July 8, 2026 • 29 mins
Lyme disease gets most of the attention, but it’s only one of several serious illnesses that ticks can spread. This week, Hari and Dr. Priyanka explain how tick-borne diseases are changing alongside our environment, why quick tick removal matters, and how to protect yourself during peak tick season. They also discuss alpha-gal syndrome, the challenges of diagnosing Lyme disease, and what to watch for after a tick bite.
See omnystudio.com/listener for privacy information.
Listen
Watch
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
This podcast is for information purposes only and should not
be considered professional medical advice. If you get bitten by
this tick, you develop a severe allergic reaction to red meat.
Speaker 2 (00:14):
Oh my god, that is so specific.
Speaker 1 (00:16):
This is like an emerging disease of climate change.
Speaker 2 (00:19):
Honestly, is this something that's going to affect cities more? Now?
Speaker 1 (00:22):
The battle human versus tics. I'm hurrycandibolu, I'm doctor prenkle Wally,
and this is health stuff.
Speaker 2 (00:34):
Hey, Prianca, Hey, how's it going good? This week's episode
has got me feel in all sorts of ways because
we're talking about ticks, and ticks scare the hell out
of me.
Speaker 1 (00:46):
Oh yeah, okay, tell me all about it. Well.
Speaker 2 (00:49):
First, growing up on the East Coast, it was definitely
a thing, the idea of be careful where you go,
especially if you're going upstate or if you're going on
a trip, like the constant feel like not wearing shorts
and short sleeve shirts because they might get bitten by
a tick. Like there's always a fear. And then I've
had friends who had lime disease, so it's also like,
oh my god, I don't want to go through that.
(01:10):
So I'm just kind of like this is yeah creeping
me out.
Speaker 1 (01:16):
Yeah, you know, growing up on the West Coast, we
don't really hear too much about ticks or ticks being
a problem. But I have to be honest with you,
with climate change and the Earth getting warmer, ticks are
now becoming more and more ubiquitous, whether you're on the
East Coast or the West coast. So this is like
(01:40):
an emerging disease of climate change. Honestly.
Speaker 2 (01:43):
Now, what I want to hear is this something that's
going to affect cities more Now.
Speaker 1 (01:48):
I think anytime you're having more industrialization and cities growing
into more areas that were originally wooded or forested, yeah,
you're gonna on the risk of having more and more
people be possibly impacted by ticks.
Speaker 2 (02:05):
I don't like it one bit, and it's really not comforting.
Speaker 1 (02:09):
Yeah I know, I know, But that's why I hope
this episode today we can at least educate our listeners
about preventing getting bitten by ticks, because I think prevention
is key here.
Speaker 2 (02:21):
Yeah, I mean summer, and that means it's tick season.
We're in the middle of it right now. So this
episode we wanted to give people some tips and tricks
for the season and to shed light on the most
common diseases that tick bites can cause, which isn't just
lime disease.
Speaker 1 (02:36):
Yeah, exactly, I thought it was just lime disease, right right.
There's actually several species of ticks. I mean, the ones
that you want to worry about are some of the
ones that transmit lime disease. But there's different names dog ticks,
deer ticks, black leg ticks, lone star ticks, and these
ticks are found throughout the United States.
Speaker 2 (02:56):
The highest concentrations of lime carrying black legs are in
the Northeast, mid Atlantic, and upper Midwest, where tickborn diseases
are most common. Geography matters here, because even if the
same species of tixes in California, there's lower infection rates.
Speaker 1 (03:12):
Yeah, geography definitely matters. Lime disease was named after this
town in Connecticut, Lime, Connecticut, where they had really high
rates of these ticks. But the ticks themselves, they really
like to thrive in wooded areas where there's tall grass
or overgrown yards. And really, like I said earlier, it
(03:35):
comes down to the transition zone where a forest meets
some kind of urban residential neighborhood.
Speaker 2 (03:42):
So lime disease receives the most attention, but there are
actually other pathogens that the ticks carry, right, definitely.
Speaker 1 (03:50):
There's all sorts of types of tickborn illnesses that we've
studied throughout medical school. Some are really scary, some are
really interesting. I remember learning about babeziosis. It's a parasitic
infection that's carried by ticks, and it presents almost like malaria.
(04:11):
In fact, in medical training, they would teach us how
to differentiate malaria from babeziosis because the two are really similar. Babziosis,
you can start off by looking really sick. You get fevers, chills,
drenching night sweats, you feel really fatigue, your muscles are aching,
(04:31):
you have a headache, you just feel like crap, you're anemic.
But then if it's not caught and treated early, it
can eventually lead to death or organ failure, especially if
someone has a compromise immune system. There's so many other
tickboard diseases though. Anaplasmosis was another one, again carried through ticks.
It's a bacterial infection and you feel like absolute garbage.
(04:55):
I mean we're talking fever, chills, worse, headache, muscle aches
and it'll drop your blood counts personally. The tickborn illness
that I think is the most fascinating is caused by
the lone star tick. It's called alpha gal syndrome. This
is a syndrome where if you get bitten by this tick,
(05:18):
you develop a severe allergic reaction to red meat.
Speaker 2 (05:22):
Oh my god, that is so specific.
Speaker 1 (05:25):
And you can't eat red meat like these types. I've
never seen a case of alpha gal in my career.
I have only read about it. But these are cases
of people they get bitten by this tick and if
they eat red meat like bee for pork, they will
break out in total body hives, severe abdominal pains. Sometimes
(05:47):
even anaphylexis requiring an EpiPen.
Speaker 2 (05:50):
Typical lone star they want they want their girls beta.
They don't want those alpha gals.
Speaker 1 (05:58):
Yeah. I remember once reading like a Reddit post of
an individual who contracted alpha gal and it was really
ironic because he wrote in this post that he goes
hunting quite a lot and has been bitten by ticks
many many times and at one point then developed Alpha
(06:20):
gal And I just thought that was so like poetically.
I don't know, there was something really poetic about this
hunter that gets bitten by a tick and then can
no longer eat the red meat that he's hunting, you know.
But I think what's important to know is that if
you get bitten by a tick once, it can still
potentially transmit multiple diseases at the same time. So if
(06:44):
there are any doctors listening out there, you know, if
someone gets bitten by a tick, you want to think
about multiple infections as a potential cause of the person's symptoms.
