WEBVTT - Cyclospora (and other diarrhea-inducing parasites) 0:00:07.760 --> 0:00:11.440 Howdy, extraordinaries. We're recording this episode in July of twenty 0:00:11.480 --> 0:00:13.440 twenty six, in the middle of an outbreak of a 0:00:13.480 --> 0:00:18.000 parasite known as cyclospora. Cyclospora appears to have contaminated some 0:00:18.040 --> 0:00:20.920 of the United States's food supply and is causing intense 0:00:21.000 --> 0:00:24.800 diarrhea and those who have become infected. Apparently, when people 0:00:24.880 --> 0:00:29.880 hear intense diarrhea, they think Kelly Waidersmith, because wow, I've 0:00:29.920 --> 0:00:32.040 been hearing from a lot of you. I will take 0:00:32.120 --> 0:00:34.919 this as a compliment. So today we're going to talk 0:00:34.920 --> 0:00:37.599 about cyclospora, and we're also going to talk about some 0:00:37.640 --> 0:00:41.080 other diarrhea inducing parasites that are important for public health. 0:00:41.680 --> 0:00:46.840 Welcome to Daniel and Kelly's runny universe and ps as. 0:00:46.880 --> 0:00:50.279 Always remember I'm not a medical doctor. If you have 0:00:50.360 --> 0:00:53.400 diarrhea that concerns you, go see a real doctor. 0:01:06.600 --> 0:01:06.720 Hi. 0:01:06.959 --> 0:01:09.200 I'm Daniel. I'm a particle physicist who likes to think 0:01:09.240 --> 0:01:12.240 about aliens, and I eat a lot of bagged salad, 0:01:12.440 --> 0:01:14.360 or at least they used to. Hello. 0:01:14.400 --> 0:01:17.800 I'm Kelly Waiter Smith. I study parasites in space, and yes, 0:01:17.880 --> 0:01:21.240 I also eat a lot of bagged lettuces and have 0:01:21.319 --> 0:01:22.600 considered giving them to the geese. 0:01:22.640 --> 0:01:28.720 Instead considered, does that mean you're still eating preprocessed, pre 0:01:29.000 --> 0:01:30.080 washed lettuce? 0:01:30.600 --> 0:01:30.919 Yeah? 0:01:31.040 --> 0:01:31.400 It does? 0:01:31.600 --> 0:01:32.080 Wow? 0:01:32.319 --> 0:01:35.199 Interesting, Yeah, I live dangerously man. 0:01:36.920 --> 0:01:38.880 Well, when this whole thing broken the news, of course, 0:01:38.880 --> 0:01:42.000 the first person I messaged for advice about what I 0:01:42.000 --> 0:01:45.600 should and should not eat was my favorite parasitologist, which, 0:01:45.640 --> 0:01:46.880 of course is you, Kelly. 0:01:47.200 --> 0:01:47.360 Well. 0:01:47.440 --> 0:01:47.720 Thanks. 0:01:47.760 --> 0:01:47.920 Yes. 0:01:47.960 --> 0:01:50.800 When cyclostpora made the news as an outbreak in July 0:01:50.880 --> 0:01:55.080 twenty twenty six, it wasn't just you who sent me messages. 0:01:55.440 --> 0:01:58.680 It was all of my extended friends and family that 0:01:58.720 --> 0:02:01.200 I haven't heard from in years, and a lot of 0:02:01.240 --> 0:02:05.640 the extraordinaries. Apparently, when people hear diarrhea, they think Kelly. 0:02:05.520 --> 0:02:07.400 And is that something that pleased you? You're like, look, 0:02:07.440 --> 0:02:08.799 I have relevant expertise. 0:02:09.120 --> 0:02:13.160 Finally, the funny thing is I don't have relevant expertise. 0:02:13.240 --> 0:02:15.480 It took a long time to prepare for this episode. 0:02:15.480 --> 0:02:18.160 These are not parasites that I've worked on or thought 0:02:18.160 --> 0:02:21.079 about much. Ever. The other interesting connection here is that 0:02:21.240 --> 0:02:23.040 the one other time in my life that a bunch 0:02:23.080 --> 0:02:25.240 of people I hadn't talked to for a very long 0:02:25.280 --> 0:02:28.680 time thought of me and reached out was when Tugo 0:02:28.760 --> 0:02:33.320 Bell brought back their Mexican pizza. 0:02:33.639 --> 0:02:35.119 What's the Kelly connection there? 