WEBVTT - Ep 99 Salmonella: A hard egg to crack 0:00:02.279 --> 0:00:04.040 My name is Beth, and I got caught up in 0:00:04.040 --> 0:00:08.800 a salmonella outbreak. I was volunteering on a tall ship, 0:00:08.960 --> 0:00:12.520 and usually in exchange volunteering, you get, you know, your 0:00:12.560 --> 0:00:14.800 meals for the weekend and the place to sleep and 0:00:15.000 --> 0:00:16.560 hang out with a crew at the festival and all 0:00:16.600 --> 0:00:20.400 of that. So we'd been working at festival for a 0:00:20.400 --> 0:00:24.480 couple of days and spent all Saturday out in the 0:00:24.520 --> 0:00:28.440 sun all day, grabbed dinner real quick, hung out with 0:00:28.440 --> 0:00:31.159 my friends, popped a couple of bars in Cleveland, you know, 0:00:31.240 --> 0:00:34.159 evening out in the town. And the next morning, got up, 0:00:34.200 --> 0:00:36.879 did the same thing over again. Ate breakfast. I was 0:00:36.880 --> 0:00:39.240 at working in the head rig, out in the sun 0:00:39.400 --> 0:00:43.680 all morning, and again it's another hot day, but you know, 0:00:43.920 --> 0:00:45.480 nothing out of the ordinary. 0:00:46.400 --> 0:00:47.520 When we took a break. 0:00:47.280 --> 0:00:50.879 For lunch, I noticed that I was really feeling just 0:00:51.040 --> 0:00:55.480 hot and tired and dehydrated, you know. I sat down 0:00:55.600 --> 0:00:58.320 in the shade, I grabbed a water bottle, drank a 0:00:58.360 --> 0:01:01.200 bunch of water, and I just assumed I'd been out 0:01:01.200 --> 0:01:04.399 in the sun too long. The festival ended that day. 0:01:04.520 --> 0:01:05.880 I was supposed to get a ride back to my 0:01:05.920 --> 0:01:08.360 car so I could go home. The woman that was 0:01:08.360 --> 0:01:11.160 supposed to give me a ride to my car, wasn't 0:01:11.240 --> 0:01:13.640 there because you'd actually taken a couple of my crewmates 0:01:13.680 --> 0:01:17.039 to urgent care. Found out later that they were kind 0:01:17.040 --> 0:01:21.120 of feeling the same thing. They were dehydrated, they were 0:01:21.400 --> 0:01:25.000 some of them had upset stomachs. I eventually got a 0:01:25.080 --> 0:01:27.559 ride back to my car and headed home. It's about 0:01:27.560 --> 0:01:30.960 a forty five minute drive from downtown Cleveland to where 0:01:31.000 --> 0:01:34.840 I was living at the time, and as I'm driving, 0:01:35.040 --> 0:01:38.280 all of a sudden it hits me just like stomach cramps, 0:01:38.680 --> 0:01:42.839 stomach pain. I really felt like I had to fart 0:01:45.319 --> 0:01:54.040 and it I almost made it that last couple miles. Well, 0:01:54.160 --> 0:02:00.560 some parts can't be trusted. So I got home. I 0:02:00.600 --> 0:02:04.840 had actually pooped my pants a little bit, and so 0:02:05.280 --> 0:02:08.080 I just took off my clothes, through them in the 0:02:08.120 --> 0:02:10.800 washing machine, start a loae to wash, took a shower, 0:02:11.200 --> 0:02:14.440 put on pajamas, and went to bed. Woke up a 0:02:14.440 --> 0:02:16.880 couple times in the middle of the night again with 0:02:16.960 --> 0:02:19.160 just an urgent need to go to the bathroom, just 0:02:20.400 --> 0:02:25.839 watery diarrhea every time. Whatever was inside of my intestines 0:02:25.919 --> 0:02:29.920 was just on the fast track out and that so 0:02:29.960 --> 0:02:34.080 I spent Sunday night. That's how I spent Monday, and 0:02:34.160 --> 0:02:38.080 as I recall, that's how I spent Tuesday too. I 0:02:38.080 --> 0:02:42.480 mean I tried to eat gland food like cheerios or 0:02:42.600 --> 0:02:45.400 instant meshed potatoes, but every time I put something in 0:02:45.520 --> 0:02:48.760 my mouth, it was just on the fast track. Clear through. 