Speaker 2 (06:54):
Like we said before, prevention is such a big part
of that. So to start, let's go over how you
get both to ticks and how the risk happens to
begin with. First of all, not every tick bite leads
to illness and transmission. It depends heavily on timing. Most
tickborn infections, including lime disease, are less likely to be
transmitted if the tick is removed within twenty four to
(07:15):
forty eight hours. So you're on a clock as soon
as you get bitten by a potentially infectious tick, like
you're immediately on the clock.
Speaker 1 (07:23):
Exactly, Yeah, which is really important. Like think of the
following example. You go for a hike, You fly to
the East coast and you go hiking and then you
fly home, let's say, cross country, and when you get
home you find the tick. Right, I would take that
(07:43):
way more seriously because it means, oh, okay, that tick's
been on me for sure for a lot longer than
if let's say you went for a hike and immediately
coming back from the hike, you strip down all your clothes,
took a shower, did a tick check, and caught a
tick way sooner. That's going to make a big difference.
Speaker 2 (08:03):
Plus, when you find the tick, you have to be
very careful with its removal, right, because if the tick
burst open or something while you're removing it, you again
run the risk.
Speaker 1 (08:11):
Yeah, if you find a tick attached to you, first
of all, you want to remove it asap. But you
don't want to just slough it off or you know,
flick it off. You actually need to take really really
fine tipped tweezers and you want to grab the tick
(08:34):
directly from on top of it and pull it straight
up with steady pressure as close to the skin as possible,
so that you remove the entire tick. That's the way
you want to remove the tick, and you don't want
to do all the other kind of folk remedies. Like,
don't burn it off, don't cover it with vasoline, don't
(08:55):
use nail polish, because the most important thing is you
want to take the tick out as soon as possible,
because the risk of contracting a disease depends on what
kind of tick you've been bidden at by, but whether
the tick has extracted a lot of your blood and
is in gorged, and then most importantly, how long it's
(09:17):
been attached to your body.
Speaker 2 (09:21):
More after this break, I have a question for you
about tick born illnesses. Lime disease obviously is a long
term illness, like people deal with that for years. But
the other illnesses that you listed are they long term
or are they something that you deal with it for
(09:41):
a week and it passes well.
Speaker 1 (09:43):
It depends. So for example, if you contracted babeziosis and
it continued to progress, it would probably not last very
long because you would develop some pretty life threatening illnesses.
Lime is one of those things that you know, actually
if you treat it early enough and aggressively enough, you
(10:03):
can kind of nip it in the bud. But it
can then stay in your body for a long time
and lead to all these other illnesses. Alpha gal syndrome,
for example, can last for years for people.
Speaker 2 (10:14):
Wow.
Speaker 1 (10:15):
So it sort of just depends on what the species
of the tick is, what it's transmitting, and what the
exact disease is like.
Speaker 2 (10:22):
Like we said earlier, species of the tick important also
whether it's engorged and how long it's been attached. This
helps separate low risk encounters from situations that require closer
monitoring a medical follow up. Tickborn illnesses are becoming more common,
like Panca said earlier, because tick habitats are expanding as
(10:43):
we go more into wooded areas, build cities outwards. Warmer
temperatures have expanded the geographic range and active season of
many tick species. Suburban development has placed more people at
the edge of forest where ticks, mice, and deer thrive,
and at the same time, declines in biodiversity can sometimes
(11:04):
increase disease transmission because ticks end up feeding more heavily
on a smaller number of animal species that are especially
effective at carrying and spreading infection. So as a result,
ticks are not only found in traditional wooded areas, but
increasingly appearing in suburban yards, parks, and other residential and
urban adjacent spaces. And this all creeps me the fuck out.
Speaker 1 (11:26):
I mean, it's it is I can I can concur
that this is incredibly stressful because you know, our world
is changing and there are impacts of destroying our environment,
and tickboard illnesses is one of those things. This is why.
(11:47):
And I think this next bit, you know, prevention is
key because if we're going to be surrounded by more ticks,
one of the things that we can do is actually
figure out how to prevent ourselves from getting bitten by them.
And this is where using insect repellants is probably one
(12:08):
of the best ways to prevent yourself from getting bitten
by ticks, usually using insect repellants that contain deet, or
pick a ride in for those of you that are
interested in maybe more plant based options than oil of
lemon eucalyptus oil is better than using nothing if you're
(12:30):
scared t ues deep or pick a ride in.
Speaker 2 (12:32):
You know I said this earlier, but wear long sleeves
and pants and tuck your pants into your socks to
prevent the ticks from reaching the skin. Stay on cleared
trails when hiking. You can use my approach also of
never leaving the apartment.
Speaker 1 (12:46):
Okay, the other option, yeah, I mean tuck your pants
into your socks, like, don't worry about the fashion statement,
like it doesn't matter. Just that is really actually a
very effective way. It also helps to wear light colored
clothing like white off white, your pastels, because then it's
(13:07):
easier to see the ticks and then you're more likely
to remove them.
Speaker 2 (13:12):
Treating clothing and gear with appropriate and sesticides like a
zero point five percent is it permethrin permethrine? Yeah, permethine,
which is more effective than ded on clothing, and performing
a thorough tick check after spending time outdoors can dramatically
reduce the risk of infection. Obviously, you're going to have
(13:32):
to do this for children. Yeah, you know, I feel
like children are less aware of what's going on. They're
less aware of where they're stepping, where they're going, what
they're being exposed to. And of course, so you have
to be thorough when you have kids.
Speaker 1 (13:45):
Yeah, So if you're checking for ticks on your kids
or yourself, you want to make sure that you look
especially under the arms, behind the knees, in the groin area,
around your ears, behind your ears, any kind of hairline
or scalp. They can get sort of hidden there, and
(14:06):
don't forget to check your belly button.
Speaker 2 (14:08):
Shower within two hours of being outdoors, which significantly reduces
the risk of lime disease and helps wash off unattached ticks.
So you know you should be taking showers anyway, but
even more so knowing that ticks are an issue. One
dry clothes on high heat for at least ten minutes
after outdoor activities. To kill ticks, washing in hot not
(14:31):
warm or cold water, but hot water is also effective.
