tissue, or you can collapse one of your lungs and get a pneumothorax from coughing. So hard is that.
The air and subcutaneous tissue is that in the nineteen eighteen flu the yeah the crackles.
Oh yeah yeah, pop snap, crackle pop under your skin. So this phase overall, the paroxysmal phase, can last anywhere from one to four weeks. But even as it starts to improve and you enter the convalescent phase, it's a very gradual improvement. Another name for protestis is actually the one hundred days cough uh huh yeah, because symptoms can continue for like up to six months. Yeah, uh, so
that's protestis wow. Yeah. It is technically treatable with antibiotics, but the antibiotics work best if you can get treatment during that catarrhal phase. Okay, which again is I mean a lot of people are never even gonna seek treatment during that phase because that phase alone can last one to two weeks, right, yeah, And so treatment with antibiotics works best if you can get it. If you can
get treatment during that initial phase. After that the problem is that the bacteria have already started releasing all those toxins. So while antibiotics are still effective at eliminating the bacterium, they don't really help with symptom treatment. Okay, so yeah, what they do do is help to prevent further spread of the disease. So it is still really important to treat with antibiotics, even if you're not treating till later in the disease course.
Right, Is there any anti toxin available.
As far as I know, No, like there's no antiitoxin treatments that we have or anything like that.
Okay, like there were, like there was for diphtheria before. Yeah, well I guess still it is. But yeah, okay, interesting, yep, this is making me feel a lot like the diphtheria episode, like you can't breathe, yeah, sort of like you have.
A pseudo membrane covering your throat.
Yeah yeah.
Yeah. It's a horrible illness.
It's really horrible, but vaccine preventable.
I think we should specify that at the outset of this episode. This is a horrible illness and it is vaccine preventable.
It really is.
No kids should be dying from protessis today, and unfortunately they are.
In theory, it could be a target for eradication.
Yes, because it's a human specific disease. So Aaron, how did we get here? Where did this horrible thing come from?
I will answer that as well as I can just after this break. So if you think back to last year during our Vaccines episodes, I talked a little bit about Protessis, particularly in the second episode, part two, where I talked a lot about the rise of vaccine hesitancy or the anti vaccine movement nowadays, and how the Protest's
vaccine actually played a pretty central role in that. And back then I remember promising, Oh, I'm not going to go into this too much, because we're going to do a full episode on Protessis, And here I am making good on that promise. So since I've already talked a lot about the history of Protessis, when it comes to the rise of the vaccine hesitancy or anti vaccine movements, I'm not going to go into too much detail on that, So I'll just refer you to Part two of Vaccines.
Good call.
But even before I can get to that part of the story of protessas, there's so much to cover beforehand. So let's go back to the beginning. Throughout history, Protessas has been somewhat overshadowed, I would say by some of the other big name diseases like smallpox, plague, cholera, tuberculosis, et cetera, sort of the ones that did really come through a population or a city and just wipe a lot of people out. But that doesn't mean that it
was minor or easily ignored. Protessas has been one of the biggest killers of children throughout history, and as I'm sure you're going to talk about it, it remains a huge problem around the world today. I've talked before about the difficulty in retrospectively diagnosing a disease based on historical accounts. Is this one easy, especially if there's no physical evidence
like skeletal damage or something like that. But yeah, Protessis doesn't have that problem as much as some of the other ones because the symptoms, as you describe this whoop, the intake of air that's so restricted, it's a pretty characteristic and very noticeable, and it also has a tendency to just infect children, And so descriptions of a disease that mostly impacted children and was accompanied by a horrific cough that then breath in afterwards sounded like whooping. It's
probably whooping cough. Safe assumption, safe assumption. This is where I think it's going to get interesting. I think so anyway. Okay, So, most historical reviews that I read of protessis say that the first definitive or most likely definitive epidemic of the disease happened in fifteen seventy eight in Paris. All right, so fifteen seventy eight, Like, that's not that long ago.
No, especially not for a human specific pathogen that is so well suited just to our one cell type.
Yes, so interesting, okay, insulting. The physician who wrote about this epidemic called the disease quinta or kintinatusis probably to indicate that the severe coughing fits that you mentioned occurred every four or five hours.
Oh okay.
And he also described it as being a new disease and or only referred it to like a couple other outbreaks. And he noted that it occurred mostly in children between the ages of four and ten, with a violent cough
that ended in vomiting, cyanosis, and often death. However, there are a couple of other possible outbreaks of Protessis that date back even for there So, in an ancient Chinese medicine treatise dating back to the six hundreds, there is mention of something called the one hundred day cough, which is the colloquial name for protessis in China today, and this in this treatise, it says that the cough will last one hundred days and if not cured, eighty to
ninety percent of people will die. WHOA, So that's very very high, very high. And so because of that, because of that extremely high reported mortality rate, many researchers dispute this inclusion as whooping cough, saying that it seems to be too lethal to be whooping cough. And there was also no mention made of the fact that it mostly happens in children. So even though it is a one hundred day cough, now it might have just changed names, right, like it might just change diseases rather.
