MrBallen’s Medical Mysteries - Ep. 42 | Deadly Tourist

Episode Date: July 23, 2024

A man vacationing in Germany becomes violently ill, and no medicine is helping. The solution may be hidden somewhere on the man’s home of Vancouver Island… where a deadly outbreak is spreading.Follow MrBallen's Medical Mysteries on Amazon Music or wherever you get your podcasts. New episodes publish for free every Tuesday. Prime members can binge episodes 41-48 early and ad-free on Amazon Music. Wondery+ subscribers can listen ad-free--join Wondery+ in the Wondery App or on Apple Podcasts.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Hey Prime members, you can binge episodes 49 to 56 right now and ad-free on Amazon Music. Download the app today. On a gray and foggy winter morning in 2001, two sanitation workers drove along the winding and rugged coastline of western Canada. Moss-covered pine trees towered overhead, and they could hear powerful waves crashing onto the shore. The workers had been called out here to dispose of something that had washed up on the beach, and when the strip of rocky sand came into view, they could see something large and grayish pink lying in the sand. It looked about six feet long, and from far away, it resembled a piece of driftwood

or maybe some trash. But as they made their way down toward the water, the wind changed directions and an awful smell hit them, pungent and rotting. That's when they realized the thing on the beach was the body of a dead porpoise. The men put on rubber gloves and masks as they got closer to the bloated, sand-covered carcass. The men exchanged troubled looks. It was unusual for a porpoise to wash ashore, and this was the third time it had happened this month. The sanitation workers wrapped the porpoise up in a tarp and carefully brought it back to their truck. Then they hopped into the truck and drove off, watching the ocean disappear in the rearview mirror. But as they left,

the driver felt a shiver run up his spine because he couldn't shake the feeling that something horrible must be lurking off the coast. A ruthless mobster, a bomb maker, a baby thief. The American dream has a dark side, and my podcast, American Criminal, exposes it all. Search for American Criminal in your podcast app now for deep dives into our country's worst, American Criminal. Have you ever wondered who created that bottle of sriracha that's living in your fridge? Or why nearly every house in America has at least one game of Monopoly? Introducing The Best Idea Yet, a brand new podcast about the surprising origin stories of the products you're obsessed with. Listen to The Best Idea Yet on the Wondery app or wherever you get your

podcasts. From Ballin Studios and Wondery, I'm Mr. Ballin, and this is Mr. Ballin's Medical Mysteries, where every week we will explore a new baffling mystery originating from the one place we all can't escape, our own bodies. So if you like today's story, please replace the follow button's milk with Elmer's glue. This episode is called Deadly Tourist. In the summer of 2001, Arthur Labe sat inside a traditional German beer garden with his family. The middle-aged man lived on Vancouver Island in Canada, where he worked as a house painter.

But now he was on his dream vacation in Germany, visiting relatives that he hadn't seen for years. He'd been looking forward to this trip for ages, and he was having a total blast. Arthur felt grateful to be on this vacation at all. A few months earlier, he had coughed up some blood, and his wife Carol insisted that he go see their doctor on Vancouver Island. The doctor would tell Arthur that he was worried about lung cancer since Arthur had been a smoker when he was young. Thankfully, Arthur's chest x-rays and follow-up testing indicated he didn't have cancer and his doctor said that it was fine for Arthur to go to Germany and enjoy his trip. And his cough actually cleared up completely a few days before he left for the trip. Arthur took a big swig of his beer and then

thought about how great it felt to sit down and relax after a full day of walking all over the city. The walking was actually the only part of the trip that Arthur was not enjoying. They'd been on their feet so much that his lower back was starting to hurt. And so Arthur made a mental note to stop by a pharmacy on the way back to the hotel for some pain relievers or maybe a hot pad. Arthur took another big sip of his beer and then looked around at all the other tourists crowded into the beer garden. Then he nodded his head at the polka band in appreciation and then settled in, enjoying a sunny afternoon and the warm glow of a nice German beer. Two hours later, the sun had sunk behind the trees, and Arthur stood up from

