Memoir that Couples Water under my bed. Growing up in New Jersey in the new Jersey Factory Town in the 1980s she believed her aunt had become deathly ill from eating an apple. No one in her family in either the United States or Columbia Spoke of infectious diseases, and even into her 30s she only knew her aunt had died of a rare Illness Called Chagas but as hernandez dug deeper she discovered that chagas, or accusing the disease, is more prevalent in the United States than to seek a virus. Today more than 300,000 americans have chagas. Why do some infectious disease make headlines and others fall by the wayside . After her aunts death, hernandez begin searching for answers about who our nation chooses to take care of and who we ignore. Crisscrossing the country she interviews patients at the epidemiologist and even veterinarians with the department of defense. Hernandez new book the kissing bug tells the story of how poverty, racism and public policies have conspired to keep this disease hidden and how this disease intersects with her own identity as im these, sister, daughter, woman, a Writer And Researcher and a citizen of the country that is only beginning to address the harms caused by chagas, and the dangers it poses. A riveting and nuanced investigation into racial politics and Forprofit Healthcare in the United States, the kissing bug reveals an intimate history of a marginalized disease and connects us to the lives at the center of it all. Joining Hernandez And Conversation this evening is amy stewart. Stewart is new times bestselling author of the cops Sisters Series which are based on two straight what americas first female deputy sheriffs and her two rambunctious sisters. A popular nonfiction titles include the drunken botanist, wicked bugs, wicked plans, and flower confidential. Her books have sold over 1 million copies worldwide, he been translated into 17 languages. This evenings if it will also include an Audience Q a so please keep the q a button at the bottom of your screen if you please use the q a button at the bottom of your screen if youd like to ask a question. As well as if someone has typed a question youd like to know the answer to please upload that particular question by clicking the thumbsup thumbs. Most important like please consider supporting daisy and powells by purchasing a copy of her new book from us. A link to buying the United States along with the enemies of books will be shared in a chat a couple times. Daisy, amy, what a joy to welcome you both and thanks for joining us tonight. Thank you so much for having me. Thank you amy for joining me. Thanks. I lived in the same neighborhood with your publisher, just up the street, and the way i i foundt about your book is that i dropped by Copycat Member come to drop something off and they handed me a copy of the galley and immediately like i saw the cover and thats all he knew about it and i immediately went on this rant about Insect Transmitted Diseases. When you read in a few minutes, we will explore the personal side of this story but the first thing i wanted to say to you and to the audience is that i really became interested in the issue of Insect Transmitted Diseases when i was writing wicked bugs which looks like a ditzy book but i did a lot of research and what really struck me about Insect Transmitted Diseases and the thing i would go around the country telling audiences is im going to tell you all these stories about these creepy bugs and the diseases they transmit and farflung places it may be youve never been to. You might be thinking reason we dont have them here in the United States is that we get lucky. We just picked the right country come to, our ancestors. The fact is in the United States we have good sanitation. We have medicine. We have passed control. With a number of ways of helping people deal with the public Health Crisis that is infectious disease and we choose not to share that with the rest of the world. Thats why some of these things happen in other places but not here and, of course, even in the United States were familiar with Lyme Disease and other types of transmitted diseases but on a different scale. I was so excited about this book even though its a tough story to tell because i just feel like we dont fully grasp these stories, and youve made it real and just made it very human and its a Family Story we can all connect to, so thank you for this book. Thank you so much. I agree with everything you are saying. Weve invested in a very particular way in this country against infectious diseases and specific communities in this country as well. Yeah, decisions have been made that protect us, absolutely. Right. There are so many things that a want to talking to you about that have to do with the Memoir Side but im also interested in the research. I know theres a bunch we can get into. Do you want to read now and then we go from there into the rest of the conversation . Yes. I am happy to read. So i want to read, i was reminded that you wrote about Charles Darwin in your book wicked bugs. A thought i would read from that section in the book, too. Its bringing together Memoir And Journalism to write about the kissing by Disease Or Chagas disease which my auntie was diagnosed with, and after many years lost her life to this disease. In its chronic form it does not have a cure. Its a parasitic disease and the parasite, usually goes after the heart. I didnt get all all the inn when i was growing up. Information i got was my auntie must have eaten some kind of fruit in your Home Country and the parasite was transmitted that way. So part of the book is also sort of describing, making sense of this disease both as a child and then as an adult and as a journalist being able to do research. So