Sawbones: A Marital Tour of Misguided Medicine - Sawbones: E. coli

Episode Date: September 20, 2022

From our earliest days of life E. coli is among us and within us, living in harmony with the rest of our colonic flora. But this week we're here to discuss the multi-dimensional E. coli's ability to really mess all that up through contaminated romaine and undercooked cheeseburgers.Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/

Sawbones 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, of Miscited Medicine. For the mouth Hello everybody and welcome to saw bones a marital tour of misguided medicine I'm your co-host Justin McRoy and I'm Sydney McRoy

I'm trying to do a really normal one that time and it came out feeling weirder than if I did it like It did it felt like you were doing an impersonation of yourself. I'm a normal guy. This is how a normal podcast has Justin, I almost made a major Club. Yeah, let's talk about that. Major Screw up. I don't know. Major something So when I sat down to put together this episode Many listeners many of you wonderful listeners had written in saying that I should talk about a recent archaeological discovery that was made in Borneo by Indonesian and Australian

scientists archaeologists of what we now Know of unless something changes in the future of as the first recorded surgical amputation Well, the first discovered I guess that wasn't recorded. Right. We found a skeleton that was missing. It was recorded. Well, yeah.

And they were like, I won't be this fan of the trash. We haven't found the record. Sorry, history. Well, they did discover a 30-ish thousand year old, somewhere in there, skeleton that was missing a left foot. And it appeared that the tibia and fibula were cleanly cut. Who? So a surgical amputation. And not only that, the age of the skeleton was, it was probably around a person that was

19 or 20 years old, ish. And there was, you could tell there had been growth around it. Like the bones had grown in certain ways. That this amputation probably occurred six or nine years before the person died. Meaning that not only did they have a surgical amputation perform, but they lived after. Right. That was not the end of their story.

Exactly. And there was no evidence in the bone at least of infection, the kind of damage you would see from infection, which means that they probably did a pretty good job of keeping it, you know, from getting contaminated, which completely changes our understanding of medical history and medical advances at the time. And that society, the structure of that society that they took the time, they were able, they had the expertise, the technology, the ability to do this, the desire to do this,

to save a member of society who no longer... Right, had value from like a working... Yes, yeah, not by our modern longer had value from like a working, you know, not by our modern sense had value, but it's the yeah, our entire understanding can shift. And also this kind of work is also really important to undo kind of racist ideas about different parts of the world and how underdeveloped they were at different times. I mean, our whole understanding of human history changes in a moment when we discover things like that. Fascinating discovery. So interesting, relevant to our show.

And I thought, I'm gonna do a whole history of amputations and surgical amputation and how we developed that technology. And I started working on that and as I was looking for resources, I found our show where we have already done this episode. It's been many years ago. This show has been going on a while. You'll have to forgive me.

Hey, I have to think about it that a lot of people will forget. This show has been going on a while. The notes I found on my computer to prove to myself, did we do that? Yes, we did this. We're so old that they're saved not on like anything in the cloud. It's not a Google Doc. Not even in the cloud. It's just it's just on this computer. It's on the hard drive of this computer. So if this if anything happens to this computer, those notes are going at some point, Justin, you need to help me move all these show notes to the cloud, to the cloud. Because it's almost like I've said that I would do that over

a dozen times. And when I offer to do it, you're always too busy doing something else for me to do it. I also, it's saved on open office, which my version of open office is so old. And I haven't, I don't know how to update it. That it has like a permanent error box on my computer screen desktop at all times. It's just on a screen. Like you might as well save it on a, a casingle. Like that's how applicable. Anyway, I need to get these show notes into the cloud before something happens. Before

something happens. So we're not. So the cloud can say Sydney, you already did this episode. So I got to share this wonderful piece of medical history. I would encourage you to go read the paper about it. It's fascinating. You know, we should have read done the episode because apparently all things, see, correct now, they were exordated. Well, I think the rest, no, I look through the show notes. The rest of it is all accurate. We used to say the first known surgical amputation was about 7,000 years ago, and now we say it was about 30,000. We should just do a thing at the beginning where we're like, hey, so anyway, in the beginning, some

people forget it's out, and then we all forgot about it beginning where I'm like, hey, so anyway, in the beginning some people forget it's out and then we all forgot about it for millennia. Anyway, okay, here we go. Yeah, and then we remembered. So instead, I'm gonna talk about E. coli. Okay. Natural transition. I did what I always do when I need a topic,

when I'm in desperation, I turn to our emails and Amanda recommended that I talk about E. coli. Amanda mentioned that it had recently been found. I don't know if it was just an Amanda's water and all water, but either way it was in the water and it was concerned. That's a massive distinction. Whether it's an Amanda's water or all water,

that's a very, that's always like the biggest difference in the Caribbean. Listen, here in West Virginia, our legislature is devoted to lowering water quality standards as far as they can go. So that's true. That is not a concern.