the table to head back to the hotel. As he got to his feet, a shock of pain burst through his lower back. Arthur immediately sank back into his seat, very surprised. Then he tried to stand again, but every time he moved, a burning pain shot through his back and up his spine. Carol was surprised that her husband couldn't stand and asked what was wrong. Arthur told her he just needed to breathe for a second, but after a few minutes, the pain was still shooting up his back. And every time he tried to stand up, the pressure on his back was blinding. Finally, he just shook his head and told Carol he did need to go to the hospital. Something was going on with his back. She nodded, then asked their son-in-law, Brian, to run and grab their rental car.

Fifteen minutes later, Arthur sat in the front passenger seat as Brian drove towards the hospital with Carol and Arthur's daughter, Jenny, in the back seat. Every time the car hit a bump, Arthur gritted his teeth in pain. Arthur could feel a brutal headache coming on too, and he wondered if the way he was feeling now had anything to do with that nasty cough he had back home. Finally, the car turned a corner, and Arthur saw the hospital up ahead, and not a moment too soon, because right at that moment, Arthur's vision had begun to blur, so he was leaning his

head against the headrest and closing his eyes. He felt hot and achy and his forehead was dripping with sweat. And by the time the car actually stopped, Arthur felt delirious. In fact, Arthur barely noticed as his car door opened and two hospital staff reached in to help him stand up. An hour later, Arthur opened his eyes and realized he was lying on his side in a hospital bed with an IV drip in his arm. Slowly, the beige room came into focus. He could hear the whirring and beeping of machines in the room, as well as conversations drifting in from the hallway.

The room suddenly felt chilly, and Arthur hoped that his fever might be breaking. His headache was getting less intense too, and for the first time since arriving at the hospital, he felt like he could actually think clearly. Arthur looked down towards the foot of his bed, and he saw Carol speaking to a middle-aged doctor in a very quiet voice. When Carol noticed Arthur was awake, she smiled at him, but Arthur knew his wife well, and he knew the look she was giving him was her putting on a very brave face. Something clearly was wrong. At this point, the doctor turned to Arthur and introduced himself as Dr. Ghent. He told Arthur that while he was unconscious, they'd performed a spinal tap so they could examine his spinal fluid for potential infections, and the lab work had just come back. Dr. Ghent kept a neutral expression as he told Arthur that his spinal fluid had a high white blood cell count, which indicated that his body was fighting an infection.

Dr. Ghent suspected that Arthur had a very serious condition called bacterial meningitis, which meant that the membranes that protected his brain and spinal column were swelling. He explained that meningitis is a potentially life-threatening infection, but they had already started Arthur on antibiotics, so he should make a full recovery. Arthur felt overwhelmed by everything the doctor was saying, and he just wanted to know how long it was going to be before he felt better again. But before he could ask any questions, Dr. Ghent told him to try and rest. He was going to be in the hospital for a few days at least. A week later, Arthur's daughter, Jenny, was getting ready to go to work on Vancouver Island.

Jenny had decided to fly back to Canada while her father was still in the hospital, but she couldn't stop worrying about him. So far, doctors in Germany had tried six different antibiotics, but her dad didn't respond to any of them. He just kept getting sicker. Jenny was about to head out the door when her phone rang. She lunged for it, knowing it was the time her mother usually called from Germany. For a split second, Jenny hoped that her mom was calling to say her dad was all better and they were just going to resume their vacation and everything was great. But as soon as Jenny picked up the phone, she could hear that her mom was crying. Carol told Jenny that the swelling in her father's brain was getting worse, and now Dr. Ghent was saying that it looked like her father was going to die. Jenny had not prepared herself for the possibility of losing her dad, and she scrambled to think of some way she could help. Finally, she offered to drive