0:02:35.760 --> 0:02:39.480 I guess I really liked Mexican pizzas, and I didn't 0:02:39.520 --> 0:02:41.880 realize how much I liked them because a bunch of 0:02:41.880 --> 0:02:44.440 people were like, Kelly, the Mexican pizza's back, and I 0:02:44.480 --> 0:02:48.200 was like so, and they're like, you loved those, and 0:02:48.240 --> 0:02:51.000 I was like, oh, I loved those. And it's kind 0:02:51.040 --> 0:02:54.120 of interesting the things that people remember about you. They 0:02:54.400 --> 0:02:56.480 did not seem important to you at the time. 0:02:56.560 --> 0:02:58.560 Well, I have a theory about that based on very 0:02:58.560 --> 0:03:01.440 little data, which is that you're very polite person and 0:03:01.480 --> 0:03:04.000 a very positive person. So maybe these folks just like 0:03:04.080 --> 0:03:06.160 went to Taco Bell with you one time and you 0:03:06.280 --> 0:03:09.720 just like enthused about your food because you're a very 0:03:09.760 --> 0:03:12.320 positive person, and that made an impression on them. 0:03:12.600 --> 0:03:14.799 Could be yeah, could be thank you. I do get 0:03:15.120 --> 0:03:18.480 I get excited about just about everything. You know, we 0:03:18.560 --> 0:03:21.040 do have it pretty good in general. 0:03:21.160 --> 0:03:24.200 Yeah, that's true. It is amazing that I could just 0:03:24.240 --> 0:03:26.320 like go to the store and buy a bag of 0:03:26.440 --> 0:03:30.840 pre washed, pre mixed salad and it's pretty good. I 0:03:31.040 --> 0:03:33.640 used to make salads every single day from scratch. You know, 0:03:33.720 --> 0:03:36.040 you buy all the ingredients, you wash them, you chop them. 0:03:36.240 --> 0:03:37.800 It was a lot of work, but I was dedicated 0:03:37.840 --> 0:03:40.800 to eating salads. And then with the rise of bagged salads, 0:03:40.800 --> 0:03:43.480 I was like, this is amazing. And I've often wondered, like, 0:03:43.520 --> 0:03:47.160 what is the infrastructure behind this? Is it really expensive 0:03:47.160 --> 0:03:50.360 for the environment? Is it opening us up to weird 0:03:50.440 --> 0:03:54.800 new bugs and parasites? And I guess now we know, well. 0:03:54.560 --> 0:03:57.600 I don't necessarily know that the rise of bag salads 0:03:58.080 --> 0:04:00.360 is the thing you can put your finger on. Were like, 0:04:00.440 --> 0:04:03.440 this is why we are at increased risk. So you know, 0:04:03.480 --> 0:04:06.760 in this case, it was shredded lettuce that got sent 0:04:06.880 --> 0:04:10.360 to Taco Bell, so it wasn't even like bagged mixed salads. 0:04:10.960 --> 0:04:13.440 And you know, you can get sick if you go 0:04:13.480 --> 0:04:16.400 to a farmer's market and you buy lettuce that people, 0:04:17.000 --> 0:04:19.120 you know, cut off the ground and threw in a bag, 0:04:19.160 --> 0:04:20.920 and you're just buying it that way, it's not mixed 0:04:20.960 --> 0:04:23.359 up with other stuff. The bad news here, Daniel, is 0:04:23.360 --> 0:04:25.560 that there's a lot of routes from butts to mouths. 0:04:28.760 --> 0:04:32.320 All right, well, let's dispense with Daniel's unfounded theories of 0:04:32.360 --> 0:04:36.400 the demise of society and get into the episode. It 0:04:36.440 --> 0:04:38.960 wasn't just me who contacted you about this, didn't We 0:04:39.000 --> 0:04:40.120 also hear from listeners. 0:04:40.200 --> 0:04:43.080 We heard from so many listeners. Here is a subset 0:04:43.360 --> 0:04:47.360 of folks who thought about diarrhea and then thought about Kelly. 0:04:48.520 --> 0:04:52.120 Hi, Daniel Kelly. This is Matt from northwest Indiana. I'm 0:04:52.200 --> 0:04:56.159 curious about cryptosporidiosis. Hopefully I said that right. That name 0:04:56.240 --> 0:04:58.720 is horrible. So several years ago now, when my wife 0:04:58.800 --> 0:05:00.760 Sydney and I were still in college, she was visiting 0:05:00.839 --> 0:05:03.280 Peru on a month long class trip. She had a 0:05:03.320 --> 0:05:05.880 great time, but it was difficult adjusting to the dietary 0:05:05.880 --> 0:05:08.600 differences of the region. Leafy Green's are ruffage of any 0:05:08.640 --> 0:05:10.560 kindra and short supply, so when they did find in 0:05:10.560 --> 0:05:13.080 a place serving salad, most of the class indulged heavily. 