0:02:49.800 --> 0:02:52.919 I started getting messages from some of my friends who 0:02:52.919 --> 0:02:56.680 were on the ship still, and it wasn't just me. 0:02:57.000 --> 0:02:59.240 It was at first it was eight or ten of 0:02:59.320 --> 0:03:01.960 us and twenty of us, and then all of a sudden, 0:03:02.240 --> 0:03:07.799 almost forty of us were sick and not getting better. 0:03:08.880 --> 0:03:12.400 Probably Tuesday, I stopped trying to eat. I'm like, I'll 0:03:12.440 --> 0:03:17.520 just let my entire digestive system empty out, reset itself, 0:03:17.560 --> 0:03:19.520 and we'll try food again in a day or two. 0:03:20.560 --> 0:03:25.320 That didn't fix the illness, but it did let me 0:03:25.720 --> 0:03:28.840 control my bowels well enough that I could actually go 0:03:28.840 --> 0:03:32.640 to urgent Care. So I did that. They collected a 0:03:32.680 --> 0:03:35.080 sample and sent it to the lab, and I went 0:03:35.120 --> 0:03:39.040 back home and lived on gatory. The next couple of days, 0:03:39.680 --> 0:03:41.600 Urgent Care called me back and they're like, oh, you 0:03:41.600 --> 0:03:45.080 have salmonilla. It should resolve itself, and you know, if not, 0:03:45.160 --> 0:03:48.840 follow with your primary care doctor. And that's really all 0:03:48.840 --> 0:03:52.040 they said about it. But you know, a week into this, 0:03:52.720 --> 0:03:56.320 I still can't eat solid food. So finally, eight and 0:03:56.360 --> 0:03:58.800 a half days later, I finally got into see my 0:03:59.200 --> 0:04:03.040 primary care position and she walked into the exam room. 0:04:03.400 --> 0:04:06.160 First thing she says is you look terrible. And the 0:04:06.160 --> 0:04:10.520 next question she asked me was did you finish your antibiotics? 0:04:11.120 --> 0:04:14.800 And I said, what an aibiotics? So it turns out 0:04:14.840 --> 0:04:19.640 that the lab results from Urgent Care had actually said 0:04:20.080 --> 0:04:23.040 you should, you know, treat this patient with this antibiotic. 0:04:23.640 --> 0:04:28.360 Urgent Care never prescribed that, So my doctor started me 0:04:28.400 --> 0:04:32.119 on the antibiotics. Four days later, all of a sudden, 0:04:32.120 --> 0:04:35.800 I can eat food again, like it's a minor miracle. 0:04:36.279 --> 0:04:39.080 But in that time and that it's about ten or 0:04:39.080 --> 0:04:42.240 eleven days between when I got sick and when I 0:04:42.320 --> 0:04:46.960 started feeling better, I dropped about sixteen pounds. You know, 0:04:47.040 --> 0:04:51.280 that took me from being a healthy weight to being underweight. 0:04:52.760 --> 0:04:55.520 And at the same time, this is happening to all 0:04:55.560 --> 0:04:59.400 of my crewmates too, so we knew that something had 0:04:59.440 --> 0:05:02.520 gone on in the ship. That weekend when the health 0:05:02.560 --> 0:05:04.800 department actually started doing surveys and talking to all the 0:05:04.800 --> 0:05:08.080 people who were and were not sick. We figured out 0:05:08.160 --> 0:05:13.200 that the people that were sick were not vegetarians, and 0:05:13.200 --> 0:05:16.120 they'd eaten dinner on board the ship on Saturday night. 0:05:17.279 --> 0:05:21.599 Saturday dinner was Mexican castrole, So there was a version 0:05:21.640 --> 0:05:23.880 with chicken in it, and there's a version that didn't 0:05:23.920 --> 0:05:27.680 have chicken in it. An interview with one of the 0:05:27.720 --> 0:05:30.520 guys that helped in the galley, he says he thinks 0:05:30.560 --> 0:05:34.160 that chicken had been cooked about six days earlier, and 0:05:34.440 --> 0:05:39.400 it was put into a wood stove after dinner one night, 0:05:40.040 --> 0:05:42.960 as the stove cooled off, so the cook goes to 0:05:43.000 --> 0:05:46.000 start the fire the next morning for breakfast and finds 0:05:46.800 --> 0:05:50.400 room temperature chicken, and the he throws in the refrigerator 0:05:51.120 --> 0:05:53.960 and that Saturday night ended up in that cast role. 0:05:54.760 --> 0:05:57.840 They also, you