Yeah, they used to call this thing one hundred day cough, and now they call proteste hundred day cough exactly.
There are also a few other poss earlier, not earlier than the six hundreds, but earlier than Paris Protest's epidemics in Persia around the fifteenth and sixteenth centuries, and so around this time, just for reference, because I didn't really know this, Persia span from modern day Iran into parts of Central Asia and India, and so in the late fourteen hundreds, which is almost a century before the Paris Protest's outbreak, there were two epidemic coughs that led to
vomiting and unconsciousness and death in many people, both children and adults, And the fact that adults were affected could suggest that this was a new disease for the population and hadn't fallen into this pattern of childhood illness yet. And there are a few other epidemics in sixteenth century Persia that seem even more conclusively to be whooping cough.
But the take home from all of this, I think is that the disease seems to be first recognized in humans only five hundred or six hundred years ago.
WHOA, that's the opposite of what I guessed, Aaron, Yeah.
So that leads to the question, is this bacterium really only five hundred or six hundred years old? Is that when it evolved?
No?
No, no, definitely not definitely not. So there was a research article from two thousand and five that investigated the evolutionary history of Bordetella protessis and found that it likely evolved from a human specific lineage of the related species Bordetella broncho septica around two point five million years ago.
I'm sorry, Yeah, So so we go from two point five million to five hundred, like, yes, what is happening?
I mean, does that mean that humans have been living with this bacterium for since before humans were humans.
And then it just all of a sudden started causing disease?
Yeah? I mean, honestly, I don't have a satisfying answer, and I couldn't find one in any of the things that I read. So I think what a few of the articles mentioned is that the most likely scenario is that the bacterium probably circulated in a relatively non virulent state in parts of Asia, possibly Southeast Asia, for most of its history, and then it evolved these virulence factors that allowed it to become super prevalent and highly contagious and also lethal.
You know, I bet that is the biggest difference between when you asked about parapotessis and bronchoseptica. Yeah, and why those don't at least aren't as prevalent. I think it is likely just that they don't cause disease as much, and it is because of those toxins like bronchoseptica doesn't produce protestis toxin, and neither does paraprotessis, and it's thought that that's one of the main toxins that causes the symptoms that we see.
That's interesting. Yeah, one of the things that was really interesting is in these papers, it's harder to get a sense of historical genetic diversity for some of these bacteria that have had vaccines used against them, because you can imagine certain lineages or certain strains or subspecies or whatever have been wiped out in some places, and so the genetic diversity that we're left with now isn't necessarily representative of its historical diversity.
Yeah, that's a good point.
But I thought that was really interesting. But yeah, I mean, it probably emerged or started causing epidemics five or six hundred years ago, because that's when widespread trade and like global travel really kind of got up and running.
So yeah, fascinating.
And another point in the column of this being a relatively new disease or recently evolved virulence. Is that physicians around the time it first started appearing, they were also baffled by the disease and seemed to make important notes of it. Okay. One physician said in eighteen ninety four that quote it is singular that a malady so distinctly marked as whoopin cough should figure so little in the records of the disease from former times. So no mention
of it in like ancient Greece or ancient Rome. Sorry, which is I had to mention ancient Greece and Rome. No mention in the Ebers Ebers Papyrus.
Oh my gosh, was this even an episode of TPWK? Why?
I don't know it. It's gonna have an asterisk next to it, for sure. And the sudden appearance or apparent sudden appearance of whoopin cough caused other problems as well, because it kind of popped up all over and in such severity it gained all these different names, even within the same language, and didn't even get its scientific name until nineteen o six, like for the bacterium. Okay, okay, but before we get to that, let's talk about a few of these names because I know that you're gonna
be excited for it. They're fine, there are yeah, we've had better ones. Okay, there's no mad staggers or whatever.
The dandy dandy fever.
Dandy fever. So. There were several English names for the disease, including whooping cough, no w chin cough, kink cough, and others. Kink cough was apparently the popular name for the disease in Scotland, and the word kink i guess was also used as a convulsive fit of coughing or laughter, a gasping for breath caused by coughing, laughing or crying. The whoop and whooping cough it's like from a definition somewhere. Yeah.
