WEBVTT - Ep 37 E. coli (unless it's beets) 0:00:00.640 --> 0:00:04.200 By the time paramedics removed Brianne Kiner from the ambulance 0:00:04.240 --> 0:00:06.560 and wheeled her into the e ER at Children's Hospital, 0:00:06.960 --> 0:00:09.879 Suzanne Kiner was doing all she could to hold herself together. 0:00:10.520 --> 0:00:14.200 Brianne was writhing in pain, and the diarrhea just kept coming, 0:00:14.880 --> 0:00:18.560 so did the blood. Suzanne was afraid to leave Brianne's side. 0:00:18.880 --> 0:00:21.320 It looked and sounded like her little girl was dying. 0:00:21.920 --> 0:00:25.080 Her breathing was rapid, she had deep pain in her chest, 0:00:25.520 --> 0:00:29.480 her urine output had practically disappeared. Even her mental condition 0:00:29.600 --> 0:00:32.280 was deteriorating, and she was slurring her words when she 0:00:32.320 --> 0:00:35.600 tried to speak. When the hospital transferred Brianne to the 0:00:35.800 --> 0:00:40.199 ICU for round the clock observation, Suzanne wanted answers. The 0:00:40.240 --> 0:00:43.040 doctors informed her that Briann's stool culture had come back 0:00:43.240 --> 0:00:46.919 and definitely showed the presence of E. Coli O one 0:00:47.000 --> 0:00:50.680 five seven h seven, and her symptoms suggested she had 0:00:50.720 --> 0:00:55.560 hemolytic uremic syndrome. Shortly after arriving in the ICU, Brianne 0:00:55.560 --> 0:00:59.520 suffered a seizure and stopped breathing. Doctor scrambled to resuscitate her. 0:01:00.160 --> 0:01:04.479 They gave her dilantin intravenously along with phenobarbital tubes were 0:01:04.480 --> 0:01:07.600 inserted in her chest. By the time doctors emerged to 0:01:07.640 --> 0:01:11.160 give Susanne an update, Brianne was in a coma. Suzanne 0:01:11.200 --> 0:01:14.440 had trouble swallowing. She wanted to scream, but all she 0:01:14.480 --> 0:02:01.440 could do was cry, WHOA yeah? 0:02:01.480 --> 0:02:02.360 Did she survive? 0:02:03.000 --> 0:02:10.480 She didhw Yes. So that first hand account is pieced 0:02:10.520 --> 0:02:13.120 together from a book called Poisoned, The True Story of 0:02:13.160 --> 0:02:15.359 the Deadly E. Coal I Outbreak that Changed the way 0:02:15.400 --> 0:02:20.160 Americans eat by Jeff Benedict. And it's about the outbreak 0:02:20.360 --> 0:02:22.560 of E. Cole I oh one five seven that you're 0:02:22.600 --> 0:02:26.000 going to hear a lot more about in nineteen ninety three. 0:02:26.400 --> 0:02:29.440 And Brienne was one of the children who was infected 0:02:29.440 --> 0:02:32.399 with E. Coli and she did survive, but she has 0:02:32.480 --> 0:02:37.480 had a lot of lingering problems because of this infection. Hi, 0:02:37.919 --> 0:02:39.960 I'm Aaron Welsh. 0:02:39.200 --> 0:02:41.160 And I'm Erin omen Updyke. 0:02:40.960 --> 0:02:43.960 And this is this podcast Will Kill You, And. 0:02:43.880 --> 0:02:46.240 Today we're talking about E. 0:02:46.400 --> 0:02:48.960 Coli E Coli. 0:02:49.280 --> 0:02:51.400 Do you know I always raise my hands up when 0:02:51.440 --> 0:02:53.920 I say the disease that we're talking about, and no 0:02:53.960 --> 0:02:55.200 one can see except. 0:02:55.000 --> 0:02:56.760 You, But I appreciate it. 0:02:57.600 --> 0:03:02.679 Thank you, so so, today's a big one. It's a 0:03:02.800 --> 0:03:03.760 massive barin. 0:03:05.040 --> 0:03:07.200 I did not realize that when we were like, let's 0:03:07.240 --> 0:03:08.080 do we call it? 0:03:08.280 --> 0:03:12.040 Yeah, it's like it's well, yeah, we'll get into it. 0:03:12.040 --> 0:03:14.959 It's so big. It's so big. It's going to be 0:03:15.000 --> 0:03:16.200 a short episode though, don't worry. 0:03:18.040 --> 0:03:21.839 Well to help us through this episode, I think it's 0:03:21.919 --> 0:03:23.840 time for quarantinis. 