Speaker 1 (14:35):
Yeah, now that's all the preventive stuff. But now let's
say you did all of the preventive measures and you
still got beaten by a pesky tick. So if you
find a tick, don't panic, don't flick it off. Get
some tweezers, and if you don't own tweezers, go find
someone with sweezers. Yes, and they need to be like
(14:56):
the skinny, pointy tweezers, and you're going to place them
directly on the belly of the tick and you're going
to pull it straight upward with steady pressure, so you
don't break off anything you want to. Just take it
out very cleanly and nicely. Don't burn it off, don't
cover it with a vaciline, don't use nail polish, just
(15:18):
remove the tick and then immediately after clean the area
with soap and water, and either write it down or
put it down in your phone the date that you
were bitten, the time that you found the tick, and
the time or when you think you might have been
(15:39):
exposed to the tick. I would even take a photo
of the tick because then you can send it to
your practitioner and they can look up the species based
off of it, and then just monitor for symptoms, like
if you notice you have a fever or headache, or
you develop a specific looking rat h We'll talk a
(16:01):
little bit about what kind of rash you can see
in lime disease. It has a very specific look, and
you can contact your healthcare provider at that time or
wait until symptoms developed, especially if the tick was on
your body for an extended period of time, because treating
(16:21):
early can definitely reduce the risk of serious illness.
Speaker 2 (16:26):
Does it make sense, like if you see a tick
and you're nervous about removing it yourself for fear it
will break and cosmoor damage, does it make sense to
see a doctor as quickly as possible to get the
tick removed or do you think this is something that
people should be able to handle on their own.
Speaker 1 (16:41):
I mean, if you can get in to see a
doctor quickly or an urgent care quickly, that's fine. But
at that point, if if you're really nervous about taking
it out yourself, because you want it out as soon
as possible, but if you really feel like you're not
going to be able to do it correctly, then and
I would just go to your nearest urgent care, or
(17:02):
if you can get in with your doctor quickly. If
your doctor's like I can't see you until you know,
two or three days, you definitely don't want to have
that tick sitting around. No, so I'd probably just go
to the urgent care. If you don't have like a
friend or someone you've never been bitten by a tick?
Is that correct? Or have you?
Speaker 2 (17:22):
I don't think so, Okay, I don't believe I have.
But I'm also not sure, Like I could have seen
something I thought was a tick and it wasn't actually
a tick and I freaked out, you.
Speaker 1 (17:31):
Know, sure, sure, Yeah, Yeah, it's hard to tell. I'm
always a big proponent of taking pictures, yeah, either before
or after removal, because then you can show it to
your doctor. I suppose now, I mean you could even
throw it into Chad GBT and ask for an analysis.
I suppose.
Speaker 2 (17:47):
But I've also perhaps have been bitten by a tick
and this is all a fever dream.
Speaker 1 (17:51):
I mean, that would be wild.
Speaker 2 (17:53):
Yeah, this podcast isn't happening. It's all in my.
Speaker 1 (17:56):
Head, right, Yeah, exactly. Yeah.
Speaker 2 (18:01):
When removing ticks, make sure you kill them afterwards, and
it would be my pleasure. An easy way is to
squish them in a plastic bag and then throw the
bag away, But make sure you kill them afterwards, otherwise
you're just releasing them into biting another person. Yeah, make
any sense.
Speaker 1 (18:20):
Other things to prevent ticks from kind of profligating is
if you have a yard, it's really important to keep
your grass short. And animals can also be a source
of acquiring ticks, like pet dogs. Yeah, so you want
to also do tick checks on your pets because they
(18:44):
could then jump from the pets to you. It can
be pet dogs, but also deer, mice, squirrels, so you know,
don't pet squirrels or don't you know, try and catch
wild mice. Definitely don't try and pet deer because you
just never know what they could be holding. As far
as ticks are concerned, we're going to take a short break.
(19:08):
Stay with us.
Speaker 2 (19:14):
Let's get into the discovery and spread of lime disease.
Speaker 1 (19:17):
Lime disease actually impact so many people. I was reading
that more than four hundred thousand people are diagnosed with
lime every year, and John Hopkins estimates that tickboard illness
costs the US healthcare system up to one point three
billion dollars annually, So this is huge. Lime really does
(19:42):
cause a lot of problems for Americans.
Speaker 2 (19:45):
In the mid nineteen seventies, children and adults around Lime,
Connecticut began developing what appeared to be juvenile arthritis at
usually high rates. And that's kind of the history of
when people discovered there's a thing called lime disease. Rheumatologists
Alan Steer helped identify the condition as a distinct disease
rather than just a simple arthritis outbreak. In nineteen eighty two,
(20:07):
scientist Willie Bergdorfer identified the bacterium responsible, finally solving the mystery.
Researchers increasingly view tickborn disease as a product of environmental
change as much as a medical problem, which we discussed earlier.
Just as we move into wooded areas as cities expand
that puts us at a greater risk.
Speaker 1 (20:27):
Yeah, if a person gets bitten by a tick, you
should keep an eye out for symptoms for up to
a month after you find that you had the tick bite,
and then definitely go get help if you develop symptoms.
And lime disease specifically has a very distinct rash that develops.
(20:49):
It actually looks like a classic bulls eye appearance. There's
sort of a ring and it's red, and it's call
air theema migrants. It's a very classic sort of description.
But you don't just get this bullseye appearing rash. You
can also get flu like symptoms in the early stages
(21:13):
like fever, chills, fatigues, headaches, muscle aches. Your lymph nodes
can eventually get swollen, your neck can feel stiff over
the next couple of weeks, and if not treated and
the infection spreads, then eventually people can develop very debilitating
joint pain, fatigue, and it can eventually impact the nervous system.
(21:36):
It can cause a Bell's palsy, which is a type
of facial paralysis, numbness, tingling, shooting, nerve pain. It can
cause heart rhythm issues like palpitations and heart block, and
then of course there's a classic arthritis which your joints
just heard, and eventually late stage lime disease. I mean
(21:57):
we're talking basically severe brain fog. So diagnosing and treating
this as early as possible is so critical to preventing
all of these late term complications. And the treatment is antibiotics,
because if someone gets hit by lime disease and they
take antibiotics just within a few days, they can actually
(22:19):
reduce their risk of developing lime disease by eighty seven percent.
If a person is very high risk for lime disease,
So let's say they have been bitten by a tick
and the tick has been identified as the exode species,
which is the deer tick, and they know let's say
(22:39):
this tick was on them for more than thirty six
hours and they got bitten in like Lime Connecticut. Okay,
so like super high risk. A single dose of an
antibiotic can help high risk individuals from developing complications of
lime disease.