In France it was known as quinta. In Italy it was called tussa farina or tossa canina canina because the cough could sound like the barking of a dog. Ah okay, yeah, And all these names kind of slowed down the accumulation of knowledge about the disease, or it made it more difficult because it took a while for someone to go through and say, ah, yes, the chincoff here is known as whoopin cough there, which is the same as quinta
there something like that. So throughout this time, though the disease itself did not slow down after its first appearance in Europe in the sixteenth century, it would continue to cause epidemics until it fell into this childhood illness pattern, so appearing every year every few years, often at a particular time of year, and then impacting mostly children. Let's
talk about that impact. The numbers of infected kids per year are more difficult to get a sense for, but we do have some census data for a couple of places that can give us an idea of the number of deaths in Sweden, for example, in the mid seventeen hundreds. Sweden seems to be particularly hard hit by whooping cough,
which I think is interesting history. But so in the mid seventeen hundreds there was a death rate of about one hundred and fifty one per one hundred thousand people every year, which is really high.
That's very high. One hundred and fifty per hundred thousand just from whooping cough.
Yes, wow. So that calculates to about twenty seven hundred children per year in a population of one point eight million, which is what it was in Sweden then, oh god, and so, as I mentioned, these numbers are on the on the high end for deaths due to whooping cough, but it was still a really bad problem in other
places as well. So in London the annual death rate was around twenty nine per one hundred thousand around that same time in the mid seventeen hundreds, calculating to about two hundred and thirty eight deaths per year in that population of seven hundred thousand. Okay, And these numbers for London, though, would increase over the course of the eighteenth century the next one hundred years, almost doubling and even occasionally surpassing the number of deaths caused by measles.
Whoa.
Yeah. So this trend in increasing virulence was repeated across a wide geographic range, which is kind of interesting because I think we have this idea that diseases tend to decrease in virulence over time, as we saw syphilis do, for instance, after its first appearance in Europe in the
late fifteenth century. But for whipping cough, this increase in virulence was probably due to a combination of an influx of new susceptibles every year or every few years, increasing population density overall, and a bunch of other things like poor nutrition, poor air quality, ineffective treatment that may have contributed, and it probably could be also or was a big part of it, that physicians just got better at diagnosing the disease and correctly attributing cases and deaths to it
over that time as it kind of grew in infamy. That makes sense, okay, In any case. By the time that microbiology as a field started and grew, protessis was high up on the list of diseases that desperately needed a cure or treatment of some kind, just as it
did in the seventeen hundreds. The mortality due to protessis and the prevalence of protessis grew also in the eighteen hundreds, with about ten percent of infections leading ending in death, and that number would be higher for children of working classes or who just had poor nutrition or in lower income. But one issue in trying to control the disease was knowing what the disease was, what was it caused by. So if you didn't know what was causing this, how
could you even try to stop it. Physicians did recognize, though, that it was contagious which I think is interesting. As we've talked about again, there is like if you read some of these old medical treatises, it's like, oh, you know, we can't ignore the fact that there is some sort of environmental component to this, but it does seem to be contagious.
So I do think that's so interesting, just that whole aspect of it. Before, you know, before we knew that bacteria or viruses were things that were transmissible from person to person. Just this idea that you could still somehow have a contagious disease despite that is so fascinating.
Yeah, So there were two researchers named Bourdette or Bordet b rd Et and Jean Jus I guess think that's right spell ge Nngou, and these two guys had struggled to isolate the bacterium because even though the symptoms of the disease could last for a really long time, there was apparently a really narrow window in which you could
actually culture the bacterium. But another issue was that it only grew in the long It had that super high specificity that you mentioned towards the long epithelial cells, so you couldn't pick it up for the blood of someone who is infected, and even if you were able to get a little like you know, muca sample, Yeah, the
bacteria would quickly die outside the body. Yeah, But they kept at it, and they first saw the bacterium under the microscope in nineteen hundred and six years later, were finally able to grow the bacterium in a lab using a special broth.
Wow. Nineteen o six.
Uh huh, nineteen oh six, that's like kind of late, but.
That's amazing that, like they were able to do it considering where it grows and how difficult it is to culture. I mean it's still hard to culture.
Yeah, no, it's it's amazing. Also, Bordet had isolated this bacterium like when they could finally first grow it from his son's sputum oh.
Was his son? Okay?
I don't know, Okay, but there was one really sad treatise that I read from eighteen twenty two, I think something like that, and the physician who wrote it lost several of his children to whooping cough and I think was inspired to research more about it after that horrible experience. Anyway, Okay, so then this development of being able to actually culture the bacterium in a lab was super important because it really laid the groundwork for trying to make a vaccine,
and that was the big target, like from the outset. Yeah, and the vaccines themselves, like ones for protesters, weren't that far behind. Just a few years after announcing they were able to culture the bacterium in the lab, these two dudes announced that they had developed a vaccine, Bordet and Jean Ju. And then not far behind was someone named
John Zahorski at Washington University in Saint Louis, OH. And he said, I've got a vaccine too, And neither of these vaccines would really prove to be that reliable, that stable, you know, that effective, And it would take another couple of decades for an effective and reliable protest's vaccine to come onto the market. During those decades, the prevalence of protessis remained high, with between five thousand and eight thousand deaths annually.