We don't worry about that. We welcome it. We all eat coal. I welcome here. So we've probably all thought or talked about E. coli at one point or another. I feel like it's one of the bacteria that people like. You say it. I mean, you have some sort of idea about it, right?

Yes. What do you think of when you think of E. coli? For me, it's like, it's all connected to fast food chains. It's like, salad bars is what I think of when I hear E. coli. I think salad bars and hamburger meat, those are the two things that I think about. And what does it cause? Pooping.

Okay, diarrhea. That's what we think. Okay, yeah, I mean, not all bacteria would I be able to mention and you would know immediately what it caused. My impression of the pooping is it's not regular pooping, it's just like pooping. And sometimes, sometimes if you've had a urinary tract infection, I always feel bad

because if you don't know that E. coli also causes a good number of urinary tract infections, I know that it's always, and I've had them too, so this is something we all experience. There's always a moment where I have to explain to a patient like it's E. coli, it's always, and I've had them too, so this is something we all experience. There's always a moment where I have to explain to a patient like it's E. coli, that's fine, that's normal, that's very common, most common, because it's not a long journey

from one orifice to the other down there. I mean, that's just the truth, and that happens, and that's the truth. Yeah. And anyway, so it can cause urinary tract infections too. But the point is we usually associate it with like food, bornellness, and diarrhea. I know it's unpleasant, sorry.

That's what we're talking about. Yeah. But when did we find it? Who is E? Who is the E of E coli? Well, let's talk about it. Oh, okay. I thought it was a mystery.

That was about to be wild. Like nobody knows. Nobody knows. It's like, it's like, Horia, no one knows why they're called that. They're just, that's what they're called. No, we know it all the bacteria, why they're named with their name pretty much

because we've changed it many times over. Like we kept changing where things belonged and like, oh, actually that doesn't belong and that, you know, Janice, it's this one or that family, it's this, you know, that, all that stuff. For the, for, Janice, it's this one or that family, it's this, you know, all that stuff. For most of human history, it's just all country name and then mums.

So it's like the Spanish mums, the German mums, the Italian mums. Hey, we did it with flu. Yeah. Or what animal? Pig flu, bird flu. I love this. Poor Spanish flu, man.

Walking in Spain, like, what'd you guys do? Oh, why'd you do this? That's what? That's why. That's terrible. See, I try not to do that. I try to always say like the influenza pandemic, 1918, not call it any specific country. We have to rectify that historical mistake. The discovery was made by Dr. Theodore Eskirek.

Mm. Do you know Eskirek? Eskirek. Eskiric. Mmm. Do you know Eskiric? Eskiric. Eskiric. Eskiricia is the word that we're going to Eskiricia coli is the full name. That's what the E is for. Cool. In 1885, he was a German Austrian pediatrician.

He was studying what kind of bacteria are in the newborn colon. Basically, he was taking samples of maconium. Do you know what meconium is? Yeah, it's the first dukey. It's the first poop, yeah. Yes. On a side note, by the way, the... No, not impressed at all.

I mean, I guess I have a father too, so I should know that. I think we've talked about it. Meconium is that first poop, and if you've ever seen one, it's kind of black and sticky and tarry. It's different. It's different than all the poops that will come. It's amazing that we've gone this far in human history. It's just

like the first thing that happens is apparent is like, this can't be right. This something is wrong here. This can't be. This can't be right. So that by the way, on a side note, maconium, whether or not it is sterile, whether or not there is bacteria in maconium, it's still kind of debated. For a long time, we thought it was sterile. We thought that like because the intra-union environment is sterile when a baby is born, that first poop is also sterile. Then there have been some studies that found some bacterial DNA in maconium, which kind of called the whole thing into question, like, well, is their bacteria in the maconium, then is their bacteria in the intra-union environment? Is that part of, like, just physiology?

That's normal. That's just part of the developmental process. And all of that got kind of called into question. So that's something we're still figuring out because we know that we get colonized with bacteria in our colon's really quickly after birth. Like really soon, you see bacteria and poop after birth. That's normal. That's part of it.

