Sawbones: A Marital Tour of Misguided Medicine - Melioidosis

Episode Date: November 9, 2021

 You may have heard about a recent deadly outbreak related to gemstone-laden room sprays. The culprit in that sad situation is called “Melioidosis,” and this week we’ve got a history of how humanity tracked down this slippery ailment.

Saw bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, talk is about books. One, two, one, not a sense, the escalant macaque for the mouth. Wow. Hello everybody and welcome to Sobbing. Whoa.

Yeah, I'm bringing my Michael Buffer slash Oprah, Oprah Buffer energy to the show today. Well, it's a, it's a marital tour of Miss Guy of Medicine and I'm your co-host Justin Acroix. And I'm Sydney, Macroix. And what it delighted is to be back with you, I'm sorry we were absent last week. It was my fault.

The things that the hospital and things there are not great at hospitals. I don't know if you've heard about this. It's rough. It's rough out there folks. But yeah, the, we're busy. There aren't enough people to run hospitals. Yeah. We need more of them. Yeah, so if you're...

And it ours, there's a strike, so. Yeah. Just lots going on. If you ever wanted to be a doctor, there's never been a better time to just start doing that. It could work with me and help me. Help me. Get a missing entry level doctor.

Now, I think a lot of places across the country are in the same position. Things are really busy. Yeah. There's a lot of people to take care of and we're all doing our best. That's not coming. Some slack that I didn't get a podcast out last week is what I'm trying to say. And I was I had other stuff to I was catching up on doom patrol and we have both been struggling. It's not that's the same. It's all the same. It's fine. Justin, did you hear

about a recent outbreak? Well, that any partner you're going to have to be a bit more specific than that. Not of COVID. Oh, no, something other than COVID. No, there's other stuff. COVID is very important to talk about and we do many episodes on that. This is not about COVID this time. This is about a different illness, one that is a lot more rare. And we usually don't see cases of in the US pretty much at all. And certainly not outbreaks like this.

And when we do see cases, it tends to be like tied to people who traveled somewhere else and that's where they got it. So this is all kind of a weird rare thing that unfortunately has happened. And that is that we have had an outbreak of cases of meliodosis. Meliodosis. Meliodosis. I admit that's not one that I'm familiar with. Every time I saw that word, I always wanted it to be melody something and it's not that. And so it's hard like to look at it and make it go from my eyes to my brain to my mouth. Is always an effort. Are there words like that for you? Mist, mist of, mist. I'm better at it now, but it used to be mist fish every time I would try to say it.

I also can't spell what? Restaurant. I always get restaurant wrong. And I also conscience and conscious and convenience. All those weird like what? You looked at me weird like, huh? Convenience. That's an easy one. It does seem like an easy one. It's no easier than conscience. But conscious, conscious, conscious. Oh, yeah, those two anyway, and then people like it's conscience and I'm like, but you don't say it that way. It's so Meliodosis is caused by a bacteria that is called Birkhold area pseudomalyye

So that easier to say. Yeah, it's usually seen in tropical or subtropical parts of the world, specifically places like Thailand or Northern Australia and some other places too. But like, that's where you see the brunt of these cases. So it is strange to see it arising in the US. We don't typically see that here. How did that happen? Well, before I get into the whole history of it,

the reason we're talking about it is that there were these are Roman therapy sprays at Walmart. Oh no! This is how this happened. Specifically, there are these better homes and gardens room sprays, which are like infused with essential oils, and I believe they say, and gemstones on them. Which I think it's weird just because I don't know how like you grind them up. Gemstones? Yeah.

They advertise any gemstones in them. Look at the bottles. I mean, look at better homes and gardens, room spray. I mean, you're gonna get a bunch of stuff about melee my doses. This is what we, my doses. I'll look into this. Anyway, so these were these were sold at Walmart stores in the US from February to October of this year, a specific Walmart stores. I guess not all Walmart stores. Yeah, I guess you gotta chase them down on eBay now. There are different flavors, specifically, like they linked it to this lavender and chamomile

one, but there were five different scents that this was linked to. And you can actually, if you are concerned, if you go to the CDC.gov slash Meliodosis, slash outbreak, they have like the 2021 multi-state outbreak of Meliodosis, and where the cases are, and they have a list of all the Walmart stores that sold it, and what flavors, and all that. So, you can, for the safety reason, please look at that. If you were concerned at all, if you have any of these Aromatherapy sprays in your home, please check this.

