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18 - FOOD POISONING

This Won't Hurt A Bit podcast.

July 07

Every year, 1 in 6 people get food poisoning. But, what is food poisoning? What should you do if you get food poisoning? What causes it and how do outbreaks happen?

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way gonna get this thing started. We're gonna do this. Yeah. Yeah, we're gonna do it. You know why we're gonna do it? Because this this this

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this viscous vis vis vis a vis I bought sushi eights and bed crab legs. A food marked as like a duck on a stick. Macaroni salad may not have been duck spicy tuna roll. It was delicious of each. And it was great when it was served. Barbecue, chicken salad, rock, oysters. I'm up all night into the next day and I was constantly vomiting into a bag in the car. Uncontrollable vomiting and diarrhea in someone else's house. Yes, it is indeed possible to have things come out of you from both ends simultaneously vomiting on myself. While I was on the toilet, it just was literally black liquid. Adam, I took us for our first house.

That scene from aliens, this chest burster things, that's what That's what I thought was going on. And I really thought I was gonna die. Have you called? My mom helped me out, but I was basically, like, the most miserable person on the planet.

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Yeah, I despise food poisoning. I feel like I'm getting it all the time. Yeah. Is that true? Do people get it a lot?

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It is fairly common, and I think we should talk about it. What? Food poisoning is what causes it, how to outbreaks happen. And how do

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we treat it? So in this episode of this one had a bit. We're going to talk to infectious disease docks and food scientists, little bit food poisoning. So we'll talk about outbreaks of popular chain restaurants And what to do if you get food poisoning. Dave, my name's Dr

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Middle Herbert. And I'm Dr Jess

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Mason, and I am Dave Mason. Food poisonings Much more common than most people realize every year. Get this. One in six people gets food poisoning. And there are more than 250 different food borne diseases from bacteria viruses. The fungus is the parasites.

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But thankfully, Dave, we are not gonna talk about all 250 today. We're only gonna discuss too, and two of the more common ones of the bacterial causes. So we're gonna focus on staph aureus and E. Coli one. A lot of people think that food poisoning on Lee comes from certain foods like raw eggs, for example, or fish. And that's true. It can. But it can also come from any food, from a cow to a cucumber to a

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candy bar. Staphylococcus was first described or identified in 18 81 by a Scottish surgeon. So Alexander Austin, who were studying the cause of wound infections, he named it staff for the Greek work for a cluster of grapes because that's what it looks like under a microscope. And I'm sure this is how he talked. Yeah, that sounds Northern dialect.

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Yeah, that's pretty much right on the button there, But it does turn out that staff is everywhere. It's not just in wound infections. It's certainly in wound infections, but it's also in the air. It's on your skin, and it is in your food. Well, staph aureus

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is pretty much everywhere. That's Greg Moran. He's an emergency physician who's also a board certified in internal medicine and infectious diseases. He's a triple threat overachiever. So

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you know, we probably all eat a bunch of staff that sitting on our food all the time, and if it's small amounts and if it's not producing a lot of toxin and it hasn't been sitting there at room temperature for a long enough time for those bacteria to grow and produce that toxin. You're not going to get enough in it to really

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hurt you. Okay, so it's the toxin that's hurting you and not the bacteria. So if I just say like a huge bowl full of staff, right, I was somehow to like, get staff and put it in a bowl. It's not the staff that's gonna make me sick when I'm eating it, it's It's the toxin that the staff is producing that's gonna make me sick, right? Yeah. In this case, that's true. It's the toxin. That's sort of the byproduct of the staff replicating that's gonna make you sick. But Dave, I do not suggest that you eat a bowlful of Steph because at that level,

stuff is probably gonna take up residence in you and do other bad things. So here, ladies and gentle boys, girls don't eat both fools of Steph. You've learned something already,

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and we could say one out of two doctors does not recommend. So

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I have to return my Costco size

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staff. But it was so cheap. Bacteria is a living organism. This is Lin Muk Lands, bro. She is a food microbiologist and a professor at the University of Massachusetts. Amherst. Toxin is something the bacteria makes. While it's growing, it's a byproduct of their job. We call it a toxin because it does something adverse in the body, so we call it a toxin win. Small amounts of it make is very sick

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and most classic way to get Steph food poisoning that they teach to every medical student, a nursing student and everybody does. Health care is from where that's right, the potato salad at the church picnic. So a little cluster of Steph that looks like Concord grapes just happened to be hanging out in your potato salad. It's 86 degrees outside,

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and that's the Steffes favorite temperature to replicate.