know, took a look around the equipment 0:05:58.120 --> 0:06:01.000 and took a lot of you know, measurements of you know, 0:06:01.040 --> 0:06:03.640 how hot the windstove got, how cold the refrigerator was, 0:06:03.680 --> 0:06:06.640 how cold the freezer was, things like that. And one 0:06:06.640 --> 0:06:09.599 of the things they discovered is there actually was not 0:06:10.120 --> 0:06:13.920 a food thermometer on board. One of the things about 0:06:13.920 --> 0:06:17.520 these ships is they have a blackwater tank and so 0:06:17.600 --> 0:06:20.679 whenever you flush a toilet on the ship, it actually 0:06:20.680 --> 0:06:23.479 doesn't flush like a toilet. You actually pumped the wastewater 0:06:23.600 --> 0:06:27.520 into the blackwater tank. That tank gets emptied basically with 0:06:28.400 --> 0:06:31.480 a septic haller truck, so those you know, big tank 0:06:31.520 --> 0:06:34.320 trucks that have the vacuum pumps. So as soon as 0:06:34.320 --> 0:06:37.760 the ship got back to Eerie, they scheduled that truck 0:06:37.800 --> 0:06:40.200 to come in and empty the blackwater tank because so 0:06:40.200 --> 0:06:43.040 many people have been using the heads that the blackwater 0:06:43.080 --> 0:06:46.080 tank was full. So first thing on Monday morning, his 0:06:46.080 --> 0:06:48.599 first stop of the day was the ship. He pulls 0:06:48.640 --> 0:06:52.200 in hooks up to all the connections so he can 0:06:52.600 --> 0:06:55.920 suck the poop out. When he emptied the truck the 0:06:55.960 --> 0:07:01.599 day before, he hadn't flipped the pump from pumping the 0:07:01.760 --> 0:07:05.680 blackwater out of his truck to sucking it into his truck. 0:07:05.839 --> 0:07:07.920 So what he actually did was he pushed a bunch 0:07:07.960 --> 0:07:12.560 of air into the blackwater tank, which pushed salmonilla contaminated 0:07:12.600 --> 0:07:17.080 pool water up through the vent and all over the 0:07:17.120 --> 0:07:20.680 plays where most of the crew sleeps, and they sanitized 0:07:20.720 --> 0:07:22.920 what they could but start for a lot of people 0:07:22.960 --> 0:07:26.000 got caught that way too, so we actually had a 0:07:26.080 --> 0:07:30.000 little secondary outbreak because the back truck was set to blow, 0:07:30.040 --> 0:07:33.800 not suck. At the end of it all, I believe 0:07:33.840 --> 0:07:37.160 there were thirty seven of us in the outbreak. It 0:07:37.280 --> 0:07:39.200 was enough, It was a large enough percentage of the 0:07:39.280 --> 0:07:42.480 crew that the ship actually had to miss some of 0:07:42.680 --> 0:07:47.160 our contracted sales and events. But it managed to take 0:07:47.240 --> 0:07:51.640 a bunch of young, healthy people and pretty much ruin 0:07:51.720 --> 0:07:55.520 an entire summer for us. Even though you started feeling 0:07:55.560 --> 0:08:00.400 better because you didn't have uncontrolled diarrhea anymore, for some 0:08:00.440 --> 0:08:03.720 of us, it was months before you could just eat 0:08:03.760 --> 0:08:07.560 whatever you wanted without thinking about it. And then a 0:08:07.600 --> 0:08:09.880 lot of us still to this day a decade later, 0:08:10.040 --> 0:08:14.880 don't eat chicken, and several of us have sworn off 0:08:14.920 --> 0:08:17.640 gatorade too. That it's just both of those things are 0:08:17.680 --> 0:08:21.360 things that remind us of that awful week that we 0:08:21.400 --> 0:08:24.760 all spent not being able to do anything more than 0:08:24.800 --> 0:08:28.840 five feet away from a toilet, and that was enough 0:08:28.840 --> 0:08:33.280 to lead to some regulatory changes in that community. And 0:08:33.320 --> 0:09:20.360 that's my story. 0:09:21.120 --> 0:09:27.280 Oh my, oh my gosh. I mean the number of 0:09:27.320 --> 0:09:31.320 times that I went, what right are you? Are you 0:09:31.440 --> 0:09:31.920 kidding me? 0:09:32.280 --> 0:09:33.280 Like I'm sorry? 