Yes. But anyway, so theyatherapy sprays in your home, please check this. Yes. But anyway, so they were selling these sprays and they found that specifically in Georgia, Kansas, Minnesota, and Texas, they found cases that were linked to these aromatherapy sprays, which is just, I mean, add it to the list of reasons why I personally am against aroma therapy.

They have sort of like, gemstones at the bottom, if you can imagine, it looks like an acquired aroma. Are they like floating in the bottom of it? Well, they're, yeah, it's quite like, imagine like aquarium rocks. Oh, I see. And you can get kind of their idea.

What do you get, like the power of the gemstones when you spray it? Well, it's also less, it's less aroma of the gemstones when you spray it. Well, it's it's also less It's less than a therapy juice they have to put in Rocks must be cheaper than the oil This is exactly I want to I this is not just all about a room therapy Obviously we've done episodes on that before um for the most part unless it's unless you're talking about like relaxation It doesn't work

It usually is touted as something that doesn't do harm, like what's the harm in a nice smell, even if it's not really helping with anything, what's the harm in a nice smell. Well, other than things we've pointed out before, like asthma or allergies, or for me, I'm allergic to all smells. And so, like when you smell it in a room,

you've made that room inhospitable to me, Sydney. Which is the greatest crime, I think we can agree it. But also, I guess occasionally, this is a pretty random rear thing. That's just kind of thing happens. Still not great though. I mean, it's like, yeah. And I'll get more into it, but let's go back

to the history of this. What is this? What is this weird bacteria? Why did this happen? How did this happen? First of all, we need to talk about Dr. Alfred Whitmore. So he trained at Cambridge and in London. Very fancy. And he joined the Indian Medical Service and was sent to work in Rangoon at a lab at Rangoon General Hospital.

That is where his part in this narrative starts, okay? So it's 1911, and he's working in this lab, and a lot of what he does, along with his assistant, CS, Krishna Swamy, the two of them mainly do autopsies. So, and try to figure out, like, what happened, and what, yeah, and describe different disease processes and stuff like that. So they are called to do an autopsy on a patient who had died recently for unknown reasons, which you have to imagine in 1911 wasn't that uncommon.

Like we didn't know very much yet. You didn't know anything. Well, we knew some things. Yeah, okay, fair. Well, we knew some things. Yeah, okay fair But not a lot of things so It was a 40-year-old man who had come to the hospital He had had fevers for like seven days prior to coming in which is he got sick or sick or finally came in He was only in the hospital for about three days before he succumbed to the mystery illness

He also was noted to have some abscesses on his arms. When I say abscess, do you know what I'm talking about, what I'm referencing? You know, you always say it, but it's hard to picture. A lot of people... Like a sore, right? Like an open sore? Well, not necessarily open. So a lot of people use the colloquial term a boil

when they mean an abscess. It's, I mean, they could be open, but oftentimes it's like the swollen, you know, hot, tender, red pocket of infection that is the abscess. Now once you open it and drain it, you have an open wound there. But abscesses are commonly formed by things like staff, bacteria, usually, and until you what we call IND in-size and drain, incision and drainage procedure, until you actually like cut them open and drain them, they can be very hard to treat, even now with antibiotics, very treatable, but you do need to open them and drain them. Whereas back

then we didn't have antibiotics either. But this patient in particular had a lot of abscesses that they attributed to the fact that he was using injection morphine. So he was addicted to what it was in all the papers they call Morphea, but morphine use. So modern day, what we would use, what we call heroin basically, this is the pre-cursor drugs. So he came to the hospital, he got sicker and sicker, nobody knew what to do and he just come to this. So they did this autopsy to try to figure out what happened, what was the cause of death. And they found that there was an infection in his lungs.