over to her dad's doctor's office here on Vancouver Island to basically fill in Arthur's primary care doctor about what was going on to see if maybe he had some ideas that the doctors in Germany had not tried yet. An hour later, Jenny fidgeted as she watched her father's doctor in Vancouver Island review her dad's scans on a computer monitor, and flip through his lab results. He asked Jenny a few questions about her dad's condition, and she did her best to fill in the blanks. Finally, the doctor closed the files and turned to her, and she sat up expectantly. But he just shook his head and told Jenny that, despite her father's serious illness,

his charts looked remarkably normal. The doctor told her that her dad was in good health when he left for Germany. He might have picked up a bug while on the trip, but his infection should be responding to antibiotics by now. Jenny begged the doctor to please just look one more time, and then Jenny held her breath as the doctor did pick up the lab results and looked them over one more time. Then Jenny noticed the doctor's expression change, like something had just occurred to him. Then he leaned in and he told Jenny there was one possible, but highly unlikely explanation.

Jenny asked him to please tell her. At this point, her family was willing to consider anything. So the doctor explained that several weeks ago, her father's blood work had shown no signs of lung cancer and they had rejoiced. But lost in the excitement was some less positive news. Arthur's blood had tested positive for a fungal infection called cryptococcus. A lot of people get cryptococcus, which had existed on Vancouver Island for years. But it's usually harmless and most people's immune systems fight

it off easily. It's only dangerous for people with compromised immune systems. And Arthur's immune system at the time was fine, so the doctor didn't even tell Arthur that he had this fungal infection. Jenny asked if this fungus could cause meningitis, and the doctor nodded, but only in extremely rare cases. However, if her father's meningitis was caused by a fungal infection, he would need completely different medications than what he was receiving in Germany right now. Antibiotics cannot stop a fungal infection. If Jenny's father had fungal meningitis,

that would mean that for the past few days, the treatments Arthur was receiving in Germany were doing nothing. Jenny tried to stay calm as the doctor placed a call to the hospital in Germany. If they started Arthur on antifungal medication right now, he might survive. Jenny just hoped they weren't too late. In the Pacific Ocean, halfway between Peru and New Zealand, lies a tiny volcanic island. It's a little-known British territory called Pitcairn,

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her microscope, then bent down over the eyepiece to take a look. The slide she had put under there contained tissue from the carcass of a dead porpoise that had washed up on the beach on nearby Vancouver Island. Dr. Lester focused her lens on a tiny cell that looked like a boiled egg. This kind of cell had become a familiar sight to her over the past year. These odd egg-shaped cells had been sent to Dr. Lester from veterinary clinics all around Vancouver Island. A growing number of sick dogs and cats were showing up at vet clinics with shortness of breath and discharge running from their noses. In more serious cases, the animals were having seizures. Some had mysterious lumps on their heads,

and all of the animals had pockets of pus called abscesses below their eyes. Veterinarians had sent in samples of the abscess tissue to Dr. Lester so she could examine them in her lab, and every time she'd found these little yellow cells that looked like boiled eggs. She knew what the cells meant, that the animals were infected with Cryptococcus, a fungus that grew on Vancouver Island. It was common for animals and humans alike to contract Cryptococcus by inhaling the spores floating in the air. Humans and animals rarely got sick from these spores. In fact, Dr. Lester usually saw no more

than maybe 6 to 10 animals with Cryptococcus infections in a year. But recently, vets on Vancouver Island had been sending her about 10 cases every single month. Dr. Lester was stumped about what could be causing the number of these infections to rise so quickly. Then, porpoises began washing up on shore, which had given Dr. Lester a very eerie feeling. Dead porpoises should rarely wash ashore, but now it was happening every few weeks. And when she began reading the porpoise autopsy reports, she started feeling even more unnerved. The porpoise's lungs had been riddled with inflammation from pneumonia. Their organs were swollen and covered in flower-like

