Do you get these random, are we being taped now?
Are we on? Are we starting? We're just trying
to get levels. So just go ahead and start talking.
Okay. Do you get these random little texts on
your phone? Like the one I got this morning are,
Your Christmas lights are still up. Could you
take them down? I mean, these are random things.
I mean, it's not even, it's, it's just random
or you get, you know, job, job, um, you know,
resumes or you get these, um, you know, uh, Tom
will get these like, um, uh, like you want to
grab some wine tonight? You know, it's, I mean,
it's just weird. You're like, Oh brother, just
get a light, get a life. It's the modern or the
robo scamming. So essentially it's people, I
mean, because we submit our information and data
to the internet, there's now all these repositories
of all of our information, which is good and
bad because, you know, you know, shopping places
can customize stuff, but now these robo companies
can buy that data and then they can, you know,
basically mass scam and maybe a small percentage
of people are just lonely enough to want to grab
wine and they'll get. I mean, fishing. They call
it fishing. Yeah. And with a P -H. P -H, yeah.
And it's... It's not great. It's not. So, um,
yeah. If anyone would fall for that, it would
be Tom. It's our older people, you know? Thank
goodness you're around. Yeah. I'm like, I know.
I'm like, no, I said, honey, just delete that.
Delete that. Or, or now we've been getting this
dermatology one and it, you know, it's like,
yeah, it's like, that's not our dermatologist,
you know? So just delete it, you know? Cause
you can hover over, you know, like the number
or whatever. And, and you're like, you know,
especially emails. And it's like, this is, this
is not right. You know? Yeah. Yeah. I guess.
If you hover over the email, the sender, and
you'll get these weird, you know, like email.
You're like, just delete this. Just delete it.
Because I didn't do that one time at work and
I got a virus in my... computer even your mom
on drugs yeah she made a mistake oh my gosh it
was like a whole day and computer gone for a
whole day yeah so well that's our podcast ladies
and gentlemen yeah don't open weird messages
yeah um well speaking of weird messages uh my
name is josh and i'm jenny and this is your mom
on drugs this is episode number 17 whoa i know
crazy and uh this this one is pretty topical
now um it's been topical i'd say for the past
decade just because we've had a resurgent of
this unfortunate pathogen we're going to do an
episode today on measles yes um and uh we're
going to talk with the mom on drugs on what measles
is um how you can treat it how you can prevent
it And all the things related, because a lot
of these diseases that we supposedly thought
we had eradicated are unfortunately coming back
in small areas. We have these outbreaks. And
I think it'd be good to talk about why these
outbreaks potentially are happening. and what
we can do to maybe prevent them or even treat
people who have these certain diseases. So we're
going to focus specifically on measles, but I
think it's a good general rule of thumb for a
lot of other pathogenic diseases that are out
there. So mom, what is measles? And I'll let
you take it away. Okay. Well, we're going to
start with a little bit of like a intro. First
of all, I want to make sure that people know
there are measles. I think it's been known as
the red measles or rubeola. There's also the
German measles, rubella, or the three -day measles.
They're not the same thing. So I want people
to understand that there's two different viruses
that cause these two different types of viral
diseases. We are talking about measles today,
not German measles. And interesting, the reason
that this came up was that actually this year
in 2025, there was an outbreak of measles in
West Texas. Um, there were, there were 762 cases
reported in West Texas alone, and there were
99, um, people hospitalized and there were two
fatalities. Um, and, and then, so we brought,
then I brought in the look and like, okay, that
was West Texas. So what's happened in the United
States in, in, in its entirety. And as of November
the 25th, there were 1 ,798 confirmed cases of
measles this year. And there were 46 outbreaks.
So that meant three or more cases in different
areas. So the West Texas one definitely was counted
as part of that. I know that you're probably
going to get to this later, but can you define
what an outbreak is? break means? Can you like
maybe kind of give a... I've got a five word
definition of what an outbreak is. Okay, perfect.
It's defined as three or more related cases at
the same time. So that's at least how the CDC,
the Centers for Disease Control and Prevention
define what an outbreak is. Okay, that's a really
good... Definition. This number of measles that
we've seen this year has been the highest that
we've seen in over three decades. The United
States declared the country that... Let me rephrase
that. In 2000, measles was declared eliminated
from the United States. And that definition was
that there were no measles spreading within the
country and new cases only occurred when somebody...
contracted the disease abroad and then brought
it back into the country. But we've seen these
recent elevated numbers. So there's concern that
we may lose our measles elimination status if
the trend continues upward. And we're going to
get a little bit more into why that happens.
Let me just give you a little bit of background
about what measles is to begin with. It's also,
like I said, it's also known as rubeola and it's
caused by a single stranded RNA virus called
paramyxovirus. And it's, it's so interesting.
It only has one antigenic type, so it doesn't
mutate. So other virus, like that's the reason
that we have to get a different flu vaccine every
year is because the virus mutates every single
year, it changes. And so it doesn't stay the
same. So the vaccine doesn't work every year.
It gets modified every year because these, this
virus can change, but this measles virus doesn't
change. It stays the same and it hasn't changed
over a year. So you can either get, measles or
you can get vaccinated for measles and you pretty
much can stay immunized against it for your,
the rest of your life. It's really quite interesting.
Can you remind folks when you say antigenic type,
I think when, when I think just maybe I can help
clarify. So when just to get it, I know we've
talked a lot about viruses on this podcast, but
if this is your first episode, listening to it,
like if you, you picture a virus is almost kind
of like, um, If you just imagine a circle, just
picture a circle in your head, and a virus essentially
on the inside is composed of usually two things.
It's composed of either DNA or RNA, which we
call them nucleic acids. You have both of these
things in your body. DNA are the instruction
codes for making things in your body, such as
hair and fingernails. There's this thing called
RNA, which is kind of the go -between between
the stuff, in your body and on your head um and
so dna basically has the instructions in order
for the your cells to make that thing it needs
to be translated meaning that like basically
your cells don't speak the dna language so there's
this stuff that basically this go -between called
rna that says, you know what, I'm going to help
you translate that language of DNA. I'm going
to turn into RNA, which you can understand. It's
kind of like if you went to Italy and you didn't
speak Italian and you brought an interpreter,
not an interpreter, a translator with you to
help you kind of bridge the gap between you and
an Italian person. So this virus essentially
has this material inside and it wants to get
its material. inside of your cells because viruses
very uniquely can't recreate their own genetic
material. Our cells do this all the time. We
call it cell division. But viruses can't do that.