And they were described as having a cheesy appearance. Oh God. Sorry. Oh, sorry about the warning. Caciating, is that better? No. Sorry. Ugh. Sorry about the warning. Caciating, is that better? No. Well, yeah. Okay.

Anyway. So I don't know what it means. Cheesy. They didn't recognize the pattern as anything that they had seen before. Right? Like, it wasn't something. They had seen tuberculosis.

They knew what that did to the lungs, they'd seen a lot of other pneumonia and things and like it just didn't fit, it didn't look like cancer, they didn't know exactly what it was. They did, this was at the point where we knew how to like do certain staining techniques like gram stains to like take bacteria, put them on a slide, look at them under a microscope, try to figure out what is this. We knew enough at that point to look for that. And they found something that looked like bacillus maliye, which was a known bacteria that was a germ we already were aware of, because it was responsible and is responsible still

for something called glanders. Glanders. Glanders. Glanders, you may not have heard of unless you are like a large animal vet. I'm not or you like have to be hard breaks. Lost to me polar bears. Dang it. These guys are big. Or if you have large animals, I don't mean like we had a really big cat. I mean like horses. That mean that's the dream, but not there yet.

Glanders is a disease of horses primarily. It has been found in humans, but it was a big problem for livestock. And so, you know, glanders is very well-known outside of, I don't know, this room. But anyone who takes care of her own large animals. And typically, you would only see it in a human being if they had had close contact with animals.

So it was weird because this guy was not, I mean, he was living in a city. He was not necessarily outward. He would have a lot of contact with horses or something. And most recently, he had been, you know, unfortunately living outside and using injection drugs. And so it just didn't fit. Like none of it, it didn't really make sense. But that was the back, that's what the bacteria looked like. So, and on top of that, this guy had also been in jail

until very recently. So how would you get a horse infection in jail? Mm. Are you gonna try to answer the? Take your horse to jail day. I know it used to be very common in this time period to be the price of notice to ride around a horse which I'm pretty sure that wasn't ever a thing. So listen to your hustle more.

They talk about bringing a horse to jail day a lot. I think that happens. So anyway, they weren't really sure, but they had this bacteria and they, you know, already sort of guess like maybe whatever we're looking at caused the sickness. So they proceeded with coaxed postulates, meaning like we have an organism. We think it caused this person to die. So let's take it, grow it, stick it in something else, see if it gets sick, do an autopsy on it, and see if it looks the same. This is a classic scientific approach to figuring out if this organism is the cause of a disease.

So that's what they did. They took some lung material. They put it on Petri dishes. Lot, they had like luxurious growth, they said. They had lots of growth. Of luxurious growth. So they, they're not as exquisite pain. Exquisite pain and luxurious growth. They took some of that, they injected it into a guinea pig.

I'm sorry, I'm sorry to all guinea pigs. I'm sorry to this guinea pig. I'm sorry to all those who love. Sorry to Riley. And you're Guinea pig. And then they, in the original paper, because you can read by the way, if you're interested, the entire paper is available online. It's 30 some pages.

Whoa. Yeah, of his, of way more. Oh, frankly, clear my schedule. I found it a very enjoyable read myself, but that's. You're saying I'm going to rule one to read it twice. Franklin clear tomorrow's schedule to I'm reading a boring thing twice. In the air who's Franklin my assistant you don't know Franklin you don't have an assistant

he's the guy at the tiny desk outside the studio you don't have to wonder what he did. He my he monitors my schedule. There's nobody there. That's so messed up right now that you don't, it's so messed up that you don't even see him as a person who sits outside my office. And haven't you ever wondered when you come to talk to me while he's sitting out there? And you always say Justin,

are you wearing a pretend mustache and pretending to be your own assistant? And Franklin always says, like no. I didn't know you named yourself Franklin then. No, that's my assistant. You're very confused. What are you, Carl Stinkums?

Carl Stinkums is. Okay. The person who puts together scavenger hunts for the girls in the style of where the world's Carmen Tandy Ago. Pandy pants. That's Philip Panty pants. Okay, they came up with that name.