tumors. And now, as Dr. Lester looked at the slide, she realized that all this damage was being caused by a cryptococcus infection. The porpoise's blood was loaded with the fungus. Dr. Lester sat back on her stool, feeling a knot starting to form in her gut. She knew how porpoises would have contracted the cryptococcus spores. Since spores are airborne, the fungus would have floated out over the ocean and settled on top of the water. The porpoises would have inhaled the spores when they came up and broke the surface to breathe. What she didn't understand was why the

number of cases was increasing now. Something weird was definitely going on. And then Dr. Lester had a chilling thought. If more animals are getting fungal infections, maybe more people are too. After all, we all breathe the same air. Dr. Lester picked up the phone to call the British Columbia Center for Disease Control. She knew it was now time to get the Human Infectious Disease Authorities involved. Half an hour later, Dr. Murray Fife hung up the phone on his desk at the British Columbia Center for Disease Control. He was the organization's head epidemiologist, and he had been absolutely swamped lately. And now, after speaking with Dr. Lester,

he needed a moment to consider what she had told him about this potential outbreak of fungal infections on Vancouver Island. Dr. Fyfe wanted to get feedback on Dr. Lester's concerns from a colleague who lived on Vancouver Island, so he picked up the phone again, this time to call the Vancouver Island Health Authority. The microbiologist who picked up said very matter-of-factly that Dr. Lester was right. There was a definite increase in human cryptococcus infections on Vancouver Island, but not among the patients they would normally expect. Usually, it was just people with compromised immune systems that got sick from cryptococcus. But lately, healthy adults

were getting sick from the fungus. It was bizarre and basically unheard of. It made no sense to Dr. Fyfe. Cryptococcus fungus had been on Vancouver Island for years, so why was it suddenly so dangerous now? He worried that something about the fungus itself was changing, and he wondered if it could even be stopped. A few days later, Dr. Fyfe sat in a conference room, totally surrounded by piles of hospital records, and feeling completely exhausted. For the last week, he and a scientist at the University of British Columbia named Karen Bartlett had been combing the region's hospital records in hopes of finding other Cryptococcus infections. His eyes hurt from hours spent reading,

but they still had not figured out when the number of infections had begun to rise. Dr. Bartlett cleared her throat and looked up while holding a file above her head. Dr. Fife raised his eyebrows as she explained that this, this file, was the oldest human case she'd found. It was from over two years ago, the beginning of 1999. The patient had been in good health when cryptococcus made her sick, just like a lot of the recent cases. A few minutes later, Dr. Bartlett gasped and handed Dr. Fife another file.

It was the medical records of a lively 45-year-old mother who had started to feel lousy just a few months ago in the fall of 2001. By the time the doctors tested her for Cryptococcus, the fungus had infected her brain and she died shortly after. Dr. Fife was shocked. He'd never heard of Cryptococcus killing an otherwise healthy adult. Even Arthur Leib, who'd been on death's door in Germany last summer, he'd recovered from his infection after receiving antifungal treatment. Suddenly, the stakes in their investigation seemed much higher. Not only were healthy adults contracting Cryptococcus, but the fungus was now, apparently, deadly, and Dr. Fyfe had no idea why. A week later, Dr. Fyfe was back at his desk,

feeling both amazed and horrified at the unfolding health crisis. After he and Dr. Bartlett discovered that cryptococcus infections were killing people on Vancouver Island, they'd sent samples of the fungus to a lab for further analysis. And now Dr. Fyfe was staring at the test results and they weren't at all what he expected. The fungus that was infecting the animals and the people on Vancouver Island was an entirely new kind of Cryptococcus fungus

than what had been on Vancouver Island for years. Under the microscope, analysts could tell that the new Cryptococcus was a completely different species from what residents were used to. But the new strain should never have been in Vancouver Island. The newcomer strain of Cryptococcus is typically found in the bark of eucalyptus trees in Australia and other warm places.