And that's just in the US.
Okay, Wow, And then three awesome scientists come onto the scene. These are whom are quarantine is named after.
Can we I feel like I imagine when you said three awesome scientists like the Western Doors opening and like some spurs. Can we throw that sound effect in?
Thanks? Yeah, let's do that. How do their partner? I don't know.
I don't know, okay, anyway, So.
Walking through the saloon doors is Pearl Kendrick, Grace l and Loney Gordon. All Right, Pearl Kendrick was born. I love the name Pearl. I think it's wonderful.
It's very adorable.
She was born in eighteen ninety three in Wheaton, Illinois. Yeah, I have no idea where that is to me either, and from I probably should. And from the start, Pearl was fascinated by evolutionary biology and disease, and after she graduated with a degree in zoology, she taught school during the week and then, in her free time on the weekends, took a train down to New York City to volunteer as a research assistant in a lab that worked on typhus.
Oh my god, I already am going to love these three women like it's gonna hurt my heart how much I love them?
Oh my gosh, Well, I just love it. It's like in my free time, unnerd after our own hearts. I love it right, Yeah, and she ended up loving her lab time her research so much. But she was like, you know what, this is what I want to do full time. I don't want to be a teacher. I want to work in a research lie full time. And so that's exactly what she did.
Wow.
She started out working at the state health departments, first in New York and then in Michigan. And then in Michigan she worked at a microbiology lab in Grand Rapids while also earning her PhD at Johns Hopkins. On the side, what she full time full time job. She's double time, full time.
Oh my god.
And while she was at this microbiology lab in Grand Rapids, she hired and mentored a scientist named Grace Eldering. Eldering was inspired to study science due to an extremely bad case of whooping cough that she had as a kid. Oh so, she, like Kendrick, worked first as a teacher after graduating, but then applied for this job in the Michigan lab where she would work with Kendrick, and together these two made headlines for their many developments in the
world of protessis wow. For instance, in the early nineteen thirties, they developed a diagnostic test for the bacterium, which was great because that could be used to determine how long an infected child was contagious, and that was then super important for quarantine and controlling the spread of the disease. Yeah. Then came their work on the whole cell protest's vaccine.
So up to this point there had been, as I mentioned, several vaccines for protests produced, but because it was so difficult to culture in the lab, only a very limited number of vaccines could be made, so it was often like a one sample, one vaccine, Like it wasn't an effective or efficient way to make vaccines. Yeah, Kendrick and Eldering found a way around this, but didn't have the
resources to widely administer the vaccine. But a visit from Eleanor Roosevelt in nineteen thirty six, she was first Lady at the time, change all that.
I'm like, my heart is fluttering. There should be feeling so hard. Can we can we make a movie?
Yeah, okay, let's do it. I would watch it. So Eleanor Roosevelt was super is she had like read about their work and she's like, I want to go to this lab and visit you and learn more about it. And she was really impressed by all of the progress
that they had made. And it's funny in reports, like not in reports, but I think in a letter or something from that time, either Kendrick or Eldering said that Eleanor Roosevelt was like one of the only people who had visited the lab who actually understood what was going on.
That's really funny.
I love that. So then, so yeah, Elean Risvelt was so impressed that she was like, all right, I'm gonna give you guys all the funding that you need. And they were like, oh great. Sweet. So then within a few years, mass production of the protesta's vaccine began. What boom, that's it. Just kidding, Yeah, like there's a third woman. There's a third woman. She's coming out of the scene.
So yeah, there was, there was. They had the ability to mass produce these vaccines, but the demand still way outpaced the supply, so they needed to find a way to increase the amount of bacteria that could be cultured in the lab. Okay, they put out an ad for a position and hired a dietitian named Loney Gordon on
the spot. Interesting, Loney also came into science sort of through these back channels as well, like working first getting her degree in this, and then working as a dietitian and then this and that, and they were then lucky enough that she applied for this position because her job was basically to try some different broth recipes until they could find one that worked well for the for Bordeteller protests.
And she got there like she wasn't that long actually, until she found that adding sheep's blood to a broth did the trick. So suddenly, with this new recipe, Kendrick, Elderling and Gordon were able to start manufacturing this wholesale protestsvaccine in large enough quantities not only for the state of Michigan, but also for other states as well.
Wow, and this is in the nineteen.
Thirties, This is in the nineteen thirties, early nineteen forties.
Yeah, three women kicking booty. Yeah, at the time when it was like vaccine, I can't that is so so cool.
It's so inspiring. I love it.
We do need to make a movie out of.