Philip Panty pants is the boss of the secret agents that go on the scavenger hunts. Right. The villain that is always trying to thwart them on the scavenger hunts is Carl Stinkham. They hate Carl Stinkham. Boy, they hate Carl Stinkham. He actually got edited out of our most recent scavenger hunt. Cause they they got so upset over him. They got the hate Carl sink. He's

not even that threatening. He usually turns out to be a good guy in the end. Almost always. It's really weird. They just don't like the drama, you know. So it's just Philip. I don't like all that conflict. Sometimes they don't like Philip panty bands, honestly, despite his cool hands. They just not like you. They're just telling me. Oh, huh. They like you. They like you. They just like me better, but they like you. So they, okay.

They do a podcast. They, in the original paper, published in 1913, went more rights after, this is after they have given this guinea pig some of this back, luxurious growth of bacteria. The guinea pig got sick and died. And then they did a nautopsy to try to figure out if it was the same thing.

So, and he writes, to our disappointment, the guinea pig died within 36 hours without any obvious inflammation of the testicles. I think taken as just a standalone sentence, it makes him look like a weird guy. Yeah, fair. Yeah. Why was he disappointed, you may wonder? Why was he so disappointed that this guinea pig's testicles

were not inflamed? Well, apparently when you did this with landers, testicular inflammation of the guinea pig was sort of a hallmark response. Oh, okay. So it wasn't just his weird kink. So if he had done that, he would have said, yeah, this probably, even though the bacteria didn't look exactly like glanders, it looks similar enough and this disease process looked like glanders, so then we gotcha.

But they didn't, this didn't confirm the diagnosis, so they felt like they were dealing with something new. So they proceeded to like what else can you do? You got one case, it looks this way, you've got to find more. And this was the quest they set out on, and I'm going to tell you all about what they found and what we know now. But first, let's go to the billing department. Let's go! Dave Phil's podcasting incident with my old radio show, The God Damn Dave Hill Show, and to one new futuristic program from the future.

If you like delightful conversations with incredible guests, technical difficulties, and actual phone calls from real-life listeners, you've just hit a street called Easy. I'm also joined by my incredible co-host, the Boy Criminal Chris Grisbeck. Say hi, Chris. Hey, Dave, it's really great to see you. That's enough, Chris. And New Jersey Chicken Rancher, Des. Say hi, Des. Hey, Dave, it's really great to have you. That's enough, Chris. And New Jersey Chicken Rancher, Des. Say hi, Des. Hey, Dave.

Dave Hill, good time, hour. Brand new episodes every Friday on Maxim Fun. Plus, the show's not even an hour. It's 90 minutes. Take that, stupid rules. We nailed it. So Sydney, what did they find? So they did a lot more autopsies. First of all, they found out that whatever this is,

it's bad. Because- And like all those good diseases that kill you. Well, because they weren't, they weren't really getting to interview a lot of like living humans and ask them about it or like recovered patients and find out what happened.

They were just doing autopsy. So like that's one clue. This is bad because everybody who has it is dead. So that's a bad thing. So they started gathering more post-mortem cases and like a word got around the hospital like hey if you have any of these sorts of cases, like let these, let the weird guys know. Let the weird guy that feels getting pig balls.

You know, you know. You know that guy. You know that guy. Basically, they did a lot of autopsies and they figured out that they could find the bacteria in lots of different places. Definitely the lungs as they had initially noted on the first autopsie, but also in the kidneys,

the urine, in the skin, in the spleen, anywhere inside a guinea pig abdomen, because they continue to do these. I mean, it was, it's a very rigorous scientific method. You do the autopsy, you localize the bacteria, you give the bacteria, you grow it, you give it to something else and see what happens. I know it's mean. I know. I know a lot of people are like, why are you keep doing, I know it's mean. It was how they figured things out. Yeah. I'm sorry. I'm sorry about that. And in many ways, it did still seem somewhat similar to Glanders, because Glanders can have kind of a diverse clinical presentation. It doesn't always look the same, right? I think we've learned that in the last year and a half with COVID, that COVID can look different and different people. Absolutely.