Speaker 2 (22:55):
Are people still visiting Lime Connecticut? You think I.
Speaker 1 (22:58):
Will never go to Lime Connecticut'll tell you that.
Speaker 2 (23:00):
It feels like you're asking for trouble at this point.
Speaker 1 (23:03):
I mean, it is like they really need to do
something about their tourism.
Speaker 2 (23:08):
Changing the name might help.
Speaker 1 (23:10):
Yes, they could do a name change Lemon perhaps, Yeah,
Or they could be maybe the first town in the
United States to create their own like bubble, Like they
can make a giant bubble over the entire town and
then eradicate all the ticks and then they could you know,
invite tourists to be like this lime free bubble in
(23:33):
the Northeast.
Speaker 2 (23:34):
Or they could go the other way and use kind
of a disaster tourism method of having like a tick
museum and some kind of you know games for kids.
They could go all in on the we created lime
disease that has a.
Speaker 1 (23:50):
Very black mirror feel to Yeah.
Speaker 2 (23:56):
Now, lime disease diagnosis is not always straightforward. It often
gets missed. Standard blood tests look for antibodies which may
not be detectable in the early stages of BLME disease infection.
This means someone can test negative even while symptomatic if
they're tested too soon. Because of this limitation, diagnosis often
relies on a combination of exposure history, symptoms, and clinical judgment,
(24:21):
especially when the characteristic rash is absent. These challenges contribute
to delayed diagnosis and confusion for patients and clinicians. This
is also why earlier we talked about if you know
you got bitten by a tick, take the picture because
it might not show up on blood test, but if
you have other kinds of evidence that could help the
(24:41):
healthcare provider actually diagnose you and get you what you need.
Speaker 1 (24:45):
Yeah, this is a very difficult disease to get a
confirmed diagnosis. I have spoken to many many patients who
have suffered for years getting the run around from the
medical system where they felt like they did have lime,
but the tests just wouldn't confirm it. It can be
(25:06):
very frustrating for people. Sometimes people get the antibiotics, like
the standard treatment, but then even after that they'll still
continue to experience symptoms like fatigue and pain and brain fog.
And this syndrome has now been coined. It's called post
treatment lime disease syndrome. It's essentially a chronic version of
(25:31):
lime disease, so it can be very challenging for people.
Speaker 2 (25:34):
There is a line disease vaccine called Limeris, which was
oh god, limeris like limericks. Okay, even then a pun
Even when we're talking about disease. We need a pun,
all right. A line vaccine called Limericks was approved in
nineteen ninety eight, but was withdrawn from the market just
(25:55):
a few days later. There were concerns about its side effects.
Combined with low public demand and legal challenges, it contributed
to its disappearance. Researchers are now developing new vaccine candidates
designed to improve both effectiveness and public confidence. Official surveillance
counts capture only a fraction of lime disease diagnoses reported
(26:16):
each year. For the reasons we explained earlier, he doesn't
show up in blood tests. Oftentimes, you have to see
a variety of symptoms before a diagnosis can even be considered,
even if you have it. The CDC estimates that roughly
four hundred and seventy six thousand Americans are diagnosed and
treated annually, far exceeding reported case totals. The gap highlights
(26:37):
the challenges of tracking a disease that has often underdiagnosed
and underreported.
Speaker 1 (26:42):
Yeah, I mean that's a huge, huge number of people
being affected by a tick. Yeah, I mean that's wild.
You know, the battle human versus tics. I don't know,
I feel like ticks might be getting the upper hand
right now.
Speaker 2 (26:56):
Oh, they absolutely are. Yeah, it's just it's also terrifying
with LME disease, the fact that you don't know and
I've had like I said earlier, I've had friends who've
had it, and it's just that not knowing what's wrong
with me. Yeah, you know, not knowing you know why
I have these symptoms, not knowing how you know, if
(27:17):
you maybe I got bit but you don't know for sure.
I mean that's in addition to like being sick, it's
like not even knowing how to get better. I mean,
that's a very difficult disease.
Speaker 1 (27:28):
It's super, super scary. But I hope this episode at
least gives people the tools to do what they can
to prevent it. So you know, again, ticks more common
in the Northeast, mid Atlantic upper Midwest, especially if you're
in wooded areas or areas around the edge, like suburban
(27:52):
edge areas. You still see them on the West Coast
as well, but again the risk really depends on number
one and how long the tick has been attached to you,
and of course the species, and the faster you can
remove the tick, like if you can remove the tick
within twenty four to forty eight hours that lowers the
(28:12):
risk of infection.
Speaker 2 (28:13):
If you develop symptoms, get treated right away, and also
make sure you search your body thoroughly for a tick
bite and especially for.
Speaker 1 (28:21):
Kids, exactly prevention, quick tick removal most effective ways to
reduce the illness, and lime is the most known, but
tick spread all sorts of other sort of serious diseases
and co infections. So go out and get your long
sleeve pants and shirts.
Speaker 2 (28:38):
Tuck those pants into your socks like you're an old
timey baseball player.
Speaker 1 (28:42):
Yes, that's the look.
Speaker 2 (28:43):
If that's what has to be fashionable to help prevent
the spread of lime disease. And that's what we're going
to have to do. We're all going to have to
look like old timey baseball players.
Speaker 1 (28:50):
We all have to make sacrifices.
Speaker 2 (28:52):
Yes, thanks for listening to this week's episode. If you'd
like to support the podcast, please keep listening, send it
to your friends, and also give us five stars wherever
you listen to your podcast. Every little bit helps and
we'll see you next week.
Speaker 1 (29:11):
Health Stuff is a production of iHeart Podcasts. The show
is hosted by me, Doctor Preanco Wally and Harrikonnebolu. Producers
are Rebecca Eisenberg, Jenna Cagel, Christina Loranger, Maya Howard, and
Katrina Norvel. Our researcher is Maria Tremarki, and our intern
is Katiya Zobel Lejayala. To send us a question, you
(29:32):
can email us a voice memo at health Stuff Podcasts
at gmail dot com. Thanks so much for listening
This podcast is for information purposes only and should not
be considered professional medical advice. If you get bitten by
this tick, you develop a severe allergic reaction to red meat.
Speaker 2 (00:14):
Oh my god, that is so specific.
Speaker 1 (00:16):
This is like an emerging disease of climate change.
