1 00:00:02,569 --> 00:00:03,980 No . No . So , 2 00:00:07,750 --> 00:00:09,861 hi . I'm so excited . Welcome back to 3 00:00:09,861 --> 00:00:12,130 Friday Facts . I'm Doctor Alice Sian . 4 00:00:12,140 --> 00:00:14,362 Hi . And I'm Doctor Elizabeth Marques . 5 00:00:14,362 --> 00:00:16,251 And we're two infectious diseases 6 00:00:16,251 --> 00:00:18,473 physicians at Brook Army Medical Center 7 00:00:18,473 --> 00:00:20,529 and we're back , um , reunited again 8 00:00:20,530 --> 00:00:24,500 for Bug Week . I'm so excited about bug 9 00:00:24,510 --> 00:00:26,940 week . I know me too . I really like 10 00:00:26,950 --> 00:00:29,819 the , um , the squish or save . Uh , 11 00:00:29,829 --> 00:00:31,940 I'm , I'm not getting very many right 12 00:00:31,940 --> 00:00:34,950 here . Yeah , same . I mean , I'm not , 13 00:00:34,959 --> 00:00:36,792 I , I'm excited about bug week . 14 00:00:36,792 --> 00:00:39,580 Normally I think of bacterial bugs but 15 00:00:39,590 --> 00:00:41,534 I know this , um , this week we're 16 00:00:41,534 --> 00:00:43,868 talking about insects for the most part , 17 00:00:43,868 --> 00:00:45,979 I would have to say I do get a lot of 18 00:00:45,979 --> 00:00:47,979 questions as an infectious diseases 19 00:00:47,979 --> 00:00:50,146 specialist about bugs . And , uh , you 20 00:00:50,146 --> 00:00:52,257 know , it is a little bit challenging 21 00:00:52,257 --> 00:00:54,423 to reorient people that , you know , I 22 00:00:54,423 --> 00:00:56,479 might not be the best person to talk 23 00:00:56,479 --> 00:00:58,701 about their bugs . If it doesn't infect 24 00:00:58,701 --> 00:00:58,319 a human . I may not know that much 25 00:00:58,330 --> 00:01:00,386 about it . Same , same . I feel like 26 00:01:00,386 --> 00:01:02,441 sometimes we only know about some of 27 00:01:02,441 --> 00:01:05,855 the bugs that do carry um , bacteria or 28 00:01:05,864 --> 00:01:08,544 viruses and that can infect people and 29 00:01:08,555 --> 00:01:10,555 parasites too . And we fought a lot 30 00:01:10,555 --> 00:01:13,214 here in central Texas . So , um , the 31 00:01:13,224 --> 00:01:15,057 things that transmit diseases in 32 00:01:15,057 --> 00:01:17,555 central Texas that feed off of us , um , 33 00:01:17,565 --> 00:01:19,787 can be things like mosquitoes and it is 34 00:01:19,787 --> 00:01:21,954 definitely mosquito season here in San 35 00:01:21,954 --> 00:01:24,525 Antonio . Oh , yes . So , um , my 36 00:01:24,535 --> 00:01:26,785 backyard loved all the rain that we've 37 00:01:26,794 --> 00:01:29,625 had recently and the mosquitoes are in 38 00:01:29,635 --> 00:01:33,519 full effect . Yes . I took my son to , 39 00:01:33,529 --> 00:01:35,696 um , soccer practice last night and my 40 00:01:35,696 --> 00:01:37,751 husband kind of warned me that there 41 00:01:37,751 --> 00:01:39,807 were a lot of mosquitoes and I , I'm 42 00:01:39,807 --> 00:01:41,918 just gonna wear long pants . It'll be 43 00:01:41,918 --> 00:01:44,196 fine . Um , and uh , unbeknownst to me , 44 00:01:44,196 --> 00:01:46,307 he slipped some repellent in my bag , 45 00:01:46,307 --> 00:01:48,362 which was helpful because long pants 46 00:01:48,362 --> 00:01:50,196 didn't , didn't make a dent . Uh 47 00:01:50,196 --> 00:01:52,830 Another way that her husband has done 48 