It had never been seen so far north, and especially not in a cold and damp climate like Vancouver Island. Dr. Fyfe wondered how a tropical fungus got so far north. There were hardly any eucalyptus trees on Vancouver Island, which meant that Dr. Fife had no idea where the fungus was hiding, or how it could even survive in this environment. Dr. Fife called Dr. Bartlett to explain the alarming lab results and admit he had no idea how to find this toxic new fungus. She paused, then told him she had an idea. She said it was time to get some

boots on the ground. A week later, Dr. Bartlett stood on a residential street on Vancouver Island, surrounded by several students from a local college. These were her volunteers, and together they were going to comb the backyards and backwoods of all of Vancouver Island, searching for answers. Dr. Bartlett looked from student to student and reminded them of their objective. They would dig up soil samples and swab tree barks in the hopes that they would capture the new strain of Cryptococcus in the wild. Each student nodded and said they understood. So Dr. Bartlett divided them into teams. She sent two teams to collect samples around the neighborhood. Then she led her group to the first house on the street where the owner

was expecting them. Dr. Bartlett was pleased to see that the homeowner, who was a middle-aged woman with tanned and sun-worn skin, was waiting in the garage. Dr. Bartlett waved as she and her volunteers walked up the driveway and the woman led them around into her backyard. Dr. Bartlett waved as she and her volunteers walked up the driveway and the woman led them around into her backyard. Dr. Bartlett had selected this house for a very specific reason. The homeowner, the woman, had survived a recent cryptococcus infection. Dr. Bartlett hoped that the fungus might be found somewhere in this woman's immediate environment, but failing that, Dr. Bartlett thought that by interviewing this woman and other survivors, once she knew what they all had in common, she could use that information to track down the source of the fungus. Dr. Bartlett nodded to the students and they fanned out into the backyard. She watched as they stooped over flower beds and scraped bark off trees,

and while the students went to work, Dr. Bartlett interviewed the woman who lived there. Dr. Bartlett asked the woman where she went on a daily basis, and the woman listed off popular nature trails she liked to hike, beaches she frequented, and also the friends and family that she visited most often. Eventually, Dr. Bartlett had asked all her questions, so she thanked the woman for helping and then tucked her notes into her satchel. Then, once all her students were done taking their samples, Dr. Bartlett led them down the street to the next house on their list. A few days later, Dr. Bartlett sat in a conference room at the British Columbia CDC, going over her notes while she waited for Dr. Fyfe. Dr. Bartlett was feeling frustrated. After canvassing what seemed like the entirety of Vancouver Island, none of the samples that she or her volunteers had collected had come back

positive for spores of this new type of cryptococcus. And her interviews with all these survivors had led nowhere too. The only thing the infected people on her list had in common was that they all lived on Vancouver Island, which of course made it impossible to pinpoint where the spores were actually coming from. They could be anywhere on the island. A few moments later, Dr. Fyfe walked into the office with a grim look on his face. He told Dr. Bartlett that somebody else had just shown up at a Vancouver Island hospital with a cryptococcus infection, which brought the total of people infected to 30 so far.

Dr. Bartlett had this nagging sense that the situation, which was already bad, could actually still get much worse. The summer of 2002 was approaching, and she was worried that there could be an explosion of cases as the weather got warmer. She stood and began pacing the room, racking her brain for ideas. Dr. Fyfe leaned against the doorframe, scratching his chin. But then Dr. Bartlett stopped pacing. She turned to Dr. Fyfe and asked if he'd be up for a lot of hard work and a lot of late nights. He laughed a little because he always did late nights and they always worked all the time, but Dr. Bartlett could tell, you know, he was up for more. So Dr. Bartlett explained what she had in mind. Since her interviews with infected people had failed

to get the information they needed, she suggested they start talking to the owners of infected pets. There were so many animal cases that there might be an overlap in the animal's daily schedules. It was a long shot, but there was a chance that it would help them pinpoint where the fungus spores were coming from. Dr. Fyfe nodded and asked Dr. Bartlett if she'd like some coffee. If they were going to spend the next few weeks driving all over Vancouver Island, interviewing hundreds and hundreds of pet owners, they would need a lot more caffeine. A week later, Dr. Bartlett climbed out of her car and knocked on the door of a house on Vancouver Island. A broad-shouldered woman with big brown eyes answered the door, and Dr. Bartlett followed