0:09:33.400 --> 0:09:37.880 What that is one of the most outrageous stories, like 0:09:39.440 --> 0:09:42.840 the old chicken. I mean, I can't. I cannot. 0:09:44.040 --> 0:09:45.320 I don't know that I'm ever going to be able 0:09:45.360 --> 0:09:46.080 to eat chicken again. 0:09:46.240 --> 0:09:47.959 Just I don't know that I'm going to be able 0:09:48.040 --> 0:09:54.000 to eat like so many things again. Well, thank you 0:09:54.200 --> 0:09:58.360 Beth so much for sharing your story, Like, oh my gosh, 0:09:58.400 --> 0:10:00.719 what an unbelievable, horrible experience. 0:10:01.320 --> 0:10:02.320 Yeah. 0:10:02.679 --> 0:10:05.160 Hi, I'm Aaron Welsh. 0:10:04.559 --> 0:10:06.719 And I'm Erin on an Updike and this. 0:10:06.840 --> 0:10:08.480 Is this podcast will kill you. 0:10:08.920 --> 0:10:10.960 Welcome. We're talking about poop today. 0:10:11.160 --> 0:10:11.760 We are. 0:10:12.120 --> 0:10:14.040 I love these days, I truly do. 0:10:16.280 --> 0:10:18.760 We talk about poop in my house like a lot lately, 0:10:18.840 --> 0:10:20.520 and so this is just like another day. 0:10:20.800 --> 0:10:24.440 I mean, I feel like it's an important thing to 0:10:24.520 --> 0:10:28.200 talk about and it people get real squeamish about it. 0:10:28.240 --> 0:10:33.280 But literally every person produces fecal waste. 0:10:33.640 --> 0:10:35.040 Yeah, everybody poops. 0:10:35.240 --> 0:10:36.120 Everyone poops. 0:10:37.240 --> 0:10:40.319 It's important. We have books about it, you know. Yeah. 0:10:40.520 --> 0:10:42.520 I guess we're not going to get that much into it. 0:10:42.760 --> 0:10:44.760 Yeah, we're not going to like Bristol stool scale it 0:10:44.800 --> 0:10:45.240 over here. 0:10:47.240 --> 0:10:50.080 Okay, adding that to my things to Google later list. 0:10:51.280 --> 0:10:55.640 We can post a picture of it anyways. 0:10:55.880 --> 0:10:59.640 Anyways, Yeah, this is gonna be an interesting episode. So 0:10:59.720 --> 0:11:02.760 this is it's not our first salmonella episode. 0:11:03.080 --> 0:11:06.120 No, it isn't. It isn't. Yeah, but the. 0:11:06.120 --> 0:11:10.240 Last time we did salmonella, we did typhoid, which is different, 0:11:11.040 --> 0:11:15.200 very different, And there's a lot of complexity in salmonella 0:11:15.320 --> 0:11:18.800 and a lot of diversity in salmonella, and it's gonna 0:11:18.840 --> 0:11:19.560 be interesting. 0:11:19.960 --> 0:11:21.920 Yeah, it definitely is. 0:11:22.760 --> 0:11:26.520 And another thing that's going to be very interesting is 0:11:26.600 --> 0:11:29.679 that in this episode we also get to learn how 0:11:29.760 --> 0:11:33.400 you determine things like the difference between the salmonella that 0:11:33.480 --> 0:11:38.120 gives you typhoid versus a slightly maybe less scary salmonella. 0:11:38.200 --> 0:11:42.360 Sarah var Yeah, we are so excited to be joined 0:11:42.480 --> 0:11:45.840 later on in this episode by Sarah Zoucha, who is 0:11:45.880 --> 0:11:48.680 a medical laboratory scientist that's going to give us a 0:11:48.720 --> 0:11:53.960 behind the scenes look at this fascinating and so important career. 0:11:54.600 --> 0:11:57.160 Like what is medical laboratory science? 0:11:57.240 --> 0:11:58.679 We've never talked about it on this. 0:11:58.720 --> 0:12:02.079 Podcast, so we'll talk about it today and we'll talk 0:12:02.120 --> 0:12:05.120 about how you choose which tests to run on various 0:12:05.160 --> 0:12:08.080 samples and what are some of the stranger samples that 0:12:08.120 --> 0:12:10.680 have shown up in the lab. But we'll get to 0:12:10.720 --> 0:12:13.800 all of those questions and more later on in the episode. 0:12:14.000 --> 0:12:17.000 Oh, I'm so excited. It's going to be so much fun. 0:12:17.080 --> 0:12:17.920 Yeah, it will be. 0:12:19.200 --> 0:12:24.000 But first, should we Is it time for quarantinees? 