im going to read from a chapter called i think i need to know, my auntie was diagnosed with this disease and who lost her life to it, and its auntie that just means sort of her nickname was like the bible auntie. She is very religious but she is nicknamed that way because she has a very long memory and hold onto every Family Story on behalf of everyone in the family, so that was her nickname. Shes the one who began when i was a child to explain the disease to me. Her stories were i can to praying the rosary. They repeat it. She moved our Kitchen Table with Pomegranate Lipstick and are tall tales about Colombians Beauty pageants and priests who wanted more than her story about how Tia Dora had almost died when she was young, thats a sick she was. I might have been almost 15 when the started to feel crowded for my arms and legs, my new height which at 52 felt quite tall. I asked, how could it be a prude almost killed her . It was contaminated she answered, matteroffact. But how . The fruit was contaminated. They can mean a mans penis and in some parts of latin america it can mean a little devil. Years later when i started reading about kissing bugs i did not know what i would find it absolutely did not expect to come across Charles Darwin. In 1835 Darwin was 26, and four is into strip in South America. In march of that year he and his guide roads to the plains d argentina. The land was flat and the air hot and for a full Day Darwin found no water and only a few houses. When they neared the village he noticed a field the color of blood. A locust invasion. People raced from their cottages and set branches on fire and weighed the Torch Bark at the locus. They shouted hoping the Noise And Smoke were turned away the tiny beasts, but nothing worked. Darwin wrote on. The men had ten deals with them and when they all finally escaped the locus and reached the village, darwin expected to sleep well. The village was nestled among gardens, it boasted a river and rows of trees. Who does not sleep like lig under a Willow Tree . But when darwin closed his eyes at night in argentina, the kissing bugs prepped out from their hiding places and the insects did not care if was Charles Darwin or not. The sun had vanished here ravenous, they set off for the evening creeping onto his body. They expected him to be asleep. They expected to feed on him. But darwin was awake and horrified, and later despite being a man assigned he wrote how disgusting it was to feel these insects quote nearly an inch long and black and soft calling in all parts of your person, gorged with your blood. The kissing bugs came to be known as and classified in the family of for the vampire like tendencies. All over the americas, however, people adopted other names. Here in texas and the southwest people have called the kissing bug a bloodsucker, and in Argentina And Bolivia people say it is probably comes from a language and they do People Today in South America and that dates back to the inca empire. But that lets itself fall and is probably a reference to these insects slip out from the crevices in the walls of houses made from mud and sticks falling toward the bodies of their sleeping victims. In central america in mexico people say the kissing bug is Aa Name thats also use for bedbugs. Years after i i grown up and t home, a man from mexico tried to explain it to me this way. There are little and big bucks. The kissing but hes told a big. Ill stop there. Thanks for listening, everyone. So have a special Surprise Guest Today for our event. Oh, my goodness. So right here yes. Thats your little friend. This is probably super gross. People are probably fleeing right now. These are all very, very naughty insects and an entomologist me this for me and i travel with that. But thats what it looks like to you guys and see, this is kind of a mediumsized one but you can see certain about how big they are. As the audience will not know this, but when i begin this project of terrified of insects. Amy, i would gone like this immediately. Thats been sort of a strange part of his journey is kind of battling that fear that had of things that prepped and call crawled through the world. Right, right. We all have these kinds of stories in our families that we sort of grew up with and that sort of absorbed maybe a certain mythology about what happens and we dont question it, and then there comes a point with we question it. So wonder if you can talk about that, like what was that process like for you and at what moment did you start to realize, i think theres more to this and maybe this is something i want to dig into some more . That something i really try to document in writing this book because it was look like to breadcrumbs to my childhood through growing up so i was translating from a auntie when i six years old. At that point she understood english but she is not english dominant so i was in first grade and i was her voice between her and a nurse or sent to the house when she was in between surgeries. She was very lucky to be diagnosed in the United States in York City a doctor there. So i knew at an early age the something happening with my auntie but didnt quite know what it was. When i was 13 and another Family Member told its because of some contaminated fruit that she ate, then as i just read when i 15, weight, the fruit is something to do with an insect. It was never any language around insect transmitted disease or zoonotic disease, and that language around science and medicine. When i was a little older like in high school was when i first heard chagas was not just this way to make for but thats the disease have been named after dr. Carlos chagas from brazil who discovered the disease in 1909 of that was quite a Shock Guy Member and a right