0:05:13.520 --> 0:05:15.560 Even before she returned home, she was not feeling well. 0:05:15.560 --> 0:05:18.080 She had stomach cramps, fatigue, and throughout her first evening 0:05:18.080 --> 0:05:21.800 back in the States, she was overcome with very intense diarrhea. Naturally, 0:05:21.839 --> 0:05:23.880 we went to the hospital and she was given fluids 0:05:23.920 --> 0:05:28.280 and they confirmed it was something called cryptosporidiosis or simply crypto, which, 0:05:28.320 --> 0:05:30.160 by the way, horrible name. I assumed the root is 0:05:30.200 --> 0:05:32.920 Greek or Latin. That probably means something non threatening, but 0:05:32.960 --> 0:05:34.920 it immediately made me think of Tales from the crypt 0:05:35.080 --> 0:05:36.920 which was childhood nightmare fuel for me. 0:05:37.080 --> 0:05:37.880 But I digress. 0:05:38.279 --> 0:05:40.040 Sydney had to do a few interviews with folks from 0:05:40.040 --> 0:05:42.520 the CDC tracking where she went in Peru and if 0:05:42.520 --> 0:05:45.080 any other students complained of similar symptoms, which several of 0:05:45.120 --> 0:05:47.680 them did. But they also stressed heavily that this parasite 0:05:47.680 --> 0:05:50.080 could have killed her, which at first felt kind of dramatic, 0:05:50.080 --> 0:05:52.960 but she was definitely dehydrated. Would a crypto fatality be 0:05:52.960 --> 0:05:56.120 caused by dehydration or something else? I suppose my question 0:05:56.120 --> 0:05:58.640 in the broadest senses, what is this bugs deal? What 0:05:58.680 --> 0:06:00.920 did it do to her to produce these symptoms? Did 0:06:00.920 --> 0:06:03.600 it likely come from icky water contaminated produce? A recent 0:06:03.680 --> 0:06:06.359 episode of The Pod on cholera shook this memory loose, 0:06:06.400 --> 0:06:08.760 as the symptoms sounded pretty similar. But are the parasitic 0:06:08.800 --> 0:06:11.240 mechanisms the same? Thanks to you both, love the show. 0:06:11.560 --> 0:06:15.960 Hello President of Parasites. How worried should I be about cyclospora? 0:06:16.279 --> 0:06:18.919 I eat a lot of salads and I'm lazy, so 0:06:19.120 --> 0:06:22.600 bag salads are very convenient should I change my habits 0:06:22.720 --> 0:06:26.080 or is this still very rare and remote? Thank you. 0:06:27.000 --> 0:06:30.839 Sarah Taber is a farm activist worth listening to. She 0:06:31.000 --> 0:06:35.040 ran for North Carolina Commissioner of Agriculture in twenty twenty four, 0:06:35.279 --> 0:06:38.320 which is how I started following her. If she's talking 0:06:38.320 --> 0:06:41.800 about a widespread outbreak of explosive diarrhea, I think that's 0:06:41.839 --> 0:06:45.520 something you really should explore as a public service. Is 0:06:45.560 --> 0:06:49.760 it cryptosporidium nerovirus? A parasite given a leg up by 0:06:49.760 --> 0:06:54.039 the climate crisis? Inquiring minds want to know. However, we 0:06:54.160 --> 0:06:57.360 definitely need an answer to the explosive diarrhea outbreak. In 0:06:57.360 --> 0:06:59.960 my lawyer days, I worked on Clean Water Act cases 0:07:00.040 --> 0:07:02.720 with the NRDC. I don't know if it's an explanation 0:07:02.760 --> 0:07:05.400 for the current outbreak on the East Coast, but I 0:07:05.480 --> 0:07:10.760 know that in California, concentrated animal feed operations CAFOs in 0:07:10.800 --> 0:07:14.840 the Central Valley crowd thousands of cattle into relatively confined 0:07:14.880 --> 0:07:18.880 areas which are surrounded by farmland cattle poop and the 0:07:19.000 --> 0:07:22.000 runoff from that poop. If it's not carefully confined, it's 0:07:22.120 --> 0:07:27.560 not can reach groundwater. Downstream Crops, especially leafy greens, can 0:07:27.640 --> 0:07:31.119 uptake that contaminated water through their roots, which is why 0:07:31.240 --> 0:07:33.600 washing the greens when you get them home doesn't remove 0:07:33.640 --> 0:07:37.000 the bacteria. I hate CAFOs, and the cattle probably aren't 0:07:37.000 --> 0:07:37.800 too thrilled either. 