0:03:24.080 --> 0:03:28.560 I think it's quarantini time. I have my first real 0:03:28.639 --> 0:03:35.200 quarantini in eleven months, yay, which feels quite exciting. What 0:03:35.240 --> 0:03:36.240 are we drinking today? 0:03:36.640 --> 0:03:43.320 We are drinking the cookie Don't so and in the 0:03:43.360 --> 0:03:46.360 Cookie don't it's actually quite delicious. 0:03:45.960 --> 0:03:47.160 It is. It's really tasty. 0:03:47.480 --> 0:03:54.080 It is dark rum and chocolate liquore, Almaretto ice cream, 0:03:54.400 --> 0:03:59.920 ice chocolate syrup. You blend it and then you pour 0:04:00.120 --> 0:04:03.080 it into a glass that is rimmed with chocolate and 0:04:03.160 --> 0:04:04.520 crushed cookies. 0:04:04.800 --> 0:04:05.960 It's so tasty. 0:04:06.120 --> 0:04:10.200 It's really good. It's so good, it's like too good. 0:04:10.240 --> 0:04:10.600 I think. 0:04:11.000 --> 0:04:14.240 Yeah. We'll post the full recipe for this quarantine as 0:04:14.240 --> 0:04:16.919 well as our non alcoholic Pussy Brita on all of 0:04:16.920 --> 0:04:19.760 our social media's and our website, so you can drink 0:04:19.800 --> 0:04:20.600 along with us. 0:04:21.080 --> 0:04:23.640 Yes and it's called the cookie don't for reasons that 0:04:23.680 --> 0:04:25.120 I'm sure you'll go into Aaron. 0:04:25.120 --> 0:04:26.760 Oh yeah, we'll talk all about it. 0:04:26.640 --> 0:04:28.400 And I'm sure that everyone here can guess. 0:04:28.640 --> 0:04:31.679 You can guess, yeah, cookie dough don't. 0:04:33.000 --> 0:04:35.200 Yeah, it works. It works better if you read it. 0:04:35.240 --> 0:04:39.120 I think it does. We didn't think this went through. 0:04:39.440 --> 0:04:41.480 It's still great. I like it. 0:04:42.560 --> 0:04:48.560 Okay, So speaking of cookie dough and don't and whatever, Aaron, 0:04:49.279 --> 0:04:50.360 should we just get started? 0:04:50.839 --> 0:04:53.920 I think so. We have merch check it out on 0:04:53.960 --> 0:04:58.800 our website, click on merch et cetera. Business. Let's do it, 0:04:59.120 --> 0:05:32.800 all right, cool, we'll take one quick break, all right. 0:05:33.800 --> 0:05:37.960 E Coli. I wrote that maybe this is the most 0:05:38.000 --> 0:05:41.760 important bacterial species we'll ever talk about, But I feel 0:05:41.760 --> 0:05:42.760 like that's overkill. 0:05:43.760 --> 0:05:45.800 Well, I feel like a lot of people might have 0:05:45.880 --> 0:05:46.760 opinions about them. 0:05:46.800 --> 0:05:49.279 They probably would, so I'm not going to make that statement, 0:05:49.360 --> 0:05:50.400 even though I just said it. 0:05:52.839 --> 0:05:54.400 But it is massively important. 0:05:54.600 --> 0:05:58.080 It is massively important. The thing about it is that E. 0:05:58.240 --> 0:06:02.360 Coli is everywhere. It's everywhere, and it's everything, and it 0:06:02.600 --> 0:06:07.440 causes almost every type of illness that you can think of. 0:06:08.760 --> 0:06:12.279 And we also use it in the lab to study 0:06:12.800 --> 0:06:17.200 every other disease pretty much. Equal is like the lab bacteria. 0:06:17.520 --> 0:06:21.680 Oh and not just every other disease, but life itself 0:06:22.080 --> 0:06:23.520 all how life works. 0:06:24.800 --> 0:06:26.839 Like literally, that's not an exaggeration. 0:06:27.000 --> 0:06:28.360 Yeah. No, I'm going to talk about it. 0:06:28.560 --> 0:06:31.560 Oh excellent. I can't wait because I'm not going to 0:06:31.640 --> 0:06:32.480 talk about it. O. 0:06:32.600 --> 0:06:32.800 Good. 0:06:34.040 --> 0:06:36.400 Oh. But we will get some of the basics out 0:06:36.400 --> 0:06:38.800 of the way first and then we'll talk about the 0:06:38.839 --> 0:06:43.920 diseases that equal I causes. Cool, perfect, Okay. So equal 0:06:44.200 --> 0:06:48.480 is a bacterium. It's a gram negative bacterium. So it's 0:06:48.680 --> 0:06:53.400 pink when we stain it on the microscope. That's what 0:06:53.480 --> 0:06:55.359 it means for the purposes of this podcast. 