Speaker 2 (00:19):
Honestly, is this something that's going to affect cities more? Now?
Speaker 1 (00:22):
The battle human versus tics. I'm hurrycandibolu, I'm doctor prenkle Wally,
and this is health stuff.
Speaker 2 (00:34):
Hey, Prianca, Hey, how's it going good? This week's episode
has got me feel in all sorts of ways because
we're talking about ticks, and ticks scare the hell out
of me.
Speaker 1 (00:46):
Oh yeah, okay, tell me all about it. Well.
Speaker 2 (00:49):
First, growing up on the East Coast, it was definitely
a thing, the idea of be careful where you go,
especially if you're going upstate or if you're going on
a trip, like the constant feel like not wearing shorts
and short sleeve shirts because they might get bitten by
a tick. Like there's always a fear. And then I've
had friends who had lime disease, so it's also like,
oh my god, I don't want to go through that.
(01:10):
So I'm just kind of like this is yeah creeping
me out.
Speaker 1 (01:16):
Yeah, you know, growing up on the West Coast, we
don't really hear too much about ticks or ticks being
a problem. But I have to be honest with you,
with climate change and the Earth getting warmer, ticks are
now becoming more and more ubiquitous, whether you're on the
East Coast or the West coast. So this is like
(01:40):
an emerging disease of climate change. Honestly.
Speaker 2 (01:43):
Now, what I want to hear is this something that's
going to affect cities more Now.
Speaker 1 (01:48):
I think anytime you're having more industrialization and cities growing
into more areas that were originally wooded or forested, yeah,
you're gonna on the risk of having more and more
people be possibly impacted by ticks.
Speaker 2 (02:05):
I don't like it one bit, and it's really not comforting.
Speaker 1 (02:09):
Yeah I know, I know, But that's why I hope
this episode today we can at least educate our listeners
about preventing getting bitten by ticks, because I think prevention
is key here.
Speaker 2 (02:21):
Yeah, I mean summer, and that means it's tick season.
We're in the middle of it right now. So this
episode we wanted to give people some tips and tricks
for the season and to shed light on the most
common diseases that tick bites can cause, which isn't just
lime disease.
Speaker 1 (02:36):
Yeah, exactly, I thought it was just lime disease, right right.
There's actually several species of ticks. I mean, the ones
that you want to worry about are some of the
ones that transmit lime disease. But there's different names dog ticks,
deer ticks, black leg ticks, lone star ticks, and these
ticks are found throughout the United States.
Speaker 2 (02:56):
The highest concentrations of lime carrying black legs are in
the Northeast, mid Atlantic, and upper Midwest, where tickborn diseases
are most common. Geography matters here, because even if the
same species of tixes in California, there's lower infection rates.
Speaker 1 (03:12):
Yeah, geography definitely matters. Lime disease was named after this
town in Connecticut, Lime, Connecticut, where they had really high
rates of these ticks. But the ticks themselves, they really
like to thrive in wooded areas where there's tall grass
or overgrown yards. And really, like I said earlier, it
(03:35):
comes down to the transition zone where a forest meets
some kind of urban residential neighborhood.
Speaker 2 (03:42):
So lime disease receives the most attention, but there are
actually other pathogens that the ticks carry, right, definitely.
Speaker 1 (03:50):
There's all sorts of types of tickborn illnesses that we've
studied throughout medical school. Some are really scary, some are
really interesting. I remember learning about babeziosis. It's a parasitic
infection that's carried by ticks, and it presents almost like malaria.
(04:11):
In fact, in medical training, they would teach us how
to differentiate malaria from babeziosis because the two are really similar. Babziosis,
you can start off by looking really sick. You get fevers, chills,
drenching night sweats, you feel really fatigue, your muscles are aching,
(04:31):
you have a headache, you just feel like crap, you're anemic.
But then if it's not caught and treated early, it
can eventually lead to death or organ failure, especially if
someone has a compromise immune system. There's so many other
tickboard diseases though. Anaplasmosis was another one, again carried through ticks.
It's a bacterial infection and you feel like absolute garbage.
(04:55):
I mean we're talking fever, chills, worse, headache, muscle aches
and it'll drop your blood counts personally. The tickborn illness
that I think is the most fascinating is caused by
the lone star tick. It's called alpha gal syndrome. This
is a syndrome where if you get bitten by this tick,
(05:18):
you develop a severe allergic reaction to red meat.
Speaker 2 (05:22):
Oh my god, that is so specific.
Speaker 1 (05:25):
And you can't eat red meat like these types. I've
never seen a case of alpha gal in my career.
I have only read about it. But these are cases
of people they get bitten by this tick and if
they eat red meat like bee for pork, they will
break out in total body hives, severe abdominal pains. Sometimes
(05:47):
even anaphylexis requiring an EpiPen.
Speaker 2 (05:50):
Typical lone star they want they want their girls beta.
They don't want those alpha gals.
Speaker 1 (05:58):
Yeah. I remember once reading like a Reddit post of
an individual who contracted alpha gal and it was really
ironic because he wrote in this post that he goes
hunting quite a lot and has been bitten by ticks
many many times and at one point then developed Alpha
(06:20):
gal And I just thought that was so like poetically.
I don't know, there was something really poetic about this
hunter that gets bitten by a tick and then can
no longer eat the red meat that he's hunting, you know.
But I think what's important to know is that if
you get bitten by a tick once, it can still
potentially transmit multiple diseases at the same time. So if
(06:44):
there are any doctors listening out there, you know, if
someone gets bitten by a tick, you want to think
about multiple infections as a potential cause of the person's symptoms.
Speaker 2 (06:54):
Like we said before, prevention is such a big part
of that. So to start, let's go over how you
get both to ticks and how the risk happens to
begin with. First of all, not every tick bite leads
to illness and transmission. It depends heavily on timing. Most
tickborn infections, including lime disease, are less likely to be
transmitted if the tick is removed within twenty four to
(07:15):
forty eight hours. So you're on a clock as soon
as you get bitten by a potentially infectious tick, like
you're immediately on the clock.
Speaker 1 (07:23):
Exactly, Yeah, which is really important. Like think of the
following example. You go for a hike, You fly to
the East coast and you go hiking and then you
fly home, let's say, cross country, and when you get
home you find the tick. Right, I would take that
(07:43):
way more seriously because it means, oh, okay, that tick's
been on me for sure for a lot longer than
if let's say you went for a hike and immediately
coming back from the hike, you strip down all your clothes,
took a shower, did a tick check, and caught a
tick way sooner. That's going to make a big difference.