We're used to the idea that like, well, that virus causes these symptoms. That bacteria causes these and well, not always. Some of them can look different and different people and Glanders are sort of like that. And this bacteria seems sort of like that. But this bacteria was modal, motile, like it could move. And that was different. And the course just generally didn't fit. It just wasn't, yeah, there are parts of it that are similar to landers, but it's definitely something new. The only time they did get the opportunity to sort of look at a living case, like the disease

progression in a living human before they died of the disease, but it was retrospective. There was another doctor named Captain NAP, who was taking care of a guy, but it was retrospective. There was another doctor named Captain NAP who was taking care of a guy. And he wrote, he took pretty meticulous records as he tried to like, you know, take care of the guy and he did not get better. And then after he died, he reached out to Whitmore and was like, Hey, I did an autopsy on this guy and the things I found seem really similar to the things that you are finding. And also I have all these meticulous case notes from his whole disease course. Would you be interested?

And also, my name is Captain Napp, which I know sounds like a preschool book character, but I assure you, I'm a real adult. It should be taken into series. It's not NAP. What? It's not it's not in AP. What it's not in AP? Well, I honey. It's an audio medium if a character is not named Captain nap You have to you have to clarify Captain Knapp Well, that's certainly that's not right either was probably pronounced nap just crank out a quick spell or is K and a pp

Knapp nap nap nap Kpp. It's not that either. Snayin is Captain Nap. Captain Knapp is pretty catchy. And what makes him soar is knowing the boys and girls are going to bed on time. So named Captain Nap. So it's superpowers from the fact that he gets eight hours of sleep every night. These notes, these meticulous notes really helped because he had a picture of what it looks like before a person dies of it.

And so he could talk about like the progression from initially the fevers, you get some like stomach symptoms, like maybe diarrhea, some general flu-like symptoms, you know, aches pains, that kind of thing, chills. And then progression to the pulmonary infection. And the skin lesions, which they had initially assumed, were just because all of these patients they were seeing were also using injection morphine. And so they thought that the skin lesions

were not part of it, but it seemed like there was a component that was that. As far as how they got it, even as they figured out, like we got a new bacteria, it causes this disease that we can see present these different ways. As far as how they got it, he still wasn't sure. And then he found someone in the office had a whole crate of better homes and gorillas in Rome, it's therapy.

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it's like, it's like, it's like, it's like, it's like, it's like, it's like, it's like, it's like,

it's like, it's like, it's like, it's like, it's like, it's like, it's like, it's like, it's like, it's like, it's like, it's like, it's like, it's like, That was a bummer. I'm sorry. It seemed to affect those who were addicted to morphine more. There was an initial like, is this because it's communicable through a needle?

Is that why? It's a needle stick thing. Or is it something to do with the fact that a lot of these patients also were unsheltered, were malnourished, were generally, were generally like more vulnerable to infection. Was it an immunity issue? Is it a jail issue? A lot of them had been in jail, but you know, it's sort of like confounders, right? Correlation does not equal causation. A lot of these things, unfortunately, then and now, tend to run together. And also, the guinea pig seemed to be able to get it from eating and drinking. Like, it was communicable through the oral route.

So, is that something that, obviously, there was a lot of, there were still a lot of questions. Now, this didn't stop him from naming it. So, we got a new bacteria. It's not bacillus mali-i, like we initially thought. So, instead, we're going to call Basilis Sudo-Malley Eye. You get it, you get it. Later, it was just, you know, and this is true, I think in all, like taxonomy,

as you learn more about different organisms, you restructure, which sort of which groups they belong in. So it started as a Basilis, but it would later have its name changed to Birkhold area because it was more closely related to other types of bacteria. Does that make sense? Yeah. And that, because we understood where it fit,

Birkhold area, if you're curious, is named for a plant pathologist, Walter Birkholder, who found that genus of bacteria. So Berkholder area for him and then pseudo-mallyi because it's sort of like Glander's mallyi, but it's not that. Even with that though, it was also often called Whitmore's disease, or Basile Day Whitmore. Basile Day Whitmore is much, or Baciel Day Whitmore. Baciel Day Whitmore is much more dramatic name. It's interesting that he didn't name it for himself.