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So first the potato salad was chilled. But as it warms up in the sun, step get s'more. Lord Holm start replicating and replicating more and replicating some more on replicating some more

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each time it replicates. It makes this super toxin called Step into our toxin, and even just the tiniest amount of this can make you sick. Get this 200 nanograms can cause illness new. Ask yourself how much is 200 nanograms? Well, that's about 11 Thousands of a grain of sugar and debts and man is no. So let's say you take a bite of this delicious, creamy, chunky potato salad, and there are no clues at all that it's sprinkled with toxin. Swallow it. It travels down your esophagus and into your stomach, and your stomach churns up the food squirting out acids. And this normally would destroy most bacteria. But not this toxin.

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So that toxin gets absorbed into your stomach and your intestinal cells that activates the centers in your brain to tell you to throw up and go poop a lot. And so bam, just like a bolt of lightning without any warning, you're running to the bathroom works built that toxin.

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Harry, are you in there? Be

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right out when you're running into first and you think you're going first. What happened? If it isn't expelled from you because there's such a violent reaction your body has to this toxin. What if you just took a bunch of like Dramamine or something to keep you from throwing up and and a modem from, you know, Bazooka king in the toilet bazooka being busy inking well in this case in this told, I don't think it would do too much it eventually you'd probably just break down. But there's probably no drug that we have in all of medicine that can stop you puke ing and vomiting and diarrhea. And at this point, it is so powerful. This stuff. Yeah, it's super powerful.

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So when it happens like this, when there is a toxin that's preformed that you eat and it makes it very sick. We call this classic food poisoning, and that's why it happens so fast, usually within an hour or two. If you say I'll cook it, I'll make it safe and cook it. You might kill those Steph orients that were growing in that ham, but you won't kill the toxic so that when you consume that Pam, you could still

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What does cooking your food protect you from?

It protects you from most bacteria and toxin, but this doesn’t work with Staph because it is heat resistance. Some studies show you have to heat your food up to 250 degrees Fahrenheit for over 10 minutes before the Staph breaks down.



get so what you're saying regardless of what I eat. The ham, the bologna sandwich on the bus, the potatoes out of candy bar, whatever. If it's got staff on it and I cook it and heat it up, that's not going to kill the toxin. I'll still all still ingest the toxin, and it will cause a

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rough night. Right? Cooking your food protects you from most bacteria and toxin, but with staff, it's super villain. Power is heat resistance. That's pretty unique to Seth.

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So what temperatures can it survive in? Like, what's the upper limit? Where I know I'm gonna kill it. What's the degrees? So some studies show that you have to heat your food up to 250 degrees Fahrenheit for over 10 or 11 minutes before that. Steph breaks down, so that's pretty hot for a fairly long time.

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It's hot that's hotter than boiling temperatures.

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So what that means is, if you've got a little bit

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of food that you think may

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be a bit off, maybe this little staff food poisoning in there little toxin, then he'd have to take that hand, for example, and reheated to 250 degrees for 10 or 15 minutes. People just don't do that. You have to cook it almost as much as when you first cooked it and the potato sell. Nobody wants potato salad cooked a 250 degrees for 10 minutes, Let me

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tell you. Yeah, so anyway, okay, so that staff staff is on you. It is in you and it is everywhere. And the best thing you can do is thio. Decrease chase out in the winter. Refrigerate. It is the bottom line. Watch food, wash your hands. Refrigerate your food. Decrease the chance of eating a bunch of toxin

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to E. Coli. So food poisoning from Steph is fairly common. Bruce, it's, you know it's all over the place. But what's really likely to land you in the hospital because it's gonna make you much more sick is another bacteria. This bacteria is called E. Coli. Now Kali is everywhere. It's all over you. It's certainly in you, and especially in your poop, we

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live in a world full of poop. In fact, even the first world is full of poo, believe it or not. And there are many infections that are spread by what we call the vehicle aural contamination route in which, yes, you're eating poop. We all do face it. Just deal with it. You were all you everyone listening here each microscopic amounts of poop on a probable daily basis. So I'm not trying to eat poop. What? No, I'm usually

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not trying. Really That's good to know you haven't had my

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code. I have high standards. But then how is this happening? And why am I eating animal poop all the time? Be coli in general is good for us. We love E. Coli were all full of E. Coli. Each one of us has trillions of E. Coli and our guts. They're good to us if we're good to them. But certain strains of E. Coli can be problematic because certain strains of E. Coli have toxins that can again make us