0:12:24.200 --> 0:12:27.079 Quarantinees? I think so? When are we drinking today? 0:12:27.160 --> 0:12:30.400 Erin, we're drinking the chicken or the egg? 0:12:31.160 --> 0:12:32.760 Lah question mark? 0:12:33.080 --> 0:12:33.480 Get it? 0:12:33.600 --> 0:12:36.680 Because they could both give you salmonella. 0:12:36.320 --> 0:12:40.880 Yeah, along with many other things. Yeah, yeah, what is 0:12:40.920 --> 0:12:42.000 in the chicken and the egg? 0:12:42.320 --> 0:12:45.600 It's a very tasty concoction without any chicken or eggs 0:12:45.640 --> 0:12:45.880 in it. 0:12:46.160 --> 0:12:46.360 Yeah. 0:12:46.520 --> 0:12:48.960 Yeah, we decided against an egg white foam for this. 0:12:48.920 --> 0:12:55.079 One, considered and discarded. But it has gin and blueberry syrup, 0:12:55.480 --> 0:12:58.800 lemon juice, some club soda, a little fizz for you. 0:12:59.040 --> 0:12:59.880 It's fantastic. 0:13:00.160 --> 0:13:02.640 And if you want to have a foam, there are 0:13:02.679 --> 0:13:06.760 many different foaming alternatives. One of them is like the 0:13:07.200 --> 0:13:11.480 water from chickpeas aqua faba. You can turn it into 0:13:11.760 --> 0:13:14.880 a like a foam, a non egg white foam topper 0:13:14.920 --> 0:13:15.720 for your cocktail. 0:13:16.200 --> 0:13:18.560 And I don't think that you can get zamonella from 0:13:18.720 --> 0:13:22.880 canned beans. Maybe just botulism. 0:13:22.960 --> 0:13:26.760 Yeah, don't quote us on any of that. I'm any 0:13:26.800 --> 0:13:29.880 of this. Moving on, moving on. 0:13:32.600 --> 0:13:35.400 We'll post the full recipe for that quarantine and our 0:13:35.440 --> 0:13:38.040 non alcoholic PLACEBA read it on our website, This podcast 0:13:38.080 --> 0:13:39.840 will kill you dot com and all of our social 0:13:39.880 --> 0:13:40.960 media channels we. 0:13:40.960 --> 0:13:45.559 Will well and on our website. I have a post 0:13:45.600 --> 0:13:50.640 it note. Check it out. You can find these sources 0:13:50.960 --> 0:13:55.800 for all of our episodes. You can find transcripts. You 0:13:55.840 --> 0:13:59.240 can find links to our bookshop dot org affiliate account, 0:13:59.320 --> 0:14:00.400 or our good reading list. 0:14:00.559 --> 0:14:02.360 I'm loving your dramatic pauses here, Aaron. 0:14:03.000 --> 0:14:06.760 You can find music by Bloodmobile. You can find links 0:14:06.800 --> 0:14:08.199 to our merch our Patreon. 0:14:09.720 --> 0:14:10.840 Can't read your own handwriting? 0:14:11.240 --> 0:14:15.280 I can't. I cannot read my own handwriting and alcohol 0:14:15.320 --> 0:14:17.360 free episodes. That'll do it? 0:14:17.960 --> 0:14:21.920 Fantastic, well done. Well shall we get into this, Aaron. 0:14:21.840 --> 0:14:22.280 Let's do it. 0:14:22.320 --> 0:14:24.920 I'm excited about it, me too. We'll take a quick 0:14:24.920 --> 0:14:25.520 break first. 0:14:58.200 --> 0:15:01.440 Like you said, Aaron, we've already it becomes somewhat familiar 0:15:01.520 --> 0:15:06.000 with the genus salmonella during our typhoid fever episode. Today, 0:15:06.200 --> 0:15:09.680 we're going to focus on all of the other serovars 0:15:09.800 --> 0:15:13.800 of salmonella and enterica, so you may or may not 0:15:14.000 --> 0:15:18.320 listeners And Aaron remember from our typhoid episode that typhoid 0:15:18.320 --> 0:15:22.960 fever is caused by a very very specific bacterium. It's 0:15:23.160 --> 0:15:28.280 Salmonella enterica subspecies enterica serovar typhee. 0:15:28.800 --> 0:15:33.160 Okay, Oh, I forgot about the subspecies part of it, yep, exactly. 0:15:33.840 --> 0:15:36.880 And I also mentioned during that episode that there's another 0:15:36.960 --> 0:15:40.920 serovar paratyphee, and there's a couple different versions of that, 0:15:41.080 --> 0:15:44.120 and together those sera VARs cause what are known as 0:15:44.360 --> 0:15:45.640 enteric fevers. 