Our inaugural episode of Season 2 of The Contagion Podcast opens as show producer Dr. Richard Oehler and show co-host Dr. Vivian Vega reflect on how much has changed in the fields of infectious diseases and public health since our Season 1 finale was posted in June. Drs. Oehler and Vega share some very timely updates in their ID news segment--recounting changes at the CDC as well as several important epidemiological and research developments. Next, Dr. Vega and our special guest, Infectious Diseases specialist and former military physician Dr. Patrick Danaher transition to a chilling yet timely exploration of bioterrorism and biological warfare, threats that no longer garner the attention they once did a couple of decades ago. The two recount bizarre early attempts — like firing rabid dog saliva or trading leprosy-tainted wine — that reveal how little was once understood about contagion. But the tone shifts as the conversation moves on to the 1984 Salmonella attack in The Dalles, Oregon, America’s first large-scale bioterrorism event. A cult known as the Rajneeshees deliberately contaminated restaurant salad bars to sway a local election, sickening more than 750 people. Through detailed epidemiologic analysis, the hosts explain how investigators connected the outbreak to the commune and why this case remains a critical public-health lesson in surveillance and preparedness.

From there, the discussion expands to bioweapons — cheap, concealable, and capable of mass panic. The doctors compare the costs of biological, chemical, and nuclear weapons, underscoring why pathogens are often called “the poor man’s nuclear bomb.” They walk through the CDC’s Category A threat list — including anthrax, smallpox, plague, and viral hemorrhagic fevers — and dissect what makes these microbes so devastating.

Listeners are then transported to the aftermath of 9/11, when anthrax-laden letters reignited national fears of invisible enemies. The podcast reconstructs the FBI investigation, profiles scientist Bruce Ivins, and explains how this attack reshaped U.S. biodefense policy, from Project BioShield to the Strategic National Stockpile.

The last segment turns to smallpox, humanity’s “crown jewel” of eradication turned nightmare scenario. Through insights from Soviet defector Ken Alibek and modern concerns about synthetic biology, the episode reveals why smallpox remains one of the most feared potential bioweapons — despite being officially eradicated in 1980.

Blending medical insight, historical storytelling, and wry humor, Contagion Pod’s Season 2 premiere reminds us that while pandemics capture headlines, the threat of bioterrorism never truly disappears.

Dr Vega would like to thank her friend Job Meiller for his musical contribution to our segment breaks. Thank you Job!

Thanks also to Dr. Ana Velez, our artistic contributor, for her original painting, “Biohazard Dream,” used in our episode thumbnail.

In the Season one finale of our show, hosts Dr. Vivian Vega and Dr. Jackie Sherbuk reflect on the evolving landscape of infectious diseases and public health. Yet rather than linger on setbacks, they look ahead, posing the critical question: “What are the future pandemic threats?”

To explore what transforms a simple pathogen into a global threat, they examine three key characteristics: transmission, virulence, and available countermeasures.

Transmission, it turns out, must strike a delicate balance. A virus must spread efficiently—fast enough to infect large populations, but not so aggressively that it incapacitates or kills its host before passing to the next person. Similarly, a pathogen that is too virulent may burn out quickly, unable to spread widely before its hosts succumb. As for countermeasures, their availability and effectiveness vary. Influenza, for instance, can be treated with antivirals, while diseases like Nipah virus remain without effective therapies.

At the time of this recording, H5N1 avian influenza stands out as a pressing concern. Dr. Vega reveals a startling fact: domestic cats may serve as an unexpected intermediary host, offering a new pathway for H5N1 to bridge the gap to humans. It’s a reminder of how creatively and unpredictably pathogens can bypass traditional barriers.

Dr. Sherbuk turns to Ebola as a striking example of how sheer virulence can catapult a disease to global attention. Past outbreaks in Africa overwhelmed health systems, exploiting cultural practices like burial rituals to fuel its spread. Even the limited number of U.S. cases during the 2014 outbreak stirred widespread public fear, driven by the virus’s high mortality rate abroad.

Not all dangerous pathogens are highly lethal. Some, like Zika virus, pose serious risks in specific populations—such as fetal abnormalities in pregnant women. Others, like HTLV-1, may cause chronic illnesses like leukemia and lymphoma.

While many pathogens naturally evolve to become less lethal—thereby enhancing their chances of transmission—some mutate unpredictably, becoming more dangerous. This is the ongoing concern with influenza: a seemingly mild strain could shift into something far deadlier.

The importance of countermeasures cannot be overstated. Yet in the aftermath of COVID-19, global readiness has been undermined by pandemic fatigue and the politicization of public health. Mistrust in vaccines, fractured health policy, and diminished international cooperation all threaten our capacity to respond to the next crisis.

But what if the next pandemic comes from a direction we didn’t anticipate?

Scientists have a name for this uncertainty: “Disease X.” The World Health Organization coined the term as a placeholder for the unknown. COVID-19 was once Disease X—until it had a name. The next one could emerge from zoonotic spillovers like HIV or Nipah, climate change, laboratory accidents, or even bioterrorism.

Whatever its origin, our best defense lies in robust surveillance, scientific agility, and global collaboration. Because the question isn’t if Disease X will come—but whether we’ll be ready when it does.

Dr Vega would like to thank her friend Job Meiller for his musical contribution to our segment breaks. Thank you Job!

Thanks also to Dr. Ana Velez, our artistic contributor, for her painting, "The Multivirus Pandemic Explosion," used in our episode thumbnail.

It felt inevitable. Years of declining childhood vaccination rates were bound to have consequences. In early 2025, those consequences became alarmingly real as a measles outbreak emerged in West Texas and Eastern New Mexico.

Before the introduction of the measles vaccine in 1963, the U.S. Centers for Disease Control and Prevention (CDC) estimated that measles infected three to four million Americans annually, causing 48,000 hospitalizations and 400 to 500 deaths each year. The introduction of the MMR (measles, mumps, and rubella) vaccine marked a turning point. The two-dose regimen—first administered between 12 and 15 months of age, with a second dose between 4 and 6 years—was remarkably effective. By 2000, measles was declared eliminated in the United States.

But in recent years, progress has unraveled. A dramatic drop in vaccination rates—fueled largely by the discredited claim linking the MMR vaccine to autism—has allowed this once-vanquished virus to resurge.

Today, vaccination rates in many states have dipped below the 95% threshold needed for herd immunity, and the current outbreak offers a grim reminder of what’s at stake. In Gaines County, Texas, where vaccine exemptions are especially high among the local Mennonite population, hundreds of measles cases have been reported—resulting in at least two deaths in Texas and New Mexico.

In this episode, hosts Dr. Vivian Vega and Dr. Jackie Sherbuk trace the recent history of measles in the U.S., focusing on the current outbreak in Texas and New Mexico. They tackle the question: Why is measles still so dangerous? The discussion includes common complications of the disease, current vaccination guidelines, and a thorough debunking of the alleged MMR-autism connection. They also highlight a growing concern: cases of vitamin A toxicity in children, stemming from widespread misconceptions about its role in measles treatment.

Dr Vega would like to thank her friend Job Meiller for his musical contribution to our segment breaks. Thank you Job!

Thanks also to Dr. Ana Velez, our artistic contributor, for her painting, "SSPE-Subacute Sclerosing Panencephalitis," used in our episode thumbnail.