This, seriously. And also they didn't stop there, like they weren't just like, oh, this is good enough, let's patter ourselven in the back. And you know, they were always seeking new ways to improve the production or efficacy of the vaccine, and so they started to play around with adjuvants, which, if you remember from The Vaccine's episode, adjuvants are basically chemicals that are added to a vaccine that can increase the effectiveness by stimulating the immune system in certain ways.
The team from Michigan used aluminum hydroxide in the Protests vaccine, which and correct me if I'm wrong, stimulates macrophages to basically do better at their jobs.
Yeah that sounds about right.
Okay, they like pick up the antigens and interact with the lymphocytes and concentrate in lymphos and so on.
Yeah, exactly, So they're able to like increase the amount of immune response by driving your cells to that area kind of Yeah.
Yeah, which makes it a longer lasting and more effective and yeah, better vaccine. And so this new and improved wholesale Protests vaccine with this adjuvant was put to the test in nineteen forty three and it was shown to be super successful provided lasting and effective protection against the disease.
And then a couple years later, in order to reduce the number of shots that children would have to get for vaccines, the PROTESTES vaccine was combined with ones for diphtheria and tetanus in the mid nineteen forties, and that's why we called it the DTP vaccine.
Yep.
And this vaccine was widely administered throughout the whole world, and as a result, the incidents of protessis fell and fell. Here's some numbers. Yes, before the protests vaccine, there were an estimated two hundred and seventy thousand cases of protessis annually in the US.
Two hundred and seven thousand.
Two hundred and seventy thousand.
Oh, I'm sorry, two seven zero.
Two seven zero zero zero zero. Wow. That's the number of cases in the nineteen eighties. So this is after the vaccine had been in use for approximately forty years, and before the vaccine hesitancy movement really began. There were between twelve hundred and four thousand cases per year.
Wow.
That's a drop of almost ninety nine percent.
Wow. Wow. Wow.
And So, as I mentioned earlier in that part two of our Vaccines episode, I went into a lot of detail about how this pushback against the DTP vaccine began, and so I'm not going to do that here, but briefly, there was a global decline in vaccination rates with the DTP vaccine, and the fears were mostly based on the protessa's component of the vaccine, and so, as you might expect,
the decline in vaccine coverage led to outbreaks. So in Sweden, for instance, the annual incidents of protessas cases went from seven hundred whoa total in nineteen eighty one to thirty two hundred and nineteen eighty five just four years later.
Wow.
In Japan there were two hundred and six cases in nineteen seventy one. In nineteen seventy nine there were thirteen thy one hundred and five.
Cases whole mackerel m HM.
Obviously something had to be done to get people to vaccinate again, or to somehow, you know, reduce these fears whatever it was. So and so, because so many people were not vaccinating out of fear that the whole cell PROTESTE vaccine would lead to deadly side effects in their kids, one solution was just to make a new vaccine, which is how we got the acellular protestas vaccine. So instead of these whole killed bacteria, which is what the you know,
the name gives it away. The previous vaccine was it included just these these toxins, these antigens from Berttella protessis and the efficacy and I'm sure you're going to talk more about this, but the efficacy of this vaccine wasn't as high as the whole cell version, but it was associated with fewer adverse reactions, and so that replaced the P component of the DTP vaccine and it became DETAP to stand for acellular protessis in the nineteen nineties.
Yeah, which Aaron means that we got at least one whole so vaccine.
Cool.
Yep. Probably a bunch actually, because we were pretty much done getting our vaccinations by the time they introduced DETAP in nineteen ninety two.
Oh yeah, yeah, excellent. One of the things that I find interesting when doing the research for some of these episodes is that I get to read these articles that were written all like over a really long time span. Yeah, so, like some were written in the eighteen hundreds, seventeen hundreds whatever, translated from this and that, and you can see how the language used and the sentiment about a topic can really changes over time. In helps especially apparent for protessis.
In more recent articles protessis has always described in the introduction as this re emerging problem that highlights the difficulties in educating the public and how quickly progress can be undone. But in these older articles or chapters from before the nineteen seventies, but like after the vaccine was developed, it was written about as a great triumph of modern medicine
in many of them. Wow, And there was one line that really stuck with me when reading one of these old articles, and it was the one that you mentioned earlier, the one from nineteen seventy five. The author says, quote as recently as nineteen forty eight, protessis remained a leading cause of death in children under fourteen years of age in the United States. Now the disease has become almost a medical curiosity. The Center for Disease Control, for example,
no longer routinely reports protessis. So aarin that was nineteen seventy five, This is twenty twenty. Tell me just how much that statement is no longer true.
Yeah, you're not gonna like it. Let's take one more quick break.
Okay, let's just go straight to the facts.
Let's do it.
Twenty eighteen, United States of America. You want to guess how many cases of protesters there were.