There's nothing wrong with that. But then the question was, well, maybe does it happen even before? So, an area where you're still investigating. Also, Maconium is from the Greek word for poppy, because, which is either because Maconium, the black sticky stuff looks like raw opium, which as I was hearing this, I was thinking like heroin

is the way that it black sticky tar. Doctors then were so rad. They're like, you know what, that looks like, it looks like heroin. Well, raw opium, but yeah. Hey, Doug, Doug, hey, am I out of my guard here? This looks like heroin, right? Like, that's heroin.

It's seen it 20 times today. It may be either that or because Aristotle noted that it makes baby sleepy, meconium, which is probably a reference to the fact that if babies aspirate or like inhale meconium while still in utero, sometimes they have issues when they're born. Oh, so that's what's important to me, you know? It's dare or not because if they ingest it, then, I mean. That's a whole syndrome. Meconium aspiration syndrome is a thing that can happen

when babies do pass. Yeah, yes, that is what it is. When they do pass, it's the first reason they have a new realm. This is a good trick. I can play out Sydney. If she says a term that has multiple words in it and I say the acronym of that,

that's what she would normally call it at work. So a lot of times I can get a half second of admiration that I'm sending, where she looks at me like, oh, then she's like, oh, wait, you just abbreviated it, okay. But that is a debate, because like that can happen. If they pass the first meconium while they're still in utero and then they inhale it, like, it's usually like an inflammatory sort of response.

It's treatable, this is not, I mean, it's something we want to treat and address, but this is not necessarily fatal or anything. But yeah, if there's bacteria in there, that's a whole other question. So far, we don't think so, but we're not sure. Anyway, I digress. He was investigating maconiums and then first tools for infants, so like after they'd been alive for a bit, looking at that poop too.

And he found these little short, rod-shaped bacteria. He called them bacterium coli-commun, meaning like I find these common bacteria in lots of colons. And he did all the tests that you do. When you find a bacteria, you do a bunch of tests on it. I remember this from microbiology lab. I remember doing these tests and then I have never done them since, but like you want to figure out what they'll grow on. It grew on blood and auger. It made these little white colonies. You can look at that. What are they, you know, what dies?

Will they take up? Like, how can you stain them so that they'll, so you can look at them? Do they ferment things? All the different things you do to try to define, where does this bacteria belong in the whole gigantic world of bacteria that we even understand? Let alone all the bacteria we haven't found yet.

There's so many bacteria out there. We are so outnumbered by germs. It wouldn't be until 1919 that the bacteria would actually bear his name. He didn't name it after himself, two other scientists. Later, Castellani and Chalmers did more research on it, helped reposition it in, you know, all of the world of bacteria, what its name should be and called it, as Grigia. Oh, we actually have some, oh, we have some audio of when he found out that they did that, hall and play right now.

Oh, great, cause it's such a good, yeah, absolutely. Oh, forever, yeah, Ty, yeah, yeah, yeah, thanks, wow. He may. Thank you. That's so great. You know, I didn't do that. I thought I had a reason. Oh, well, thank you. You, kidders. That's really nice. He may have actually passed away by then. It doesn't. It's not a matter of. Okay. I know. I know you looked at Barry every saw every solving topic, but like, this doesn't actually matter in this case. So E. coli, and we're gonna go through the history. So we found it.

What has it done since then? A lot of stuff. It is, like I said, it's one of the earliest bacteria to colonize our colons. It is there with us from our earliest days of life. E. coli lives among us within us inside us and is a part of who we are. Which makes it an important bacteria.

And there are lots of different strains, and they do lots of different things. Some of them are pathogenic and we're gonna talk about some of those and they can cause great harm to humans and they have in the past and they will. I do not see any reality where they don't continue to occasionally because I've seen y' have in the past and they will. I do not see any reality where they don't continue to occasionally because I've seen

y'all in the bathroom. Who's y'all? You know, you out there who don't wash your hands, I've seen you. I've been in many public restrooms and watch people walk right out of those stalls and write out that door. And don't you think nobody's watching Sydney is watching. Sydney is always watching. Sydney sees you.

Sydney sees you in all your hands. There are always going to be a lot of them. Sydney sees you. Sydney sees you. You know, watch your hands. They're always gonna be with you. Sydney sees you. Not watch your hands. Teaser. Just you looking judgmental. I see that happen. I always want to. There is no non-judgmental way to say, Hey, you forgot to wash your hands. There's no way to say that. And you think you would think now having like being in COVID times that everybody would be on board. And maybe it's better.