a write about this in the book of just realizing like this whole time i thought it was like some fancy latin medical term but is actually the person, like a person who discovered this and has been connected with this. When i was older i learned a little bit more as my auntie was overcome decades going in and out of hospitals, being affected in different for her it was her gastrointestinal system. So i knew from the medical care taking side the kind of impact that the parasite could have but it wasnt really until she died which was really quite a shock for me at the time because i think its hard for people who dont have a chronic Family Member to understand that you kind of, the kind of magical thinking that you get into over the years, you know, because youre constantly and hospitals, the person is constantly very, very sick, that you just think well, they are just sick again. Its one of those times again. So the end of her life was quite a shock, and when i started researching is when i found out this isnt rare at all. Theres 300,000 people in the United States who have this disease. They are all like my auntie. They are immigrants from souther central america or mexico, and very few of them know they are infected because the parasite can be dormant and your body, life actually, its only one in three people who are infected who go on to develop usually cardiac complications. It was actually in the wake of her death that i started to actually put more of the pieces together, including my family was not totally lying to me about the fruit. You can have fruit thats infected with these insects but usually it leads to acute outbreaks in groups of people because its been transmitted in juice for some kind of food, which was not the case for my auntie. She probably had exposure to the insect at some point. It was quite a a long journeyf putting the pieces together and it sounds so coherent when i tell you about it now but while i was writing if it was like sort of holding, trying to do 10,000 puzzle pieces, you know. Felt like a lot of information i was holding at the same time. In some ways that kind of true. When you look at the finished book it all seems so obvious and it all seems so clear, when we are writing and when were muddling through it and babbling with the story, is this a Book Or Isnt this book . Like none of that is clear. So true. Whenever things about this book is that it feels to me like its very much a part of a particular kind of Science Writing thats very immersive and blends so beautifully, a Firstperson Story and investigative journalist. The research perspective, but and also you are talking about the chagas is a real person, id like was so interesting to me about site is its all real people. Like, science is a story we tell ourselves about the world we live in. Thats what it is, and scientists are the storytellers, the ones who are figuring it out and putting it together so the rest of us can understand it. Like a really think about rebecca, henrietta lacks, stories she became personally involved with and also a story about people. Some Ways Mary Roach because she generally not a Family Connection but she nonetheless is putting yourself in the story and you get to read about like how scientists actually do the work. I wonder like when youre thinking about writing this did you sort of like now i just looks like a beautifully done thing, but was there a time when you like what is this even going to be . How im going to work out how to tell the story . Its interesting you mention those to make books because i studied those books very carefully. Because initially i was not plan to include any memoir. I thought it would maybe be on the rebecca scored side of the point where i would write more intimately about the patients that i met. So i give full credit to my amazing editor who is like what about number, what about the story with your antiwhat she was the one who really cheese that out and then in the process of writing that i realize my gosh, that voice, that into that voice is what needs to be the backbone here, what im talking about my can complicate a Motherdaughter Relationship with her or whether im talking to a in South America, like that voice is what is consistent. Youre right that is what im seeing in his books and i studied the one on cadavers was so fantastic it was i was no matter where she went it was her voice. It was like that intimate quality to the voice that was not only introduce me to people in places it also the same voice explaining the signs and making it a text i wanted to read as opposed to text i wanted to avoid. I did think about that a lot and it was a very conscious decision to like have that voice be the anchor to the Book And Sort of like the guide for people. I knew there would be readers, i hope there would be readers who would maybe shy away from a book about Medicine And Science who would take up this one. So i thought about that a lot. One thing invested in this but its a juggling act, right . I came to appreciate much more deeply what science journalists have been doing for a long time and especially as you are saying immersive, because i did like, for example, i did end up, we have these insects in the United States. Theyre usually in the southern part of the country. They are all over california and in the southwest and texas has quite a number of species of them, so having started out being terrified of insects i ended up in texas. I wanted to see what researchers were doing there. I went out hunting for kissing bugs in the middle of the Night And Thought and exactly what it looks like him which is kind of shocking that it was easy to track them actually what was surprising for me but also really amazing as you are saying, these are