0:07:38.920 --> 0:07:42.320 Hey, Dan, knowing, Kelly gloy Dan checking in. I've got 0:07:42.320 --> 0:07:45.400 a question for you guys today about parasites. Why father 0:07:45.520 --> 0:07:48.760 often avoids eating fruits because he's concerned about getting parasites 0:07:48.800 --> 0:07:52.760 from them. Can we actually get parasites simply by eating fruit? 0:07:53.240 --> 0:07:56.320 If so, what parasites are they and what fruits would 0:07:56.320 --> 0:07:57.440 they typically be found on? 0:07:57.880 --> 0:08:01.200 Thank you? All right, So Kelly tell us how big 0:08:01.280 --> 0:08:02.680 of a problem is this. 0:08:02.920 --> 0:08:05.640 Well it's pretty big. So according to the World Health Organization, 0:08:05.840 --> 0:08:10.600 one point seven billion kiddos suffer from diarrheal diseases every year. 0:08:10.840 --> 0:08:12.600 One point seven billion with a. 0:08:12.560 --> 0:08:14.200 Bee billion with a bee. 0:08:14.040 --> 0:08:16.240 Like a big fraction of humanity. We're talking about a. 0:08:16.200 --> 0:08:19.480 Big fraction of humanity has a diarrheal disease. And this 0:08:19.520 --> 0:08:22.920 could also be like ecoli. It's definitely not just cyclospora. 0:08:22.960 --> 0:08:26.520 There's lots of parasites and pathogens that can cause diarrhea, 0:08:26.800 --> 0:08:29.520 but diarrhea globally is still a huge problem. 0:08:29.840 --> 0:08:32.800 Wow. Does that mean like that the volume of diarrhea 0:08:32.840 --> 0:08:36.600 produced annually is like, no, a pretty big number in 0:08:36.679 --> 0:08:39.840 terms of like leaders or swimming pools or something. 0:08:40.000 --> 0:08:41.400 Yeah, I was gonna say, I don't know the number 0:08:41.440 --> 0:08:44.920 of Olympic swimming pools full of diarrhea that our species 0:08:44.960 --> 0:08:48.240 creates each year, but that's probably a lot. It's probably 0:08:48.280 --> 0:08:51.480 a big number, but you know, and so that is funny. 0:08:52.000 --> 0:08:53.880 But about half a million kids under the age of 0:08:53.960 --> 0:08:56.959 nine every year die from diarrheal diseases. I know, I'm 0:08:56.960 --> 0:08:59.319 such a stink and ray of sunshine, but a lot 0:08:59.360 --> 0:09:01.800 of these cases of diarrhea could be avoided if people 0:09:01.840 --> 0:09:04.800 had safe drinking water and better sanitation. And that's going 0:09:04.840 --> 0:09:07.320 to be a theme for today. But because I am 0:09:07.360 --> 0:09:10.480 a parasite person, we're going to for today stay away 0:09:10.520 --> 0:09:14.079 from the bacteria and viruses that cause diarrhea and focus 0:09:14.160 --> 0:09:17.440 on the parasites. And so what we're talking about here 0:09:17.559 --> 0:09:21.599 are single celled eukaryotic critters, so they've got you know, 0:09:21.679 --> 0:09:26.440 a nucleus, membrane bound organelles, stuff like that, rather than 0:09:26.559 --> 0:09:29.360 bacteria and viruses. So we're talking about stuff that like 0:09:29.559 --> 0:09:32.559 is distantly related to malaria. For example, just to help 0:09:32.600 --> 0:09:35.240 you get like a foothold. These are small. You can't 0:09:35.280 --> 0:09:36.400 see them with the naked eye. 0:09:36.559 --> 0:09:39.000 Wait, malaria is caused by a parasite. 0:09:39.280 --> 0:09:42.240 Malaria is caused by a parasite that is, you know, 0:09:42.440 --> 0:09:45.480 distantly related but like somewhat related to the parasites that 0:09:45.520 --> 0:09:46.440 we're talking about today. 0:09:49.280 --> 0:09:52.200 All right, So my calculations suggest that there's about ten 0:09:52.400 --> 0:09:56.160 thousand Olympic sized swimming pools of diarrhea produced by humans 0:09:56.200 --> 0:09:58.720 every year. Wow, and now you're telling me that we're 0:09:58.760 --> 0:10:01.680 only focusing on a fraction of that that's produced by 0:10:01.960 --> 0:10:07.360 parasitic infections, not parasitic infections, parasitic what's the word parasit? 0:10:07.440 --> 0:10:08.480 Infections with parasites? 