Maybe like, I mean, I have, this is anecdotal. I haven't collected data. Maybe it is better. Maybe if you did an observational study, which is creepy, where you watch people in bathrooms to see. Yeah, you can get what's the body that approves that kind of thing. IRB approval, yeah.

I will be approval of that. No, you're not gonna get I have to be approval to watch people in bathrooms and see if they wash their hands. Yeah. But if you did, maybe the numbers are better now. I don't know, but I know it's still out. I know that anecdotally, I see you people wash your hands.

So it's also in addition to being pathogenic, there are probiotic strains that have like benefit for our colons. They're like part of the harmonious environment. Our colonic flora. We have natural flora inside our bodies in various areas. There's certain flora that is supposed to inhabit different parts. And when we find it there, we go, that's just part of normal oral flora or normal vaginal flora normal colonic flora whatever so There that is equalized part of that and it lives in harmony and it's supposed to be there balance is really important In these parts of our body if everything is in balance the way it should be

We function well and our our parts our bits function well If something starts you know We function well and our parts, our bits function well. If something starts growing over everything else and taking control and trying to take over like I throw a colonic coup, things get out of whack. But I wanna talk about the times that Eskiriki Akola has caused problems. Okay, instead of found solutions. But before we do that, we got to go to the billing department.

Let's go. The medicines, the medicines that ask you let my God before the mouth. Hey there beautiful people, I'm Trevelle Anderson. And I'm Jared Hill. We are the hosts of Fanty, the show where we have complex and complicated conversations about the gray areas in our lives, the things that we really, really love sometimes, but also have some problematic feelings about. Yes, we get into it all.

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So Cindy, you're about to tell me there's actually a downside to a coli? Yeah, so there have been outbreaks, and this is probably why you associate them with fast food, because there have been well-publicized outbreaks of Eskreek Eukohline infections related, specifically to fast food. It's not always fast food, right? We know that. I feel like every other month we hear about there's contaminated something somewhere,

whether it's meat or a vegetable product or a salad or a restaurant or a certain company that makes something or a grocery store. Yeah, it's always very gratifying when that happens with lettuce because it's like, I knew it. That serves you right. Let us eat it.

It was rough when we couldn't- It was rough edge. It was rough when peanut butter was on the- Oh yeah. Yeah, I had to settle for... Had to settle for... That wasn't equal, I know. I know, I know.

It was some else, but yeah, that was rough because we had to throw away our peanut butter. I know. I know. That was rough. And our children are very picky about peanut butter. I discovered, I didn't know they were picky about peanut butter until...

Apparently, if you gave your kids the same peanut butter the whole life, they'd only like that. Yeah, and gave her kids the same peanut butter whole life. They only like that Yeah, and when you give them other peanut butter, they know how do they know how you send them to school with the sandwich and they come home And they have an eatin' it and they're like I hated that and you you're like what I hate that peanut butter you can tell So there have been some outbreaks that have happened because of a specific strain of E. coli. And if you're in the medical world, you know, 0157, H7, if you're not, you're like, that's, that's what you named it. You called it that series of numbers and letters and we're like, good, good job. Good.

It's done. That's done. This strain is one that we talk about a lot of medical school and a lot of people are familiar with because it can cause a bloody diarrhea. So, a lot of intestinal damage and bloody diarrhea and there's some life threatening complications that can result. It makes about 70,000-ish people in the U.S. sick every year. They're outbreaks everywhere. But the first big outbreak of, and I should say, by the way, the way the thing that distinguishes these more deadly, or I shouldn't even the way, the way the thing that distinguishes these more deadly,

or I shouldn't even say deadly, like more dangerous, more morbidity associated with certain strains, are, is a shiga toxin, that's the name of the toxin, shiga toxin. And it specifically does more damage than a lot of the other, there are lots of ways you call I can mess with your gut, shiga toxin is like the the worst if that makes sense. So anyway, in 1982, the first big outbreak in the US of E. coli-0157-H7 occurred. In August of that year, several people in Oregon and Michigan started describing a diurel illness that was unique in its severity. It started out pretty typical if you've had either like

what you thought of as a stomach bug or perhaps you were worried about some sort of foodborne illness, some sort of food poisoning, you get some cramping and then you get some watery diarrhea. And that in and of itself, you probably wouldn't, I mean, we don't all necessarily go to the doctor for, right? Like, nobody would report that. You get some cramping some watery diarrhea

then it goes away and you go, who I'm not eating at that restaurant for a while but then you inevitably go back because that's because we're human. In this case, it was followed up by bloody diarrhea. In all of these cases in this specific outbreak, everybody got better. It all resolved. Okay.