A lot of people did back then. I always wonder how you would feel about that, right? Like for your name to become synonymous with a disease, I'm not sure I love that, like I say. Although I get why people would like it, just like I'm not sure I'd be into it. Really get why people would like it, just like, I'm not sure I'll be into it. Really? It's like a negative contagion, right?

There's not a lot of diseases that make, make you give you a eight foot vertical leap, you know what I mean? There's not a lot of diseases that like, give you two and a half times the strength of a normal human. I guess, I guess so. Yeah, I mean, typically a disease is a bad thing to get but like Good diseases about this lot That's probably a whole other episode. I could maybe make a case for things, but anyway

The I don't know I because you're you get it named after you because like you discovered it or you were the first one to isolate it Or you were the first one to describe what it did. I get it logically, but that also requires like a deep dive into history, right? To like figure that out, buying large is just gonna be like, well not really, because you don't assume that it's named

for like the person who invented it. I invented this bacteria. I made it. Yeah, but you're also, we wouldn't name it for an evil genius. Yeah, but also like, anytime anybody talks about your thing, it's gonna be in the context of like,

hey, I'm beating this. I beat macaroids. I'm fighting macaroids really hard. I lost my mom to macaroids. Like, none of it's good. It's all bad. All of that sounded bad. I have to stay home. I have been really bad macaroids really hard. I lost my mom to Macaroise. Like none of it's good. It's all bad. All of that sounded bad. I have to stay home. I have been really bad Macaroise right now. I'll be honest. I'm in the toilet all day. If one of us was going to be able to explain the compulsion to name something after themselves, I would think like the white guy in the room would

be able to explain that to me because that's what it all is. It's usually like a white guy who's like, I know 30 other people have already found this, but I'm gonna publish it and call it me. Well, I guess you really put me in my place. I hope you get a new suit. I hope you get a kids' macro. I don't know why Whitmore didn't want to name it after himself or why other people do.

I mean, obviously, Walter Berkold or the plant pathologist was all about it. I don't know anything about Walter Berkold or other than this, so I don't know what his proclivities were. Eventually, Stanton and Fletcher published some papers about the disease to help, because it's usually like a building, it's like a building block thing, right? Through overtime, we learn more about it. And they were the ones who first coined the term meliodosis, which was in reference to the Greek for a condition

similar to a distemper of asses. Again, Sorry, I say again. Calling back to Glanders. A condition similar to a distimper of asses. As in like, donkeys. I got to. You know, you get it. I get it because you said the word and you wouldn't say that normally. I like it.

I just love the scientific system of naming everything about like, well, it's sort of like this. It's an entire naming system that like, there's a seed somewhere where like, there was the first thing that we named something and then everything else is just named. It's fun, it's like a spinoff. Yes, it's how much it's like or not like that original thing

that we named that one time. That's probably Greek as far as I can tell. The presentation, as we would eventually come to understand it, like I said, it can vary. You can have skin presentations of the disease. They're different. This is true now. There are different ways you can get it. You can get a skin thing where it's an abscess with swelling and pain and fever.

You can get a blood infection. That's obviously worse, where you get fever, joint pain, respiratory problems, abdominal pain. You can get a lung infection. We talked about, you can get a lung infection, like we talked about, you can get a CNS central nervous system infection, like the brain or meninges kind of thing. So there are lots of different ways of how exactly how you're exposed to it and how much of it gets into your body and where it goes, that it would present. Any kind of underlying disease does put you at risk, so it is in a sense like what we would think of as like an opportunistic kind of pathogen, meaning if it gets an opportunity.

Have you heard that term? So if there's something that you know can suppress your immune system or makes you more likely to get a disease, it's on set as usually two to four weeks from contact. Most commonly, it's inhaled. Like you come into contact with contaminated soil or water droplets and can inhale little bits of it. It generally is not passed from person to person. There was one rare case where somebody got it from like a tropical freshwater fish.