Speaker 2 (08:03):
Plus, when you find the tick, you have to be
very careful with its removal, right, because if the tick
burst open or something while you're removing it, you again
run the risk.
Speaker 1 (08:11):
Yeah, if you find a tick attached to you, first
of all, you want to remove it asap. But you
don't want to just slough it off or you know,
flick it off. You actually need to take really really
fine tipped tweezers and you want to grab the tick
(08:34):
directly from on top of it and pull it straight
up with steady pressure as close to the skin as possible,
so that you remove the entire tick. That's the way
you want to remove the tick, and you don't want
to do all the other kind of folk remedies. Like,
don't burn it off, don't cover it with vasoline, don't
(08:55):
use nail polish, because the most important thing is you
want to take the tick out as soon as possible,
because the risk of contracting a disease depends on what
kind of tick you've been bidden at by, but whether
the tick has extracted a lot of your blood and
is in gorged, and then most importantly, how long it's
(09:17):
been attached to your body.
Speaker 2 (09:21):
More after this break, I have a question for you
about tick born illnesses. Lime disease obviously is a long
term illness, like people deal with that for years. But
the other illnesses that you listed are they long term
or are they something that you deal with it for
(09:41):
a week and it passes well.
Speaker 1 (09:43):
It depends. So for example, if you contracted babeziosis and
it continued to progress, it would probably not last very
long because you would develop some pretty life threatening illnesses.
Lime is one of those things that you know, actually
if you treat it early enough and aggressively enough, you
(10:03):
can kind of nip it in the bud. But it
can then stay in your body for a long time
and lead to all these other illnesses. Alpha gal syndrome,
for example, can last for years for people.
Speaker 2 (10:14):
Wow.
Speaker 1 (10:15):
So it sort of just depends on what the species
of the tick is, what it's transmitting, and what the
exact disease is like.
Speaker 2 (10:22):
Like we said earlier, species of the tick important also
whether it's engorged and how long it's been attached. This
helps separate low risk encounters from situations that require closer
monitoring a medical follow up. Tickborn illnesses are becoming more common,
like Panca said earlier, because tick habitats are expanding as
(10:43):
we go more into wooded areas, build cities outwards. Warmer
temperatures have expanded the geographic range and active season of
many tick species. Suburban development has placed more people at
the edge of forest where ticks, mice, and deer thrive,
and at the same time, declines in biodiversity can sometimes
(11:04):
increase disease transmission because ticks end up feeding more heavily
on a smaller number of animal species that are especially
effective at carrying and spreading infection. So as a result,
ticks are not only found in traditional wooded areas, but
increasingly appearing in suburban yards, parks, and other residential and
urban adjacent spaces. And this all creeps me the fuck out.
Speaker 1 (11:26):
I mean, it's it is I can I can concur
that this is incredibly stressful because you know, our world
is changing and there are impacts of destroying our environment,
and tickboard illnesses is one of those things. This is why.
(11:47):
And I think this next bit, you know, prevention is
key because if we're going to be surrounded by more ticks,
one of the things that we can do is actually
figure out how to prevent ourselves from getting bitten by them.
And this is where using insect repellants is probably one
(12:08):
of the best ways to prevent yourself from getting bitten
by ticks, usually using insect repellants that contain deet, or
pick a ride in for those of you that are
interested in maybe more plant based options than oil of
lemon eucalyptus oil is better than using nothing if you're
(12:30):
scared t ues deep or pick a ride in.
Speaker 2 (12:32):
You know I said this earlier, but wear long sleeves
and pants and tuck your pants into your socks to
prevent the ticks from reaching the skin. Stay on cleared
trails when hiking. You can use my approach also of
never leaving the apartment.
Speaker 1 (12:46):
Okay, the other option, yeah, I mean tuck your pants
into your socks, like, don't worry about the fashion statement,
like it doesn't matter. Just that is really actually a
very effective way. It also helps to wear light colored
clothing like white off white, your pastels, because then it's
(13:07):
easier to see the ticks and then you're more likely
to remove them.
Speaker 2 (13:12):
Treating clothing and gear with appropriate and sesticides like a
zero point five percent is it permethrin permethrine? Yeah, permethine,
which is more effective than ded on clothing, and performing
a thorough tick check after spending time outdoors can dramatically
reduce the risk of infection. Obviously, you're going to have
(13:32):
to do this for children. Yeah, you know, I feel
like children are less aware of what's going on. They're
less aware of where they're stepping, where they're going, what
they're being exposed to. And of course, so you have
to be thorough when you have kids.
Speaker 1 (13:45):
Yeah, So if you're checking for ticks on your kids
or yourself, you want to make sure that you look
especially under the arms, behind the knees, in the groin area,
around your ears, behind your ears, any kind of hairline
or scalp. They can get sort of hidden there, and
(14:06):
don't forget to check your belly button.
Speaker 2 (14:08):
Shower within two hours of being outdoors, which significantly reduces
the risk of lime disease and helps wash off unattached ticks.
So you know you should be taking showers anyway, but
even more so knowing that ticks are an issue. One
dry clothes on high heat for at least ten minutes
after outdoor activities. To kill ticks, washing in hot not
(14:31):
warm or cold water, but hot water is also effective.
Speaker 1 (14:35):
Yeah, now that's all the preventive stuff. But now let's
say you did all of the preventive measures and you
still got beaten by a pesky tick. So if you
find a tick, don't panic, don't flick it off. Get
some tweezers, and if you don't own tweezers, go find
someone with sweezers. Yes, and they need to be like
(14:56):
the skinny, pointy tweezers, and you're going to place them
directly on the belly of the tick and you're going
to pull it straight upward with steady pressure, so you
don't break off anything you want to. Just take it
out very cleanly and nicely. Don't burn it off, don't
cover it with a vaciline, don't use nail polish, just
(15:18):
remove the tick and then immediately after clean the area
with soap and water, and either write it down or
put it down in your phone the date that you
were bitten, the time that you found the tick, and
the time or when you think you might have been
(15:39):
exposed to the tick. I would even take a photo
of the tick because then you can send it to
your practitioner and they can look up the species based
off of it, and then just monitor for symptoms, like
if you notice you have a fever or headache, or
you develop a specific looking rat h We'll talk a
(16:01):
little bit about what kind of rash you can see
in lime disease. It has a very specific look, and
you can contact your healthcare provider at that time or
wait until symptoms developed, especially if the tick was on
your body for an extended period of time, because treating
(16:21):
early can definitely reduce the risk of serious illness.