They rely on other organisms to make more of
themselves, hence why they infect us. And usually
they do that by attaching to the outside of that
circle that I told you about. They're like these,
basically these locks or these things that kind
of open quote unquote doors. When we call those
antigens. And just so happens that every now
and then a virus will mutate just enough that
it locks right into your cell and it gains entry.
Most of the time your cells are really good at
keeping out bad actors of the things that they
don't want. But every now and then it'll be able
to get inside. And what's unique, like my mom
said, is like what's unique about measles is
that it just has this one antigenic type, meaning
that there's just one variety. Meaning that if
it deviated at all, it wouldn't be able to get
inside of the cell. So it actually behooves the
measles virus to stay the same so it can keep
getting inside of the same types of cells in
your body. Where something like the flu, it actually...
does a different strategy. It basically changes
its antigens. It has multiple types. It's like,
well, I'm going to try antigen A or I'm going
to try antigen B or gamma. And it's going to
basically do variability to keep your body guessing
of what it should be attacking every year. So
this is a unique thing about different organisms.
Some organisms try to stay the same throughout
time and other organisms try to differ throughout
time. So just kind of want to give a beat. Brief
background of like why viruses do what they do
and how they get into your body and what's unique
about measles in this case. So with that being
said, take it away, mom. OK, so the measles virus
is very contagious and it's it's really one of
the most contagious diseases. So it way long
time ago. Thousands of years ago, they thought
that there was animal to human transmission,
but now the measles virus can only be transmitted
from person to person, human to human. And it
can affect anyone, but mostly it affects kiddos
and mostly affects children. So before we had
vaccines for measles, it was almost. it was almost
universal. You got measles in, in childhood.
And by the time you were 15 years old, almost
90, over 90 % of people were immune to the measles
virus because they'd had it. Like I had, I had
the measles. You've had the measles. I had the
measles, but my kiddos like Josh and his brother,
Joel, they got the vaccine. So they did not have
the measles and stuff. So. Yeah. And it's a similar
principle is like, whether you get the vaccine
or the measles, you then get quote unquote immunity
from that thing because. your body has seen that
virus before. So the same principle applies.
It's seen the antigen either from the vaccine
or from the virus, and it remembers that for
next time. Right. I just found this very interesting
about this virus. So it... So because it's so
contagious, it can even cause outbreaks in populations
where there's less than 10 % of people susceptible
to it. Because it'll find the ones that have
not yet had it and get them. And then they can
spread it to those that haven't had it already.
And then you can have a little outbreak and stuff,
which is like what's happened in West Texas.
And then it may settle down again. But if you
then have a group of people that, for whatever
reason, reason have not developed immunity to
the measles vaccine, measles virus, then you
could have a little outbreak again and stuff
so it can cycle over years. That's why we see
a lot of these small outbreaks because it's just
so good at finding those specific people who
don't have immunity to it. Right. Wow. And so
anyway, so it usually occurs in the late winter
or early spring. And you think that seems that's
a lot of. diseases, really, you know, these viral
diseases, because when the weather gets colder,
people are more, stay more inside rather than
outside. So, you know, these types of viruses
are very common to spread in schools, in your
household, where there's, you know, lots of people
put together at the same time and stuff. It's
not just the measles is not just located in the
United States, though. It is a worldwide issue.
In 2023, the World Health Organization estimated
that there were over 107 ,000 measles deaths
globally. That's deaths with measles. Mostly
that happened in unvaccinated or under vaccinated
children that were less than five years of age.
So they. The reason that measles may be resurging
in the United States is that there has been an
increasing trend of vaccine hesitancy for a variety
of different personal reasons and also lower
vaccination rates in general. And so that can
cause our population or our country to lose its
elimination status if we have a continued elevation
in our trend with measles. People could bring,
you know, with the elimination status, people
could bring measles into our country if they
went someplace else where they did have measles
and then brought it back to the country and stuff.
But that would not be counted as against the
United States because it came from someplace
else. Right. And I guess the measles has to,
I mean, we had our elimination status in 2000,
right? Right. I assume that was because a lot
of people had been vaccinated against measles
as well as had just been infected before, right?
So there's just not as many reservoirs for those
individuals to be infected. Right. But in that
25 years, obviously we've had a lot of new babies
being born. And like you said, vaccine hesitancy
has risen in the past 25 years. So it has to
come from somewhere. So my guess is that it could
come from other parts of the world. And then
when they come in contact with those people who
then carry it to their newborns or their young
kids, that essentially can cause those small
outbreaks. Right. Because it will find, again,
because if people are around, go to school, especially
because it targets little kiddos or daycares,
you know, and stuff, depending, then it could
spread pretty rapidly and stuff. And I know we're
going to talk about. what the actual mechanism
of measles is a little bit later. It's a very
interesting way that it infects people inside
of your body. Do you want me to talk about it
now? Well, let me just, well, that's a great
transit. Let me, let me just give the little,
like the global and you go into the detail. Okay.
All right. So the measles virus is transmitted
primarily by respiratory droplets. So, and it's
really over short distances. It doesn't hang
around on surfaces for long time periods. So
that, I mean, you can get it that way, but it's
most commonly happening through talking, coughing.
you know, spitting or whatever and stuff. It
does. And it's primarily these infectious secretions.
So you think about little kids and they're, you
know, they're two years old and they're putting
everything in their mouth. And then their friend
comes behind in the daycare and puts that same
thing in the mouth. Then they're going to, they
could easily transmit it that way. It grows in
your respiratory mucosa, which is kind of the
lining. of your nose or your lung area and stuff.
And then it will spread to your lymph nodes about
two to four days after it enters into your body.
And then it goes from your lymph nodes, which
are your, they're nodes throughout your body
and they're kind of like your messenger system
inside your body. And then, so when the virus
gets into your lymph nodes and it spreads throughout
your bloodstream and it can go throughout your
entire body and then the symptoms will start
developing. Yeah. I mean, that's a great segue.
This disease is so interesting because not only,
like mom said, it goes throughout your entire
body because just like your circulatory system,
your lymph system is also kind of distributed
all throughout your body. It's part of your immune
system. So it essentially helps fight infection.