How on earth they prove that. And like I said, the one thing that Whitmore even knew, back when they first figured all this out, was that it seemed pretty bad since all of the patients that he knew had it, he met on autopsy. And he also, like I said, theorized this relationship to injecting morphia, morphine. But again, this is probably more related to underlying disease, opportunistic infections, unclean food or water sources, that kind of thing. And that is true to this day that like when we see cases of meliodosis now underlying disease, it is more of an opportunistic thing, which is part of why it's more rare, why you don't

just see outbreaks affecting everybody all at once, right? Because well, yes, you could get it if you're healthy. It's more likely that if you have some other health condition, that you would, now instead of what he witnessed, now we see things like diabetes can put you at higher risk for contracting immunodoses, liver, kidney or lung disease, any kind of other immunosuppression in addition to like, malnutrition and stuff like that. We didn't, of course, have great meds for this when we first figured it all out. We didn't have antibiotics yet, right?

Like, this was 1911, up to like 1913, as we were defining all this stuff. So we didn't have any antibiotics to treat it. It must have been a very frustrating time, by the way, to write like these 30-page papers, defining a disease process, and then at the end go, so good luck with that one. Yeah, I got, I don't know what to tell you end go, so good luck with that one. That is that, yeah. I got, I don't know what to tell you to do,

but good luck with it. That's what it looks like. So you're reading this in a hundred years. You spent all day reading this 30 page paper. I hope you can figure it out. I hope somebody else figured it out. That's the reading. I hope you appreciate all the great information you'd hear, Sid.

Anyway. Thanks for reading my boring work. Prior to 1989 Which I was gonna say that's not that long ago. I don't know is it feels lost all Perspective the standard treatment was a three three drug combination of Chlorian phenoclechlorian phenocle tro co-try mox is all in doxycycline but Chlorinphenicol, co-trimoxazol, and doxycycline. But even with that regimen, this is prior to 1989, this is what we would use.

So like in the modern era, it was associated with a mortality rate of 80%. Oh my God. Yes. Geez. Now at that time is when we get septazidine introduced, which is a different antibiotic, which worked a lot better. Okay.

So now we have better medications to treat this, and the mortality rate is 40% in resource limited settings and like 10% in resource rich settings, which mainly has to do with like the degree of not just access to the right drugs, but like what sort of supportive care you can provide the patient while they're recovering from the disease. And how much more difficult that is in certain parts of the world than others. So it's still a big bad deal. I mean, those numbers are still incredibly high, but we do have things that can treat it now thank goodness. Much more effectively than we did prior to 1989. It has been investigated as a bioterrorism weapon in the past.

Ghost. Yeah. Glanders apparently was used by the Germans in World War I, as he Germans in World War I, on Allied cows. I don't know that the cows knew that they were part of the Allied forces. Yeah, you could tell. They had that error about them. But they became part of the Allied forces? Yeah, you could tell. They had that error about them. But they became part of the Allied forces

and then they were infected with Glantars. Maybe they're not Allied cows. Maybe they're cows that are allied with each other. Maybe they're just like, no, no, no. We just look out for one another as cows. We're not participating in your geopolitical squabbles. Listen, I don't think there are any animals that are. You can fool yourself, but like, they're over us.

Our species, the human race, they're done with us. We're just messing everything up. The cows are not your allies, they're each others allies. They're playing an earth's allies. We need to get on board. Or the trees are gonna wipe us out. Have you seen that movie? The happening?

The happening, the trees are gonna wipe us us out. Have you seen that movie? The happening? The happening. The trees are going to wipe us out if you're not careful. There was also an out-brank link to a panda in the Paris Zoo in the 70s. That was highly publicized. And this is usually how you kind of see this, like these sort of like, sporadic outbreaks. There are, like I said, specific parts of the world

where it is still endemic, but it's not all over the world. We've had four cases in the US linked to these sprays. Hopefully we won't have any more now that obviously. And the grand scheme, that's still very limited, like in terms of the spread. Oh, yeah. No, I'm not. When you think about how many of these are out there. This is one of those things where it is really neglected.