Speaker 2 (16:26):
Does it make sense, like if you see a tick
and you're nervous about removing it yourself for fear it
will break and cosmoor damage, does it make sense to
see a doctor as quickly as possible to get the
tick removed or do you think this is something that
people should be able to handle on their own.
Speaker 1 (16:41):
I mean, if you can get in to see a
doctor quickly or an urgent care quickly, that's fine. But
at that point, if if you're really nervous about taking
it out yourself, because you want it out as soon
as possible, but if you really feel like you're not
going to be able to do it correctly, then and
I would just go to your nearest urgent care, or
(17:02):
if you can get in with your doctor quickly. If
your doctor's like I can't see you until you know,
two or three days, you definitely don't want to have
that tick sitting around. No, so I'd probably just go
to the urgent care. If you don't have like a
friend or someone you've never been bitten by a tick?
Is that correct? Or have you?
Speaker 2 (17:22):
I don't think so, Okay, I don't believe I have.
But I'm also not sure, Like I could have seen
something I thought was a tick and it wasn't actually
a tick and I freaked out, you.
Speaker 1 (17:31):
Know, sure, sure, Yeah, Yeah, it's hard to tell. I'm
always a big proponent of taking pictures, yeah, either before
or after removal, because then you can show it to
your doctor. I suppose now, I mean you could even
throw it into Chad GBT and ask for an analysis.
I suppose.
Speaker 2 (17:47):
But I've also perhaps have been bitten by a tick
and this is all a fever dream.
Speaker 1 (17:51):
I mean, that would be wild.
Speaker 2 (17:53):
Yeah, this podcast isn't happening. It's all in my.
Speaker 1 (17:56):
Head, right, Yeah, exactly. Yeah.
Speaker 2 (18:01):
When removing ticks, make sure you kill them afterwards, and
it would be my pleasure. An easy way is to
squish them in a plastic bag and then throw the
bag away, But make sure you kill them afterwards, otherwise
you're just releasing them into biting another person. Yeah, make
any sense.
Speaker 1 (18:20):
Other things to prevent ticks from kind of profligating is
if you have a yard, it's really important to keep
your grass short. And animals can also be a source
of acquiring ticks, like pet dogs. Yeah, so you want
to also do tick checks on your pets because they
(18:44):
could then jump from the pets to you. It can
be pet dogs, but also deer, mice, squirrels, so you know,
don't pet squirrels or don't you know, try and catch
wild mice. Definitely don't try and pet deer because you
just never know what they could be holding. As far
as ticks are concerned, we're going to take a short break.
(19:08):
Stay with us.
Speaker 2 (19:14):
Let's get into the discovery and spread of lime disease.
Speaker 1 (19:17):
Lime disease actually impact so many people. I was reading
that more than four hundred thousand people are diagnosed with
lime every year, and John Hopkins estimates that tickboard illness
costs the US healthcare system up to one point three
billion dollars annually, So this is huge. Lime really does
(19:42):
cause a lot of problems for Americans.
Speaker 2 (19:45):
In the mid nineteen seventies, children and adults around Lime,
Connecticut began developing what appeared to be juvenile arthritis at
usually high rates. And that's kind of the history of
when people discovered there's a thing called lime disease. Rheumatologists
Alan Steer helped identify the condition as a distinct disease
rather than just a simple arthritis outbreak. In nineteen eighty two,
(20:07):
scientist Willie Bergdorfer identified the bacterium responsible, finally solving the mystery.
Researchers increasingly view tickborn disease as a product of environmental
change as much as a medical problem, which we discussed earlier.
Just as we move into wooded areas as cities expand
that puts us at a greater risk.
Speaker 1 (20:27):
Yeah, if a person gets bitten by a tick, you
should keep an eye out for symptoms for up to
a month after you find that you had the tick bite,
and then definitely go get help if you develop symptoms.
And lime disease specifically has a very distinct rash that develops.
(20:49):
It actually looks like a classic bulls eye appearance. There's
sort of a ring and it's red, and it's call
air theema migrants. It's a very classic sort of description.
But you don't just get this bullseye appearing rash. You
can also get flu like symptoms in the early stages
(21:13):
like fever, chills, fatigues, headaches, muscle aches. Your lymph nodes
can eventually get swollen, your neck can feel stiff over
the next couple of weeks, and if not treated and
the infection spreads, then eventually people can develop very debilitating
joint pain, fatigue, and it can eventually impact the nervous system.
(21:36):
It can cause a Bell's palsy, which is a type
of facial paralysis, numbness, tingling, shooting, nerve pain. It can
cause heart rhythm issues like palpitations and heart block, and
then of course there's a classic arthritis which your joints
just heard, and eventually late stage lime disease. I mean
(21:57):
we're talking basically severe brain fog. So diagnosing and treating
this as early as possible is so critical to preventing
all of these late term complications. And the treatment is antibiotics,
because if someone gets hit by lime disease and they
take antibiotics just within a few days, they can actually
(22:19):
reduce their risk of developing lime disease by eighty seven percent.
If a person is very high risk for lime disease,
So let's say they have been bitten by a tick
and the tick has been identified as the exode species,
which is the deer tick, and they know let's say
(22:39):
this tick was on them for more than thirty six
hours and they got bitten in like Lime Connecticut. Okay,
so like super high risk. A single dose of an
antibiotic can help high risk individuals from developing complications of
lime disease.
Speaker 2 (22:55):
Are people still visiting Lime Connecticut? You think I.
Speaker 1 (22:58):
Will never go to Lime Connecticut'll tell you that.
Speaker 2 (23:00):
It feels like you're asking for trouble at this point.
Speaker 1 (23:03):
I mean, it is like they really need to do
something about their tourism.
Speaker 2 (23:08):
Changing the name might help.
Speaker 1 (23:10):
Yes, they could do a name change Lemon perhaps, Yeah,
Or they could be maybe the first town in the
United States to create their own like bubble, Like they
can make a giant bubble over the entire town and
then eradicate all the ticks and then they could you know,
invite tourists to be like this lime free bubble in
(23:33):
the Northeast.