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sick. So there's no more lamentably calling us, and that's good and they're helpful. We like

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them. But if

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you get one of these other bad strains of you call India got, they can make you sick. They take over. I can produce things like traveler's diarrhea. You

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go down to Mexico, some other developing countries someplace where maybe the water isn't treated as effectively or the food gets contaminated with it. And that's the classic cause of traveler's. Diarrhea is actually E. Coli, which is the bacteria that were all full of. But if you get strange that are different from the strange that normally live in your gut, they were replaced. Those strains. There's an epic battle going on of the good E. Coli and bad E. Coli in your gut, and until that gets sorted out, you will get symptoms of diarrhea and sometimes vomiting.

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So let's go over this again. Be very clear. Most E. Coli, your friend. You can talk

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to them but your friends. But when new strain comes to town, they've got to sort out their differences in your gut, and until that happens, you're probably gonna get a little bit of diarrhea. But that's not the type of E. Coli food poisoning that makes you really,

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What is the super power of E. coli?

They have the ability to break down your intestinal wall, get into your bloodstream, and make toxin in you.



really sick. There's a couple of strains by the names of 015787 and 0 26 These strains can make you

11:14
What is the super power of E. coli?

They have the ability to break down your intestinal wall, get into your bloodstream, and make toxin in you.



really sick, so we remember from staff. The superpower was heat resistance, but with E. Coli, they're super power is they have the ability to break down your intestinal wall and get into your bloodstream and make toxin in you and E. Coli eyes toxin. It's really bad, and it's called Shiga toxin. So let's say you're gonna grill up some hamburgers for dinner, and you, like many people like it medium rare, right? Of course, doesn't. Who doesn't? But inside your hamburger Patty,

it's pink, and it's bursting with delicious burger flavor, but it's also bursting with some nasty strains of E. Coli. Because you see E. Coli, it was in the G I tract of the cow, but during the slaughtering and butchering and grinding, a little of the gut flora got thrown in the mix. And now it's in your unsuspecting hamburger, so you take a bite of your juicy E. Coli bird. This'll

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time when you eat that E. Coli, because that's basically what you're eating. It goes to your stomach.

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It has the ability to attach to your intestinal wall.

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Gets about sort of sitting up house. This is a nice place to live. It starts to replicate, and it's tough to replicate, and it sort of invades into the tissues that line you're get. And then it starts to produce toxins. As part of its growing cycle,

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the chicken toxin goes into the cell surface along the intestine, and it can actually kill the cells along the intestines. You can also get into the bloodstream and go through the body,

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so you start to get Billy Payne and you start to bleed and you start their bloody diarrhea, and you also get sort of the nausea and the vomiting as well. So now you've got this horrible combo is that you're nauseous. You're vomiting, you've got diarrhea, there's blood in your diarrhea, and you also can get a fever. Your mother or grandmother used to call this dysentery. It's bad.

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Very bad. In addition to the pain and vomiting and bloody diarrhea, the toxin from these bad strains of E. Coli can also cause something much, much worse that can cause a syndrome called hemolytic uremic syndrome. Where these toxins actually get into our system, they could break down our blood cells. They can damage the kidney. They can cause neurologic symptoms

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and can in some cases, be fatal. So hemolytic uremic syndrome can occur in as many as 10% of people who get this bad strain a bucolic, especially in kids under the age of 10 years of age. So just as Dr Moran said, it could make you anemic, it can cause kidney failure. It could even cause neurological problems, and sometimes it can even kill you. This is a bad player. So E. Coli is like a little coding of seasoning on any steak,

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a seasoning on.

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It's going to get cooked off right under under extreme temperatures. But it's when you start grinding up that steak and it's getting all mixed in the middle. That's

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problem exactly. You got it, Dave. So there might be E. Coli on steak, like you said, but it's on the outside, so you cook it. You've killed that E. Coli, but it's when it's ground up, just like you said. It's all mixed in. And that's why, with hamburger meter ground meats, you have to cook them all the way through. If you really like that pink like raw meat tastes juice. Yeah, the pink juice. It's safer to get your steak like that, then your burger

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and this happens to me all the time, and I literally happen to me like two days ago. So I'm going to a hamburger, joint, Thai and hamburger joint, and it's really good. And the gentleman, they says. So how would you like your hamburger done? I'm like, Well done place cooked all the way through, like Excuse me, sir. Yes, I want it. Well done. But no, I want it well done. He didn't go on to say, Ask me why? Because I would have said because they're poopie in the middle

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of What?

