Dr. Peter Hotez - 1 in 20 Americans Has This Parasite and Doesn't Know It!

**Peter Hotez** (0:00)
Parasitic infections and related tropical diseases are widespread in the US. Most of them are being missed and not being done again.

**Gabrielle Lyon** (0:07)
Do you think that it's more important now than ever to be able to identify these things early and often?

**Peter Hotez** (0:14)
The other problem with a lot of these parasitic diseases, the diagnostic tests for those, at which we'd love to do, but we don't have the funding. And the other problem is the specialty tests are not done everywhere. Physicians also just don't bother because it's a lot of extra work.

**Gabrielle Lyon** (0:31)
How are we in this position at this stage of medicine?

**Peter Hotez** (0:36)
Our vaccine, which is quite innovative, works on the fact that we over decades worked out the pathway by which hookworms degrade the hemoglobin. We could take the protein components involved that the worm uses to feed, make a vaccine out of that, and it induces an antibody response. And now we can make our vaccine, we think, for probably $2 to $3 a dose.

**Gabrielle Lyon** (0:58)
There's a recognition that science is imperfect and always evolving, and that we can change the hypotheses and things get proven right and things that get proven wrong. But there was a respect. There is a lot of frustration with this, the idea of experts and the level of distrust. Do you think there's a way to restore trust?

**Peter Hotez** (1:17)
This has become a big issue right now, and unfortunately it's gonna get worse before it gets better, because...

**Gabrielle Lyon** (1:31)
Dr. Hotez, welcome to the show.

**Peter Hotez** (1:33)
Thank you, Dr. Lyons. Great to see you.

**Gabrielle Lyon** (1:35)
Great to see you too.

**Peter Hotez** (1:36)
And feel free to call me Peter.

**Gabrielle Lyon** (1:37)
You know, I have been thinking a lot about your work. And as I was preparing for this episode, I called my mentor, Don, and I said, Don, okay, so we're going to be talking about this.
And he said, you know, my question is, is that when he was growing up, so he's in his 70s, he said we had three or four vaccines. Now, by the time a child is no longer a child, they've had, what, 75?

**Peter Hotez** (2:03)
When I was a house officer resident in Boston in the 1980s, we vaccinated kids against eight illnesses, okay? It was diphtheria, pertussis, tetanus, polio, measles, mumps, rubella, and I believe we were giving influenza vaccines at that time on an annual basis. We were vaccinating against eight diseases, right? So what was my worst nightmare as a house officer, as a resident in Boston at that time? It was admitting kids with bacterial meningitis, either Hibb meningitis, they're called homophilous influenza type B, it was pneumococcal meningitis, and it was two forms of meningococcal meningitis.
And I can't tell you how much time I spent with parents, after doing the lumbar puncture, the spinal tap and doing the gram stain and seeing the bacteria under the microscope and getting a confirmatory die goes in the lab and admitting them to the pediatric ICU. And knowing that a significant number of those kids will die, a significant number of those kids, even if they survive a lot, permanent neurologic injury. And one of the better outcomes is deafness, right? So, and then what happened is, though we had, we added the four vaccines for the four forms of bacterial meningitis. And now we, now that those diseases are gone. So are those the ones you want to add back? So now that brings us from 8 to 12 diseases. OK. And then we started vaccinating against two forms of cancer, cervical cancer caused by human papillomavirus. And now Australia is actually going to eliminate cervical cancer by 2035 because the uptake is so high. And we're going to vaccinate against liver cancer from hepatitis B. So that brought us to 14
And then we added the rotavirus vaccine. That was the leading cause of hospitalization in the winter. We added varicella vaccine. And I think it was hepatitis A. So that brought us to 17 So we went from 8 to 17 diseases. And you could say, OK, which one do you want to take out? So it's not 75, right? And right off the bat, that 75 number comes from assuming you do an influenza vaccine every year for 20 years. So that brings you right down to what they would say is 50 But in fact, it's about 25 to 30 immunizations.

**Gabrielle Lyon** (4:31)
OK, so thank you for clearing that up. I love it when Don's wrong. Did the speed at which the vaccine came to market with COVID, was that too fast?