And with measles specifically, it actually targets
cells inside of your immune system. Which is
not good because you need your immune, very much
like HIV, like you need your immune system to
fight these off. But the measles has found a
way to essentially infect parts of your immune
system. These things called dendritic cells,
which are kind of like the quote unquote mother
brain of your immune system. And because they
infect them, it just means that they get inside
and they replicate. Just like I said before,
my analogy of like they put their genetic material
inside of these cells and then these cells essentially
become factories to make millions of copies of
a single virus. I mean, it's an amazing strategy
the viruses have developed. So because these
dendritic cells don't sense danger, they then
travel back to the lymph nodes of where they
originate and then they start releasing all these
virus particles into the lymph nodes. And then
the lymph node cells essentially spread throughout
the body, which is how they get into places like
the lungs and to the spleen and the rest of your
body. And just like mom said, once they get into
the respiratory system, that's where a lot of
these droplets get created and you can breathe
out and then spread it to somebody else. Yes.
That is how the spreading happens. And then obviously
there are things inside of the body. when you
get measles that happen poorly too. But before
I move on to what potentially could happen to
you inside of your own body, and my mom will
probably get to this a little bit later, one
of the unique things about measles that it causes
this thing is called, I'm trying to remember
the name, but it's basically like immune amnesia.
What happens is a lot of people, you can get
sick from measles and there'll be some symptoms
that my mom will talk about. But one of the bad
things about it is that if you get measles, any
memory, that you've had of previous diseases
before actually gets erased. So if you've had
immunity against like a common cold or like the
flu or because it affects these immune cells,
these immune cells essentially die and their
memory gets wiped. They don't remember what they've
seen before. So even if you get measles and you
survive that, you will forget. the immune memory
that you had against, you know, things that could
cause pneumonia or like all these other diseases.
Actually, a lot of people get sick and potentially
die from secondary infections as well that they
would have normally fought off without, you know,
basically this immune memory being wiped as well.
So just want to... Yeah, that's a great point.
So typically you'll see signs and symptoms of
the measles about eight to 12 days after you've
been infected with the virus. And that marks
the end of the incubation period. And then the
first thing that you'll see, as far as clinical
presentation, you have what we call a prodrome.
And this is characteristic of measles. It usually
happens, like I said, about one to two weeks
after you've been infected. And the first thing
is you're going to have a fever. Your fever can
get pretty high. It can be as high as 105, which
is a really high fever. And then there's something
called the three C's that are associated with
measles. You've got cough. Choriza, which is
a fancy word for runny nose, and conjunctivitis,
which is an inflammation or an infection in your
eye. Shout out to our episode on conjunctivitis.
There you go. You can also see diarrhea in patients
as well. That could last as long as a month in
kiddos or anybody who's had the measles. The
other thing that's really characteristic of measles
is something called Coplex spots. K -O -P -L
-I -K apostrophe S. Coplic spots. They're these
bluish white spots that are in the mouth on the
jaw and kind of in the buckled kind of jaw area.
And they're kind of bluish white and then they're
surrounded by redness. And so they're characteristic
of the measles. Inside the mouth. Inside the
mouth. Inside the mouth. And they will develop
about two to three. days after the initial symptoms.
And then they then fade with the onset of the
rash. Because the third thing that happens is
that you develop a rash. It is characterized
by large flat spots and then small raised bumps.
And it will happen about three to five days after
that initial symptom of the three C's happens
and stuff. Or you'll see the rash about 14 days
after you initially came in contact with the
virus, but you've got this initial program that
you have first. Usually the rash begins behind
the ears and on the neck and hairline, and then
it progresses to involve the face. your trunk
area, you know, your stomach, your back, your
arms, and then it will go down to leg and feet
involvement so it can cover your entire body.
And that process may take about two days. And
so you've got, now you've got a rash. And that
rash signals that your immune system is working
against the virus. That's the signal that your
body is showing. Usually you may have some loss
of appetite or you may have some swollen lymph
nodes as a result of this virus that's seen along
with the rash. And then the rash will start fading
to a kind of a brownish color and it flakes off
about three to four days after it started developing.
And then it will fade off. Usually then within
about two weeks after being initially infected,
you can be done with. with the measles illness.
But if you have a fever that persists for longer
than that time period, it could mean that you
have one of the complications that Joshua alluded
to earlier. And so there are several... Potential
complications that happen along with the measles
that he talked about, this immune amnesia. One
is that because this happens a lot in kids, they
could end up with otitis media, which is a bacterial
or viral air infection. That happens in about
7 % to 9 % of patients that have gotten the measles.
Or you can end up with bronchopneumonia. croup
or laryngitis. So you can have these lower respiratory
infections that happen in about 5 % of kiddos.
They can become serious. Pneumonia is always
serious. And so you just want to make sure that
if you're a kiddo or even if you're an unimmunized
adult and you get the measles, that you contact
your healthcare provider, you know, if this is
not going away. One other thing that can happen
is that you could get dehydrated if you have
diarrhea, especially in little kiddos, and sometimes
there could be vomiting. So you want to make
sure that you get fluids into those kiddos and
stuff, and your pediatrician or your healthcare
provider can help you with a plan to make sure
that that gets managed. Another big thing is
that you don't want to get the measles if you're
pregnant. The measles virus in pregnant women,
So first of all, for the mom itself, it increases
their risk for pneumonia and death because when
you are pregnant, your immune system is kind
of dampened a little bit to keep your body from
attacking the baby that's growing inside of you.
But then also you can have adverse pregnancy
outcomes with it. So you can have pregnancy loss,
premature delivery or low birth weight, and the
measles virus can be transmitted to the fetus.
And so when they're born, they could have. febrile
rash syndrome. Again, they could get really,
really sick, including getting encephalitis,
which is a brain infection. What advice would
you give for a pregnant or someone who wanting
to become pregnant to avoid measles? Would you
just essentially just avoid basically any child
who potentially is in contact with it? Would
you recommend them wearing a N95 mask because
it will prevent some of the droplets? If I was
a pregnant woman, wanting to limit this risk,
what would you recommend to me to avoid it? Um,
I'd say one of the first things that could be
done is that you could have antibody titers drawn
to see if you have immunity to the measles vaccine
yourself, you know? So if you've already, I mean,
measles virus. Yes. I'm sorry. Yes. You could
do that. If you know, for a fact that you've
never had the measles or you've never been vaccinated
against the measles, then yes. Um, avoidance
of those primary people who haven't been vaccinated
and maybe haven't had the disease yet. Right.
Those are the people with the highest risk. Right.
We're talking about because, you know, if you've
already had the virus, then your body is going
to respond against it. And so it's not going
to be as much of a risk for a pregnant woman.