0:06:57.320 --> 0:06:59.839 That's really the important takeaway is that a pink. 0:06:59.720 --> 0:07:04.679 BacT pink little bacteria. If you're going to paint it color, 0:07:04.760 --> 0:07:08.080 you should choose it's rod shaped so it looks like 0:07:08.120 --> 0:07:10.840 a little tic tac. Okay, yeah, you have it in 0:07:10.880 --> 0:07:16.360 your mind now. For the most part, in our bodies, E. 0:07:16.440 --> 0:07:21.600 Coli is a normal and important component of our gut microflora. 0:07:22.080 --> 0:07:24.600 It's always there, and it's supposed to be there. It's 0:07:24.640 --> 0:07:28.880 part of a healthy microbiome. But this is this podcast 0:07:28.960 --> 0:07:31.520 will kill you. So that's not the ecoli that we're 0:07:31.520 --> 0:07:32.560 going to talk about today. 0:07:33.240 --> 0:07:35.640 Nope, although we could talk a little bit about those guys. 0:07:35.880 --> 0:07:41.440 Sure. Sure. So Aaron, when you think of the E. 0:07:41.480 --> 0:07:45.320 Coli that makes you sick, what do you think. 0:07:45.080 --> 0:07:49.040 Of you mean, like, what symptoms and signs and stuff. Oh, 0:07:49.360 --> 0:07:53.080 I would say, well, after reading that first hand account, 0:07:53.120 --> 0:07:57.320 I would say bloody diarrhea, bloody diarrhea, and then also 0:07:57.440 --> 0:07:59.680 whatever hus is. But I was hoping you were going 0:07:59.720 --> 0:08:00.360 to tell me about that. 0:08:00.400 --> 0:08:03.320 Don't worry, I'm going to Okay, Bloody diarrhea is the 0:08:03.320 --> 0:08:05.680 thing that probably comes to most people's minds when they 0:08:05.720 --> 0:08:08.480 think of E. Coli first, and that's because of just 0:08:08.560 --> 0:08:10.640 like you said, that oh one to five seven outbreak, 0:08:10.680 --> 0:08:14.520 which we'll talk about, you'll talk about, et cetera. Yeah, 0:08:14.920 --> 0:08:19.840 the diarrheagenic that's their official name. The diarrhegenic E Coli 0:08:20.200 --> 0:08:26.600 are probably the most infamous of the ecoalies that cause disease, 0:08:27.120 --> 0:08:31.320 but they're not the only ones. So here's how I'm 0:08:31.320 --> 0:08:33.720 going to structure this biology section because E. Coli is 0:08:33.760 --> 0:08:36.760 so big. First, we're going to talk really quickly about 0:08:36.800 --> 0:08:41.720 what makes the pathogenic ecoali strains different than all of 0:08:41.800 --> 0:08:45.360 the normal ecoli or all of the non pathogenic ecoal 0:08:45.400 --> 0:08:48.480 i that live in our gut happily, okay, and then 0:08:48.520 --> 0:08:52.600 we'll talk about the non diarrheagenic ecoli just briefly, and 0:08:52.640 --> 0:08:54.200 then we'll talk poop cool. 0:08:54.720 --> 0:08:57.559 Oh great, love talking poop met too. 0:08:57.559 --> 0:09:00.640 It's one of my favorite things to talk about. Okay. 0:09:01.880 --> 0:09:06.000 So the main difference between the E. Coli hanging out 0:09:06.160 --> 0:09:09.240 in our guts happily right now and the E. Coli 0:09:09.400 --> 0:09:12.199 that made that little girl in the first hand account 0:09:12.240 --> 0:09:17.160 massively sick, or what are called virulence factors. We've talked 0:09:17.160 --> 0:09:21.280 about these before, right, I think so, I think so? Sure. Well, 0:09:21.480 --> 0:09:24.600 if you don't remember what a virulence factor is, it's 0:09:24.640 --> 0:09:31.959 basically just stuff things. Yeah, that clears it up, Things 0:09:32.120 --> 0:09:36.600 that a bacteria or a virus or a parasite makes 0:09:37.480 --> 0:09:41.400 that helps it to cause disease in an organism. So 0:09:41.960 --> 0:09:47.120 let me give you some examples. Sometimes virulence factors allow 0:09:47.200 --> 0:09:51.680 for bacteria to attach to certain cells and colonize a 0:09:51.760 --> 0:09:54.200 new area in a host that they wouldn't be able 0:09:54.240 --> 0:09:54.760 to before. 