real people, you know, and they loaded the truck with all of their equipment and he spent hours out there looking at bugs, hoping to catch what they came to catch. Its just fascinating actually. I wonder if the scientists you have connected with were more eager to talk to you because of the connection you had . Were you forthcoming without . Im not just a journalist, i the Family Story here, and do you feel like that made the more open and more welcoming and more willing to give you time . Yeah, with scientists and doctors, initially i was not disclosing a personal connection. I had some interesting interviews with them where toward the intimate interviews they would suddenly say are you interested in this . Because just a lot of people as you know have not been interested in this disease. Its neglected. Its on that World Health Organization list of neglected diseases around the world. They would kind of remember or think of it as an afterthought like why do you care, of all people . Sometimes they would ask because im latina or the heard my last name, if were doing a Phone Interview they would say is any chance you had a connection with Chagas Disease with your Family Background . And the reason i didnt mention it, well, tried to think. I was not planning to do Anything Memoir at the beginnings i was like would i disclose this . As a went on i think i have like that very classic Journalism Training and so you never refill anything personal. However, when i approached families i always shared that first because i grew up in a workingclass immigrant family, like a completely understand some of the dynamics that are at play there. When a stranger shows up at your door and is asking about your medical history, your medical experiences. Usually i had a connection either to another patient or a doctor but i still felt like i know its going to create a stern sense that these if i disclose that i had an antiwas diagnosed with this disease. It was tricky, however, amy, because so many times patients want to know what had happened for her, and i couldnt say shes managing her symptoms, she is well. I couldnt any of that. It was always very painful to have to tell them that should ultimately died from this disease. I think it puts them at ease but it also created, put me, i was a traditional journalist in that sense when is interviewing patients. It was definitely i was like inhabiting multiple positions at the same time but some the patient i ended up interviewing over the span of several years, many visits, spent time with him in hospitals, so the relationships also changed over time. Maybe you can talk to folks have not read the book, talk a little bit about what was it like bringing this information back to your family . From what you read people will understand that there were stories in the family about what was wrong with your aunt and so here you go off finding out what really went on, event able to place in this global context and being able to place in the context of other Insect Transmitted Diseases. In your bring this back to people had been the keepers of this other story. Yeah. They were always really surprised about how much i was learning. I dont think that they sought in contradiction to the stories that we had in our home. I think they saw it as sort of addition, and disses to their story basically very few hold onto she was contaminated by eating food, thats it, period. But it was like additional information and i think they appreciated it, think they were also very moved to hear about the stories about the families because we are very isolated with our experience. We never met another family who have been impacted by Chagas Disease, and so i think like there was sort of an emotional journey sometimes especially for my mother and her other sister to hear like that someone is having cardiac issues, that theyre also in and out of hospitals. Its sort of that strange experience people have in any kind of patient Support Group where you are grateful to not be alone and then at the same to you know what anyone else to be suffering from this either. Probably the most surprising story that i brought back home was the fact that this parasite could be transmitted from a mother to a child during pregnancy. Congenital chagas was definitely not something that we knew about at all. My auntie had not been able to have children. We had no idea this existed. That was quite a shock because public health campaigns are underway in different parts of latin america in different capacities but historically people have thought about this as an old Persons Disease because thats when you see the symptoms. You could be infected as a teenager, even as a child but now its like 30 years later and you are in your 40s and now youre exhibiting shortness of breath. Nagging you a pacemaker or defibrillator. Thats what one patients had to become like like her father was infected, her sister as well. Her sister was in need of a pacemaker but she really thought this doesnt happen to children. This is limited public Health Information thats out there so that was really, probably the most surprising news i brought back home and really disturbing that i learned out around the same time that the Zika Virus was happening and underway and in headlines and so everyone was talking about that. It felt like, it felt terrifyin terrifying. To note that this disease can also be transmitted that way. At that was another part shocking there was about 8000 babies that are born every year with his disease. In the u. S. That number is smaller is like anywhere between 60300 but we dont do prenatal screening in this country. Thats something a hopeful will change in the coming years that we will start to screen. When i dug into the numbers