Dr. Jessica Pelletier, Dr. Sidwell Kyeyune, and Dr. Kakande Reagan discuss the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of Marburg virus disease.

Take-Home Points:

• Marburg virus disease infection can occur via zoonotic exposure to Egyptian fruit bats or via human-to-human transmission.
• Initial symptoms are non-specific but can progress to hemorrhage, multiorgan failure, and death.
• Diagnosis involves RT-PCR.
• Treatment is mostly supportive, including blood products (for bleeding), IV fluid resuscitation, and symptom control (with avoidance of NSAIDs).
• Remdesivir and monoclonal antibodies may be given under compassionate use.
• PPE involves standard, contact, and droplet precautions, with environmental decontamination via chlorine.
• Morbidity and mortality are high, so infection prevention is essential.

You can view the full show notes and references here: https://docs.google.com/document/d/12A8bV3BxUbWBRocbi66Gy31b0vAyt2ZUIQU04btgEPI/edit?usp=sharing

Image attribution: generated with Adobe Firefly.

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• More jazz guitar: more Jazz guitar.wav by Sub-d: https://freesound.org/s/49658/ -- License: Creative Commons 0
• Ragtime Logo Standard Version: https://pixabay.com/sound-effects/ragtime-logo-standard-version-116100/
• Counting to 20: Creative Commons 0: http://creativecommons.org/publicdomain/zero/1.0/
• Monkey noise (imitation) 3 by wilika2 -- https://freesound.org/s/588625/ -- License: Creative Commons 0
• bat.wav by tomschuetz -- https://freesound.org/s/635147/ -- License: Attribution NonCommercial 4.0
• Bats Settling into Trees by Yoyodaman234 -- https://freesound.org/s/667578/ -- License: Creative Commons 0
• disappointed aww by kanyonwyvern -- https://freesound.org/s/727358/ -- License: Creative Commons 0
• Ambulance_Traffic_Mic on top of car.WAV by deleted_user_6718832 -- https://freesound.org/s/365254/ -- License: Creative Commons 0

Dr. Jessica Pelletier, Dr. Lawrence Mendy, Dr. Elicana Nduhuura, and Malan Alfred Opoka discuss the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of Crimean-Congo Hemorrhagic Fever (CCHF).

Take-Home Points:

• CCHF is a severe tick-borne viral illness caused by CCHFV, occurring in Africa, the Middle East, Asia, and parts of Europe.
• Transmission is primarily via Hyalomma tick bites, but also through contact with infected animal tissues or the blood/body fluids of infected patients.
• High-risk groups include farmers, livestock handlers, abattoir workers, veterinarians, hunters, military personnel, healthcare workers, and travelers to endemic areas.
• CCHF progresses through four phases: incubation, prehemorrhagic, hemorrhagic, and convalescent. Early symptoms are nonspecific (fever, headache, myalgia, back pain, nausea, vomiting, abdominal pain, weakness). Hemorrhagic signs (e.g., petechiae, epistaxis, hematemesis) indicate severe disease.
• Labs often show thrombocytopenia, leukopenia, elevated liver enzymes, and DIC.
• Diagnosis is by RT-PCR in the acute phase; serology (IgM/IgG) is useful later.
• Management is supportive: isolation, fluids, blood products, and avoidance of NSAIDs. Ribavirin is commonly used, though mortality benefit is uncertain.
• Mortality ranges from 10–40%, depending on severity and complications (e.g., shock, DIC, multiorgan failure).
• Prevention includes tick avoidance, protective equipment, animal handling precautions, and infection control in healthcare settings.