0:09:55.000 --> 0:09:58.840 Oh yeah, okay, like little velcrow, little velcro strips. 0:09:59.400 --> 0:10:02.240 Sometimes it might be like a capsule kind of like 0:10:02.280 --> 0:10:05.640 an armor that allows it to evade a certain part 0:10:05.679 --> 0:10:09.080 of our immune response. That could be a virulence factor. 0:10:09.520 --> 0:10:12.920 It could be an endotoxin that the bacterium produces that 0:10:13.280 --> 0:10:16.559 also allows it to evade the immune system, or an 0:10:16.600 --> 0:10:20.040 exotoxin that it produces and sends out into our body 0:10:20.080 --> 0:10:22.360 and actually causes damage to other cells. 0:10:23.040 --> 0:10:23.319 Cool. 0:10:23.360 --> 0:10:28.200 Okay, So virulence factors are literally anything that a pathogen 0:10:28.360 --> 0:10:32.280 can make that makes it more virulent, aka makes you 0:10:32.360 --> 0:10:32.960 get sicker. 0:10:33.200 --> 0:10:34.640 Cool sounds reasonable. 0:10:35.000 --> 0:10:38.199 So these subtypes of E. Coli that are they're called 0:10:38.240 --> 0:10:43.960 different pathotypes because they are pathogenic, collectively have a couple 0:10:44.000 --> 0:10:50.000 of main virulence factors that allow them to get us sick. 0:10:50.720 --> 0:10:54.200 And those two things are different types of adhesons which 0:10:54.360 --> 0:10:59.880 allow them to adhere and colonize new areas, and toxins. 0:11:00.360 --> 0:11:02.920 Those are the two things that Ecoli tends to use 0:11:03.000 --> 0:11:06.480 to be able to invade new organs in our body 0:11:06.840 --> 0:11:10.640 and make us sick in new ways. So another important 0:11:10.640 --> 0:11:13.800 thing about the virulence factors in E. Coli is that 0:11:13.920 --> 0:11:19.800 a large number of them are on plasmids, which we've 0:11:19.840 --> 0:11:24.760 talked about before. I think, right, oh, did we talk 0:11:24.800 --> 0:11:29.800 about it with cholera Maybe, because cholera definitely has plasmids anyways. 0:11:29.840 --> 0:11:34.160 Plasmids are a little round pieces of DNA that bacteria 0:11:34.280 --> 0:11:37.440 can move from like one bacterium to another, they can 0:11:37.520 --> 0:11:40.400 like pass it off, and so basically this allows for 0:11:40.440 --> 0:11:45.000 ecoli to hand off virulence factors in like between different 0:11:45.080 --> 0:11:50.480 strains of bacteria, right, okay, Okay, that's like that's the 0:11:50.480 --> 0:11:53.960 whole pathogenesis. Like, that's how all of these ecoli have 0:11:54.040 --> 0:11:57.199 come to be, is just little changes in their toxins 0:11:57.320 --> 0:12:01.520 or their virulence factors or their adheson whatever that allows 0:12:01.559 --> 0:12:06.079 them to make us sick. Okay, So what kinds of 0:12:06.160 --> 0:12:11.280 ways can ecoli make us sick? So many different ways? Yeah, 0:12:11.360 --> 0:12:15.480 all right. The two main kinds of disease that you 0:12:15.520 --> 0:12:21.160 can get from E. Coli besides diarrhea are urinary tract infections. 0:12:21.559 --> 0:12:24.840 Oh yeah, did you try that? I think I did 0:12:24.920 --> 0:12:26.400 know that at one point. I don't know. It feels 0:12:26.440 --> 0:12:28.160 like a recovered memory. Yeah. 0:12:28.200 --> 0:12:34.120 So these strains of ecoli are called you peck. So 0:12:34.360 --> 0:12:36.679 many ridiculous acronyms. 0:12:36.160 --> 0:12:40.640 With no don't love. I don't love acronym you. 0:12:40.760 --> 0:12:45.520 Peck is europathogenic ecoal i. Okay, okay, they're all like that. 0:12:45.559 --> 0:12:48.480 They're all like blah blah. Pathogenic ecoal i, they're really 0:12:48.679 --> 0:12:51.080 so they all end in PEC. Yeah, yeah, they're all 0:12:51.360 --> 0:12:55.160 mostly sometimes they're like hex. Well you'll see. 0:12:56.559 --> 0:12:58.600 Heck and ecola, heck and e coli. 0:13:00.480 --> 0:13:01.360 That's funny. 