Anthony writes:

One of your guests questioned the travel warnings concerning Zika, noting that there are no alerts for France where the incidence of toxoplasmosis is high.  This was nice as a rhetorical flourish, but the comparison is not apt.  The parasite problem in France is thought to be due to the consumption of under-cooked meat, something quite easy for a traveler to avoid.  There also are screenings and drugs for toxoplasmosis.

Dickson should have been there!

Thank you.

Carolyn replies:

Yes, I don’t necessarily disagree with that. However, one could argue that given that ZIKV is transmitted by a mosquito, precautions could also be taken to limit exposure. My point, as I am sure you know, was to point out that these precautions are a bit of an overreaction. Pregnant women are tested monthly for toxo in France (which we do not do in the US given the much lower rates of infection), but there are no drugs that can be used to treat it. Yes, there are screens, but there are also therapeutics being screened/developed for ZIKV I am sure, but I don’t really think that screens taking place would make me feel any better as a pregnant woman who would travel!

Aarchan writes:

Hi Vincent,

I’m a silent fan of TWIV — I’ve had a longstanding fascination with viruses.. trained for a year as a Hughes Fellow at the NIH with Teh Jeang and worked on our early understanding of HIV’s Tat-Tar interactions in the early 1990s…

I’m now on the faculty at Jules Stein-UCLA… the Zika story is fascinating and the eye involvement goes along with findings we see in some other TORCH syndromes.

The complexity of placental penetration from TWIV 375 notwithstanding, the virus is getting into the eye and destroying the developing retinal architecture, potentially suggesting wider neurologic deficits in these children which will likely become manifest as they get older and are further investigated.

A couple of links for your take on future TWIVs:


Aarchan Joshi, M.D.


South Bay Eye Institute

Assistant Clinical Professor

Jules Stein Eye Institute

UCLA Geffen School of Medicine

Robin writes:

Anthony writes:

As far as I’m concerned, the longer, the better!  If I need a couple of sittings to finish a Podcast, that’s great.

Your Podcasts have been a great spark for me.  I’ve tried to start one — with very limited success — and have extended my blogging as seen here:

Carol writes:

When I first heard the news about Zika and microcephaly I immediately thought of the rise of anencephaly in (I believe the 1980s) along the Rio Grande. Then, it was attributed to agricultural pollutants, and others,  coming from both the US and Mexico. One can’t help but to wonder if a viral disease was the real culprit. Any thoughts?


Spencer writes:

Dear TWIV team,

The Zika episode was another great one for TWIV.  Perhaps one of the best!  I’ve been listening since the very beginning.

Your discussion centered on contracting Zika virus during pregnancy and the difficulties of crossing the placenta.  Is there any information about the long term sequelae of Zika virus infection in humans?  Certainly other viruses and other infectious agents can have long standing effects even years after the initial infection occurs.  This leads to a question of whether a woman who contracts the virus maybe even many years before pregnancy is also potentially at risk later on, even if the the viremia is not sustained?  What evidence exists that this is or is not a concern?


Spencer Kroll MD Phd

Tim writes:

Thought you would be interested in this article!

Anthony writes:

Researcher illegally shares millions of science papers free online to spread knowledge

Vic writes:

Dear TViV Team,

I am a long, long, long time listener (episodes 1-374) and a first time emailer…

I thought that I should say something regarding Alan’s remarks concerning cruise ships and norovirus. I should tell you that I live in Kristiansand, Norway and work as a Ship’s Agent for one of world’s largest suppliers of logistics to the cruise industry.

When a cruise ship arrives in a new port, the first person onboard in the morning, and the last person to leave the ship in the afternoon is the Ship’s Agent. The Agent handles paperwork for the police and customs, arranges transport for ship’s personnel, purchases supplies, finds spare parts, and, most importantly, coordinates medical services for crew and passengers. I am onboard more than 100 different cruise ships each season here in ports along the southern and western coasts of Norway.

Alan is correct that most cruise ships are flagged in countries that require fewer regulations. Here in Norway, we see ships that are primarily flagged in the Bahamas, Malta, and Antigua. However, the regulations that the ships are trying to avoid have more to do with taxation than sanitation. There are very strict rules concerning labor laws, environmental contamination, and especially sanitation for vessels that call here in Norway and other European ports.

The cruise ships are, without exception, completely paranoid about sanitation. There are hand sanitising stations at every gangway, at every elevator and stair landing, at the entrance and exit to every restaurant, in the crew galley, and in all areas where passengers gather. Some of the ships have personnel stationed at the gangway who require you to sanitise your hands when you leave or return to the ship.

The ships desperately want to avoid the terrible publicity that is generated when 350 passengers share a bout of norovirus, so they are as proactive as they can be to minimise the potential for an outbreak. I don’t think they are so concerned with the publicity generated by taking advantage of tax breaks from Malta.

Love the show!  Keep up the good work!

med venlig hilsen,


AJ writes:

Hello TWIV team,

I read what was to my friend, an alarming article, and to me, a very funny one! Here is a link:

Sorry if you have already discussed this, although there isn’t much about the article itself that’s really worth talking about. Except that Epstein Barr virus actually likes cheese… makes me wonder if it prefers a good bottle of Pinot Grigio or Malbec with its cheese. But after reading this, I was delighted by the humorous aspects, and rather horrified how it could be very seductive to people. Blame problems on some external enemy! I tried to think of what people could do to combat such evangelistic misinformation, and I realized that what you guys are doing is probably the best cure. Talking to people about medicine in an honest and thorough way, and making it understandable. So thank you again!

Although, in the article’s defense, I will thank the medical medium that his cure is to eat healthier. I guess that probably will help people with a lot of their problems.



In San Diego, where it was enviably warm degrees Celsius today, and sunny.

Justin writes:

Also just curious is there any merit to purposefully giving a woman Zika before she tries to get pregnant as an attempt to avoid microcephaly?

Anthony writes:

Is the Zika Virus (or Something Worse) Killing Nicaragua’s Monkeys?

Leave a Reply

Your email address will not be published. Required fields are marked *

One comment on “TWiV 376 letters