However, it was concerning enough that people went and sought medical care, which I think is pretty typical. You know, when we see blood, we start to worry more. We go seek some sort of evaluation and diagnosis. So people sought out medical care, and this is how they discovered that all of these cases had this same strain like O157H7 in their stool. This was the offending agent. So where did it come from? And they eventually linked it.

Now, this is what's interesting. The paper, which was published in the New England Journal of Medicine. An EMJ. Mm-hmm. Three days before I was born. Wow, that is interesting. Yeah, March 24, 1983. Three days before I was born.

It's called hemorrhagic colitis associated. Sorry, an EJM. How did you, oh. That was acting. Hemorrhagic colitis associated with a rare escharicucleicetero type. It was linked to, I think it's cool that it was three days before I was born, that this was huge paper. Sure.

Okay, but anyway. It was linked. John, you know John Lennon was shot a month after I was born. I thought we were just saying stuff. And how it was in relation to the date of our birth. Anyway, what they figured out with epidemiological investigative techniques is that these people in Oregon and Michigan had all eaten undercooked hamburger from a popular national fast food chain.

This was not, by the way, this was in 1982 that this happened. It was published in 1983, but it happened in 1982. And that's a long time ago. And I think that whatever restaurant was responsible, you would expect that by now, people wouldn't still be like, oh, I'm never eating there. Like, you would hear that. And it's be like, well, I hope they've cleaned their act

up since 1982. It was not immediately available to me. I mean, I found it. I'm not saying I had to do like some incredible dark web sleuthing to find the name of the fast food chain, but it wasn't immediately clear in the articles that I was reading about this outbreak. What fast food chain it was?

Have you wanted to do some dark web sleuthing, said, where do you think you would have started with that? I would have asked you. Oh. Sid, where do you think I would have started with that? I would have asked you. Oh. Sid, what do you think I would have started with that? I don't know how you get there. I probably would have gone to like Coursera or something, like I got a master class.

Like, do you have how to use Dark Web? I don't know how to, I don't know if it's on our computer. The Dark Web? Go on. Continue podcast, please. We actually don't have enough time for you. Is it like the email that I can only get on this computer? There's one kind of email that only comes to my laptop and I can't get on my phone

and I don't know how to find it. All right, whatever you're gonna say next, just go for it. It was McDonald's. Yeah, we all knew who it was. I didn't know it was McDonald's. I found it in an article that was written about it later. And that's what we assume.

I think there was this sort of like veil of secrecy around it at the time. Like they all agreed, we won't tell people it's McDonald's. And I don't know if it was necessarily like this nefarious like, well, corporations paid people off to hide the secret. Or if it was like legitimate, we don't want to scare everybody because so many people eat McDonald's,

and if we put this out there, you're gonna have like, people, because like lots of people get diarrhea, and so every time someone gets diarrhea, so many people, you know, statistically, you're gonna think, oh my God, they're McDonald's. Yeah, it's also this like, we do a little bit of this just as a society, like just all agreeing, like we don't really want to remember the thing about McDonald's,

right? And everybody's like, no, stop mentioning it. Let it fade into the out of the public consciousness. You also have to think about, and Justin, I feel like this is an area of history you know more about. So it's 1982, the concept of everyone eating from the same restaurant in the entire country is still pretty new, right? In what year? 1982? I mean, sort of, yeah, I mean it's early-ish. Because we're talking about like, at this point, how long had we been having massive

food-borne outbreaks? Well, probably not there. I mean, if they were happening. It was certainly had a lot more local sourcing in that, those days rather than, you know, someone plant in Montana, shipping out all the military. Exactly.