of course putting on the Journalist Hat i was like how many babies are being born to women from these regions . Cepi South America, since America And Mexico, for being born and yes, and it is 700,000 babies each year so its quite a number of children that we continue to miss. Right. Thats another public lps and it something i heard a lot of stories about when its working on wicked bugs public health peace. Some come from latin america to the United States or you can imagine similar journeys elsewhere in the world where you come from one place and you come to another place and theres no expertise and his new city or in country about health issues you might have dealt with blackcomb. So theres really no sense might remember that not everybody has had the same trajectory around the world. Absolutely. In the u. S. Because of the way medical schools are set out, theres not a lot of teaching on parasitic diseases. The idea is your graduate am med school and go into specially and its not going to be parasitic diseases because it isnt money and i was able to talk to a professor does teach about parasitic diseases and was able to be really honest with me. He said my students are graduating with a notice about of debt and yes they are not using neglected diseases. Its kind of a little miraculous he gets to teach one course on this and cover it but i think the push really has to come from public health advocates and the public Health Side of it to change things. For those of you who dont know, jimmy carters foundation, the carter center, has a huge Help Component that is focused on insecttransmitted diseases. I had to go look because it remember if that six disease was one of them or not and it isnt. They have about six others to work on but they committed to actually a limited in them and it takes that kind of focus, in this case a big foundation to really say we really going to go in and it will be published by village, one pill at a time or one vaccine at a time until there are zero people left with this particular disease. Without that, where are we . Yeah, that was a big Aha Moment when i was working on this book is realizing so many times with contingencies of breath and eradicate them even though eradication can be possible, and so with Chagas Disease disproportionately affects immigrants who are also in lowwage jobs and to have the same kind of access to Health Care that others have. Its more a kin to Lyme Disease. You will not get you for being in the room was someone who has it. It really is incredibly easy for this to be neglected but the same is true when a I Look ate history of tuberculosis and eyes like we dont worry about tb in the u. S. Anymore but we did not eradicate it globally. And so when you look at the u. S. , like you as Tuberculosis Competency immigrant communities or those who have been in prison or in homeless shelters, those congregate living spaces. Same thing with hiv. You look at hiv in the u. S. And you think like its not an issue anymore and its completing an epidemic in the black community and the south. We have made strategic decisions and im a little nervous about what that means in terms of covid. I feel like i really appreciate biden pushing now for vaccines to get to other countries because we cant have just a containment policy. It really needs to be eradication. I was going to ask you, im assuming the book was completely done and turned in before covid started, or right as a starting, is that about right . It was, yeah. So now in hindsight has anything changed in terms of your perspective or when you think about this other disease another we had a year of covid, is there any new insight or any new take that as come to you . We have actually halted the presses because it was in the beginning of production and so when that pandemic hit we had to pause and say okay, how to address this in the book . Just because of the timeline. What was surprising was how easy it was in the book to transitio transition, so any, you probably saw a copy earlier than this. There is now like some new pages on covid because it was disturbing how easy it was, all the racial, all the racial disparities in healthcare that i was talked about with Chagas Disease and with tuberculosis and hiv, i mean completely came to the forefront and still are at the forefront with code. So even vaccination congested answering a News Report about vaccination rates in california over all are doing really good but they are disproportionally much higher in white images then for people of color. Those disparities, they are in our Face And Covid with an interface but i think its easy to forget about them once the crisis is over. I feel like my shift and my perspective is i am hopeful that be because of the scale of this pandemic that were not going to forget so quickly i want to put it away so quickly but i think that still is yet to be determined. If this pandemic has really change how we think about public policy, how we think about Healthcare And Healthcare access and racial disparity, i think it still remains to be seen. Right. I know. I thought about that and how this is been a year where anyone can see that whats happening in india affects us, and so on. Maybe those lessons will stick with us. We are going to start taking questions pretty soon, so Everybody Think of some questions and please put them in the q a and we are about to get into that. Before we do i was interested in a little bit about the writing process. Like did you write pieces of the book as he felt complete to you and then later had to sort of work out the timeline . What was the process of writing this narrative . It moves around in time. Youve got this Family Story that goes back a ways and then youve got, i know what the Research