0:10:08.600 --> 0:10:11.600 Okay, all right, yeah, what fraction of those ten thousand 0:10:11.640 --> 0:10:14.439 swimming pools do you think probably come from parasites? Or 0:10:14.480 --> 0:10:17.280 we're dealing with the bulk of the diarrhea or a 0:10:17.480 --> 0:10:19.760 little offshoot, a little rivulet of it. 0:10:19.920 --> 0:10:22.040 Oh god, all right, let's say somewhere in between. So 0:10:22.120 --> 0:10:24.880 sometimes it can be hard to identify the particular cause 0:10:25.160 --> 0:10:28.680 of a diarrheal disease, and so you aggregate. I'll be 0:10:28.720 --> 0:10:31.720 giving you some numbers, mostly US based for the parasites 0:10:31.760 --> 0:10:33.480 we're talking about today to help you get a handle 0:10:33.760 --> 0:10:35.040 on how common these things are. 0:10:35.240 --> 0:10:38.240 All right, so we're focusing on the parasites and what 0:10:38.280 --> 0:10:41.320 are the parasites that mostly cause diarrhea? 0:10:41.400 --> 0:10:45.000 So before we get into the species, let's go ahead 0:10:45.040 --> 0:10:47.240 and do like an overview just to make it easier, 0:10:47.280 --> 0:10:49.480 because if we go into too much detail about the species, 0:10:49.480 --> 0:10:51.160 I think it's easy to get sort of bogged down 0:10:51.200 --> 0:10:54.640 with information. So let's talk about some like commonalities first 0:10:54.720 --> 0:10:57.560 to make this a little easier to digest. So, for 0:10:57.800 --> 0:11:01.000 all of the poor parasites we're talking about today, symptoms 0:11:01.040 --> 0:11:06.440 they cause include watery diarrhea, stomach pain, nausea, and vomiting. 0:11:06.480 --> 0:11:08.480 You usually get a little bit of a fever and 0:11:08.679 --> 0:11:11.040 you don't have much of an appetite. We don't have 0:11:11.200 --> 0:11:15.400 vaccines for any of these, oh, which sucks. And they 0:11:15.480 --> 0:11:19.040 all take about a week for symptoms to show up 0:11:19.200 --> 0:11:22.280 after you get infected. So we're gonna talk about what 0:11:22.320 --> 0:11:24.839 they're doing to your gut in particular. But this week 0:11:24.920 --> 0:11:29.080 between ingestion and the onset of symptoms is part of 0:11:29.080 --> 0:11:31.480 what makes it so hard to figure out where outbreaks start. 0:11:31.840 --> 0:11:34.079 All right, Well, I'm really curious, like why it takes 0:11:34.080 --> 0:11:37.679 a week to get the symptoms, and why exactly they 0:11:37.720 --> 0:11:41.079 cause diarrhea, Like is it a byproduct? Are they intentionally 0:11:41.120 --> 0:11:44.040 causing diarrhea because it helps, you know, with their life 0:11:44.040 --> 0:11:46.400 cycle or whatever. Dig into the details for me. 0:11:46.720 --> 0:11:48.480 Oh yes, okay, So you got to hold on a 0:11:48.520 --> 0:11:51.120 little bit. For each one of them, they induce diarrhea 0:11:51.200 --> 0:11:54.400 for slightly different reasons, and they're doing slightly different things 0:11:54.400 --> 0:11:57.280 inside your gut, which I think is absolutely fascinating. And 0:11:57.520 --> 0:11:59.720 I'm gonna, you know, to cut to the chase. Nobody's 0:11:59.720 --> 0:12:02.199 gonna be surprised to hear me say. We don't understand 0:12:02.440 --> 0:12:07.360 really well what is exactly causing the diarrhea, but the 0:12:07.400 --> 0:12:09.959 things that they're doing when they're inside of our intestines 0:12:10.040 --> 0:12:14.200 make it pretty easy to imagine why diarrhea is happening. 0:12:14.280 --> 0:12:16.199 So we will get to that, I promise. 0:12:16.360 --> 0:12:18.880 All right, So how do we run into these critters? 