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If you grind your own burger, What if you take it by your own

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stay? Yeah, that's probably

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a lot safer. Grindley Neuro mean greater the way that could work. If you washed the ads out of steak and flush a league away off and make sure that everything else is clean and then you ground your own, it's probably be much safer, but that a food processing that occurs, you know that these two be joined plants. And if you want to do it, that's

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Dave got really bad food poisoning. We went to an unnamed, really expensive hamburger place. Donald's Theo Angus Quarter Pounder. Only the best. The Royal Allergies way went to this really expensive place, and they had the most expensive burger on the menu. Was was like 80 bucks, something like that. I was like Dave Foley was $200. Yeah, I wasn't gonna do it. He wasn't gonna do it

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like $100

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on a burger was like Dave, do it, Do it you love burgers once in a lifetime opportunity to eat this burger, get it? And he's like, knives. The guilty as they get it. So he got it. He ate the burger. So good. Best burger he's ever had, right? Yeah, Most delicious. Like

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two hours later, it all came out. Okay, maybe it wasn't the hamburger. Maybe it was the potato cellar with staff staff still get that still eat again. It's super good.

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Nearly two dozen Children died after eating free school lunches. The health department says

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80 people got sick after eating at Mariscos restaurant

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Bluebell Icecream recall this spring for listeria contamination. A bakery in Sydney's South has been shut down following a serious salmonella outbreak. One mother says, Don't eat chicken might be to blame. Every so often, Ah, food will get contaminated and that can make a lot of people sick. So here is Dr Vanessa Carty to tell us more. There are very many different strains of E. Coli, but by Father, Nastiest and scariest is E. Coli 0157 h seven. In 2006 there was an outbreak of the strain in 29 U. S. States, and it was linked to the consumption of roll bagged spinach.

Spinach have been grown in California on a farm where the water irrigation system was contaminated with fecal runoff from Angus cattle and possibly also some wild deer. What was particularly difficult about this case was that the bacteria had been absorbed into the plants themselves, so washing and rinsing the leaves before consumption didn't remove the bacteria and the toxin. Outbreaks of bloody diarrhea and dehydration ensued, with 276 people falling ill, 31 of them developing hemolytic uremic syndrome and three people actually dying from the food poisoning. 10 years after this spinach outbreak, some of these dangerous strains of E. Coli well, they're still causing some major outbreaks. A local Chipotle restaurant was temporarily closed after dozens of customers reported getting sick.

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So in the news recently here in the U. S. Chipotle Fast Food Mexican restaurant, which is spectacular, is not part of the bomb. So they recently unfortunately suffered a multistate outbreak of food poisoning. With these two dangerous strains of E. Coli that we've been talking about

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and as many as 55 people got sick, causing the chain too close many of its restaurants, and they had a huge plunged 50% decrease in their business at the time. How

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does the CDC know when there is an outbreak at a particular place? How does that information get sent to them? And then they know like, Oh, it was Chipotle, eh? That's the problem. And not like all these random little things. Yeah, this is a really cool thing, because you can imagine, Like, if you get sick over here and somebody gets sick over there and how could you possibly sort of work at where it comes from? So in the E s is surveillance that's supposed to occur all the time. So if you are sick and you got bloody diarrhea and you're really sick and you go see just what she does after she makes you feel better is report this disease to the hospital and then the hospital reports it to a local health agency. Those health agencies report all of these cases to a centralized area all from the CDC, and the CDC is always looking.

And there's always some food poisoning going all the time. But when they see a big spike that all these reports coming on from L. A candidate. Go hang on a minute. This is way above normal. Something bad going on your primary care doctors doing the same thing. The pathologist that works in the hospital is doing the same thing. If he sees an E. Coli 0157 h seven strain in some poop that's been sent to him. Oh, heard they have descended on till the CDC. So all of this comes together and gets reported to sort of local agencies than state agencies and then even federal agencies, so that they can go there is an outbreak. Then they send their investigators. From where did the badness

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come? They asked a bunch of people when they ate what they ate, where they ate which restaurant they visited. They did gene sequencing to trace the types of infection. And then the company was working on it itself. But unfortunately, they did not find an obvious source. It could have been the lettuce, the salsa. It could have even been sorry. Mel, Some of the beef from Australia.