It's not on the list of neglected tropical diseases, I do not believe. Like I was looking to see because as I was reading more about it, it's not something that I have studied a lot because I've certainly never treated an any one for it. But as I was reading more about it, I do not believe it has actually listed as one of those, but it should be because it is a disease that impacts parts of the world that often do not get enough attention as to what their specific healthcare problems are, right? It deserves more time and money and research efforts and all those things, but when you have

these certain sorts of bugs that don't affect the US or Europe and these places, you don't get as much time and attention and money, you know, turn towards them. And so it is rare that we would see it in the US. I don't think this is something you should be afraid of. I think that if you have these sprays, you should get rid of them. But this is not like an alarmist sort of thing. It's more just what was this thing you read about in the news. Like I said, the places where they actually had the cases were in Georgia, Texas, Kansas, Minnesota, two of those people unfortunately died of the condition. And like I said, we do have treatments now. It's still very tough to treat. You need two weeks of IV antibiotics up to eight

in some cases, depending on where the infection is. And then three to six months follow-up of oral antibiotics after that. So like, and that's sort of similar to, you could liken it to tuberculosis, is something that we can treat, but it's hard and it takes multiple drugs for an extended period of time to treat it.

Meliodosis is similar in that sense. But again, there's been that recall, so I would check if you do have the better homes and gardens essential oil and fused a room with therapy, room spray with gemstones. Or you have a, we'll say it, an aunt who you think definitely has that somewhere in her bathroom. Just go ahead and give her a quick buzz.

Everybody's got that. And I did, I guess I didn't answer that question. How did it get in the room spray? How? Well, it is often found in contaminated, like it can just be in dirt and water. From the rocks. So these were made, these, these sprays were made in parts of the ingredients. I don't know where they were all put together. Everything's, I don't know how all that works. I'm not in that line. But the parts of it at least came from parts of the world where it can just live naturally

in the soil or water. So something, whether it was the rocks in the bottom or something in the lavender or chamomile or one of the other essential oils, whatever it was synthesized from, somewhere in there, it was contaminated with the bacteria. This is why I keep saying

you can't trust this natural stuff, Sydney. Rocks, oils, all this stuff from nature. No, thank you. Give me chemicals made in a factory. You know, pound it. Thank you. Well, I don't know. I didn't pound it. No, but it does, it does. I mean, we talk about this a lot on the show, the idea that something that is, quote, unquote, natural is perceived as safe. Yeah. And that is not to say that we should all be afraid of room sprays, because this is a very rare random occurrence that happened.

If you want Sydney to be able to relax in your room, maybe you should be afraid of room sprays. They just every single any kind of scent though perfume, cologne, candles, all of them. It's very sad. Air fresheners, I can't do any of it. I live in a scentless, sometimes I'll have a small candle in my office for just a little Cologne, candles, all of them. It's very sad. Air fresheners, I can't do any of it. A little bit of sentless. Sometimes I'll have a small candle in my office for just a little bit of said.

Charlie asked me what my favorite scent was and I said clean. Not. Not even clean, because like clean linens is like a scent. You're just like anti-send. Anyway, thank you, Sidney, for that fascinating history. And thank you to you for listening. We very much appreciate it. You're the best. And like just thanks. If you want to,

we wrote a book, it's called the Salbo's book. There's a paperback version with some new information about COVID, and it's not like new information about, like we haven't unearthed anything, but it's got new chapters in this book. So, so good. Check that out at anywhere. Find books are sold. Justin, I should note, if somebody does have this, I said, get rid of it. You actually shouldn't throw it away or dispose of it in the trash.

What should you do? If you do have this product, obviously don't use it. Don't open it. Yeah. Double bag it in Ziploc bags and then put it in a cardboard box. This is really what they recommend and then return it to a Walmart store. And then wash all of your sheets or linens that may have been exposed to a clothes or anything like that.

Wipe anything down that it may have gotten on with disinfectant and then obviously seek medical care if you're sick. But I should make that note that you shouldn't just start in the trash. There's a very specific way of returning to Walmart so they can... Man. Make sure you tell them this is the bad poison room spray. Make sure you don't open this. We're turning it to Walmart so they can dispose of it properly. It's not a sentence I ever thought I would say. Right. That is for sure. That has been a specialist at Walmart at your local Walmart store. Thank you.

I give for listening. Thanks to taxpayers for these. There's some medicines as the intro and outro program. But thank you to you back with you again next week until the my name is Justin McRoy. I'm Sydney McRoy. And as always, don't drill a hole in your head! Maximumfun.org

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