It's the evolution of like the food industry in America, but also specifically in this case, fast food, the concept that because somebody ate them, ate them at a McDonald's and Oregon and got sick, that you'd be worried about eating into McDonald's in West Virginia, that wouldn't have been as clear cut then as it is now. Where like, if you hear about, uh-oh,

a McDonald's hamburger made somebody sick, we know enough about how food is distributed that you might worry about your hamburger here in West Virginia, right? So I feel like that's part of why you don't see this kind of being recognized until like the 80s is that It was happening sporadically maybe before

But then when everybody started getting their food from the same places you get outbreaks. Yeah So it was undercooked hamburger and why by the way, I think I've explained this to you before why is it? Why will I never eat a hamburger that's not well done? But I would eat a steak that wasn't well done. Because when you grind meat, there's so many more surfaces for the bacteria to go on, because the meat is inside of a cut of meat, should theoretically should be free of bacteria because it's inside there's no exposure to the outside. So there's less vector for affection.

So in the exactly, in theory, if you cook the outside of a steak, you've killed the bacteria. Now, if it's set out for a long, I mean, obviously there are limitations to that, but with that with camera. If it's a long time bat, if it's set out a long, long time, it's good again.

Don't think about that. No one likes to, we don't want to think about how the aging works, right? No, we don't. When, and the other thing to think about is that E. coli also lives in the intestines of animals. And so that E. coli that's in that undercooked meat is getting from inside the intestines of those animals

all through that hamburger. I'm sorry, I know that's upsetting. This is why I don't eat hamburgers unless they are fully cooked. It's wild to me that McDonald's even has the mechanism by which undercooked beef could be served. This was 1982.

Okay, yeah, yeah, having sense. So anyway, 10 years later, another outbreak occurs. And in that time period, I will say there wasn't this huge public panic about fast food or about hamburger or about food contamination that didn't happen. And in part, it was probably because they never said

the name of the, well, I mean, eventually, they said the name of the restaurant, but it was not always, everyone did not know. Right. And there wasn't this big, like, the media didn't have this big heyday with it, just wasn't this big, like, the media didn't have this big heyday with it, just wasn't this big thing until 1993 when the Jack in the Box outbreak occurred. And I think most people are sort of vaguely, and there are no Jack in the Box in this area.

So like, but that was why I think that's why it's a regional chain, right? Mm-hm. That isn't in other areas, right? So I think that that is why that sticks in my crawl a little bit more because the first time I heard about Jack in the box was this E. coli outbreak. So it was an early connection. So at Jack in the box, there was,

and this was much bigger too. The other thing about it is this was much more of a severe, widespread outbreak, contaminated hamburger. It was called the, they linked it to a specific burger, the monster burger, most people at the monster burger, which the tagline for the monster burger was so good, it's scary.

It's scary, it's good. It caused 732 people in four states to become sick, so big, a big, big outbreak, right? It's a big outbreak, it's a big burger. A big hunger, big burger, big flavor, big outbreak. And it's one of the biggest, like, if we look back at sheer numbers, people getting sick. I mean, we've had big contaminations. We know periodically when, like, we can't get romaine at the supermarket, right? We've had these big, giant food contaminations,

but to make this many people sick, it was notable. Yeah, but I bet when you get that contact tracing call about the fact that you ate a monster burger and it gave you super diary, it's like, yeah, it sounds about right, actually, you're probably right about that. It's weird how the idea that I ate this food and it gave me diarrhea has now become like the price you pay. Like we talk about it is almost like,

well, of course you did, you ate it wherever. And it's like, why is that? Why have we accepted that? Yeah, that's probably you spending too much time with me and my brothers. That's true. That is true. So the other hard part about this specific outbreak is that we, and we already knew this to some extent, I'm not saying this is when we discovered it, but it's when we saw it

happen in all at once, was that you can get a complication from E. coli-157, H7 called hemolytic uremic syndrome. There are other bacteria diurel illnesses that can do this too, and then sometimes it's not necessarily associated with that, but this is what we connect it most strongly with. And the specific syndrome,

which happened in some of these cases and four people actually perished from this related to the outbreak, causes basically kidney failure and your platelets get really low and it can be a deadly complication. And so again, it's not only E. coli that does this. There are other things that can do it too, but it's because of the shegatoxin that is in specific strains. And so that is why E. coli-o-on-577-H7, when I learned about it in medical school, was one of the shegatoxin that is in specific strains. And so that is why E. coli-o-on-577H7,

when I learned about it in medical school, was one of the bigger deals. Like, there are lots of things that can give you diarrhea. There are lots of things that you can get from contaminated food. This is one of the big deal things you need to think about. There have been other strains of E. coli that are not the O-157 H7 that have caused illness as well.

