WEBVTT

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The story that I'm going
to tell you today,

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for me, began back in 2006.

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That was when I first heard
about an outbreak of mysterious illness

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that was happening in the Amazon
rainforest of Peru.

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The people that were getting sick
from this illness,

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they had horrifying symptoms, nightmarish.

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They had unbelievable headaches,

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they couldn't eat or drink.

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Some of them were even hallucinating --

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confused and aggressive.

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The most tragic part of all

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was that many of the victims
were children.

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And of all of those that got sick,

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none survived.

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It turned out that what was killing
people was a virus,

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but it wasn't Ebola, it wasn't Zika,

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it wasn't even some new virus
never before seen by science.

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These people were dying
of an ancient killer,

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one that we've known about for centuries.

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They were dying of rabies.

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And what all of them had in common
was that as they slept,

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they'd all been bitten by the only mammal
that lives exclusively on a diet of blood:

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the vampire bat.

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These sorts of outbreaks
that jump from bats into people,

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they've become more and more common
in the last couple of decades.

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In 2003, it was SARS.

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It showed up in Chinese animal markets
and spread globally.

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That virus, like the one from Peru,
was eventually traced back to bats,

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which have probably harbored it,
undetected, for centuries.

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Then, 10 years later, we see Ebola
showing up in West Africa,

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and that surprised just about everybody

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because, according
to the science at the time,

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Ebola wasn't really supposed
to be in West Africa.

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That ended up causing the largest
and most widespread Ebola outbreak

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in history.

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So there's a disturbing trend here, right?

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Deadly viruses are appearing in places
where we can't really expect them,

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and as a global health community,

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we're caught on our heels.

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We're constantly chasing
after the next viral emergency

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in this perpetual cycle,

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always trying to extinguish epidemics
after they've already started.

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So with new diseases appearing every year,

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now is really the time

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that we need to start thinking
about what we can do about it.

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If we just wait for the next
Ebola to happen,

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we might not be so lucky next time.

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We might face a different virus,

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one that's more deadly,

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one that spreads better among people,

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or maybe one that just completely
outwits our vaccines,

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leaving us defenseless.

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So can we anticipate pandemics?

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Can we stop them?

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Those are really hard questions to answer,

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and the reason is that the pandemics --

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the ones that spread globally,

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the ones that we really
want to anticipate --

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they're actually really rare events.

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And for us as a species
that is a good thing --

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that's why we're all here.

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But from a scientific standpoint,
it's a little bit of a problem.

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That's because if something
happens just once or twice,

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that's really not enough
to find any patterns.

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Patterns that could tell us when
or where the next pandemic might strike.

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So what do we do?

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Well, I think one of the solutions
we may have is to study some viruses

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that routinely jump from wild
animals into people,

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or into our pets, or our livestock,

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even if they're not the same viruses

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that we think are going
to cause pandemics.

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If we can use
those everyday killer viruses

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to work out some of the patterns

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of what drives that initial, crucial jump
from one species to the next,

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and, potentially, how we might stop it,

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then we're going to end up better prepared

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for those viruses that jump
between species more rarely

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but pose a greater threat of pandemics.

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Now, rabies, as terrible as it is,

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turns out to be a pretty nice
virus in this case.

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You see, rabies is a scary, deadly virus.

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It has 100 percent fatality.

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That means if you get infected with rabies
and you don't get treated early,

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there's nothing that can be done.

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There is no cure.

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You will die.

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And rabies is not just
a problem of the past either.

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Even today, rabies still kills
50 to 60,000 people every year.

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Just put that number in some perspective.

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Imagine the whole West African
Ebola outbreak --

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about two-and-a-half years;

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you condense all the people
that died in that outbreak

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into just a single year.

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That's pretty bad.

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But then, you multiply it by four,

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and that's what happens
with rabies every single year.

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So what sets rabies apart
from a virus like Ebola

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is that when people get it,

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they tend not to spread it onward.

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That means that every single time
a person gets rabies,

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it's because they were bitten
by a rabid animal,

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and usually, that's a dog or a bat.

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But it also means that those jumps
between species,

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which are so important to understand,
but so rare for most viruses,

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for rabies, they're actually
happening by the thousands.