0:13:02.520 --> 0:13:03.679 She sounds surprised. 0:13:03.800 --> 0:13:07.400 She liked it. It was good. Okay. So the upeck, 0:13:07.520 --> 0:13:12.600 the europathogenic ecoal i, are strains of ecoli that are 0:13:12.640 --> 0:13:16.880 really good at attaching to our urinary tract walls. Okay, 0:13:16.920 --> 0:13:19.440 So they have adhesions that allow them to do that, 0:13:20.080 --> 0:13:24.400 and they are the most common cause by far of UTI's. 0:13:25.800 --> 0:13:29.120 So that means like, okay, right, like eighty percent of 0:13:29.200 --> 0:13:33.320 UTI's or something like that are caused by ecole. And 0:13:33.400 --> 0:13:37.319 if you don't know what a UTI is, the symptoms 0:13:37.320 --> 0:13:42.000 generally are things like burning on urination, increase frequency meaning 0:13:42.120 --> 0:13:44.520 you have to pee way more often than normal, or 0:13:44.679 --> 0:13:46.719 urgency where you're like, if I don't pee right now, 0:13:46.760 --> 0:13:47.800 I'm on pima pants. 0:13:48.679 --> 0:13:53.439 So that sounds a lot like gonrhea, Aaron, How are 0:13:53.480 --> 0:13:55.680 people going to distinguish between the two. 0:13:56.760 --> 0:14:01.880 So another thing that upeck can cause ganeri prostatitis. No, 0:14:02.080 --> 0:14:05.680 but it is prostatitis, and gonorrhea is another common cause 0:14:05.720 --> 0:14:09.200 of prostatitis actually, so that's if it goes up the 0:14:09.360 --> 0:14:13.480 urethra far enough to invade the prostate. But then these 0:14:13.559 --> 0:14:15.960 strains of E. Coli can actually keep going up and 0:14:16.000 --> 0:14:19.280 then can also cause like pylonephritis, which is kidney infections 0:14:19.320 --> 0:14:23.040 as well, which is you can imagine more serious than 0:14:24.040 --> 0:14:30.040 only an bladder infection. Okay, so we covered three already. 0:14:30.360 --> 0:14:35.200 We've got bladder infection, kidney infection, prostate infection, all from UPEC. 0:14:35.920 --> 0:14:41.440 Then we have the m neck. I don't know if 0:14:41.480 --> 0:14:43.560 you're supposed to say it like that, but these are 0:14:43.640 --> 0:14:47.280 the meningitis associated ecoli. 0:14:47.480 --> 0:14:48.440 Ooh, that's right. 0:14:48.920 --> 0:14:52.160 Yeah, So this is one of the most common causes 0:14:52.240 --> 0:14:57.840 of meningitis in neonates, so tiny babies. It can also 0:14:57.960 --> 0:15:01.120 cause meningitis in adults, but it's much less common compared 0:15:01.120 --> 0:15:01.920 to other causes. 0:15:02.960 --> 0:15:03.320 Why. 0:15:04.600 --> 0:15:08.760 I think that just other bacteria are better at colonizing 0:15:08.800 --> 0:15:12.160 the mining geese, and so you'd have to be pretty 0:15:12.200 --> 0:15:16.080 sick already or have a root of entry. So these 0:15:16.120 --> 0:15:20.880 strains of E. Coli are associated mostly with meningitis following 0:15:20.960 --> 0:15:23.960 like a neurosurgical procedure in ADU. 0:15:24.040 --> 0:15:27.080 Oh okay, okay, yeah. 0:15:26.720 --> 0:15:30.520 But what's really scary is that in neonates, this type 0:15:30.520 --> 0:15:32.960 of E. Coli infection has a fatality rate of like 0:15:33.000 --> 0:15:34.360 fifteen to forty percent. 0:15:34.880 --> 0:15:35.360 Wow. 0:15:35.520 --> 0:15:39.280 Yeah, it's really it's really gnarly, and it's also an 0:15:39.400 --> 0:15:45.440 extremely common cause overall adults and children of bacterial sepsis. 0:15:45.800 --> 0:15:49.600 So bloodstream infections, right, and that can actually be from 0:15:49.720 --> 0:15:53.360 any strain of E. Coli, not only the UPEC or 0:15:53.480 --> 0:15:56.160 m NEX strains. You can have any any way that 0:15:56.160 --> 0:15:58.440 ecoli can gets into your blood. Once it gets there, 0:15:58.520 --> 0:16:00.800 it's pretty good at estabel and infection. 