You can view the full show notes and references here: https://docs.google.com/document/d/1jDZcgifY0BKCgB3fzPxzePjcu_eOfJYSFEqhAAhg-IA/edit?usp=sharing

Image attribution: generated with Adobe Firefly using this image as a reference:

By Adam Cuerden - Own work, Public Domain, https://commons.wikimedia.org/w/index.php?curid=3148918

Episode sound attributions:

• More jazz guitar: more Jazz guitar.wav by Sub-d: https://freesound.org/s/49658/ -- License: Creative Commons 0
• Ragtime Logo Standard Version: https://pixabay.com/sound-effects/ragtime-logo-standard-version-116100/
• Counting to 20: Creative Commons 0: http://creativecommons.org/publicdomain/zero/1.0/
• Sheep on Shearing Day 4 by Ali_6868 -- https://freesound.org/s/679001/ -- License: Creative Commons 0
• harpsicord_dream-leave3.flac by zerolagtime -- https://freesound.org/s/29628/ -- License: Attribution 4.0
• Ambulance_Traffic_Mic on top of car.WAV by deleted_user_6718832 -- https://freesound.org/s/365254/ -- License: Creative Commons 0

Credit goes to Nakamatte Swaburah for assisting Dr. Pelletier with the writing of the podcast transcript.

Dr. Jessica Pelletier and Dr. Sabel Bass co-interview Dr. Valentine Aroh, discussing the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of Lassa fever.

Take-Home Points:

• Lassa fever is a viral hemorrhagic fever endemic to West Africa.
• Rats are the primary animal reservoir and are becoming more of an issue as dry seasons lengthen in the face of climate change.
• Mortality rates vary widely due to underreporting; many cases are asymptomatic, but among the symptomatic, mortality is quite high.
• Pregnant women are at extremely high risk for severe disease and death.
• Lassa can resemble other endemic viral illnesses and hemorrhagic fevers, but facial swelling is a distinctive feature.
• RT-PCR is the gold standard for diagnosis.
• Treatment is largely symptomatic, but Ribavirin can be tried in the first 6 days of symptoms.
• Contact and droplet precautions are essential to prevent the spread of disease.

You can view the full show notes and references here: https://docs.google.com/document/d/1pn2Ml_rDbHfgBqHRC9KIWL6z5qlUsR8QeeghcAavy6o/edit?usp=sharing

Image attribution: generated with Adobe Firefly

Episode sound attributions:

• More jazz guitar: more Jazz guitar.wav by Sub-d: https://freesound.org/s/49658/ -- License: Creative Commons 0
• Ragtime Logo Standard Version: https://pixabay.com/sound-effects/ragtime-logo-standard-version-116100/
• Counting to 20: Creative Commons 0: http://creativecommons.org/publicdomain/zero/1.0/
• airplane_stereo_flyby_05.wav by Izmotion -- https://freesound.org/s/623159/ -- License: Creative Commons 0
• cough9.aiff by Fratz -- https://freesound.org/s/19124/ -- License: Attribution 4.0
• vomit sound effect.wav by KirbyTheSoundingMan -- https://freesound.org/s/672378/ -- License: Creative Commons 0
• Toilets at Mount McIntyre Recreation Centre- Main Floor by SoundsLikeYukon -- https://freesound.org/s/852220/ -- License: Creative Commons 0
• Cat Smokey Meow 1 by redjamie7 -- https://freesound.org/s/729031/ -- License: Attribution 4.0

Dr. Jessica Pelletier and Dr. Nicholas Maxwell discuss two re-emerging diseases in the era of the rising phenomenon of vaccine hesitancy: measles and mumps. They cover vaccine safety for preventing both diseases, followed by the clinical presentation, diagnosis, management, and close-contact protection measures for measles and mumps. The episode closes with a discussion of how to talk to families about vaccines.

Take-Home Points:

• We are seeing a resurgence of vaccine-preventable diseases; this is multifactorial, but some of it has to do with the pandemic, global conflict, and misinformation.
• Though there are several formulations and the dosing schedule for measles plus or minus mumps vaccine may vary from country to country, these vaccines are highly safe and effective in the prevention of these diseases.
• It is our responsibility as healthcare providers to educate our patients and their families about vaccine safety, finding ways to connect with them without judgment.