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So in a way, rabies
is almost like the fruit fly

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or the lab mouse of deadly viruses.

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This is a virus that we can use
and study to find patterns

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and potentially test out new solutions.

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And so, when I first heard
about that outbreak of rabies

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in the Peruvian Amazon,

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it struck me as something
potentially powerful

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because this was a virus that was jumping
from bats into other animals

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often enough that we might
be able to anticipate it ...

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Maybe even stop it.

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So as a first-year graduate student

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with a vague memory
of my high school Spanish class,

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I jumped onto a plane
and flew off to Peru,

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looking for vampire bats.

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And the first couple of years
of this project were really tough.

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I had no shortage of ambitious plans
to rid Latin America of rabies,

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but at the same time,

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there seemed to be an equally endless
supply of mudslides and flat tires,

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power outages, stomach bugs
all stopping me.

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But that was kind of par for the course,

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working in South America,

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and to me, it was part of the adventure.

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But what kept me going

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was the knowledge that for the first time,

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the work that I was doing
might actually have some real impact

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on people's lives in the short term.

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And that struck me the most

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when we actually went out to the Amazon

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and were trying to catch vampire bats.

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You see, all we had to do was show up
at a village and ask around.

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"Who's been getting bitten
by a bat lately?"

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And people raised their hands,

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because in these communities,

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getting bitten by a bat
is an everyday occurrence,

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happens every day.

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And so all we had to do
was go to the right house,

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open up a net

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and show up at night,

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and wait until the bats tried
to fly in and feed on human blood.

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So to me, seeing a child with a bite wound
on his head or blood stains on his sheets,

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that was more than enough motivation

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to get past whatever logistical
or physical headache

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I happened to be feeling on that day.

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Since we were working
all night long, though,

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I had plenty of time to think about
how I might actually solve this problem,

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and it stood out to me
that there were two burning questions.

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The first was that we know
that people are bitten all the time,

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but rabies outbreaks
aren't happening all the time --

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every couple of years,
maybe even every decade,

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you get a rabies outbreak.

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So if we could somehow anticipate
when and where the next outbreak would be,

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that would be a real opportunity,

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meaning we could vaccinate
people ahead of time,

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before anybody starts dying.

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But the other side of that coin

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is that vaccination
is really just a Band-Aid.

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It's kind of a strategy of damage control.

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Of course it's lifesaving and important
and we have to do it,

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but at the end of the day,

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no matter how many cows,
how many people we vaccinate,

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we're still going to have exactly the same
amount of rabies up there in the bats.

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The actual risk of getting bitten
hasn't changed at all.

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So my second question was this:

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Could we somehow
cut the virus off at its source?

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If we could somehow reduce the amount
of rabies in the bats themselves,

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then that would be a real game changer.

NOTE Paragraph

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We'd been talking about shifting

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from a strategy of damage control
to one based on prevention.

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So, how do we begin to do that?

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Well, the first thing
we needed to understand

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was how this virus actually works
in its natural host --

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in the bats.

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And that is a tall order
for any infectious disease,

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particularly one in a reclusive
species like bats,

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but we had to start somewhere.

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So the way we started
was looking at some historical data.

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When and where had these outbreaks
happened in the past?

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And it became clear
that rabies was a virus

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that just had to be on the move.

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It couldn't sit still.

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The virus might circulate in one area
for a year, maybe two,

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but unless it found a new group of bats
to infect somewhere else,

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it was pretty much bound to go extinct.

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So with that, we solved one key part
of the rabies transmission challenge.

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We knew we were dealing
with a virus on the move,

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but we still couldn't say
where it was going.

NOTE Paragraph

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Essentially, what I wanted was
more of a Google Maps-style prediction,

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which is, "What's
the destination of the virus?

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What's the route it's going
to take to get there?

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How fast will it move?"

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To do that, I turned
to the genomes of rabies.

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You see, rabies, like many other viruses,
has a tiny little genome,

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but one that evolves
really, really quickly.

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So quickly that by the time the virus
has moved from one point to the next,

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it's going to have picked up
a couple of new mutations.

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And so all we have to do
is kind of connect the dots

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across an evolutionary tree,

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and that's going to tell us
where the virus has been in the past

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and how it spread across the landscape.