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No, I don't believe it could be that. So the company sent a really good job that double down on their food handling practices and tried to clean things up a CZ much as possible. But it's a really good reminder that even though you've got the full weight of CDC experts and government agencies and even the company of themselves trying as hard as they can, sometimes you can't find out where this stuff came from. Often they do, but sometimes they can't. So remember, next time you get sick and your shore, Dave, it was that really expensive burger you had last night at Jimmy's home of undercooked Pettys and beer. Finding the real culprit sometimes can be very

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difficult, so don't give your dog a hard time if they can't confirm your gut feeling that the source was that place you ate last night.

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S. O. You mentioned earlier that there are some really crazy toxins out there, like in the 250 category. I'd like to hear just a couple entertainment, all right, I think there's two really interesting ones that took me up. So there's this really interesting food poisoning called secretary food poisoning. Sometimes if you eat a fish contaminated with the little guy called a dino fledge late and it's little sigur toxin. You can develop crazy neurological funding. So in addition to the usual nausea, vomiting, diarrhea, you can now get muscle pain. You could get numbness. You get vertigo like the whole world is spinning. You can start to get hallucinations, and you get this thing called Cold Caledonia

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cold. Aladin Eah, It's this burning hot sensation when you touch something cold, but it's something cold. It feels burning hot. So your nerves are backwards for

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hot and cold switched. Thank you. Some crazy toxicologists even think that you can transmit this toxin sexually so your snuggle bunny might get symptoms as well. What? That's a crazy, although you probably don't want to be having sex with people that are vomiting and having just say that a good thing. So while the symptoms usually they lost a few days, it has been reported that you can have these symptoms on and off for years.

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Yeah, and this toxin really messes with your nerves, and unfortunately there's no known treatment.

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What fish do I need to avoid? So this does not happen to me or just It happens in a couple of different fish, But Barrack Oudeh is the classic fish. Okay, so just avoid

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barracuda. And there's another crazy one David's called Skomal Roid, and it comes from a fish like mackerel or tuna or

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bonito. So if you take these fish and you leave them out and the bacteria is in there, the bacteria start to digest the fish, and in the process they convert some of the muscle, which is history Dean, into this stuff called histamine. Now histamine causes facial swelling and flushing and sweating and burning so peppery taste on your tongue and people with asthma can actually have full on asthma attacks from this bed.

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Yeah, but the good news is that we do have medications for it that can help, like epinephrine and anti histamines like Benadryl.

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So just like everything else in life with food poisoning, don't leave at your tuner to rot before you eat it. You know, don't take a tuna sandwich and living on the back of the bus for six years. In fact, there was a big, huge number of cases that occurred at USC County L. A. About 10 years ago, when about 13 or 15 people came to the amounts apartment all red faced and sweating and looking bad, and Billy Melon walked in and said that scoreboard first poisoning. And sure enough that it'll eating at the same restaurant. He must have been trained for a long time To be. Just walk into a room like this is what you got. I'm done. Drop the mic recognition. Seen it before.

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Well, he's super smart. So, Dave,

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as you can imagine, a person can lose a lot of fluid with food poisoning your puke in your diary ring. And at first it's just sort of the floor that's in your stomach and your intestines. You just flushed. But if you've got it really bad and you keep vomiting and you keep having lots of diarrhea than your body, Aquila berates. So you start to shift fluid from all over your body into those cells. So over time you lose a lot of fluid. And in that fluid is a lot of electrolytes, things like sodium and potassium. And so just putting back water if you're really sick is not gonna replace those electrolytes. And if you don't replace those electrolytes, you could make yourself even more

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sick if you cannot keep any fluids down whatsoever. for hours and are vomiting large amounts, having large amounts of diarrhea. That's getting to the point where you're feeling weak and dizzy. You know, you feel when you stand up, you're feeling like you're gonna pass out and you're unable to get enough fluids in your mouth to try to correct that. That might be a situation in which you may need

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to go to the emergency room. So places like the W H O of these w hat you who? The World Health Organization, Who exactly? They've got these sort of replacement fluids that they suggest for people that are really dehydrated. And they've got little fluid electrolytes. Good stuff. So you can buy pre made versions of this like Pedialyte. So it has a little fluid, has little salt, has it'll glucose? And the glucose is in there because it actually takes energy. Your guts, as cells require little energy to absorb that fluid. So it's little bit of water, a little bit of soul, a little bit of like PDO.