Speaker 2 (23:34):
Or they could go the other way and use kind
of a disaster tourism method of having like a tick
museum and some kind of you know games for kids.
They could go all in on the we created lime
disease that has a.
Speaker 1 (23:50):
Very black mirror feel to Yeah.
Speaker 2 (23:56):
Now, lime disease diagnosis is not always straightforward. It often
gets missed. Standard blood tests look for antibodies which may
not be detectable in the early stages of BLME disease infection.
This means someone can test negative even while symptomatic if
they're tested too soon. Because of this limitation, diagnosis often
relies on a combination of exposure history, symptoms, and clinical judgment,
(24:21):
especially when the characteristic rash is absent. These challenges contribute
to delayed diagnosis and confusion for patients and clinicians. This
is also why earlier we talked about if you know
you got bitten by a tick, take the picture because
it might not show up on blood test, but if
you have other kinds of evidence that could help the
(24:41):
healthcare provider actually diagnose you and get you what you need.
Speaker 1 (24:45):
Yeah, this is a very difficult disease to get a
confirmed diagnosis. I have spoken to many many patients who
have suffered for years getting the run around from the
medical system where they felt like they did have lime,
but the tests just wouldn't confirm it. It can be
(25:06):
very frustrating for people. Sometimes people get the antibiotics, like
the standard treatment, but then even after that they'll still
continue to experience symptoms like fatigue and pain and brain fog.
And this syndrome has now been coined. It's called post
treatment lime disease syndrome. It's essentially a chronic version of
(25:31):
lime disease, so it can be very challenging for people.
Speaker 2 (25:34):
There is a line disease vaccine called Limeris, which was
oh god, limeris like limericks. Okay, even then a pun
Even when we're talking about disease. We need a pun,
all right. A line vaccine called Limericks was approved in
nineteen ninety eight, but was withdrawn from the market just
(25:55):
a few days later. There were concerns about its side effects.
Combined with low public demand and legal challenges, it contributed
to its disappearance. Researchers are now developing new vaccine candidates
designed to improve both effectiveness and public confidence. Official surveillance
counts capture only a fraction of lime disease diagnoses reported
(26:16):
each year. For the reasons we explained earlier, he doesn't
show up in blood tests. Oftentimes, you have to see
a variety of symptoms before a diagnosis can even be considered,
even if you have it. The CDC estimates that roughly
four hundred and seventy six thousand Americans are diagnosed and
treated annually, far exceeding reported case totals. The gap highlights
(26:37):
the challenges of tracking a disease that has often underdiagnosed
and underreported.
Speaker 1 (26:42):
Yeah, I mean that's a huge, huge number of people
being affected by a tick. Yeah, I mean that's wild.
You know, the battle human versus tics. I don't know,
I feel like ticks might be getting the upper hand
right now.
Speaker 2 (26:56):
Oh, they absolutely are. Yeah, it's just it's also terrifying
with LME disease, the fact that you don't know and
I've had like I said earlier, I've had friends who've
had it, and it's just that not knowing what's wrong
with me. Yeah, you know, not knowing you know why
I have these symptoms, not knowing how you know, if
(27:17):
you maybe I got bit but you don't know for sure.
I mean that's in addition to like being sick, it's
like not even knowing how to get better. I mean,
that's a very difficult disease.
Speaker 1 (27:28):
It's super, super scary. But I hope this episode at
least gives people the tools to do what they can
to prevent it. So you know, again, ticks more common
in the Northeast, mid Atlantic upper Midwest, especially if you're
in wooded areas or areas around the edge, like suburban
(27:52):
edge areas. You still see them on the West Coast
as well, but again the risk really depends on number
one and how long the tick has been attached to you,
and of course the species, and the faster you can
remove the tick, like if you can remove the tick
within twenty four to forty eight hours that lowers the
(28:12):
risk of infection.
Speaker 2 (28:13):
If you develop symptoms, get treated right away, and also
make sure you search your body thoroughly for a tick
bite and especially for.
Speaker 1 (28:21):
Kids, exactly prevention, quick tick removal most effective ways to
reduce the illness, and lime is the most known, but
tick spread all sorts of other sort of serious diseases
and co infections. So go out and get your long
sleeve pants and shirts.
Speaker 2 (28:38):
Tuck those pants into your socks like you're an old
timey baseball player.
Speaker 1 (28:42):
Yes, that's the look.
Speaker 2 (28:43):
If that's what has to be fashionable to help prevent
the spread of lime disease. And that's what we're going
to have to do. We're all going to have to
look like old timey baseball players.
Speaker 1 (28:50):
We all have to make sacrifices.
Speaker 2 (28:52):
Yes, thanks for listening to this week's episode. If you'd
like to support the podcast, please keep listening, send it
to your friends, and also give us five stars wherever
you listen to your podcast. Every little bit helps and
we'll see you next week.
Speaker 1 (29:11):
Health Stuff is a production of iHeart Podcasts. The show
is hosted by me, Doctor Preanco Wally and Harrikonnebolu. Producers
are Rebecca Eisenberg, Jenna Cagel, Christina Loranger, Maya Howard, and
Katrina Norvel. Our researcher is Maria Tremarki, and our intern
is Katiya Zobel Lejayala. To send us a question, you
(29:32):
can email us a voice memo at health Stuff Podcasts
at gmail dot com. Thanks so much for listening
Popular Podcasts
Betrayal Weekly
Betrayal Weekly is back for a new season. Every Thursday, Betrayal Weekly shares first-hand accounts of broken trust, shocking deceptions, and the trail of destruction they leave behind. Hosted by Andrea Gunning, this weekly ongoing series digs into real-life stories of betrayal and the aftermath. From stories of double lives to dark discoveries, these are cautionary tales and accounts of resilience against all odds. From the producers of the critically acclaimed Betrayal series, Betrayal Weekly drops new episodes every Thursday. If you would like to share your story, you can reach out to the Betrayal Team by emailing them at betrayalpod@gmail.com and follow us on Instagram at @betrayalpod and @glasspodcasts. Please join our Substack for additional exclusive content, curated book recommendations, and community discussions. Sign up FREE by clicking this link Beyond Betrayal Substack. Join our community dedicated to truth, resilience, and healing. Your voice matters! Be a part of our Betrayal journey on Substack.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com