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So, I went out and I collected cow brains,

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because that's where
you get rabies viruses.

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And from genome sequences that we got
from the viruses in those cow brains,

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I was able to work out

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that this is a virus that spreads
between 10 and 20 miles each year.

NOTE Paragraph

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OK, so that means we do now have
the speed limit of the virus,

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but still missing that other key part
of where is it going in the first place.

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For that, I needed to think
a little bit more like a bat,

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because rabies is a virus --

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it doesn't move by itself,

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it has to be moved around by its bat host,

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so I needed to think about
how far to fly and how often to fly.

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My imagination didn't get me
all that far with this

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and neither did little digital trackers
that we first tried putting on bats.

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We just couldn't get
the information we needed.

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So instead, we turned
to the mating patterns of bats.

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We could look at certain parts
of the bat genome,

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and they were telling us that some
groups of bats were mating with each other

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and others were more isolated.

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And the virus was basically following
the trail laid out by the bat genomes.

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Yet one of those trails stood out
as being a little bit surprising --

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hard to believe.

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That was one that seemed to cross
straight over the Peruvian Andes,

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crossing from the Amazon
to the Pacific coast,

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and that was kind of hard to believe,

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as I said,

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because the Andes are really tall --
about 22,000 feet,

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and that's way too high
for a vampire to fly.

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Yet --

NOTE Paragraph

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(Laughter)

NOTE Paragraph

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when we looked more closely,

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we saw, in the northern part of Peru,

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a network of valley systems
that was not quite too tall

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for the bats on either side
to be mating with each other.

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And we looked a little bit more closely --

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sure enough, there's rabies
spreading through those valleys,

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just about 10 miles each year.

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Basically, exactly as our evolutionary
models had predicated it would be.

NOTE Paragraph

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What I didn't tell you

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is that that's actually
kind of an important thing

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because rabies had never been seen before
on the western slopes of the Andes,

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or on the whole Pacific coast
of South America,

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so we were actually witnessing,
in real time, a historical first invasion

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into a pretty big part of South America,

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which raises the key question:

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"What are we going to do about that?"

NOTE Paragraph

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Well, the obvious short-term
thing we can do is tell people:

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you need to vaccinate yourselves,
vaccinate your animals;

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rabies is coming.

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But in the longer term,

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it would be even more powerful
if we could use that new information

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to stop the virus
from arriving altogether.

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Of course, we can't just tell bats,
"Don't fly today,"

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but maybe we could stop the virus
from hitching a ride along with the bat.

NOTE Paragraph

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And that brings us to the key lesson
that we have learned

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from rabies-management programs
all around the world,

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whether it's dogs, foxes,
skunks, raccoons,

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North America, Africa, Europe.

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It's that vaccinating the animal source
is the only thing that stops rabies.

NOTE Paragraph

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So, can we vaccinate bats?

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You hear about vaccinating dogs
and cats all the time,

00:12:29.146 --> 00:12:31.603
but you don't hear too much
about vaccinating bats.

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It might sound like a crazy question,

00:12:34.671 --> 00:12:39.845
but the good news is that we actually
already have edible rabies vaccines

00:12:39.869 --> 00:12:41.731
that are specially designed for bats.

00:12:42.351 --> 00:12:43.974
And what's even better

00:12:43.998 --> 00:12:47.819
is that these vaccines
can actually spread from bat to bat.

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All you have to do is smear it on one

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and let the bats' habit
of grooming each other

00:12:53.212 --> 00:12:55.217
take care of the rest of the work for you.

00:12:55.241 --> 00:12:57.484
So that means, at the very least,

00:12:57.508 --> 00:13:00.747
we don't have to be out there vaccinating
millions of bats one by one

00:13:00.771 --> 00:13:02.272
with tiny little syringes.

NOTE Paragraph

00:13:02.296 --> 00:13:03.885
(Laughter)

NOTE Paragraph

00:13:03.909 --> 00:13:07.418
But just because we have that tool
doesn't mean we know how to use it.

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Now we have a whole laundry
list of questions.

00:13:09.821 --> 00:13:11.917
How many bats do we need to vaccinate?