But if you are, let's say you're a mom and you've
got other kiddos, you know, and stuff, you know,
you want to make sure that you get them immunized
against measles because. The illness is far worse
than the vaccine, and we're going to get to that
in just a few minutes. There are some rare complications
that can happen with measles disease as well,
too. They don't happen in everybody, but they're
serious enough to just be concerned with. I think
it's because they affect these dendritic cells
that Joshua talked about. One of them is called
post -measles encephalitis. I'm sorry, it's called
post measles encephalomyelitis. And what that
means is you get inflammation in the lining around
your brain, as well as the lining that goes around
your nerve, your nerve tract that comes from
your spinal cord. We call it the myelin sheath.
Yes. And if you've heard of MS, you might've
heard that the immune system will attack this
sheath. It kind of keeps your cells insulated
so they can send signals. Um, yeah. So mom said
that it'll, it'll. Right. So this happens rarely
in about one in a thousand cases and it usually
affects older kiddos and adults. And it can occur
within two weeks of the rash onset. And it's
characterized by fever, seizures, and neurologic
abnormalities. So, um, so maybe that could be
a whole plethora of things. Um, and it's really
interesting. It's thought to be an autoimmune
disorder. that it targets the myelin and the
measles virus doesn't have to be there anymore.
So it's just one of those weird things with this
virus. Yeah, the immune system is so, if anybody
wants to basically think about how wonderfully
our bodies work, you just go read about the immune
system. It is so complicated. There are so many
moving parts. There are so many different types
of cells working in conjunction with one another.
One of the interesting trade -offs that I've
read about the immune system is that you think
about even as early as 300 to 400 years ago,
I mean, even maybe 100 or 200 years ago, most
of the primary causes of death, especially in
young kids, was infectious disease. One of the
reasons that our median age you know, for life
was so low, like in the 40s, was because our
infant mortality was so high. One of the greatest
things we've done as a society is that we've
dropped infant mortality to near zero. It's incredible
what we can do nowadays. That being said, what
our bodies have done as a trade -off prior to
modern medicine coming around and dropping infant
mortality so low is that basically it's selected
for individuals with a hyperactive immune system.
So evolution basically said, okay, what we're
going to do is we're going to select for people
who just, their immune system is incredibly on,
on, imagine the most anxious person you can imagine
and multiply that by 10 and that's your immune
system because it basically assumes that false
positives are going to be positive. So anytime
it eats something or anytime it consumes something,
we're just going to assume that that's a threat.
And that we are going to attack it, which is
why a lot of times you see people with food allergies
or weird allergies to various things in nature.
But a lot of times, we didn't have sanitation.
We didn't have hand washing. We didn't have soap.
We didn't have vaccines. And so a lot of times
your body was constantly fighting off against
things like bacteria, viruses, even large like
parasites, things that are massive in size compared
to things like viruses. At least in America,
in the Western world where we have clean drinking
water, a lot of those risks are almost zero to
having any of those here in the United States.
You don't have to worry about Giardia in your
water, especially in our tap water. But it does.
So now you have this really hyperactive immune
system that if you give it something like the
measles and just like mom said, one in a thousand
cases will then react. This immune system will
react. to this measles virus, and it does it
for too long. There's not this stop mechanism.
They're like, okay, we can stop now. And so it'll
do it long enough that it attacks your nerve
cells and the myelin sheath, which can cause
these long -term. I know this is a long tangent,
but it's like a lot of times with these autoimmune
cases, it's just... really just a byproduct of
our ancestors essentially finding a way to survive.
And now we live in this very sanitary, sterile
environment, which is wonderful. But every now
and then your body will kind of overcorrect against
things that, you know, probably shouldn't overcorrect
against. Right. And then a couple of other rare
complications from the measles is it's called
measles. And I don't know a lot about these,
but I just wanted to just throw them out there.
One is called measles. Measles inclusion body
encephalitis. So again, you're going to have
another type of an inflammation around the lining
around your brain. It can occur months to years
after an acute infection due to a persistent
measles virus infection. It could be some sort
of like sub. you know, sub presence of the measles
virus there. And again, there's another one called
sub acute sclerosing panencephalitis. Again,
we're talking about these infections with a persistent
measles virus infection that can affect the lining
around your brain. Yeah. And if you, anytime
you hear the word itis, that usually is just
a term for inflammation. And then the words before
it just refer to the specific cell type or area
in which the inflammation is occurring. And because
this place, because measles goes everywhere and
your body is really fighting it, sometimes there's
just going to be a large battle that's going
to be happening somewhere. that is going to potentially
cause these long -term effects. So even though
these words are very long, it's like, it's literally
just saying like, hey, here's the specific area
where this is happening. Right. In developing
countries, you will see, well, I mean. In developing
countries, you'll see death more associated with
measles, although we did have a couple of fatalities
in West Texas. And again, it just depends on
how sick the kiddo gets. And then in developing
countries, this has not happened in our country
because we've got better health care. But blindness,
it's one of the leading causes of blindness if
kiddos get measles in developing countries. Wow,
I did not know that. That's really sad. Some
viruses have treatments for them and some do
not. The measles virus, there is no specific
antiviral treatment for it. So basically, if
you get the measles, it's primarily supportive
care that you're going to use to manage it. Things
like fever control with either acetaminophen,
Tylenol, or non -steroidal anti -inflammatory
drugs like ibuprofen or naproxen. Rest in fluids
is, you know, it's the whole gamut of what supportive
care is. It's, you know, controlling fever, rest
in fluids, prevention and correction of dehydration,
which goes along with giving fluids, and infection
control measures, which would mean isolating.
keeping your sick person away from other people
as well as wearing masks as well too. Yeah. Can
you, can you speak to just the, like, why is
it so important to take an NSAID for example,
and also to replenish fluids, just like on a
basic, like, I think maybe people don't understand,
like, well, why would you want to reduce the
fever? Like, why would you want to reduce the
inflammation? You know, I'm not I'm not an expert
in this area, but I do know that fevers that
go really high in some kiddos or people's threshold
is lower than others. It can cause seizures and
and they call it. febrile seizures or seizures
with fever. It doesn't mean that you have a seizure
disorder, but it just means that your temperature
in your body has gotten so high that that's just
one of the reactions to having a really high
fever. So that's definitely one reason. Also
too, if you've ever had a fever, you feel crummy.
And so if you get, or if you're able to lower
it a little bit, you feel a little better, even
though you're not well and stuff. So those would
be my two main reasons as far as lowering fever.