00:01:52,839 --> 00:01:54,672 great things . He's always super 49 00:01:54,672 --> 00:01:57,870 prepared . So doctor , what are some , 50 00:01:58,010 --> 00:02:00,232 you mentioned we're worried about we're 51 00:02:00,232 --> 00:02:02,454 talking mosquitoes . So what do we have 52 00:02:02,454 --> 00:02:04,399 to worry about with mosquitoes and 53 00:02:04,399 --> 00:02:06,621 infections ? So , ok , so anything that 54 00:02:06,621 --> 00:02:08,621 feeds on us here , there's a lot of 55 00:02:08,621 --> 00:02:10,677 different species of mosquitoes . So 56 00:02:10,677 --> 00:02:12,788 different things can get introduced , 57 00:02:12,788 --> 00:02:15,066 whether they are common or um uncommon . 58 00:02:15,066 --> 00:02:17,288 Um We have in the past had outbreaks of 59 00:02:17,288 --> 00:02:19,399 West Nile virus here in San Antonio . 60 00:02:19,399 --> 00:02:21,510 Um , but uh occasionally I still have 61 00:02:21,510 --> 00:02:23,454 gotten patients with cases of rare 62 00:02:23,454 --> 00:02:25,566 diseases just because of the mosquito 63 00:02:25,566 --> 00:02:27,732 uh life cycle . There's so many , um , 64 00:02:27,732 --> 00:02:29,979 they are uh pretty active depending on 65 00:02:29,990 --> 00:02:32,212 the species at different times of day . 66 00:02:32,212 --> 00:02:34,323 So I do advise my patients to protect 67 00:02:34,323 --> 00:02:36,434 against them at all times of day here 68 00:02:36,434 --> 00:02:38,546 in San Antonio . Yeah . So there have 69 00:02:38,546 --> 00:02:40,768 been some aggressive day feeders around 70 00:02:40,768 --> 00:02:42,879 here recently . Um And so yes . And , 71 00:02:42,879 --> 00:02:45,046 and when we talk about protection , uh 72 00:02:45,046 --> 00:02:47,470 often what um people may use permethrin 73 00:02:47,679 --> 00:02:50,199 products on , on their clothing or 74 00:02:50,210 --> 00:02:53,809 other areas to mosquitoes can prevent 75 00:02:53,820 --> 00:02:56,039 other in insects from like penetrating 76 00:02:56,050 --> 00:02:59,169 the area as well as um mosquito 77 00:02:59,179 --> 00:03:02,039 repellents such as de often if you want 78 00:03:02,050 --> 00:03:04,309 it to work . well , we often say about 79 00:03:04,320 --> 00:03:07,320 30% deed . It is the , the best 80 00:03:07,330 --> 00:03:10,729 concentration for efficacy . And I tell 81 00:03:10,740 --> 00:03:12,740 my patients , if they buy a product 82 00:03:12,740 --> 00:03:14,907 that says contains deep and it doesn't 83 00:03:14,907 --> 00:03:17,073 stink , it doesn't work . It's usually 84 00:03:17,073 --> 00:03:19,129 not the right concentration . Um And 85 00:03:19,129 --> 00:03:22,479 their permethrin we do um uh uh we've 86 00:03:22,490 --> 00:03:24,657 seen those products that you can treat 87 00:03:24,657 --> 00:03:26,657 your grass or your lawn as well and 88 00:03:26,657 --> 00:03:28,712 those are um related to permethrin , 89 00:03:28,712 --> 00:03:30,823 which we know is impregnated in their 90 00:03:30,823 --> 00:03:32,712 uniforms . Um And those are areas 91 00:03:32,712 --> 00:03:34,879 avoiding standing water if you can and 92 00:03:34,879 --> 00:03:37,101 making sure the big buckets that filled 93 00:03:37,101 --> 00:03:39,323 up with the rain are dumped out because 94 00:03:39,323 --> 00:03:41,379 those mosquito