You can view the full show notes and references here: https://docs.google.com/document/d/1biOevjeGk8eVeAeBEWNEchfoJuRWzPbfIKP63cmSEjo/edit?usp=sharing

Image attribution: generated with Adobe Firefly

Episode sound attributions:

• More jazz guitar: more Jazz guitar.wav by Sub-d: https://freesound.org/s/49658/ -- License: Creative Commons 0
• Ragtime Logo Standard Version: https://pixabay.com/sound-effects/ragtime-logo-standard-version-116100/
• Counting to 20: Creative Commons 0: http://creativecommons.org/publicdomain/zero/1.0/
• chime.wav by hypocore -- https://freesound.org/s/164088/ -- License: Creative Commons 0
• Tape Rewind #1 by Hajisounds: https://freesound.org/s/679970/ -- License: Creative Commons 0
• cha ching.wav by creek23 -- https://freesound.org/s/75235/ -- License: Attribution NonCommercial 4.0Open_03.WAV by kjackson -- https://freesound.org/s/32634/ -- License: Attribution NonCommercial 3.0Single Coin Return.wav by tweeterdj -- https://freesound.org/s/29649/ -- License: Attribution 3.0
• Ambulance_Traffic_Mic on top of car.WAV by deleted_user_6718832 -- https://freesound.org/s/365254/ -- License: Creative Commons 0

Dr. Jessica Pelletier, Dr. John George Johnson, Dr. Akan Otu, and Dr. Bri Bennett discuss the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of rabies.

Take-Home Points:

• Rabies is an encephalomyelitis that occurs after inoculation from infected saliva.
• Many countries have successfully eradicated this disease, but 59,000 people still die of the disease yearly.
• Canine vaccination programs, PREP for high-risk individuals, and PEP after potential rabies exposure prevent disease.
• Initial symptoms are flu-like and non-specific. Once symptoms have started, all we can offer is supportive care.

You can view the full show notes and references here: https://docs.google.com/document/d/1cagKcATrYkKi1M3DL4wgjThpFIlqeG4Ai1U1aOHv1vQ/edit?usp=sharing

Image attribution: generated with Adobe Firefly

Episode sound attributions:

• More jazz guitar: more Jazz guitar.wav by Sub-d: https://freesound.org/s/49658/ -- License: Creative Commons 0
• Ragtime Logo Standard Version: https://pixabay.com/sound-effects/ragtime-logo-standard-version-116100/
• Counting to 20: Creative Commons 0: http://creativecommons.org/publicdomain/zero/1.0/
• Animal Dog Bark And Growl 01.wav by abhisheky948 -- https://freesound.org/s/625501/ -- License: Creative Commons 0
• cha ching.wav by creek23 -- https://freesound.org/s/75235/ -- License: Attribution NonCommercial 4.0Open_03.WAV by kjackson -- https://freesound.org/s/32634/ -- License: Attribution NonCommercial 3.0Single Coin Return.wav by tweeterdj -- https://freesound.org/s/29649/ -- License: Attribution 3.0
• TOONAnml-Blue Snowball Microphone, CU_Puppy Barking, Human Imitation, Cartoon_Nicholas Judy_TDC by designerschoice -- https://freesound.org/s/805052/ -- License: Creative Commons 0

Dr. Jessica Pelletier and Dr. Mulungi Jonathan discuss the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of cryptococcosis.

Take-Home Points:

• Cryptococcus is deadly and demands early recognition.
• Most global burden is in Sub‑Saharan Africa.
• Crypto isn’t just an HIV disease.
• CNS and lungs are the most commonly affected organs.
• CrAg LFA is the best diagnostic tool in resource‑limited settings.
• Elevated intracranial pressure is the major killer.
  • Positive pulmonary crypto requires a lumbar puncture - even without neuro symptoms.
• After managing the ABCDs, treatment = antifungals + ICP control + supportive care.