0:16:01.360 --> 0:16:01.920 Yikes. 0:16:02.360 --> 0:16:08.760 Yeah, so so those are collectively you want another academ here? 0:16:09.000 --> 0:16:11.480 Oh gosh, does end in heck er pecker? 0:16:12.160 --> 0:16:12.760 Yeah it does? 0:16:13.160 --> 0:16:13.600 What is it? 0:16:13.640 --> 0:16:15.280 Okay, they're the xpecs. 0:16:16.600 --> 0:16:18.720 I can't, I can't, I can't. 0:16:19.000 --> 0:16:23.280 These are the those are the extra intestinal pathogenic equal ie. 0:16:23.640 --> 0:16:27.320 Those we just talked about easy to remember, sure peck, 0:16:27.840 --> 0:16:30.880 XPEC eu peck. That's all we've learned so far. M 0:16:30.920 --> 0:16:33.240 neck Oh goodness, I can't. 0:16:34.360 --> 0:16:38.480 Okay, now we get into the more fun ones. Oh yikes, Okay, 0:16:39.600 --> 0:16:50.000 the EPEX people are gonna hate me. So now we're 0:16:50.000 --> 0:16:52.800 going to talk about the ones that actually colonize your 0:16:52.840 --> 0:16:56.960 gut in a way that is bad. The taro pathogenic 0:16:57.200 --> 0:17:02.400 equal ie the most famous of which we've heard a 0:17:02.400 --> 0:17:05.920 little bit about already, and that is the entaro hemorrhagic 0:17:06.520 --> 0:17:07.800 ecoal i e heck. 0:17:11.680 --> 0:17:16.160 Okay, So e hek is a form of epek. Yeah, bro, okay, 0:17:17.720 --> 0:17:20.040 it totally is. Do you want to know what gets 0:17:20.040 --> 0:17:22.479 even worse though? Aarin I even I, this is too 0:17:22.560 --> 0:17:23.240 much for even me. 0:17:23.680 --> 0:17:28.760 Ehk is also called s tech or v tech. Uh 0:17:28.800 --> 0:17:31.439 why let me tell you why? I'm so glad you asked. 0:17:31.520 --> 0:17:35.720 Oh no, The enterohemorrhagic E. Coal i are the strains 0:17:35.760 --> 0:17:42.680 that cause bloody diarrhea. Okay, Entaro heemorrhagic, like hemorrhage means 0:17:42.800 --> 0:17:45.960 bleeding out and taro means your gut. Okay. So that's 0:17:46.000 --> 0:17:49.359 like a broad umbrella term that encompasses a number of 0:17:49.440 --> 0:17:52.280 different strains of E. Coli, all of which end up 0:17:52.320 --> 0:17:56.399 with symptoms like bloody diarrhea. Some of those strains produce 0:17:56.440 --> 0:18:01.920 a toxin called shiga toxin. Oh yeah, t s tech 0:18:02.440 --> 0:18:07.840 siga toxin E. Coli. Some other strains produce a toxin 0:18:07.920 --> 0:18:11.639 that's really really similar to shiga toxin that is called 0:18:11.960 --> 0:18:17.320 suga like toxin oh, okay, or verotoxin vero toxin. 0:18:17.640 --> 0:18:23.720 Sure, so those two phrases are interchangeable, and yet they 0:18:23.800 --> 0:18:28.520 still give rise to two different acronyms. Three Oh, I'm sorry, yes, 0:18:28.560 --> 0:18:29.320 three yeah. 0:18:29.320 --> 0:18:31.879 V tech s tech EHK. I think it's annoying, So 0:18:32.000 --> 0:18:34.440 I just go with EHK because it's the broadest one 0:18:34.480 --> 0:18:35.880 and it encompasses all of them. 0:18:36.440 --> 0:18:39.760 Cool, I mean, I'm just rolling with it. 0:18:40.040 --> 0:18:43.360 Yeah, all right, So let's talk about what this actually 0:18:43.400 --> 0:18:47.240 does inside of your body. This shiga toxin or suga 0:18:47.400 --> 0:18:53.439 like toxin. It's the same toxin that's produced by another bacteria, Shigella, 0:18:54.760 --> 0:18:57.960 which arguably might actually just be a subspecies of Ecoli. 0:18:58.280 --> 0:19:01.720 Okay, yeah, so I'm glad. Yeah, I talk a little 0:19:01.720 --> 0:19:02.159 bit about it. 0:19:02.160 --> 0:19:06.240 But yeah, yeah, it's basically it. Basically they are so 0:19:06.359 --> 0:19:08.920 closely related it might as well be a subspecies. It's 0:19:08.960 --> 0:19:11.679 also possible that equoali oh one to five seven should 0:19:11.720 --> 0:19:12.920 actually be a Shagella. 