Is it more than five thousand?
Oh yes, Oh, my gosh, fifteen thousand, Okay, fifteen thousand cases of protessis in the US in twenty eighteen, including five deaths.
And cases of a vaccine preventable illness.
Yep. So let's talk about that. Well, first, really briefly, we'll talk about it across the globe, and then we really need to spend some time talking about this vaccine preventable disease aspect. The World Health Organization didn't have super great numbers more recently, like in the last couple of years, but for example, in twenty fourteen, it was estimated that there were twenty four over twenty four million cases of protessis worldwide and over one hundred and sixty thousand deaths
in children under age five years. What one hundred and sixty thousand deaths from pertessis in children under age five in twenty fourteen, Oh and there are gosh, yeah, So this is not a disease that has gone away, and in fact, it's been on the rise for a number of years now, probably since the nineties. It's been kind of increasing every year and there's a number of reasons
for that. So let's start talking about this vaccine. You mentioned that in the late eighties early nineties is when we pretty much switched from a whole cell vaccine to an a cellular vaccine. That's really important. The acellular vaccine does not provide as long lasting immunity as the whole cell vaccine, So that means that immunity, while it still exists, is not for your whole life when you get the
acellular vaccine. However, and this is really important, especially I think in talking to people who are vaccine hesitant, who maybe sometimes use that as an excuse. While it doesn't provide long lasting immunity, wouldn't it be better just to get infected with the disease that kills people to begin with. Even getting infected with Pertessis does not provide lifetime immunity.
Interesting.
Yeah, this is a very interesting aspect of Protessis that I didn't realize until starting to research this. So, yeah, even getting infected doesn't provide lifelong immunity. Does it provide longer immunity than getting a vaccine? Yes, most likely, but it's still you can get reinfected with bordetella. Protessis. Even if you get infected as a child and survive that infection.
Is the infection less severe in subsequent infections, So.
Overall, great question overall whether you get infected and survive, which again not everyone does. If you get infected or you get vaccinated, then the disease that you get subsequently is most likely to be less severe. So even though vaccination doesn't provide lifelong immunity, it's massively protective against serious
illness and death from protessis. Even with the whole cell vaccine, immunity does wane, but it's usually over like maybe ten, fifteen, twenty years, whereas with the acellular it might be seven to ten years that your immunity starts to wane. So that means that if you got your last vaccine, say when you went to kindergarten, then by the time you get to high school, you might not be immune anymore, or at least not completely immune. Your immunity has waned.
So what we see is, while we have these really high numbers of protessis today in the United States and across the globe, it's not just because of vaccine hesitancy. It's not only an unvaccinated people. We also see increasing we see actually a shift in the age groups of people who get infected. So, while you talked about kind of throughout the last five hundred years of this disease, it's been mostly a disease of children, right, not babies necessarily,
but children. This is a disease of childhood. Maybe like one to two year olds up to like ten year olds were the majority of people who got sick before the introduction of any vaccine. Now today the largest numbers of people who get sick are actually adolescents and young adults. So in twenty eighteen in the US, thirty percent of those fifteen thousand cases were in people age eleven to nineteen.
Wow, okay, I have a question about sort of the vaccine. Now when you go to the doctor and you because I know the TEENNUS vaccine, you need.
To get re upped every yeah, ten.
Years, when they give you that booster. Is it DTaP or is it just tetanus?
Good question. It used to be just td which is tetanus and diphtheria. Now it's recommended that adolescents get at least one booster of t DAP, which is the adult version of tetanus, diphtheria, and acellular protessis. But it didn't used to be the case. So because we thought, oh, this provides a long enough immunity that because the whole cell vaccine did.
Yeah.
But now it's recognized that immunity wanes faster than we may be expected, and that's part of the reason that we see an increase in the number of cases in older age groups. But this is really important because the other group that's massively affected besides adolescence are the very very old who are immunocompromised and tiny babies who are too young to be fully vaccinated right And in those groups over up to fifty percent of them will be hospitalized.
And in that age group is where we also see the highest mortality rates. So while infants under the age of six months were only nine percent of the total cases of protessis in the US in twenty eighteen, forty two percent of those babies were hospitalized.
Two questions, how old do you have to be to get the first protestis vaccine? Second question, when you go in for your tetanus booster, do you have to specifically ask for tap?
First question is easy. You get your first d tap at around two months of age, as early as six weeks, but usually at around the eight week two month mark. And it's a series of like four vaccines usually, so you get it at two months, at four months, at six months, and so that's why up to six months you haven't gotten your full dose of it, So you're still at risk, okay, And in those kids and in older adolescents, it's more likely to present with an atypical course,
which we kind of touched on a little bit. We hinted at in the biology section. But once you have some antibodies that you've built up against this infection, you're less likely to have that characteristic whoop of the whooping cough oh okay, because you have a less kind of intense infection. But what's also scary is that in tiny infants this can also present with just apnea, which means cessation of breathing entirely. So you don't have the coughing,
you don't have the whoop. You just have babies who stop breathing, which is terrifying.