You can view the full show notes and references here: https://docs.google.com/document/d/18JtGpSXAu3qCWntKqd5ALuLF-C0FkvlT0VQtKMAUsxE/edit?usp=sharing

Image attribution: generated with Adobe Firefly

Episode sound attributions:

• More jazz guitar: more Jazz guitar.wav by Sub-d: https://freesound.org/s/49658/ -- License: Creative Commons 0
• Ragtime Logo Standard Version: https://pixabay.com/sound-effects/ragtime-logo-standard-version-116100/

Dr. Bri Bennett, Dr. Kakande Reagan, and Dr. Jessica Pelletier discuss the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of snake envenomation - a neglected tropical disease.

Take-Home Points:

• Snakebites cause major global death and disability, especially in LMICs.
• Most dangerous bites come from vipers and elapids.
• Venom effects fall into three categories: cytotoxic, hemotoxic, and neurotoxic.
• Diagnosis is clinical; 20WBCT helps assess coagulopathy.
• Antivenom is the only specific treatment—give early when indicated.
• Avoid harmful first aid (tourniquets, cutting, sucking).
• Immobilize the limb and seek urgent medical care.
• Supportive care (airway, fluids, monitoring) saves lives.
• Do not perform fasciotomy.
• Encourage rehab and follow‑up to prevent long‑term disability.

You can view the full show notes and references here: https://docs.google.com/document/d/1HJ-Mo-3rOZzSr_wVGHn3y0FKq5pSZGWJ1E0Iaf5aMjQ/edit?usp=sharing

Image attribution: generated with Microsoft Copilot using open-access image (it was published prior to July 2017 under the Creative Commons CC0 1.0 Universal Public Domain Dedication license) - https://pixabay.com/

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• Counting to 20: Creative Commons 0: http://creativecommons.org/publicdomain/zero/1.0/
• More jazz guitar: more Jazz guitar.wav by Sub-d: https://freesound.org/s/49658/ -- License: Creative Commons 0
• Ragtime Logo Standard Version: https://pixabay.com/sound-effects/ragtime-logo-standard-version-116100/
• Primitive Snake Charmer Melody by simonjsounds -- https://freesound.org/s/260873/ -- License: Creative Commons 0
• Snake.wav by Julian_Eftei -- https://freesound.org/s/553366/ -- License: Attribution 4.0
• Cocktail Sounds.wav by KenRT -- https://freesound.org/s/319994/ -- License: Creative Commons 0
• Ambulance_Traffic_Mic on top of car.WAV by deleted_user_6718832 -- https://freesound.org/s/365254/ -- License: Creative Commons 0

Dr. Jessica Pelletier and Dr. Mulungi Jonathan discuss the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of chromoblastomycosis.

Take-Home Points:

• CBM is a NTD that disproportionately impacts males who work outdoors in tropical climates.
• Infection occurs via direct innoculation, and the disease progression is slow.
• Early intervention is critical for preventing morbidity, and usually involves surgical removal of the lesions when they are small.
• Larger lesions generally require a combination of prolonged antifungals and cryotherapy.
• Prevention of serious disease involves keeping covered when working outdoors in warm climates, maintaining good hygiene, and early presentation to care.

You can view the full show notes and references here: https://docs.google.com/document/d/1jcLOOniP5LvClXT7HW1ozs-SiEah2k5SXUf0Z_eAhys/edit?usp=sharing

Image attribution: generated with Adobe Firefly

Episode sound attributions:

• Counting to 20: Creative Commons 0: http://creativecommons.org/publicdomain/zero/1.0/
• More jazz guitar: more Jazz guitar.wav by Sub-d: https://freesound.org/s/49658/ -- License: Creative Commons 0
• Ragtime Logo Standard Version: https://pixabay.com/sound-effects/ragtime-logo-standard-version-116100/
• Audience laughing by Soundeffects4You -- https://freesound.org/s/231258/ -- License: Creative Commons 0