0:19:13.440 --> 0:19:17.480 It's like some Ecoli strains should be Shigella and some 0:19:17.600 --> 0:19:19.320 Shagella strains should be Ecoli. 0:19:19.600 --> 0:19:21.720 Yes, is yeah what I wrote? 0:19:21.760 --> 0:19:25.200 Okay, Yeah, anyway, that blew my mind, by the way. 0:19:25.280 --> 0:19:29.560 Yeah, yeah, so they all produce this toxin that the 0:19:29.640 --> 0:19:33.679 bacteria can then release that causes damage directly to the 0:19:33.800 --> 0:19:38.720 mucosa of your intestine. These bacteria tend to colonize in 0:19:38.760 --> 0:19:42.480 your large intestine, in your colon, and when they release 0:19:42.560 --> 0:19:47.040 this toxin, they can cause perforation of your intestine. They 0:19:47.040 --> 0:19:50.240 can cause necrosis, so they can cause your your colon 0:19:50.280 --> 0:19:53.600 to actually die in places, and this is what results 0:19:53.640 --> 0:19:58.560 in the bloody stools that you see in enterohemorrhagic equali infections. 0:19:59.040 --> 0:20:01.560 Question about this unless you're going to cover this in 0:20:01.560 --> 0:20:02.280 the poop section. 0:20:02.960 --> 0:20:04.560 Oh we're in the poop section girl. 0:20:04.760 --> 0:20:07.680 Oh great, okay, okay, I thought so. I didn't want 0:20:07.680 --> 0:20:09.800 to get my hopes up in case we weren't. So 0:20:11.200 --> 0:20:16.520 bloody diarrhea doesn't mean red blood in your poop. 0:20:17.480 --> 0:20:21.960 Great, question, it can, and in this case it probably does. 0:20:22.320 --> 0:20:22.800 Okay. 0:20:23.119 --> 0:20:26.840 It all depends on where you're bleeding from. Yeah, So 0:20:27.000 --> 0:20:30.399 the higher up you bleed in your GI tract, the 0:20:30.400 --> 0:20:33.040 more black your stool is going to look when you 0:20:33.040 --> 0:20:36.320 poop it out right. The lower down you're bleeding, the 0:20:36.320 --> 0:20:38.240 more bright red this blood is going to be. 0:20:38.800 --> 0:20:43.280 But soose S tech V tech et cetera. Whatever, ones 0:20:43.320 --> 0:20:46.879 that actually cause the hemorrhage. E heck, cause the hemorrhage 0:20:46.920 --> 0:20:50.240 in your gut. That can that can produce any shade 0:20:50.359 --> 0:20:52.040 of bloody diarrhea. 0:20:52.240 --> 0:20:54.879 Yeah yeah, because they colonize your colon, and your colon 0:20:54.960 --> 0:20:58.560 is pretty big and large. So if they're colonizing closer 0:20:58.600 --> 0:21:06.720 to no erin, I'm gonna get my, oh my anatomy. 0:21:06.920 --> 0:21:09.359 If they're colonizing closer to the left side where the 0:21:09.400 --> 0:21:11.960 outlet is, then it might be more bright red blood. 0:21:12.000 --> 0:21:14.480 If they're colonizing closer to the start of your colon, 0:21:14.560 --> 0:21:16.600 it might be a darker color. 0:21:16.960 --> 0:21:22.119 Okay. In any case, seek medical attention. Yeah rah, Unless 0:21:22.160 --> 0:21:23.960 you ate beats the night before. 0:21:23.720 --> 0:21:29.160 Unless you unless it's beats. I feel like we've had 0:21:29.200 --> 0:21:31.360 so many good title possibilities already. 0:21:32.040 --> 0:21:34.080 Well, I also feel like we've mentioned beats on a 0:21:34.119 --> 0:21:38.320 couple other podcasts or a couple of other episodes before ECOLI. 0:21:38.560 --> 0:21:50.119 Unless it's beats. Unless it's beats, okay, beats by beats. Okay. 0:21:50.960 --> 0:21:54.280 So that's the damage that this toxin and that this 0:21:54.400 --> 0:21:59.479 bacteria causes in your colon where it's actually colonizing. But 0:21:59.680 --> 0:22:05.040 what's really really dangerous about these enterohemorrhagic equali is that 0:22:05.080 --> 0:22:08.760 the toxin can actually leave the intestine and get into 0:22:08.800 --> 0:22:13.240 your bloodstream. If that happens, it can make it all 0:22:13.280 --> 0:22:17.879 the way to the kidneys, where it causes inflammation in 0:22:17.920 --> 0:22:21.120 the kidneys that can end up causing kidney failure. 