Yeah, that's horrifying.
Yep. Your second question was do you have to specifically ask for a tea DAP at this point the recommendation is if you haven't, If you are an adult who hasn't had a tea DAP booster at any point in your life, then you should get one. And then after that you would just get your regular tetanus and diphtheria every ten years. But let's talk about a couple of specific groups that should get boosters and can talk to their physicians about this.
Yeah, would you just go to your physician and say, hey, can you check my tighters?
Absolutely check that you could do that. Yeah, check my records. Have I had one recently? If not, most physicians will be like, yeah, let's give you a tea DAP because certainly not going to hurt you.
I was gonna say, is there any harm in like getting an early booster.
No, there isn't. And there are a few groups who should really consider getting boosters. Number one, anyone who's going to be in contact with a tiny baby pregnancy. It's now recommended and it's in a lot of countries. It's standard practice that during pregnancy, in the third trimester, so between like twenty seven and thirty six weeks, we give tea DAP boosters. And this has been hugely important in preventing illness in that tiny baby age group, so pre
two months, where that baby is entirely unvaccinated. If you vaccinate during pregnancy, then you can pass annabodies, maternal antibodies onto the baby, right, which is it's massively protected.
It's amazing and didn't used to.
Be standard practice. Unfortunately. That's pretty much all I have aaron about the state of protesters today. I tried to find some current research on what's going on and the NIAID. The NIH page was last updated in twenty sixteen.
WHOA, right, come on, come on, But well, it's it's hard because it's like with many of the other diseases that we do an episode on, it's like, oh, and then there's a new drug therapy, there's a new vaccine in development, there's a new something. But this is like, we have antibiotics that can work if you if you give them early enough, and we have a vaccine that works. So maybe the progress needs to be made in public education in access, like reducing the barriers to vaccine access.
I would say there could still be work to be done on creating a more effective vaccine that produces longer lasting immunity as well, especially since we're seeing waning immunity and kind of developing a better immunization schedule perhaps for older children and adults. But what's hard is that it's easy to give vaccines to small kids because they come to the doctor on a regular schedule. Once kids get older and become adults, we don't necessarily go to the
doctor on a regular schedule. So it's really hard. Even if you have an effective vaccine to give a booster, it's hard to get that booster to everyone to actually create the herd immunity that we need to protect the vulnerable people in our population.
It still seems like an upward battle.
It's an upward battle, for sure. It always is with diseases though, isn't it.
Yeah, Yeah, But there's a lot of amazing work done in this upward battle, and for you know, pushing for VACUS vaccine education information and for just promoting the use of vaccines. And so one of these amazing people who's working on this you heard from earlier, Catherine Hughes, and we wanted to have her talk a little bit about like, for Riley.
As traumatic as it was, I'm sure to go through and to relive it, you have really turned this into a lot of advocacy and done amazing things as a result of this tragic situation. So can you tell us a little bit about sort of what that's been like for you to kind of take the worst possible situation and try and make something good out of it.
I really believe that life can be measured in years, but it can also be measured in impact, and so when Riley died, we felt devastated that his life was so short in years, but we thought that perhaps we could somehow extend his life by making sure that it had an impact on the world. So we sort of were loaded with that really strong urge to do something
to create a legacy for Riley. But we were also filled with this sense that what happened was so unfair and that it was preventable, and that it shouldn't happen to other babies and other families. So we were really driven to spread awareness and we started our campaign, which is called the Light for Riley Campaign. We were really determined to shine a light on the importance of vaccination
and the dangers of hooping cough. It was when Riley was really sick in hospital that I sort of jumped on my phone and began googling, you know, all the information I could find out about hooping cough and that's when I learned that other countries were offering pregnant mums a hooping core vaccine during pregnancy, and I felt so upset that this hadn't been offered to me in my pregnancy. I'd had the flu vaccine in pregnancy. I knew I was the type of mum to say, you know, yes,
you know, if you recommend it, I'll do it. And we know now that babies are born to mums who have this hooping core vaccine in pregnancy, the chance of them catching hooping cough is drastically reduced. So I truly believe Riley would probably still be here with us today if this pregnancy hooping core vaccine had been offered to me. So with that knowledge, it was very instinctive for us
to embark on our life for Riley campaign. We've you know, done media interviews and social media campaigns, and we travel around to pregnancy expos where we talk to pregnant mums about the importance of getting vaccinated. And we've seen really good uptake of this vaccine in Australia. So around eighty percent of mums saying yes to this pregnancy vaccine. But then again, that's still twenty percent of babies who have been born at risk of contracting this disease, which is
always circulating around our community. So there's so much more that we want to do.