As far as fluids, I mean, Dehydration for kiddos,
I mean, you can get really sick if you don't
have the right amount of fluid in your body because
you've got it working. I mean, it infuses your
whole body. What's the largest fluid in your
body? Yes, that's right. No, no, I was asking
what is the largest fluid in your body? Oh, is
it plasma? And what's that a part of? Just your
circulatory system. Your circulatory system.
So yeah, if you don't have enough fluid to...
pump all the things that your body needs throughout
your body, then yeah, I mean, you're going to
essentially, it's going to be harder to transport
the things that you need. Right. And when you
get dehydrated, either through vomiting or diarrhea,
you also lose some of your, um, what we call
electrolytes. So sodium, potassium, and they
are, they are used in all of your body cells,
your heart. And so you get rid of that. If you're,
if that gets all messed up, then things don't
work and it makes you even sicker than you already
were. So that's, that's, and, and with, if, if,
if you had a, smaller baby that got that then
they could that could be that could be harder
because they can't communicate as well and stuff
and also yeah so um so those will be my my uh
it'd be great if babies could talk but they don't
they don't you just kind of have to assume for
them i know yeah i think it's one of probably
the tougher things about treating kids is like
is that there is that lack of communication like
imagine you see this this tiny little creature
suffering yes and you with an adult they can
either say my stomach hurts or this hurts but
like they're just crying and so you just kind
of have to assume okay what can i do here i imagine
just as a pediatrician hats go off to our pediatricians
out there but like yeah it's amazing to treat
people who can't communicate effectively right
or parents you know figuring out what to do with
their kiddo absolutely yeah so um so in in in
developing countries um uh kiddos can be vitamin
a deficient And vitamin A deficiency can occur
with, well, maybe not vitamin A deficiency, but
the measles virus can lower serum vitamin A levels.
And vitamin A is... part of the immune response.
So if you have vitamin A deficiency, then giving
vitamin A is also recommended, but we don't have
to do that a whole lot in our country because
we don't have a lot of vitamin A deficiency here.
Fun fact, it's also vitamin A is important for
developing proper eyesight, which also helps
lead to not being blind. Yes. So there's actually
this really, if anyone's interested in donating
to a great charity, there's this great charity
called givewell .org. Head there right now. And
they provide vitamin A supplementation to kids
specifically in Bangladesh who specifically go
through this condition. So you give them extra
vitamin A to reduce the amount of blindness.
There you go. That's a great, that's a great.
Donate 50 bucks this holiday season. There you
go. So now you may be saying, okay, if we get
the measles, I mean, is that, what can we do?
I mean, I don't think I really want to get this
disease. So amazingly. There is prevention, and
primarily prevention is going to be in the form
of a vaccine. And there is, like I said before,
if you become immune to the measles virus, you
are typically considered immune for life. There
are some certain caveats to that. If you have
an autoimmune disorder or an immune deficiency,
that could... you might not necessarily be immune
for life. But most of us who have had it or have
been vaccinated will be immune for life. It's
mainly due to that because it has that one antigenic
type. Just that one antigenic type. So there's
not a lot of variability there. Right, right.
I'm going to talk first of all about the vaccination
process just in general. So it's a live attenuated
vaccine. There are a lot of vaccines that are
killed vaccines, but the measles vaccine as well
as mumps and rubella are what we call a live
attenuated vaccine. So it means it's got a portion
of the virus, but not the whole virus. And it's
killed, but it's... So it's weakened, but it
will cause your body to have an antibody response.
So the antigen is the virus. It's the thing that's
attacking your body. The antibody is going to
be the thing that your body has to fight it off.
And so you put this little bit of killed vaccine
or live attenuated vaccine into your body and
it mounts this antibody response so that when
if you get. If your body is faced with the real
virus, it will already have the defense mechanisms
in place to fight that virus off. Yeah, and just
as a reminder, this is the exact same process
that happens when you get infected with measles.
But with vaccines, we have dosed it out to give
the proper dosage to provide an adequate immune
response without causing excess harm. And mom
can speak to this more about, I think that happens
in phase two clinical trials when you figure
out what dose needs to. Yes. Mostly the first
phase one trials are usually looking to see what
kind of adverse effects you're going to have
and if it's toxic or not. And yes, then you can
do dose ranging studies after that as well. Yeah,
because when you get infected with a virus, it
wants to give you as much antigen as possible
because it wants to replicate itself. But for
us, we've just learned like, well, if you just
give it a little bit, just enough so that it
simulates an immune response without any of these
other things that we discussed, like any of the
encephalopathies or any of the fevers or things
like that, that is the goal of giving someone
a proper working vaccine so that you can basically
get the same outcome without the harm. Or lesser
harm, we should say. And so as investigators
have looked at the response to vaccination with
the measles vaccine, initially it was a one -dose
vaccine, but it's now a two -dose series. So
you give the first dose when babies are 12 to
15 months of age. And it's administered in combination
with mumps and rubella. So kiddos need less shots,
you know, primarily. And rubella is the German
measles, right? Yes. We mentioned earlier. Yes,
they're all different viruses, but they've been
common in childhood and have been, you know,
almost eradicated because of the vaccine movement
and stuff. And then you give the second dose
when the kiddo is four to six years of age. And
after you've had both of these doses of the measles,
mumps, rubella vaccine, then you, I think it's
95 % or 99%, it's 99 % effective against these
viruses after that second vaccine. The other
thing too, is that dose two of the measles vaccine
can be given with mumps and rubella. only or
with that second dose get also be given in conjunction
with varicella which is the chicken pox so to
again to minimize the number of sticks or shots
that your baby has there your kiddo needs yeah
i know a lot of people are are sensitive to that
as well um and i think the reason we give multiple
shots to very much similar like the covid boosters
was like you essentially want to have a certain
there's a benefit to spacing them out because
it gives your body a chance to kind of like mount
a better you know, immune response, like almost
like giving, you know, 15 micrograms of antigen
all at once doesn't seem to be as good as giving
10 in the first one and five in the second one.