That happens all over the globe. So it's not just this one bad actor. There was one specifically in Germany in 2011. This was it. It was also a shigatoxin producing one that seems to be our worst, right? Like when you have that shigatoxin president. Well, you just said shigatoxin president. Well, you just said shigatoxin president, and that sounds very scary to me.

Why did we elect a shigatoxin? What were we thinking? Just stuff wasn't bad enough. 4,300 people got sick. 852 people got that complication, that hemolytic uremis syndrome. And over 5 people died. They linked this one actually to Fenugreek.

Oh, what is that? That sounds familiar. So Fenugreek seeds, these sprouts, the reason that I know about Fenugreek is that it was recommended to me for breastfeeding. Oh, that may be why I'm talking about that. So that is how they figured it out is that most of the people who got sick were healthy young adult women. And they were more like, I mean, Fenugreek is highly,

you can, I mean, there are other, like, sort of health connections to Fenugreek, but I know for me, I had people telling me to eat Fenugreek when I was trying to breastfeed. So there's the connection there. Which just to highlight, I say that just to highlight that like E. coli is not just in hamburgers, it's not just in meat.

That is often what we think of, like you said, when we think of E. coli. But it is in like you said lettuce and spinach, cookie dough. Oh, that's a rough one because I have been guilty of eating raw cookie dough. You really shouldn't eat raw cookie dough. It's been linked to apple juice. It's been linked to cheese.

It's been linked to, like I said, it's brown. So any raw stuff, raw milk, please don't drink raw milk. Can eat the raw cookie dough. If you're going to get it from apples and stuff, like just eat it. Just eat it. You have to think about things like petting zoos. It's been linked to outbreaks at petting zoos because animals have it.

Look for those hand-washing stations, y'all. If they don't have a hand-washing station to the petting zoo, well, I don't know if you want to go in that petting zoo, I don't know, bud. Water parks? Well, you're playing your money, it takes your chance to survive. I don't know how much you love the flodge.

Oh, yeah, not that part. Not that part. I don't know if any out, by the way, I don't know if any outbreaks associated with great will flots. That was just, it is a water park. I don't mean to malign the good name of the great will. Yeah, you could mention those are or the beach or boomers or bleak beach.

Overall there are six. There are six different pathogenic types of E. coli that cause diarrhea summer. Worse than others, there's one, for instance, that causes most of travelers diarrhea, which is typically more benign and self-limited than these other things we're talking about. But also, as I said, some E. coli is good. It can be a probiotic. It can be, and it's also very useful in molecular biology. It's one of the big, there's some microbes that we found are very useful in constructing things, making things in molecular biology. So, pharmaceuticals are made using it, things like erythropoeetin, human growth hormone, there are some clotting factors, insulin, different

things that we need bacteria to help us create. E. coli is part of that process. It's been used in like industrial chemicals, like phenol and manateol. So it's a very useful bacteria. And in many cases, the strains are not not only are they not harmful, but they're good that they're in your colon. But then there's rogue strains. So at the end of the day, what should you do? How do you avoid getting an infection related to E. coli? You can't. No. Just give hope. I mean, obviously we can't control everything. But things,

let's let's be proactive. What, harm reduction. What can we do to limit our risk? Wash our hands. Wash your hands and cook your food. Cook your food, you're weird. Wash your hands and cook your food. Our two major ways you can reduce your risk of getting equal our other foodborne illnesses.

Again, understanding that when you eat at a restaurant, when you eat food that's been mass-produced from who knows where. So just don't sweat it. There are always gonna be risks in life, but cook your food, wash your hands, can limit your risks. Especially if you're at a petting zoo,

please wash your hands. Petting zoo's a great love petting zoo. Please wash your hands. Love a petting zoo, please wash your hands. I mean, I don't know that I'm gonna change anything said. It seems like he called us way around every corner to snatch me up and put me into it. Diary event and so I will continue my existence unabated.

I hope you will do the same unless your heart's and minds have been changed by this. And you decided to find the washer hands. And I approve of that. Simmelvice had it right. Sydney's always watching. And you decided to find them wash your hands. And I approve of that. Simmelvice had it right. Sydney's always watching. Sydney knows when you don't wash your hands. Thank you so much for listening.

Thanks to the taxpayers for the use of their song Medicines as the intro and outro of our program. And thanks to you for listening. We really appreciate it. That is gonna do it for us for this week. So until next time, my name is Justin McRoy. I'm Sydney McRoy. As always, don't draw a hole in your head. Alright!