larva just really , I 95 00:03:41,379 --> 00:03:43,490 mean , they could survive in a bottle 96 00:03:43,490 --> 00:03:46,179 cap worth full of water . Um But , you 97 00:03:46,190 --> 00:03:48,869 know , here in San Antonio , um uh not 98 00:03:48,880 --> 00:03:51,047 a terrible amount what you can do from 99 00:03:51,047 --> 00:03:52,880 the environment because all your 100 00:03:52,880 --> 00:03:55,102 neighbors have all those standing water 101 00:03:55,102 --> 00:03:57,324 piles as well . I know , I know , I , I 102 00:03:57,324 --> 00:03:59,547 live near um this ditch that always has 103 00:03:59,547 --> 00:04:01,769 a little bit of water . And so I really 104 00:04:01,769 --> 00:04:03,880 think that that's probably a breeding 105 00:04:03,880 --> 00:04:05,880 ground for our area . So , I mean , 106 00:04:05,880 --> 00:04:08,158 that's pretty much mosquitoes . I mean , 107 00:04:08,158 --> 00:04:08,149 what I talk , I talk to people , um , a 108 00:04:08,160 --> 00:04:10,460 lot of times about is if you don't get 109 00:04:10,470 --> 00:04:12,414 bitten by a mosquito , they're not 110 00:04:12,414 --> 00:04:14,637 gonna give you anything . So again , do 111 00:04:14,637 --> 00:04:16,470 your best to not get bitten by a 112 00:04:16,470 --> 00:04:18,581 mosquito and then they won't transmit 113 00:04:18,581 --> 00:04:20,581 an infection to you . But we also , 114 00:04:20,581 --> 00:04:23,098 there are other insects that we um need 115 00:04:23,109 --> 00:04:25,220 to worry about . So I want to plug uh 116 00:04:25,220 --> 00:04:28,419 briefly , uh there are some uh rarer 117 00:04:28,428 --> 00:04:30,829 diseases like chavis diseases that are 118 00:04:30,838 --> 00:04:32,949 present in something called a kissing 119 00:04:32,949 --> 00:04:34,949 bug or redo it bug here in town . I 120 00:04:34,949 --> 00:04:37,060 wanna say that because my mom's gonna 121 00:04:37,060 --> 00:04:39,060 watch this and she is obsessed with 122 00:04:39,060 --> 00:04:41,529 kissing bugs . Um Those , um uh those 123 00:04:41,540 --> 00:04:43,429 uh typically aren't too much of a 124 00:04:43,429 --> 00:04:45,750 problem unless you're an avid , avid , 125 00:04:45,760 --> 00:04:48,750 avid gardener . Um , here in the US . 126 00:04:48,760 --> 00:04:51,190 But what my patients do run into , um , 127 00:04:51,200 --> 00:04:53,200 whether they live in a city or they 128 00:04:53,200 --> 00:04:55,033 live um in the suburbs or in the 129 00:04:55,033 --> 00:04:57,311 countryside is something called typhus . 130 00:04:57,350 --> 00:04:59,839 And that's a disease that lives in 131 00:04:59,850 --> 00:05:02,420 fleas , um , that are present in small 132 00:05:02,429 --> 00:05:05,029 mammals here in Texas . And we know we , 133 00:05:05,114 --> 00:05:07,114 we have all those feral cats . I've 134 00:05:07,114 --> 00:05:09,058 seen gray foxes . Now , we're just 135 00:05:09,058 --> 00:05:11,545 saying the possums , the possums , um 136 00:05:11,554 --> 00:05:14,385 and then house pets as well interact 137 00:05:14,394 --> 00:05:16,172 with these other animals in the 138 00:05:16,172 --> 00:05:18,394 environment and can get fleas as well . 