This combination effect seems to provide a better.
immune response and that's another reason too
for this second dose for these um the to to combat
um an antibody response for these viruses is
that if you did potentially have a failure to
that first dose then if you're giving this second
dose like amps up your immune system and you're
able to to get to get that taking a sniff or
something be like what was that and then a second
sniff would be like oh that's the chicken there
you go there you go so um So anyway, so there
are adults that can get the measles if they have
somehow, you know, been not immunized and didn't
get the disease for whatever reason. So the recommendation
for immunization in an adult that is unvaccinated
is one dose if they were born before or after
1957, if they don't have any evidence of measles
immunity. But if you are a student that's going
to college or an adult that's going to college
or if you're going to be traveling internationally
or if you are a health care personnel, if you
are part of the health care personnel or you're
a military person, then in those categories,
it's a two -dose. vaccine recommendation just
to make sure that you're vaccinated. Because
again, you think about why kiddos that go to
college, because again, you're thinking about
living in the dorm, closed spaces, and it's just
easier for those viruses to be transmitted. So
you want to protect your kiddo. So, you know,
like Josh said. Primarily, the vaccine has minimal
adverse effects. It might have a little bit of
an effect that looks kind of like the disease,
but it's not going to be like the disease because
you could have a little bit of fever. Up to 66
% of patients may have fever, but that can be
combated with a dose of Tylenol or ibuprofen
after you get the vaccine, and it's short -lived.
You can have soreness or redness or pain at the
injection site, which is common for most of our
patients. immunizations. You could have a mild
rash. You could have a little bit of pain or
stiffness in your joints. And you could have
loss of appetite, irritability, or drowsiness.
Those are the main things that you might see
after it. It's short -lived. And it's just a,
I guess this is maybe a personal opinion, but
it's like, it's a better. adverse effect outcome
than what the disease causes itself. I think
the kids gets a lot sicker, you know, with the,
with the disease than they do with after they
get the immunization. Yeah. I think that's such
a, it's a point that we talk about all the time
is that there's no such thing as a pure solution.
Like if, if there are no side effects, there
are no effects. And every time we're talking
about health, we're always talking about trade
-offs. And I think I think everybody's definition
of how they want trade -offs in health to be
in this country is going to be very different.
But at the end of the day, I always like to think
about driving and cars and safety and that when
I think about coming into contact with infectious
diseases. Most of the time when you get in the
car, you're not going to get in a car crash.
You know, so you might think, why do I need to
put on this seatbelt? Like, why have airbags?
Like, why have this, you know, really rigid frame?
You know, like, but there's going to be that
one time that you wish you did have those things.
And most of the time, it does not behoove you
to do all those things. But that one in a thousand
chance. I think that's the thing that it's hard
for people to think about, including myself.
I think we always think that we're either part
of the majority or the exception to the rule,
whether you're playing the lottery or you're
avoiding a bad disease. But just like my mom
said, if your insurance company is paying you
or your healthcare provider for a vaccine, so
it's already covered by your insurance or I think
even, I don't know if you pay for a vaccine out
of pocket, it's probably between 50 to 100 bucks.
But comparing that to potentially going to the
hospital and having to deal with all of these
complications, they're going to definitely be
so much more expensive and potentially life altering
or threatening. So I think at the end of the
day, you always have to ask yourself that question.
Like, am I going to play the odds on this? And
especially when it seems like there's very little
evidence to suggest that the harm of the vaccine
exceeds the harm of the measles virus itself.
It's your choice. We're just giving you informed
consent, and then you go and make a decision
for yourself. These diseases, especially measles,
are no joke. I think we live in a time where
we have the luxury of asking ourselves, why do
we need to worry about this? Because we work
so hard to try to eradicate it. It's interesting
to live in a time where we have to talk about
this again. Again, it's an interesting question
because it ends up conflicting between individual
versus collective health. Even though you might
not want to vaccinate yourself or your child,
does that mean that now you have the ability
to infect my immunocompromised child? It gets
these really interesting trade -offs. how we
decide what what healthy means in an individual
uh sense or in a collective sense and i think
too remember these vaccines are going to be primarily
administered in a pediatrician or a family medicine
offices they these are not the vaccines that
you go to the pharmacy and get per se because
pharmacists can vaccinate kiddos young young
kiddos and stuff they can do oh golly pharmacists
and i don't but i never did it myself maybe they're
12 maybe they're 10 i have to look that up as
far as what the age as far as when a pharmacist
can give a vaccination but it's not babies and
stuff so um so usually get those vaccines in
the pediatrician's office or the family medicine
And so that's a conversation that you could have
with your healthcare provider as far as just
the risks and benefits to your baby, your kiddo.
Excellent. You know, we talked earlier about,
Josh had a great question and I totally blanked
on this, but there are a couple of things you
can do if you've been exposed to the measles
and you're not sick yet. And we call it post
-exposure prophylaxis or post -exposure prevention.
And this is going to be recommendations for those
that can't prove that they have immunity to the
measles virus. The first thing is that you can
give the measles, mumps, rubella vaccine to the
individual if you give it within 72 hours of
being exposed to the measles. The second thing
that can be done, and this is the thing that
could be done to a pregnant patient if they have
been exposed to measles, but they obviously can't
get the vaccine. The vaccine is not recommended
for pregnant patients. But you can get something
called immune globulin or immune. immunoglobulin.
And it gives you passive immunity. So it can
be administered, and then it can help mount an
antibody response within your body to fight against
the virus if you get it within six days of exposure.
And the types of people that would get that would
be those that could get really sick if they got
measles, including infants six months to less
than a year of age, pregnant women, or immunocompromised
individuals. And interestingly, you don't want
to give the measles, mumps, rubella vaccine and
immunoglobulin together at the same time because
the antibodies that are in the immunoglobulin
will interfere with the efficacy of the vaccine.
Interesting. So they kind of fight against each
other. Okay. Yeah, it's one or the other. There
is a little bit of a list of people who should
not receive the measles vaccine. This is kind
of the standard thing for anything. It's like
if you've had an allergic reaction to it before,
then you're not going to give it again. Pregnant
patients should not get it. And you want to avoid
getting pregnant within one month of getting
the MMR vaccine. Anybody with a weakened immune
system. I thought this was really interesting.
Anybody that has a condition that makes them
bruise or bleed easily because the vaccination
can cause a transient lowering of your platelet
count within four to six weeks of getting it.
So if you already have an issue that causes you
to bruise or bleed easily, you don't want lowered
platelets. I don't know the incidence of the
number of people this would affect. I feel like
it's got to be hemophiliacs. It could be hemophiliacs.
People who just can't clot well or vitamin K
deficiency. There's got to be pretty far and
few people. But something to be aware of. If
you've had a blood transfusion or a blood product.
Within three months, you want to avoid that because
the antibodies in a blood product can reduce
the vaccine effectiveness. Same to anybody with
tuberculosis or anybody who's feeling unwell
or who's really sick, you don't want to get it.