her into the kitchen. This was the 24th pet owner that Dr. Bartlett had interviewed in person, so at this point she basically had her questions memorized. She began by asking where the pet owner regularly took her dog, and the woman gave predictable answers like hiking trails and restaurants and friends' houses, except this time the broad-shouldered woman also mentioned a place called Rath Trevor Beach Provincial Park. That name stuck with Dr. Bartlett through the rest of the interview because other pet owners had mentioned it as well, and so Dr. Bartlett felt like that place might be worth looking into. About 36 hours later, Dr. Bartlett met her student volunteers at Rath-Trevor Beach and told them to swab everything. And two weeks after

submitting those samples, Dr. Bartlett and Dr. Fyfe had a startling realization. Fir trees all over Rath-Trevor Beach tested positive for the new deadly fungus, and so the air in this park contained huge quantities of spores. And once Dr. Fyfe and Dr. Bartlett looked into this park further, the explanation for why this was became clear. Because of its location, the weather at Rath Trevor Beach was unlike the rest of Vancouver Island. It was warmer and enjoyed a drier, more Mediterranean climate. In other words, it was the perfect place for a fungus that prefers the warm, dry air of Australia rather than the typically chilly and wet Canada. So anybody who stopped at that park or just lived near it would have been breathing

in these spores day in and day out. And most of the people who had contracted this infection were eventually found to have gone into or near this park. In the summer of 2002, Dr. Fyfe posted signs at Rath Trevor Beach Park warning people about the danger posed by this fungus. However, the park was not closed because Dr. Bartlett and her students eventually found spores in several other spots on Vancouver Island as well. So they realized there was really no way to actually contain the outbreak because clearly it basically had spread all around the island. Between 1999 and 2006, 165 human cases of Cryptococcus infections were reported in British Columbia. In total, eight people died. As for Arthur Labe, he recovered from the disease once his hospital

in Germany put him on that antifungal medication, and he was ultimately able to return to work, but his wife Carol says he's not quite as active as he used to be. Nobody knows how this fungus arrived on Vancouver Island, but the spores can live on surfaces for many, many years. So it could have been transported by humans or wind currents coming up from the tropics, or even by porpoises that migrated across the ocean. Today, scientists are still working to find a way to prevent this infection, but currently most scientists think there's really nothing we can do until humans and animals just naturally develop immunity to the

disease. Mr. Ballin's Medical Mysteries early and ad-free on Amazon Music. Download the app today. And also, Wondery Plus subscribers can listen to Mr. Ballin's Medical Mysteries ad-free. Join Wondery Plus today. Before you go, tell us about yourself by completing a short survey at listenersurvey.com. From Ballin Studios and Wondery, this is Mr. Ballin's Medical Mysteries, hosted by me, Mr. Ballin. A quick note about our stories. We use aliases sometimes because we don't know the names of the real people in the story. And also, in most cases, we can't know exactly what was said, but everything is based on a lot of research. And a reminder, the content in this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

This episode was written by Aaron Lan. Our editor is Heather Dundas. Sound design is by Andrew Law. Our coordinating producer is Taylor Sniffen. And our managing producer is Sophia Martins. Our senior producer is Alex Benidon. Our associate producers and researchers are Sarah Bytack and Tasia Palaconda. Fact-checking was done by Sheila Patterson.

For Ballin Studios, our head of production is Zach Leavitt. Script editing is by Scott Allen and Evan Allen. Our coordinating producer is Matub Zare. Executive producers are myself, Mr. Ballin, and Nick Witters. For Wondery, our head of sound is Marcelino Villapando. Senior producers are Laura Donna Palavoda and Dave Schilling. Senior managing producer is Ryan Lohr. Our executive producers are Aaron O'Flaherty and Marshall Louis for Wondery.

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