139 00:05:18,394 --> 00:05:21,125 So , protecting your , um , um , your 140 00:05:21,135 --> 00:05:23,505 small mammals from fleas is a really 141 00:05:23,515 --> 00:05:25,744 great way to keep yourself safe . Um , 142 00:05:25,755 --> 00:05:29,545 and if you do , um , uh , tend to have 143 00:05:29,554 --> 00:05:33,079 a large population of uh mammals around 144 00:05:33,089 --> 00:05:35,579 your house , this is a vulnerability 145 00:05:35,589 --> 00:05:38,380 for you as well . Um Do you wanna 146 00:05:38,390 --> 00:05:40,668 describe typhus like the disease ? Yes . 147 00:05:40,668 --> 00:05:43,589 So , um , typically for when , for 148 00:05:43,600 --> 00:05:45,822 people that have typhus , they're often 149 00:05:45,822 --> 00:05:47,989 will have a fever , you will typically 150 00:05:47,989 --> 00:05:50,510 have a pretty noticeable fever . And 151 00:05:50,519 --> 00:05:52,579 then you may notice after you , you 152 00:05:52,589 --> 00:05:54,478 start having fevers , if you look 153 00:05:54,478 --> 00:05:56,533 closely , you may see the onset of a 154 00:05:56,533 --> 00:05:58,645 rash on your body . So specifically , 155 00:05:58,645 --> 00:06:00,811 if you look at , at your body and your 156 00:06:00,811 --> 00:06:02,922 abdomen and your chest , um you , you 157 00:06:02,922 --> 00:06:06,190 may notice a faint um red rash . Um , a 158 00:06:06,200 --> 00:06:08,079 lot of people also have pretty 159 00:06:08,089 --> 00:06:10,410 significant headaches . So I would say 160 00:06:10,420 --> 00:06:13,609 a headache , rash , fever , maybe with 161 00:06:13,619 --> 00:06:15,841 some loss of appetite are the , are the 162 00:06:15,841 --> 00:06:18,008 main , um , symptoms that I've seen in 163 00:06:18,008 --> 00:06:20,008 our patients . Yeah , I've seen the 164 00:06:20,008 --> 00:06:21,897 same , I've seen a couple of very 165 00:06:21,897 --> 00:06:24,063 severe cases that have a little bit of 166 00:06:24,063 --> 00:06:26,230 unusual presentation . Um , and that's 167 00:06:26,230 --> 00:06:28,175 where we would , we'd be concerned 168 00:06:28,175 --> 00:06:30,286 about those cases being missed . So , 169 00:06:30,286 --> 00:06:32,286 if you have significant exposure to 170 00:06:32,286 --> 00:06:34,397 animals or fleas , it's always a good 171 00:06:34,397 --> 00:06:36,563 idea if you're not feeling well to let 172 00:06:36,563 --> 00:06:38,675 your doctor know about that , so they 173 00:06:38,675 --> 00:06:40,841 can go ahead and test you or treat you 174 00:06:40,841 --> 00:06:42,897 with an antibiotic . Um because that 175 00:06:42,897 --> 00:06:45,119 one is a bacterial infection . Um , and 176 00:06:45,119 --> 00:06:47,063 then I want to double down on , if 177 00:06:47,063 --> 00:06:49,175 you're not bitten , you can't get the 178 00:06:49,175 --> 00:06:51,397 disease . And this is what an , um , an 179 00:06:51,397 --> 00:06:53,508 army entomologist told me . He says , 180 00:06:53,508 --> 00:06:55,619 well , you know , um , medications to 181 00:06:55,619 --> 00:06:57,619 prevent these bacterial diseases or 182 00:06:57,619 --> 00:06:59,786 medic , uh medical evacuation pathways 183 00:06:59,786 --> 00:07:01,897 to present these parasites are really 184 00:07:01,897 --> 00:07:01,600 the last line of defense and the first 185 00:07:01,609 --> 00:07:03,887 line of defense is to not get bit . So , 186 00:07:03,887 --> 00:07:05,910 I love that model . Um , and , um , 187 00:07:05,920 --> 00:07:08,179 while here in Texas , the best you can 188 00:07:08,190 --> 00:07:11,410 do , um , is the , this , uh , you know , 189 00:07:11,420 --> 00:07:13,531 first line of defense and not getting 190 00:07:13,531 --> 00:07:15,950 bit as best you can . Um , if you are 191 00:07:15,959 --> 00:07:18,181 going to be traveling to the tropics or 192 00:07:18,181 --> 00:07:20,690 another country , um , you might be at 193 00:07:20,700 --> 00:07:22,700 risk for things that we can prevent 194 00:07:22,700 --> 00:07:25,250 with either immunizations or with anti 195 00:07:25,290 --> 00:07:27,690 para medications like such as for 196 00:07:27,700 --> 00:07:30,470 malaria . Um , and if you are uh , uh , 197 00:07:30,480 --> 00:07:33,119 Tricare beneficiary , active duty 198 00:07:33,130 --> 00:07:35,408 dependent retiree , that kind of thing , 199 00:07:35,408 --> 00:07:37,709 you can always contact the bay , um , 200 00:07:37,720 --> 00:07:40,209 infectious diseases travel clinic for a 201 00:07:40,220 --> 00:07:42,442 self referral appointment to see if you 202 00:07:42,442 --> 00:07:44,664 benefit from vaccines or anti parasitic 203 00:07:44,664 --> 00:07:48,100 or um , um , um , uh , 204 00:07:48,109 --> 00:07:50,769 bacterial medications . And so that's 205 00:07:50,779 --> 00:07:52,835 another way to prevent yourself from 206 00:07:52,835 --> 00:07:55,057 getting sick by one of those definitely 207 00:07:55,057 --> 00:07:57,057 squish bugs on . Yeah . So , yeah , 208 00:07:57,057 --> 00:07:59,160 please take advantage of , of our 209 00:07:59,170 --> 00:08:01,160 clinic and definitely if you're 210 00:08:01,170 --> 00:08:03,910 traveling , um , we're available for 211 00:08:03,920 --> 00:08:05,976 those resources and let's not forget 212 00:08:05,976 --> 00:08:08,690 about the ticks , ticks . Yes . Yes . 213 00:08:08,700 --> 00:08:10,867 So it is summer time and people may be 214 00:08:10,867 --> 00:08:13,799 going on hikes . So , certainly wear 215 00:08:13,809 --> 00:08:16,220 clothing that protects your body . So , 216 00:08:16,230 --> 00:08:18,452 I mean , um , typically we'll see ticks 217 00:08:18,452 --> 00:08:21,000 and tall grasses and they'll find a way 218 00:08:21,010 --> 00:08:23,121 to , to , to get to your skin so they 219 00:08:23,121 --> 00:08:25,288 can get to your blood supply . So , if 220 00:08:25,288 --> 00:08:27,440 you're wearing long pants and long 221 00:08:27,450 --> 00:08:29,672 sleeves or , um , boots , they're gonna 222 00:08:29,672 --> 00:08:31,894 have a hard time getting access to , to 223 00:08:31,894 --> 00:08:34,809 your skin . So , um , protect yourself 224 00:08:34,820 --> 00:08:36,931 again . If you protect yourself , the 225 00:08:36,931 --> 00:08:38,987 tick can't get to you . Tick , can't 226 00:08:38,987 --> 00:08:41,098 bite you . Tick can't infect you with 227 00:08:41,098 --> 00:08:43,209 what , you know , sometimes it can be 228 00:08:43,209 --> 00:08:45,431 bacterial infections . Sometimes it can 229 00:08:45,431 --> 00:08:48,599 be , um , parasites . Yeah . I , um , 230 00:08:48,940 --> 00:08:51,849 I , uh , and get inspected for ticks as 231 00:08:51,859 --> 00:08:54,440 well . Um , I , like I said , soccer 232 00:08:54,450 --> 00:08:56,506 yesterday definitely was wearing