It's incredible work that you're doing, and it's also really inspiring because this must not be an easy thing to do. In your experience with the Light for Raley campaign, what do you feel like have been the biggest challenges you've had to overcome.
I think we've had two challenges with our Light for Raley campaign. The first is just coping with grief while trying to put ourselves out there. Grief is a funny thing and I think it's different for person, but that's certainly been a challenge trying to manage grief and advocacy. And the second challenge we've faced was, you know, for want of a better word, being attacked by the anti
vaccine movement. This happened within a day of Riley's death, where we're getting messages on Facebook from anti vaccine activists and we've had an incredible amount of blog posts and Facebook messages and comments and all sorts of things from the anti vaccine movement. I truly believe that Riley's death is a bit of an uncomfortable truth for them. Riley was unvaccinated who was too young to be vaccinated, and it's probably scary for them to realize that unvaccinated children
die from vaccine preventable diseases. We've also seen a lot of conspiracy theories about us. We've been told that we're actors, that we've been paid by Big Farmer. We've been told that Riley never existed. We've been told that we murdered him, all sorts of stuff. And again, I think it's just because anti vaxes can feel very uncomfortable when it comes to facing the truth. The best way for us to deal with the anti vax movement is really to give
them as little attention as possible. We don't respond to them. For the most part, we ignore them. The people that we want to focus on, of those who are on the fence or just don't know much about vaccination, they're really the people that we want Riley's message to get across to.
What sort of future plans do you have for the Late for Riley campaign? Do you have anything that's currently in the works or anything upcoming.
In twenty sixteen, we launched our charity, the Immunization Foundation of Australia, and so that's kept us really busy. I absolutely love being a director of this foundation because we're not just focused on hooping cough, but on immunization in general. We want all babies and all families to be protected from these potentially deadly vaccine preventable diseases. So we'll continue traveling. I do lots of speaking and workshops. We present to schools.
We've got puppet shows for kids to make them feel more comfortable with the process of vaccinating. We're looking to collect more stories about families who have suffered through vaccine preventable diseases, because we believe it is so important that people know these stories. Because vaccination is almost a victim of its own success. We don't see these stories around so much because vaccines work so well, but as parents,
we need to know why we vaccinate. And we're also looking at hopefully being able to donate some vaccines overseas later this year as well to children in developing countries.
That's wonderful. What an inspiring campaign. Where can our listeners learn more or read more about Like for Riley and some of the work that you're doing through the campaign.
If you go to our Facebook page, which is just like for Riley on Facebook, you can read all about Riley's story there and then also on our website which is www. Dot IFA dot org dot au.
Thank you so much for sharing your story not only with us and our listeners, but with everyone around the world with your campaign and all of the work that you're doing. It's really incredible.
Yeah, this was really wonderful. Thank you again, so so much. We really appreciate it.
Thank you. Thanks, it's such a pleasure to speak to you guys. And apologies for my terrible Australian twang. Hopefully it doesn't ruin your whole podcast.
I love it, perfect, We love it.
I think we need a little bit more twang on our for sure. For sure.
That was fantastic. It's so inspiring to hear yet another awesome woman doing incredible work on protessis. Yeah, should we uh get into sources? Let's okay, I have somehow accumulated an unbelievable number of sources for this one. There was a like consolidated No, there was no like usually I'm like, oh, great, there's a book. I'll read that book. But there was no single book this times, so it was much more of a digging down the rabbit hole. But I'll mention
a few of these. So one was from Aslana Body at all from twenty fifteen, and that was about these possible epidemics in Persia. A couple great articles about just the history of protessis won by James Cherry from twenty fifteen, another by Chow at All from twenty sixteen. And the evolutionary paper came from Dievatapoulos at all two thousand and five.
And the title of our quarantiny three Women and a Baby came from a title of a chapter of a book in between Hope and Fear, A History of Vaccines and Human Immunity from by Michael Kinsch And that one I mentioned also on our vaccines episode. Yeah, and honestly, there are a bunch more, and I'll just put them all on our website. Sorry, that was a really long list.
Yeah, I have a number. We'll post all of them on our website this podcast will kill You dot com under the episodes tab. All right, So thank you to Bloodmobile for providing the music for this episode and all of our episodes.
Thank you again to Catherine Hughes for being so amazing and coming onto our podcast and be willing to share her story, and we hope that you all enjoyed it as well, and we will post links to Light for Riley in our show notes and on our website, so keep an eye out for that.
And thank you to you all for listening. As always, we love making this podcast, so thanks for letting us do that.
Yes, we do well with that.
Wash your hands, you filthy animals.