And anybody who's received a vaccine within the
last four weeks, you want to give your body time
to mount immune responses to the different vaccines.
And then anybody with a history of febrile seizures,
it's thought that there's a small incidence of
people who could have a febrile seizure after
the vaccination. So if you have a history of
febrile seizures, you may not want to get the
vaccine. We always love to do our, I always love
looking up our section that we do every time
when we do this podcast about what are the misunderstandings
or myths. associated with a particular topic
that you're talking about today. So measles is
no different. Tell me about it for this one.
So the first one that I'm sure everybody is raging
about is the fact that the measles, mumps, rubella
vaccine can cause autism. And there have been
so many... looks at this over, I mean, it's been
30 some years that they've looked at different
studies and different assessments of can this
vaccine cause autism? And there has been no definitive
evidence that's shown it. There was a large study
in Danish children. It was over 650 ,000 Danish
children that was done not too long ago. And
they found that it did not increase autism risk.
or trigger autism, and it wasn't associated with
the clustering of autism cases. So it's been
looked at so much, and yet I know that people
want to still, I mean, even recently, want to
make a connection between this vaccine and autism,
and it just hasn't been documented. Yeah, I mean,
this has a really interesting story that we won't
get into. It really does. go into the realm of
ideology versus evidence. And I think sometimes
when you want to believe something really bad,
you will just try to make something fit. So this
was a story that was started by this guy named
Andrew Wakefield back in the mid to late 90s,
who was a medical doctor actually here in Austin,
Texas, who basically suggested a potential link
between the MMR vaccine. It also came out later
when he published this in The Lancet that the
data was actually fraudulent and it got retracted.
Of course, that story didn't make it as big.
And we've kind of been dealing with the fallout
ever since. And the thing about autism, it's
a syndrome that has like 80 % genetic link. So
essentially there's like a... 80 % linked to
being inherited rather than being environmental.
And I think a lot of people focus on the fact
what must be environmental because the rates
are rising. And a lot of the reasons the rates
are rising is because the DSM -5, which is the
manual for psychiatric and psychological disorders,
basically included things like Asperger's and
other basically neurological conditions into
the scope of autism so that they could be diagnosed
more easily, so that parents could potentially
get more resources from their insurance companies.
And I think because that changed, and then the
vaccination rate, you know, where giving kids
vaccines also went up, there's like correlation,
but correlation does not equal causation. And
there's so many great graphs out there to show
that. But as mom says, like, you would expect
to see All over the world, this happening, not
just in the United States, but happening in Denmark.
And so our DSM is different from Denmark's DSM.
So again, this is going to boil down to what
I think personally is like, do you trust the
system that we are in, which is evidence -based,
constantly correcting for our mistakes, working
with the government, working with pharmaceutical
companies to come up with tested? You know, hypotheses
or do you just think that the world is a very
broken place full of environmental toxins put
there by large corporations to make you sick?
And people now in our highest ranks of government
really do believe that. And so even though there's
very, there's almost no evidence to suggest this
link, it now persists. It's really unfortunate
because I think we're going to see more kids
especially get measles because of this. Unfortunately,
more kids might die or have permanent disabilities
because of it. It's just because of this myth
won't die. We want to communicate a sensitivity
towards anyone that has a kiddo that is autistic.
I have not had to walk that path, but I know
that, you know, I know that the question would
be why, you know, how did this happen? And I
know that different avenues are explored to figure
out what is the reason. And sometimes, you know,
particularly like... Definitive reason may not
be able to be determined, but they've done enough
work with at least this vaccine combination that
it doesn't appear that the evidence is really
strong against that. That was much more polite
than mine. So we'll go to the next myth. So I
thought this was interesting. The spread of measles
can be controlled with proper sanitation. Now,
there are some things that you can control with
proper sanitation, like cholera, which is a foodborne
illness or things that happen in dirty water,
contaminated water, typhoid, but not the measles.
We've talked about how this virus gets spread.
Proper sanitation and, oh my gosh, pardon me.
Supportive therapy is recommended. It will not
prevent getting the measles if you wash your
hands and keep your counters clean. I mean, that's
good to do anyway, but it won't prevent it. But
it's because it's spread by droplets and breathing
other people's air. Right. The third one is that
the... The measles mumps rubella vaccine does
not prevent serious illness and death. That the
number of measles. deaths dropped long before
the vaccine was introduced and it is no longer
deadly. Well, we've already talked about that,
that that's not necessarily the case. The measles
vaccine does prevent thousands of deaths every
year worldwide. The number of measles deaths
may have begun to decrease before the vaccine
was introduced, but that was due to improvements
in treatment of things that happened to patients
who got sick with the measles and then had a
complication like knowing how to treat pneumonia
or things like that. serious illness and death
from measles, it still can happen regularly.
And in the 10 years before the vaccine was available,
about 500 United States measles -related deaths
happened and reported to the Centers for Disease
Control every year. And since the vaccine has
been developed, the U .S. measles -related deaths
have been increasingly rare because the vaccine
has prevented people from getting the measles
in the first place. There was a really interesting
study that was pointed out by this great YouTuber
named Debunk the Funk. Shout out Debunk the Funk
for giving great information. But to this very
question, it was really interesting, because
a lot of people will say, well, measles is going
away to begin with. We didn't really need the
vaccine because we had sanitation. So there was
this great paper that was published. Well, did
the vaccination actually make a difference? Because
different countries got access to the measles
vaccines at different times. So if you look at
a country like Denmark, I think they did Denmark,
Sweden, and the United States, and they both
rolled out their measles vaccines at different
time. And their time lagged, you know, basically
because they got it at different times. And like
mom said at the beginning of this episode, measles
is very seasonal, you know, depending on when
you're kind of all going inside and you're breathing
each other's air. So you do kind of see this
roller coaster of a, you know, increasing cases,
decreasing cases, very much like we saw in COVID
as well, depending on the time of year. But once
you saw the vaccination get introduced, the cases
dropped off a cliff. They just took this nosedive
almost down to zero. And you could see by year
and when the vaccine was rolled out for each
country that it went down to zero. So just like
mom said, even though these outcomes were getting
better due to treatment and treating some of
those like secondary infections because the measles
does wipe out your immune system, those cases
almost went to zero because of the vaccine efforts.
And you can see that on a time lag and on different
countries as well, which I thought was a really
cool. That's cool. And, you know, in June. Ingenuitive?