0:15:45.240 --> 0:15:46.800 Or the typhoid fevers. 0:15:47.480 --> 0:15:52.640 Okay, so let's refamiliarize ourselves with salmonella and talk about 0:15:52.720 --> 0:15:54.120 all of the rest of them, shall we. 0:15:54.440 --> 0:15:55.680 I'm excited, let's do it. 0:15:55.960 --> 0:15:57.160 Let's so. 0:15:57.360 --> 0:16:04.640 Salmonella enterica is a negative, facultatively intracellular anaerobe, which means 0:16:04.680 --> 0:16:08.280 it can live and grow both inside and outside oursells, 0:16:08.760 --> 0:16:11.640 and both with or without the presence of oxygen. So 0:16:11.680 --> 0:16:17.800 it's quite versatile, I guess. And it is present worldwide. 0:16:18.120 --> 0:16:23.080 It's absolutely everywhere. And today we're focusing on all of 0:16:23.080 --> 0:16:27.120 the non enteric fever causing seravars. These are often called 0:16:27.440 --> 0:16:30.960 nts non typhoid salmonella. 0:16:31.320 --> 0:16:32.360 Oh. 0:16:32.440 --> 0:16:35.800 So, there are over twenty five hundred, two thousand and 0:16:35.880 --> 0:16:41.200 five hundred serivars of Salmonella enterica that are in six 0:16:41.400 --> 0:16:42.920 different subspecies. 0:16:43.600 --> 0:16:46.400 Okay, so quick question, And I don't know if we 0:16:46.520 --> 0:16:52.240 covered this on typhoid, what makes a seravar a seravar? 0:16:52.520 --> 0:16:53.920 I knew that you were going to ask that, and 0:16:53.960 --> 0:16:55.120 I still don't really know. 0:16:55.880 --> 0:16:58.840 Did I ask that on sealin R have typhoid? 0:17:00.120 --> 0:17:05.280 I can't remember. I still don't fully understand because it 0:17:05.320 --> 0:17:09.960 gets into the like very confusing genetics of bacterial species 0:17:09.960 --> 0:17:11.800 and like how you define a species and how you 0:17:11.800 --> 0:17:15.960 define a subspecies. I don't know the answer, but we 0:17:15.960 --> 0:17:18.879 can at least narrow it down a little further because 0:17:18.920 --> 0:17:23.840 of those six different subspecies of Salmonella enterica, we're focusing 0:17:23.960 --> 0:17:29.600 on Salmonella enterica subspecies enterica. So all of the serovars 0:17:29.920 --> 0:17:34.399 that cause disease in humans and other animals are in 0:17:34.680 --> 0:17:40.119 this very specific subspecies. And there are over fifteen hundred 0:17:40.160 --> 0:17:43.040 different seravars just in this subspecies alone. 0:17:43.560 --> 0:17:45.520 That's yeah, wow. 0:17:45.920 --> 0:17:46.200 Yeah. 0:17:46.320 --> 0:17:50.440 Basically, all of these different sero of VARs have differences 0:17:50.480 --> 0:17:53.840 between them obviously that lead for them to have differential 0:17:53.920 --> 0:17:55.080 host specificity. 0:17:55.440 --> 0:17:56.320 So some of these. 0:17:56.200 --> 0:17:59.840 Ser VARs infect and cause illness in a really wide 0:18:00.119 --> 0:18:04.199 range of host species, and others have a relatively narrow 0:18:04.240 --> 0:18:08.680 host range, like for example, Typhie right, which really only 0:18:08.800 --> 0:18:13.760 causes disease in humans. But luckily for what we're talking 0:18:13.800 --> 0:18:19.040 about today, most of the non typhoid subspecies, the pathogenic ones, 0:18:19.200 --> 0:18:25.680 cause pretty similar disease. They cause enterocolitis or diarrhea, so 0:18:25.720 --> 0:18:28.440 that's why they often get lumped together as the non 0:18:28.520 --> 0:18:33.040 typhoid Salmonella group. They definitely have a range in their 0:18:33.080 --> 0:18:35.760 severity and like I said, their host specificity, so some 0:18:35.960 --> 0:18:39.560 might really only cause disease in birds or in reptiles 0:18:39.600 --> 0:18:42.640 and only rarely in humans, where others are much more 0:18:42.640 --> 0:18:47.320 common in humans, etc. And they can range in their severity, 0:18:48.119 --> 0:18:52.000 and they can also differ in their susceptibility to