00:13:11.941 --> 00:13:14.368
What time of the year
do we need to be vaccinating?

00:13:14.392 --> 00:13:16.914
How many times a year
do we need to be vaccinating?

00:13:18.067 --> 00:13:20.609
All of these are questions
that are really fundamental

00:13:20.633 --> 00:13:22.876
to rolling out any sort
of vaccination campaign,

00:13:22.900 --> 00:13:25.758
but they're questions
that we can't answer in the laboratory.

00:13:25.782 --> 00:13:28.646
So instead, we're taking
a slightly more colorful approach.

00:13:29.250 --> 00:13:32.895
We're using real wild bats,
but fake vaccines.

00:13:33.795 --> 00:13:36.211
We use edible gels that make bat hair glow

00:13:36.235 --> 00:13:39.838
and UV powders that spread between
bats when they bump into each other,

00:13:39.862 --> 00:13:42.901
and that's letting us study
how well a real vaccine might spread

00:13:42.925 --> 00:13:44.955
in these wild colonies of bats.

00:13:45.908 --> 00:13:48.251
We're still in the earliest
phases of this work,

00:13:48.275 --> 00:13:50.712
but our results so far
are incredibly encouraging.

00:13:51.310 --> 00:13:54.406
They're suggesting that using
the vaccines that we already have,

00:13:54.430 --> 00:13:57.704
we could potentially drastically reduce
the size of rabies outbreaks.

00:13:58.637 --> 00:14:01.439
And that matters, because as you remember,

00:14:01.463 --> 00:14:04.243
rabies is a virus that always
has to be on the move,

00:14:04.267 --> 00:14:07.382
and so every time we reduce
the size of an outbreak,

00:14:07.406 --> 00:14:08.867
we're also reducing the chance

00:14:08.891 --> 00:14:11.136
that the virus makes it
onto the next colony.

00:14:11.160 --> 00:14:13.655
We're breaking a link
in the chain of transmission.

00:14:14.289 --> 00:14:15.881
And so every time we do that,

00:14:15.905 --> 00:14:18.782
we're bringing the virus
one step closer to extinction.

00:14:18.806 --> 00:14:23.518
And so the thought, for me,
of a world in the not-too-distant future

00:14:23.542 --> 00:14:26.813
where we're actually talking
about getting rid of rabies altogether,

00:14:26.837 --> 00:14:28.908
that is incredibly
encouraging and exciting.

NOTE Paragraph

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So let me return to the original question.

00:14:31.819 --> 00:14:33.303
Can we prevent pandemics?

00:14:34.119 --> 00:14:38.219
Well, there is no silver-bullet
solution to this problem,

00:14:38.243 --> 00:14:41.678
but my experiences with rabies
have left me pretty optimistic about it.

00:14:42.282 --> 00:14:44.275
I think we're not too far from a future

00:14:44.299 --> 00:14:47.942
where we're going to have genomics
to forecast outbreaks

00:14:47.966 --> 00:14:50.371
and we're going to have clever
new technologies,

00:14:50.395 --> 00:14:53.299
like edible, self-spreading vaccines,

00:14:53.323 --> 00:14:55.612
that can get rid of these
viruses at their source

00:14:55.636 --> 00:14:57.907
before they have a chance
to jump into people.

NOTE Paragraph

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So when it comes to fighting pandemics,

00:15:01.087 --> 00:15:03.433
the holy grail is just to get
one step ahead.

00:15:04.202 --> 00:15:05.352
And if you ask me,

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I think one of the ways
that we can do that

00:15:07.400 --> 00:15:09.983
is using some of the problems
that we already have now,

00:15:10.007 --> 00:15:11.239
like rabies --

00:15:11.263 --> 00:15:14.024
sort of the way an astronaut
might use a flight simulator,

00:15:14.048 --> 00:15:16.016
figuring out what works and what doesn't,

00:15:16.040 --> 00:15:17.565
and building up our tool set

00:15:17.589 --> 00:15:19.187
so that when the stakes are high,

00:15:19.211 --> 00:15:20.459
we're not flying blind.

NOTE Paragraph

00:15:20.884 --> 00:15:22.035
Thank you.

NOTE Paragraph

00:15:22.059 --> 00:15:25.916
(Applause)