0:12:18.880 --> 0:12:21.120 Why do they end up in our guts? Yeah? 0:12:21.160 --> 0:12:23.600 So for all of them, we're talking about the fecal 0:12:23.840 --> 0:12:26.959 oral route again, which we'll called poop to mouth. Yeah. 0:12:27.000 --> 0:12:29.200 I know, it's so gross, it's so gross, but there's 0:12:29.320 --> 0:12:31.720 so many ways these parasites can get to us. They 0:12:31.760 --> 0:12:34.440 can get to us by changing diapers. So these are 0:12:34.480 --> 0:12:36.640 parasite you have to be really worried about in like 0:12:36.720 --> 0:12:40.400 childcare settings. These are parasites that you can get by 0:12:40.480 --> 0:12:43.800 drinking water at the public pool, which is why if 0:12:43.840 --> 0:12:46.480 anyone poops in the pool, they immediately shut the whole 0:12:46.480 --> 0:12:49.280 pool down. You know, like the first time someone shut 0:12:49.280 --> 0:12:51.720 a pool down because a baby pooped in the pool, 0:12:51.880 --> 0:12:54.120 my first thought was, wasn't that what the chlorine is for? 0:12:54.559 --> 0:12:57.520 But like, you need a lot more chlorine to kill 0:12:57.520 --> 0:12:59.920 these parasites, and some of them are resistant to chlor 0:13:00.400 --> 0:13:03.560 which is a real pain. So drinking water from a 0:13:03.559 --> 0:13:07.840 public pool, drinking water from a beautiful bubbling brook or 0:13:07.880 --> 0:13:10.959 a river or a lake, there's wild animals out there 0:13:11.000 --> 0:13:15.359 pooping or you know, if we're talking about something like cyclospora, 0:13:15.520 --> 0:13:19.000 it's because human feces accidentally ended up getting on our 0:13:19.040 --> 0:13:21.080 food and then gets into our face. 0:13:21.559 --> 0:13:24.240 I gotta say, Kelly, for like how gross it is 0:13:24.880 --> 0:13:27.720 the concept of like, you know, the poop to mouth 0:13:27.800 --> 0:13:32.160 throughout Nobody wants to be eating poop and it's dangerous. 0:13:32.600 --> 0:13:35.800 Why aren't we better at keeping poop out of our 0:13:35.840 --> 0:13:37.800 water and out of our food, like it seems like 0:13:37.840 --> 0:13:38.960 it should be a priority. 0:13:39.120 --> 0:13:41.439 Yes, I know, right, But okay, so before we talk 0:13:41.480 --> 0:13:43.880 about how it goes wrong and why that's frustrating, I 0:13:43.920 --> 0:13:46.480 do think we should note that we actually do a 0:13:46.520 --> 0:13:48.760 good job most of the time. Like the reason the 0:13:48.800 --> 0:13:51.680 cyclospora thing is in the news is because something fell 0:13:51.720 --> 0:13:54.120 apart and now we have cyclospora, and it's news because 0:13:54.120 --> 0:13:56.160 it doesn't happen often's you know, most of the time, 0:13:56.559 --> 0:13:59.440 at least if you live in the United States, you 0:13:59.480 --> 0:14:02.480 can take a sip of water from the faucet and 0:14:02.559 --> 0:14:05.160 you don't have to worry about getting a parasite that's 0:14:05.160 --> 0:14:08.599 going to give you diarrhea. So one of the problems 0:14:08.720 --> 0:14:11.000 for some of these parasites is that it's not just 0:14:11.200 --> 0:14:13.440 humans that are in the life cycle of the parasite. So, 0:14:13.480 --> 0:14:16.079 for example, if you're out and you take a drink 0:14:16.080 --> 0:14:19.680 from a beautiful river, you might be ingesting a parasite 0:14:19.680 --> 0:14:22.760 that was put there by beavers. There's another parasite we're 0:14:22.760 --> 0:14:25.000 going to talk about today that's a really big problem 0:14:25.040 --> 0:14:27.400 for cattle. And so if you have cattle that are 0:14:27.480 --> 0:14:32.040 anywhere in a watershed and the rain washes cattle poop 0:14:32.200 --> 0:14:35.600 into a stream that subsequently feeds a public water supply, 0:14:36.200 --> 0:14:37.640 then you've got a problem there too. 0:14:37.880 --> 0:14:40.160 But if you're taking water from a stream for a 0:14:40.200 --> 0:14:42.800 public water supply, you gotta clean it. You can't just 0:14:42.840 --> 0:14:44.680 be like, look, we found some water. I mean, if 0:14:44.680 --> 0:14:46.640 I'm out hiking and I see a stream, I don't 0:14:46.720 --> 0:14:49.240 just like put my face into it, right, I like 0:14:49.680 --> 0:14:52.320 only filter it or treat it or whatever. So why 0:14:52.320 --> 0:14:55.800 aren't we cleaning our public water to prevent there from 0:14:55.800 --> 0:14:56.480 being pooping it? 0:14:56.520 --> 0:14:59.320 Okay, but again, we are cleaning our water, and that's 0:14:59.320 --> 0:15:02.600 why this doesn't have and often but yeah, well, so 0:15:02.640 --> 0:15:05.280 some