antibiotics 0:18:52.160 --> 0:18:54.199 for a number of different reasons. We'll get into a 0:18:54.200 --> 0:18:57.560 little more later, but an important thing to keep in 0:18:57.600 --> 0:19:00.880 mind is that when characteristics that make a particular sera 0:19:01.000 --> 0:19:04.800 var more invasive or more likely to cause an invasive 0:19:04.840 --> 0:19:10.119 disease a more serious disease, combined with characteristics that confer 0:19:10.160 --> 0:19:14.520 antibiotic resistance, those two things combined can make for a 0:19:14.520 --> 0:19:20.840 pretty dangerous seraph ar. Yeah yeah, Okay, So let's get 0:19:20.880 --> 0:19:24.080 into how we get this, shall we? I think everybody 0:19:24.119 --> 0:19:29.080 knows at this point. Yeah, just like typhoid, other strains 0:19:29.080 --> 0:19:31.680 of salmonella in erica, I might refer to them as 0:19:31.720 --> 0:19:34.160 just nts or salmonella. 0:19:34.640 --> 0:19:38.040 I mean, I say salmonella throughout cool I think the 0:19:38.080 --> 0:19:38.480 whole time. 0:19:38.560 --> 0:19:45.440 Yeah, these are transmitted primarily fecal oral in some capacity. 0:19:45.960 --> 0:19:48.719 Poop is where these bacteria. 0:19:48.240 --> 0:19:52.359 Come from, and poop has to somehow make it into 0:19:52.400 --> 0:19:56.520 your mouth. Salmonella is really a gut pathogen. It's found 0:19:56.640 --> 0:20:00.639 as a commensal organism in the guts of a lot 0:20:00.720 --> 0:20:05.040 of different animals. So salmonella can make its way into 0:20:05.080 --> 0:20:09.360 the soil or the water wherever there is fecal contamination. 0:20:10.280 --> 0:20:13.280 But even if they're naturally in the gut of an animal, 0:20:13.320 --> 0:20:16.000 that doesn't mean that they should be in anywhere that 0:20:16.040 --> 0:20:19.560 they would come into contact with the food supply, right, Like, Okay, 0:20:19.600 --> 0:20:21.600 they're in the gut, they shouldn't be in the breast, 0:20:21.640 --> 0:20:23.800 they shouldn't be in the meat, they shouldn't be in 0:20:23.840 --> 0:20:26.480 the feathers, they shouldn't be anywhere else except for in 0:20:26.560 --> 0:20:27.440 the gut, right. 0:20:27.960 --> 0:20:28.240 Yeah. 0:20:28.800 --> 0:20:32.840 And also like salmonilla typhe that we talked about the 0:20:32.880 --> 0:20:36.040 other serivars of salmonilla do tend to require a relatively 0:20:36.119 --> 0:20:40.680 large infectious dose, upwards of fifty thousand bacteria in order 0:20:40.720 --> 0:20:44.359 to establish an infection. That's a lot. It is a lot, 0:20:44.800 --> 0:20:48.040 but these bacteria can grow to be in really high numbers, 0:20:48.359 --> 0:20:51.080 as we'll talk about in just a second. So when 0:20:51.119 --> 0:20:55.600 you get exposed to a pathogenic serivar of salmonilla, you 0:20:55.680 --> 0:20:58.400 eat it right on your chicken. 0:20:58.160 --> 0:20:59.560 Casserole or whatever. 0:21:00.880 --> 0:21:05.160 It travels through your stomach, through your intestines, and generally 0:21:05.320 --> 0:21:08.480 establishes an infection in the terminal ilium, which is like 0:21:08.520 --> 0:21:11.680 the last bit of your small intestine, or in your 0:21:11.680 --> 0:21:14.159 colon the large intestine. Those are the two areas that 0:21:14.200 --> 0:21:18.080 salmonella likes. Asterisk, I'm talking about human infection. I know 0:21:18.240 --> 0:21:19.920 nothing about the guts of other animals. 0:21:21.520 --> 0:21:23.520 Why does it like those areas? 