Process is like. Sometimes you do one bit of it early even though thats towards the end of the book and then you have to rearrange everything in your mind to put into a narrative. What was that like . Its so fun to talk with you because you really know it and that describes it perfectly. I would say probably, even though i was not going to write it as an immoral am not planning to write much about my auntie, because as a learning new information i was gaining insights into my childhood experiences i did find my sobriety i would say writing a little fragments and thinking this is kind of for me at this is to get more clarity about what happened in our family. What i was i put it away and what i was really focused on, i was probably the patient stories which makes up the third part of the book is probably what was written first. Initially i thought i would do a much deeper dive into their stories, make in the backbone of the book. So yes, it is part three that happened first. And then the research, i was writing as i went along. I also did have like the big okay, ive got six months, i need to sit down and start polishing and writing further. I would say a chunk of the research i did, the Research Writing at it as a went along. What was really challenging, actually ended up being that Memoir Part where i gave my editor i dont even know how many pages, i should go back and look, and she is amazing and she returned to me like here are chapters in this are long text which was amazing. It was almost at the last moment possible that the structure for the book came to me. The original title was actually in search of the kissing bug but i realized oh, right, i am searching, ive been searching for so much if it sounds obvious as azure saying before it sounds obvious now but it was quite a moment of lights went off in my head like yes, im searching. That was when i realized i could organize it around that kind of searching for the Family Story in part one and then searching more for the medicine in the science in part two because i felt like i wanted readers to have that not necessarily super technical information but the medicine and the assigns, td of understanding before they went into reading about the families. Part of it was my family is not the only one that has mythology around it, just like the patient who said that this is a disease that only affects older people. I was having that kind of material in the chapters that were about the patient. I was realizing okay, i need the readers to have the technical information so they can really appreciate now how it looks on the ground in Someones Day to day life. I think i took a picture at one point of like 1 million posted notes on the wall of light if i move the part about doctor chagas to the middle, will it make sense . There was just craziness all around and at one point the posted notes are all attached together in total columns because i was your turn to figure it out. My words of wisdom now i like him you will find the structure. It happens when you least expect it, apparently, has that been true for you with the hiding the structures for your book or argue the other way where i know some writers need to have that structure at the beginning before any writing can happen and work from the outline. You know, i think for me one of the editors gave me good insight early on which is the author in this case was the narrator but youre a standin for the reader. The story needs to be experienced in such a way that a reader coming in fresh is making these discoveries with you, and so the tricky bit is you cant know too much in the beginning. So its like this job of shuttling it around and making sure that you as the narrator are not terribly informed at the beginning and that you go through a Character Arc just like in a novel and you come out the other and transformed by what you learn because thats what the reader wants to do along with you. That makes this one of these books that will be read just in the way you are looking for like Rebecca Salute or Rebecca Skloot or Mary Roach and it e read by people thinking about Science Writing in this very kind of like approachable and enthralling and engrossing way where you go on a journey, like i think thats my favorite kind of Science Writing. Thank thank you so much. That means a lot to me. Good stuff. Do you want to jump into questions . Lets do it. All right. Let me just get into this. This this is a great questioo start off with. The cdc says a few cases of chagas to see some contact with bugs have been documented in this country. This is such an important thing. Do people know when they have been bitten . Are many people who have been bitten unaware of it. Was this is a great question. Yes, most people when they are bitten, its very easy to miss it. Ill talk both perspectives in latin america and then here. You will get your Bug Bites, you have like allergic reaction to whether was a bite but i thatn be easy to miss, especially if you dont know, if youre living in an area with a lot of kissing bugs, im talking about rural areas of South America central america. You do know they are super dangerous or sometimes in the communities they do know they are dangerous and you should stay away from them at their part your day to day life. The symptoms are not dramatic. I cute stage will be the first two months and you might have a fever, you might have aches. The most you might have a swollen eyelid or some of that material the parasite entered your body but the symptoms tend to resolve in most cases tend to resolve pretty quickly which is part of what is the challenge is that there are not like these huge red Flags Kind of alerts that would make someone seek medical attention, and then the reality also for