outbreaks that have happened in the past have happened 0:15:05.320 --> 0:15:09.440 at facilities where some part of their water treatment equipment 0:15:09.480 --> 0:15:11.760 had broken down and they just didn't realize it yet, 0:15:12.000 --> 0:15:14.160 and then people started getting sick and they didn't realize it. 0:15:14.440 --> 0:15:16.760 And then sometimes the problem is that, like to kill 0:15:16.800 --> 0:15:20.120 these parasites takes a lot of chlorine, and maybe not 0:15:20.360 --> 0:15:23.160 enough was added at a certain time, and so you know, 0:15:23.200 --> 0:15:26.440 this is like a system that needs constant surveillance and vigilance, 0:15:26.480 --> 0:15:28.640 and sometimes that falls apart. 0:15:29.400 --> 0:15:32.200 I was hearing today an interview on NPR with an 0:15:32.240 --> 0:15:35.480 expert at the FDA who's saying that they just don't 0:15:35.560 --> 0:15:40.320 have the resources to like check if farms are following protocols. 0:15:40.360 --> 0:15:43.320 Like farmers, if they see a pile of animal poop 0:15:43.640 --> 0:15:46.400 on their iceberg lettuce field are supposed to like coordinate 0:15:46.520 --> 0:15:48.960 off and nobody's supposed to ever get that lettuce that's 0:15:49.040 --> 0:15:52.280 near the poop. But the FDA doesn't even have the 0:15:52.320 --> 0:15:56.760 resources to send inspectors to visit farms every three years. Wow, 0:15:56.920 --> 0:16:00.680 Like that's too much for the FDA to handle. So basically, 0:16:00.720 --> 0:16:04.800 I think we're relying on farms and farmers and mega 0:16:04.880 --> 0:16:08.080 corporations to police themselves and we always know how well 0:16:08.120 --> 0:16:08.640 that goes. 0:16:09.120 --> 0:16:12.080 Yeah, Okay, so then let's jump to some recent regulatory changes. 0:16:12.080 --> 0:16:13.720 We can talk about that now. So, like you were 0:16:13.720 --> 0:16:17.080 talking about, on farms, if there is poop in the field, 0:16:17.200 --> 0:16:20.480 just supposed to coordinate off. Yeah, But if somebody has 0:16:20.520 --> 0:16:23.200 pooped in the field, that probably means you have not 0:16:23.440 --> 0:16:25.680 given them access to a toilet, or you have not 0:16:25.800 --> 0:16:28.080 given them sufficient breaks so that they can get to 0:16:28.200 --> 0:16:31.200 a toilet. It could just mean someone got lazy, but like. 0:16:31.480 --> 0:16:33.360 Or it could be animal poop also right where. 0:16:33.200 --> 0:16:35.360 It could be animal poop also, right, But you know, 0:16:35.680 --> 0:16:38.400 animal poop kind of looks like soil, right, and after 0:16:38.440 --> 0:16:41.200 a little while it becomes soil. That's like part of 0:16:41.200 --> 0:16:44.160 the process. And so I think it's easy to miss 0:16:44.200 --> 0:16:46.560 these things. And yes, it does sound like there's a 0:16:46.560 --> 0:16:50.360 shortage of people. And an increasing problem here is that 0:16:50.680 --> 0:16:53.680 in twenty twenty five, the Trump administration cut back a 0:16:53.680 --> 0:16:56.360 lot of jobs, and those jobs got cut at the federal, state, 0:16:56.400 --> 0:16:59.360 and local level, And so there's a lot of reports 0:16:59.360 --> 0:17:02.320 from public health both officials right now saying look, it's 0:17:02.360 --> 0:17:04.359 always been hard to do our job, and it's even 0:17:04.520 --> 0:17:08.120 harder to do our job now because we don't have 0:17:08.200 --> 0:17:10.639 the people power that we need. You know, we were 0:17:10.640 --> 0:17:14.880 already underpowered before. Another problem is that there are different 0:17:15.040 --> 0:17:19.480 places where you are required to report food born illness. So, 0:17:19.560 --> 0:17:22.919 for example, if someone comes into your doctor's office and 0:17:22.960 --> 0:17:27.359 you decide that they've encountered cyclospora in twenty twenty five, 0:17:27.480 --> 0:17:30.560 you would need to report that to at least two places. 