the 233 00:08:56,506 --> 00:08:58,617 long pants , but I could not wear the 234 00:08:58,617 --> 00:09:00,783 long shirt because I was so hot . Um , 235 00:09:00,783 --> 00:09:03,006 so I can imagine some people hiking are 236 00:09:03,006 --> 00:09:02,960 going to be wearing tank tops and 237 00:09:02,969 --> 00:09:06,380 shirts and t-shirts , shorts . And so , 238 00:09:06,390 --> 00:09:09,750 um , take a look at where , uh , 239 00:09:09,820 --> 00:09:11,909 uh , at your extremities , anything 240 00:09:11,919 --> 00:09:13,975 that could have been exposed for the 241 00:09:13,975 --> 00:09:16,086 tick to latch on you . And it's not a 242 00:09:16,086 --> 00:09:18,308 bad idea to take a second look later on 243 00:09:18,308 --> 00:09:20,820 because if one of those animals got on 244 00:09:20,830 --> 00:09:23,520 because they're animals got onto your 245 00:09:23,530 --> 00:09:26,239 clothing , it could then latch on to 246 00:09:26,250 --> 00:09:28,083 you in an area that maybe wasn't 247 00:09:28,083 --> 00:09:30,789 exposed as well . And so I remember we 248 00:09:30,799 --> 00:09:32,910 went hiking in Harper . Spy me and my 249 00:09:32,910 --> 00:09:34,966 husband and two days later I found a 250 00:09:34,966 --> 00:09:38,280 tick on his arm . I was like , happens . 251 00:09:38,289 --> 00:09:40,456 Yeah . So if you have a bunny , I , so 252 00:09:40,456 --> 00:09:42,789 I can see it like , you know , Alice 253 00:09:42,799 --> 00:09:44,855 and her husband , they can also help 254 00:09:44,855 --> 00:09:47,021 identify ticks on each other . So it's 255 00:09:47,021 --> 00:09:49,021 always good to get a second pair of 256 00:09:49,021 --> 00:09:52,390 eyes to look for ticks . Oh , yes . Yes . 257 00:09:52,580 --> 00:09:55,840 Um , uh , and this summer when we go 258 00:09:55,849 --> 00:09:58,640 hiking together , I hope we get to 259 00:09:58,650 --> 00:10:02,590 avoid . Uh , yes . So we're , we're 260 00:10:02,599 --> 00:10:04,932 traveling to Spain together this summer . 261 00:10:04,932 --> 00:10:07,099 We're meeting up in Spain , meeting up 262 00:10:07,099 --> 00:10:09,210 and I'm really excited because , um , 263 00:10:09,210 --> 00:10:11,321 we have boys that are a similar age , 264 00:10:11,330 --> 00:10:13,919 um , and they love hikes and I think 265 00:10:13,929 --> 00:10:16,151 we're gonna enjoy some nice hikes . The 266 00:10:16,151 --> 00:10:18,207 weather should be hopefully a little 267 00:10:18,207 --> 00:10:20,429 bit cooler and , um , I'm excited about 268 00:10:20,429 --> 00:10:22,429 that . Yeah , I can't wait for that 269 00:10:22,429 --> 00:10:24,485 either . My kids have been trying to 270 00:10:24,485 --> 00:10:26,707 brush up on their Spanish and so , uh , 271 00:10:26,707 --> 00:10:28,596 we're all pumped about , um , our 272 00:10:28,596 --> 00:10:31,244 vacation together . Yes . So , um , all 273 00:10:31,255 --> 00:10:33,311 right . Well , that's all that we've 274 00:10:33,311 --> 00:10:35,477 got for today . Um , thanks for coming 275 00:10:35,477 --> 00:10:37,533 back and , uh , taking a look at our 276 00:10:37,533 --> 00:10:39,755 Friday facts and let us know how we can 277 00:10:39,755 --> 00:10:41,977 help you out going forward . Yes . Have 278 00:10:41,977 --> 00:10:41,684 a safe summer . Take care .