rural areas in South America and central America And Mexico is that even if you did want to get medical axis you oftentimes cant. People are living very far away from doctors and hospitals. And in the u. S. Its similar. The insects here, you dont tend to get that swollen eyelid but you have like allergic skin reaction. You are usually, you are either camping or you live out on a ranch or you have that kind of exposure, and you dont think of it as being anything different than any other Bug Bite that you happen to be getting at the moment. Its not like Lyme Disease we are looking for a very kind Rash Or Anything like that. It is really easy to miss it in the acute stage which for adults with difficult because in that acute stage there are two medications that can oftentimes be successful in eradicating that parasite, but once youre out of that acute stage, medications dont work in the same way and then you go into that chronic phase. The cdc has documented fewer than 100 people. It is very stringent Rules Route decides someone is affected. You have to test positive on two out of three tests, and thats because its a very, there was a scientist who hates it when i say that parasite is cunning, but the parasite is cunning, and the parasite can really be very elusive at times. Its possible to get false negatives and false positives so the cdc has those rules in place for that. A lot of people have tested positive in the u. S. , people that i interviewed, it was next where i interviewed one woman in california who clearly had a Bug Bite but is also arbitrate in the sense should out on a piece of property in california with her spouse and their children, and no one except her got a bite and got infected or everybody was tested ultimately. Another woman who i write about in the book, most likely was infected at her Mothers House where she would visit sometimes in texas, but her mother was not infected herself. Its a little bit, we cant say because you have exposure youre definitely going to get bit and going to get infected. Its quite complicated, if that makes sense. Right. Parasitic diseases are like that. Its not a guarantee youre automatically going to get infected. Most of us do tend to not think much about Bug Bites. We dont think about it when we travel either. When i was touring for wicked bugs i would always tell people tell me where youre going on vacation and i will ruin your trip. I will tell you what is going to kill you. Im one of those people like i travel with a lot of Bug Control products, anybody else on the triple make fun of me but i have gone to the Cdc Website at a time. Ive gotten my vaccines, my travel vaccines and i loaded up with protective stop it its because i think the thing is nature is powerful. We understand that when it comes to something like here on the pacific coast we understand when it comes to the ocean we dont turn your back on the ocean. We understand what we think about Fire And Flood that we forget it when it comes to a little tiny insect. Absolutely. Lets see. A few more questions. Can to talk but other insect diseases, like malaria for example . Do have take you want to well, malaria is incredibly prevalent, a facts even millions more people, affects people in many, many regions of the world. So i would say Thats Part of the reason it gets more attention in certain ways, although i found this surprising myself. Malaria is considered a neglected disease. There is no reason we should not have eradication of malaria that it disproportionally affects poor people around the world. In fact, during this pandemic one of the medical beds that he read that hasnt has reah me was from a researcher medical operands she was thinking about oped she works a malaria and she was thinking what would it be like if through the resources we are throwing at covid if we through this at malaria . Her lab was having to put on hold everything of course that they were doing for Malaria And Malaria patients to focus on covid. For her it was such a painful reminder of the inequities. We dont put more money towards malaria because its not coming around the world. Its that come into wealthy countries in the same way that it comes to these very poor countries, so yes, i think that is part. I know like if you like we all know malaria but it is neglected in terms of funding. Its not as the collected as insinuate chagas and River Blindness and all these other diseases are but its still considered a neglected disease. This might answer also another question. Maureen is saying if the disease is caused by parasite is a possible there are therefore the pipe would not result in chagas easy and it is yes. Thats true of mosquitoes as well. For instance, a mosquito important does oppose a lot of threat because malaria is also a parasitic disease. They have to pick it up from one place and delivered to another place. All these terms have to do with Community Spread and in certain critical mass in the community suddenly theres a a Bunch Ofs walking around with this disease. That something that is change this last year, right . We have all become so nuanced in the language of Medicine And Science in ways we were not before. Contact tracing. We know the terms. Nancy wants to know, there are two nancys with two questions. Where are these bugs found in whats the treatment for Chagas Disease . So kissing bugs largely found in South America, central America And Mexico, in rural areas. They are very picky about their temperature. I say there goldilocks. They dont like it too hot, too cold. After just right in the 60s temperate climate but they are here in the u. S. As well, as you said before in the South And Southwest all over california. Texas has quite a number of species of these insects. It stands