0:22:21.800 --> 0:22:22.119 Yikes. 0:22:22.520 --> 0:22:26.320 And then what it also does is it it causes 0:22:26.400 --> 0:22:30.359 damage in your small blood vessels that then leads to 0:22:30.960 --> 0:22:34.919 small clots forming inside of your blood vessels, like little 0:22:34.960 --> 0:22:40.359 teensy tiny clots that when your blood then passes over 0:22:40.560 --> 0:22:45.160 these clotted chunks in your blood vessels, it shears your 0:22:45.200 --> 0:22:46.040 red blood cells. 0:22:46.240 --> 0:22:47.280 Oh my goodness. 0:22:47.600 --> 0:22:50.800 Right, And so this is what's called a hemolytic anemia 0:22:50.920 --> 0:22:54.919 because your red blood cells are literally bursting open. Whoa, 0:22:54.960 --> 0:22:59.400 because they're traveling over these tiny microclots. And those clots 0:22:59.400 --> 0:23:02.480 are formed by platelets. So now all your platelets in 0:23:02.520 --> 0:23:05.720 your blood are being used up. So the three main 0:23:05.960 --> 0:23:11.360 signs that you see are renal failure, kidney failure, this 0:23:11.560 --> 0:23:17.160 hemolytic anemia, and thrombocytopenia, which means your your platelet count 0:23:17.200 --> 0:23:20.960 is low. And that collectively is what's known as hemolytic 0:23:21.119 --> 0:23:24.320 uremix syndrome. Oh wasn't that. 0:23:24.320 --> 0:23:31.320 Okay, Wow, So I have a question, Okay, how does 0:23:31.400 --> 0:23:35.199 it does it benefit ecoali to produce this toxin in 0:23:35.320 --> 0:23:39.160 terms of their replication or in terms of their ability 0:23:39.200 --> 0:23:42.639 to colonize new areas? Like why do they Why do 0:23:42.720 --> 0:23:45.080 some strains produce this toxin and some don't? Does it 0:23:45.080 --> 0:23:46.880 give them some sort of fitness advantage? 0:23:47.080 --> 0:23:49.480 That's a really really good question. I don't fully know 0:23:49.560 --> 0:23:51.439 the answer to that, but what I can tell you 0:23:51.640 --> 0:23:55.640 is that a lot of these strains of E. Coli, 0:23:56.320 --> 0:23:59.359 especially like oh one five seven, are naturally found in 0:23:59.400 --> 0:24:04.119 the guts of ruminants like cows and cheap So I 0:24:04.240 --> 0:24:08.040 wonder if it provides a fitness advantage in those environments 0:24:08.080 --> 0:24:11.480 in some way. M right, like guts, the guts of 0:24:11.560 --> 0:24:15.520 cows are bananas, They're like have five stomachs and stuff. 0:24:15.560 --> 0:24:18.080 So I know, what if the microfloor is totally different 0:24:18.080 --> 0:24:18.840 at each one of them. 0:24:19.040 --> 0:24:21.120 Oh, it probably is, I know. 0:24:21.080 --> 0:24:24.399 But like there's probably a study out there, but but 0:24:24.440 --> 0:24:25.480 we just haven't read it. 0:24:25.520 --> 0:24:27.840 Isn't that veterinarians going to be like, you guys, let 0:24:27.840 --> 0:24:30.120 me tell you tell us we want to not Yeah, 0:24:30.240 --> 0:24:32.960 we want to know. That's a really good question. Though, 0:24:34.560 --> 0:24:38.840 because yeah, the toxins are expensive for bacteria to produce, 0:24:39.200 --> 0:24:42.080 so presumably in some way it has to be. You 0:24:42.080 --> 0:24:46.440 would think, because these strains are so prevalent, you would 0:24:46.440 --> 0:24:51.080 think that, yeah, it does cause some kind of fitness advantage. Probably, 0:24:51.720 --> 0:24:59.120 great question. So yeah, that's uh. That is the enterohemorrhagic ecoalize, 0:24:59.560 --> 0:25:02.960 the most famous of which is E. Coli one five 0:25:03.000 --> 0:25:07.840 to seven H seven specific, let's just call it. That's 0:25:07.840 --> 0:25:13.879 what I do for most of it. Yeah, this is 0:25:13.920 --> 0:25:19.440