0:21:23.920 --> 0:21:27.320 I think that that's just where it makes a great 0:21:27.320 --> 0:21:31.480 home in the epithelium. Okay, the epithelium is different throughout 0:21:31.480 --> 0:21:34.120 your whole rest of your gut, and your small intestine 0:21:34.280 --> 0:21:36.480 prior to that has a lot of like villi and 0:21:36.520 --> 0:21:39.359 all these little things that I don't know exactly why, 0:21:39.600 --> 0:21:41.920 But that's not where salmonella likes to make its home. 0:21:42.200 --> 0:21:42.560 Okay. 0:21:44.440 --> 0:21:47.439 Now, once it's there, they sort of grab on to 0:21:47.520 --> 0:21:52.080 that epithelium and they have a number of different virulence 0:21:52.119 --> 0:21:57.159 factors that what they do is induce a huge amount 0:21:57.320 --> 0:22:01.719 of inflammation, especially neutrophills, which are often one of our 0:22:01.840 --> 0:22:04.480 first responders, one of our first white blood cells to 0:22:04.560 --> 0:22:08.040 like rush into the scene, and they induce a ton 0:22:08.119 --> 0:22:10.960 of this. So you have tons and tons of neutrophils 0:22:10.960 --> 0:22:15.520 and other like inflammatory cells cytokines rushing to the area. 0:22:16.119 --> 0:22:18.840 And this all starts to happen. Within one to three 0:22:18.920 --> 0:22:22.959 hours of an infection. You see massive amounts of inflammation 0:22:23.280 --> 0:22:26.800 coming in. To try and fight off these bacteria, we 0:22:26.880 --> 0:22:29.600 start making a whole bunch of proteins, We start secreting 0:22:29.640 --> 0:22:32.520 things to try and fend off these bacteria, and then 0:22:32.560 --> 0:22:36.080 within a few more hours is when the diarrhea starts. 0:22:36.320 --> 0:22:38.640 Okay, So symptoms. 0:22:38.080 --> 0:22:41.320 Start within like six to twelve hours after exposure, but 0:22:41.680 --> 0:22:46.800 after the development of this intense amount of inflammation. Right, So, 0:22:46.840 --> 0:22:52.560 typically the symptoms are a pretty acute onset of really 0:22:53.000 --> 0:23:01.520 painful crampy crampy abdominal pain, and watery diarrhea. Sometimes this 0:23:01.640 --> 0:23:05.320 diarrhea can be bloody, especially more common in kids who 0:23:05.359 --> 0:23:09.080 tend to have even more severe inflammation. And then it's 0:23:09.119 --> 0:23:11.480 also not uncommon to have a lot of nausea and 0:23:11.520 --> 0:23:14.359 vomiting because your whole colon and that last part of 0:23:14.400 --> 0:23:17.280 your small intestine are just full of inflammation. It makes 0:23:17.280 --> 0:23:18.960 your whole guts really angry. 0:23:19.480 --> 0:23:22.280 To your body is just like, get everything out of 0:23:22.359 --> 0:23:24.000 me now, exactly. 0:23:25.320 --> 0:23:30.200 And the good news is that without any treatment whatsoever, 0:23:31.320 --> 0:23:36.119 Salmonella entercholitis salmonella related diarrhea tends to be a self 0:23:36.160 --> 0:23:38.760 limited infection that does clear up over the course of 0:23:38.800 --> 0:23:41.439 about a week, which is a really long time to 0:23:41.480 --> 0:23:44.520 be having massive diarrhea and nausea and vomiting. 0:23:44.400 --> 0:23:46.479 Right and not being able to keep anything down. 0:23:46.680 --> 0:23:49.320 Yeah, So as long as you can keep something down, 0:23:49.359 --> 0:23:52.399 as long as you can stay hydrated and avoid electrolyte 0:23:52.400 --> 0:23:56.280 imbalances from this diarrhea, then you're going to be okay. 0:23:57.000 --> 0:24:00.959 And in general, antibiotics are actually not recommend it, Like 0:24:01.040 --> 0:24:04.480 the CDC, the World Health Organization, it's generally agreed upon 0:24:04.640 --> 0:24:09.160 that for this type of self limited diarrhea, you generally 0:24:09.240 --> 0:24:12.880 don't give antibiotics, and the only times that you do 0:24:13.000 --> 0:24:16.919 are if there are specific risk factors that make you 0:24:17.000 --> 0:24:20.320 think that this is likely to become an invasive infection 0:24:20.640 --> 0:24:23.200 or you have very high risk of it just being 0:24:23.200 --> 0:24:26.600 a really severe diarrhea, like in our first hand account, 0:24:26.720 --> 0:24:30.919 if you're not keeping anything down, then of course something 0:24:31.000 --> 0:24:35.920