0:17:30.560 --> 0:17:32.760 I believe one of them was food net, and so 0:17:32.880 --> 0:17:35.320 food Net kept track of a bunch of different food 0:17:35.320 --> 0:17:37.840 born illnesses. But as of twenty twenty five, the Trump 0:17:37.880 --> 0:17:41.080 administration said you don't need to report to food net anymore. 0:17:41.119 --> 0:17:43.960 There's only two diseases that you need to report to 0:17:43.960 --> 0:17:48.200 food nets. Their argument was that there are other organizations 0:17:48.280 --> 0:17:50.879 that deal with food born illnesses, and to be fair, 0:17:50.960 --> 0:17:55.440 the National Notifiable Diseases Surveillance System is a system still 0:17:55.480 --> 0:17:58.439 in place where cyclospora should be reported to if you 0:17:58.680 --> 0:18:01.639 happen to encounter it, but you used to also need 0:18:01.680 --> 0:18:04.320 to report it to food net. And so the more 0:18:04.359 --> 0:18:07.120 connections we have between the people whose job it is 0:18:07.520 --> 0:18:09.880 to try to make sure these diseases aren't getting to us, 0:18:09.880 --> 0:18:11.920 and once they do get to us, that we identify 0:18:11.960 --> 0:18:13.919 the source and get it off of our shelves quickly, 0:18:14.280 --> 0:18:17.480 like that system has become less robust in the last 0:18:17.520 --> 0:18:20.200 year or so, not ideal, and so a bunch of 0:18:20.240 --> 0:18:23.080 public health officials are saying, in the past, we probably 0:18:23.080 --> 0:18:25.960 would have nailed this down sooner. But as we'll talk about, 0:18:25.960 --> 0:18:28.160 it's hard to nail down the sources of these things. 0:18:28.680 --> 0:18:31.399 So real quick, let's talk about what happens when an 0:18:31.400 --> 0:18:35.399 outbreak starts. So you know, some doctor's office, for example, 0:18:35.440 --> 0:18:38.760 might identify one or more cases of cyclospora or some 0:18:38.840 --> 0:18:41.280 other food born illness that we're talking about today or 0:18:41.320 --> 0:18:44.160 poop to mouth illness, and then they have to report 0:18:44.200 --> 0:18:47.320 it to the state and federal levels in some cases 0:18:47.359 --> 0:18:51.040 depending on the disease, and then public health officials will 0:18:51.080 --> 0:18:54.320 go and they'll interview anyone who has been identified as 0:18:54.320 --> 0:18:57.080 having encountered this parasite and become infected by it. 0:18:57.280 --> 0:19:00.320 Interview meaning like, tell us everything you've eaten the last 0:19:00.359 --> 0:19:02.200 three weeks and every time you've dipped your finger in 0:19:02.240 --> 0:19:03.080 a stream or something. 0:19:03.480 --> 0:19:06.280 Yes, right, and you've identified why this is so hard? Right? 0:19:06.320 --> 0:19:08.600 And so if the deal was they were looking at 0:19:08.640 --> 0:19:11.760 something where you eat it and then twelve hours later 0:19:11.840 --> 0:19:15.160 you have horrible diarrhea, then you'd only have twelve hours 0:19:15.200 --> 0:19:17.160 of like what did you eat? Where did you go? 0:19:17.359 --> 0:19:20.320 To think about? But if the illness takes one to 0:19:20.400 --> 0:19:23.120 two weeks to start showing symptoms, you've got to remember 0:19:23.200 --> 0:19:25.119 like in the last two weeks, did I go to 0:19:25.240 --> 0:19:27.360 Taco Bell? Did I go to Burger King? How many 0:19:27.400 --> 0:19:28.640 bag salads did I eat? 0:19:28.720 --> 0:19:30.120 Did I did I go swimming? 0:19:30.240 --> 0:19:31.080 Did I go swimming? 0:19:31.240 --> 0:19:31.440 Right? 0:19:31.680 --> 0:19:35.640 Did I have sex with a partner where I interacted 0:19:35.720 --> 0:19:38.919 with their buttole at all like I'm sorry, but that 0:19:39.080 --> 0:19:41.240 is another common routes that you find on like the 0:19:41.280 --> 0:19:44.199 CDC and the FDA web pages, Like, there's just a 0:19:44.280 --> 0:19:47.040 lot of different routes through which you can encounter a 0:19:47.040 --> 0:19:49.600 lot of these kinds of parasites. And then it's someone's 0:19:49.720 --> 0:19:52.240 job to go through all of those data and look 0:19:52.240 --> 0:19:57.720