out for the reason. There are two medications. What has been approved by the fda for use in the United States, and the World Health Organization considers it to be an essential medicine because researchers dont understand why but for children even passed the acute phase of the Disease Treatment with medication can be really effective and they can be really effective with newborns that are born with this disease. For adults in the chronic Stage Sort of the Parasite Loading your body. Its very essential for women who are thinking about having children because studies have shown that it can perhaps lower the chances of you passing that parasite along to your child during pregnancy. But yes, that drug is not fda approved which is a good thing and was quite a struggle by advocates and patient. One more thing that might be helpful for people to remember, too, is sometimes, and this is again familiar but sometimes he says hes become more prevalent in the human population because changes in human behavior. For instance, in latin america people living closer and closer to wilderness areas and deforestation happening, and so there was once a time when by large the bugs get kind cag out by themselves and people were somewhere else. We are seeing changes in the ecosystem that of bringing us into closer contact and more opportunities for exposure. Absolutely. Here in the u. S. The same thing is happening. Thats what was surprising to me about taxes because i became so fascinated back whats going on in texas . Texas since i have the highest number of people with this disease. Its actually California Bar and we has the most people in the country with this disease because of its immigrant population. People in texas are seeing more and more of this insect. Theyre saying their dogs contracted, theres k9 Chagas Disease in this exactly what you described is more and more of texas is getting developed. I dont know thats necessarily the Cause And Effect that was like a feature whats happening in texas that stands out to me. So when i interviewed said my wife opened up her purse and found what in her bag on your iphone of all places here from his perspective, this is a veterinarian, and from his perspective its like this is kissing Bug Country and were showing up and turning these ranches into corporate Headquarters And Housing for people that are coming to work at these companies. We are entering the insects perspective, were the Ones Ae entering their territory and destabilizing them. So its interesting, it was an interesting process for me to think about it from the inses perspective. Right, right. I think this is such an incredible book and it could not be more timely. I hope you guys would check out the book and also want to say as were wrapping up, we i just want to say whenever i speak an independent bookstore i always urge people, buy a book there are you still at a bookstore. I can tell you first in the way they stay open as a people show up and buy books. The last time i did an event at powells i said that and it there were tons of people there. I know its impossible to imagine a moment when powells doesnt exist but literally even a huge bookstore like this keeps its doors open because everyday people walking and buy books and thats the only way that math works. Now more than ever please get something at powells and support all your independent bookstores. It so important and have signed copies and bookplates which is wonderful. Theres many reasons to shop from powells, i agree. Yes, absolutely. Well, any other questions, comments, before we wrap up . Anything else what to say to folks . Thank you for coming. I will help you pick up a copy from powells, and thank you so much for being here tonight with us. Thank you, amy. Im a big fan of your work so this is a treat. This was great. Its nice to see your face. Thank you so much. Thank you both. It was wonderful to host you both this evening, and thank you for anyone for tuning in tonight. Please consider purchasing a copy of this book right here. You can get on powells. Com and while youre there please be sure to check out our line up of other than to look for to seeing you at another one very soon. Daisy and Amy Thanks so much again for joining us tonight, and for the great talk. Thank you. Have a good night, everyone. Thanks. Stacey abrams voting rights activists in 2010 democratic nominee for governor of georgia recently discussed her Suspense Novel while justice sleeps seven in the halls of the u. S. Supreme court. I was on a panel at once and one of the people said either people in this world who get as many times at bat as they want and are those of us who we strike out, we are done. We dont just strike at. We get ejected from the game. That is so often the groups of people i end up working with and i try to serve in my other life as an advocate or a politician. Those for whom there are no second chances or at least the notion of a second chance is very remote. You Cant Risk it. Yes, it is entirely possible that avery could have another shot but she is no guarantee and the desperation that follows that is something i felt, that when i finished Law School and my family, we were very economically precarious i was the first one with real money, and i could make couldnt make mistakes. I couldnt stumble and cost us this one opportunity. Amazing siblings would all do well eventually but you dont know it for sure. The sense of responsibility i think is one part of what i wanted to imbue in my character but also want to create space for anyone else whos thinking about do i take risks . Like what is at stake and what am i willing to jeopardize to do what i think is right . To watch the rest of this program visit our website booktv. Org, use the search box