Intuitive? It's not intuitive. Ingenuity. Yeah,
ingenuity. I don't know if you know that's a
word. I don't know if it was ingenuitive. I don't
know if that's a word or not either. It was a
fun study. It was a very fun way to figure that
out. Okay. So to piggyback on that, worldwide
from 2000 to 2016, we saw an 84. percent decrease
in measles deaths worldwide, with 20 million
deaths prevented. And then, so what we saw before
the vaccine was that there were about 600 ,000
cases reported yearly. This was in the mid -1950s
to 63 cases reported in 2010. So the vaccine
does really work. The next myth is that measles
vaccine can be deadly. There have been no deaths
shown to be related to the vaccine in healthy
people. There have been rare cases of deaths
from vaccine side effects among children who
are immune compromised. And so that is the reason
why the vaccine is not recommended for use in
immunocompromised children. And you can have
side effects from the vaccine, but usually it's
not death. And the last myth that we have is
that the measles, mumps, rubella vaccine can
cause the measles. And it does not cause the
measles. It is made from a live virus. The virus
is weakened so that it doesn't cause the disease,
but it rather causes your immune system to recognize
the virus and develop immunity to it. And because
the immune system gets... gets fired up, you
may have some mild symptoms that look like the
measles disease. But we've talked about this
itself. It's not the disease itself. So you could
have, like we talked about a little fever, a
little malaise, a little irritability for a baby,
but it's, it's very short lived compared to the
disease. I always say it's like, that's the sign
of your immune system working. It's just like,
it's learning what it's responding to. And I
know a lot of people think, oh, the vaccine makes
me sick. It's like it. all you're doing is triggering
an immune response. And because people are so
different, like if I got a vaccine versus you
got a vaccine, because we're both humans, but
our physiology might be different that the antigen
that I get in one vaccine might promote a milder
response opposed to you, which might a greater
response. So just like I, you know, this is such
a terrible analogy, but my brother. can handle
hot sauce like it's nobody's business. And he
makes his own spicy mayo because it's not hot
enough. If you give me a tenth of what he consumes,
I will think that is way too much, even though
he's my brother. So for some reason, his capsaicin
receptors, which is the molecule for spiciness,
FYI, and he just is so much more tolerant, even
though we're 50 % related to one another. So
just imagine that you're giving the same vaccine
or the same medication to multiple people. You're
obviously going to get different responses. But
the thing that you really don't want is you want
to give an actual virus to somebody because that
virus just wants to replicate over and over and
over again. Absolutely. So to wrap up our talk
about measles today, I wanted to just bring it
to a close with some key takeaways. The first
is that measles is a highly contagious virus
and it's primarily a childhood virus and it's
seen a resurgence. in the United States in recent
years, as we talked about, due to a little bit
of vaccine hesitancy or unvaccinated kiddos.
It's spread primarily through respiratory droplets
with a variety of systemic symptoms that usually
last up to 14 days. Supportive therapy is used
to treat measles cases, but measles vaccine in
combination with the mumps, rubella, and varicella
vaccines as well is optimal to prevent measles
cases and potential complications. Yeah, I think
it's a really good takeaway. I think the last
thing I'll say, and I'm debating whether to cut
this at the end of it, is like, this is unfortunate
that it's become a political issue. I think it's
really unfortunate that we can't all as conservatives
or liberals. And my mom identifies as a conservative,
I'm a liberal. And here we are talking about,
you know. an infectious disease that could be
combative of the vaccine. So I just want to let
people know there's no political bias here. My
mom and I are just very interested in the healthcare
system and science, and we want to help people
as much as we can. And it's really unfortunate
that during this time that there are people who
feel like they can't support a certain healthcare
initiative because it's going to go against their
political party. And I really wish this could
be one of those issues among many other issues
in which we can just kind of take a look at the
evidence and say, okay, what is going to be the
best bang for our buck here? Do we want to vaccinate
our kids against this disease or do we want to
potentially hospitalize a lot of these kids for
this disease? So I kind of just wanted to put
that caveat in there because I think sometimes
you can hear a certain perspective and think,
oh, you know, these people are just obviously
slanted and biased. Nothing could be further
from the truth with my mom and I. We differ on
a lot of the ways that we want to run this country,
but we definitely agree that the best way to
get the best health outcomes for people is to
follow the evidence and then provide that evidence
to the public, and then they can make their own
decision on their health care. And we hope that
our highest orders of government would do the
same. I'd say one thing, too, is that, you know,
as we've talked about, too, the measles vaccine
is not... It's not for everyone. And then we
talked about the reasons why and stuff. And so,
I mean, ultimately we're looking for ways to
keep our kiddos or. from getting this disease
because it's not a good one. You know, I mean,
it doesn't always hospitalize everybody, but
they're sick for two weeks, you know, versus,
you know, an immune response to the vaccine that
may last 24 to 48 hours. But that's a personal
preference, you know, for parents. And I understand
that as well, too. It can impact other people
if you don't vaccinate your kiddo because it
is very contagious. And there are some things
to do if you can't get the vaccine, primarily
the immune globulin to help fight against this
infection as well too. Yeah. That's an interesting
area about health in general is that a lot of
times it really does buttress against this like
individual choice versus collective health. Because
one might argue if they're driving in their car
without a seatbelt, like, well, this is my choice.
This is my right. I can do what I want. And I
partly agree with that. But if that person gets
in a wreck and that person is a father or mother,
and then they leave that child behind as an orphan,
then somebody has to take care of that child.
And that essentially that child becomes, you
know, a ward of the state and we have to make
this. And if you think about every action you
make has a knock on effect. So I really do want
people to have their individual choice, but also
the sense that you do have neighbors and you
do have people that you need to look out for.
And I think. We can walk and chew gum at the
same time. We can have our individual liberty
and freedom while also looking out for one another.
And I think that would be a really wonderful
place to live in. Would you agree? I would agree.
Good. Yeah. Well, thanks again for coming back
to Your Mom on Drugs with me, the son. along
with mom, the wonderful professor of pharmacy.
We're looking forward to another year in 2026.
We're going to kind of revamp some stuff. I might
have some video podcasts, maybe some I'm like,
you know, talking about current topics in terms
of social media, just like short little essays
and things like that. But if you like what you've
heard, please tell a friend. Like we just want
to spread good health information so that you
feel informed. And it's just interesting to learn
about the ways that, you know, drugs and our
bodies interact with one another. So any closing
thoughts for 2025? Merry Christmas. Merry Christmas
and happy holidays to my people who aren't Christians.
All right. Bye. Bye.