I've had that before with food poisoning. If I had to pick one, it has to be cherry flavor, a guess, But grape, I can't d'oh now another really important thing that comes up in people asked this all the time. Well, what about just Gatorade? Because that was made to rehydrate. Well, that's actually not the best fluid solution. That's Ah, got too much assaults and too much sugar in it. So if you're going to use Gatorade to rehydrate yourself, most people say deluded about half and half half a cup of Gatorade and put 1/2 a cup

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of water in There is a way to do your own solution that you can make. According to the W H O. You can take a leader of clean water and add one level teaspoon of salt, and then you add four heaping teaspoons of sugar and you mix it all up, and that works pretty well for most people. Sometimes when people get sick, they feeling dehydrated, so they'll chug a hole bottle of something all at once, and then it's just gonna come right back up again. But sometimes if you try just tiny sips, just take 1/2 sip wayto half a minute, another half sip. Wait a minute, another half set. Very tiny amounts like that often will allow you to get enough fluids into keep you from having to go to the emergency department. So in the e. R,

we have some advanced technology. We have the ability to give you fluids through your vein. We call it an ivy. Is this alien technology exactly so in the E. R will usually put in an I V. If you're not able to hold down fluids and rehydrate

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you that way? You know there's another really crazy way we can hydrate people in the ear, and it's done in kids. And it's done in vet institutions. Is that you can put the fluid subcutaneous Lee, you say, like a bullets, right? So they stick these needles under the skin and they give you a big bowl of fluid, and then you absorb it from under skin. So they do that in dogs and cats and stuff, but it can actually be done in humans and in some Third World countries. They do that fairly frequently, cause I can't get an I V, and I put the little metal under the skin, give you some fluid under the skin, and then you absorb it. Weird,

27:3
How can we avoid food poisoning?

Food preparation is crucial. Keep your cooking area clean. When you cook stuff, don’t put it back with the raw stuff. If you’re traveling, boil it, peel it yourself, cook it, or forget it.



Nice, very

27:4
How can we avoid food poisoning?

Food preparation is crucial. Keep your cooking area clean. When you cook stuff, don’t put it back with the raw stuff. If you’re traveling, boil it, peel it yourself, cook it, or forget it.



cool way. Avoid all of this food poisoning. Now cook it. Clean it. What worked? What was very simple. Stop eating. Yeah. So what's the food? Preparation is really important, and there's a science to sort of keeping things clean. You know, everybody knows this. I think that, you know, you keep your kitchen clean, you wash stuff off.

If you're preparing meat, you don't prepare the salad next to make this kind of thing. Wash your food's. It's all pretty basic stuff. But it's not that basic. Because I've seen people in my family in particular makes him really grievous errors, cause I didn't quite understand it. So my brother would take steak and he'd marinated up and he'd leave it out in the marinade for hours and hours, and then he'd throw it on the barbecue and make these great steaks, and then he would take the stick and dip it back. A marinade, no bad idea. So just remember when you cook stuff, don't put it back with the roll

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stuff, and then if you're traveling a good tip, remember is boil it, peel it, cook it or forget it. So what we mean is boiling it obvious, right? Most food that you boil, you're gonna kill the bacteria and the toxin because most them can't take it except for staff

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Intro toxin 50 and peel it because fruits, if you peel it yourself really unlikely to have bacteria inside them. But we say peel it yourself because the scenario could be you're a little vendor. They've got some nice fruit there. They peel it for you in the vanity, but unfortunately the little vendor,

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he's got a little bit of poopy under their fingernail,

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and they're handing you a nice piece of orange, plus a bit of poopy good travel toe. Excellent travel Tip. I will peel my own fruit

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and then cook it for the same reasons because it kills most bacteria

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and toxins. And if you can't do those things, then forget it. Just have a beer, and that's usually sterile, so you'll be fine or two. I mean, that's what vacations

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for here is the safest and most delicious for traveling options,

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and you need some extra calories so motive to have three or

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four. And also remember that if you're really dehydrated, take frequent sips of water or a deluded sports drink. And if you really can't keep fluids down. Just come and see us in the air.

29:3

And if you're having bloody diarrhea, you've got that dysentery syndrome. Just come and see us in the here. And in fact, I think it is a good general rule that if you go to the bathroom and out comes blood with your poop, you should probably come into this.

29:15

Just come see us. Yeah, but please, if you do come in, please do not bring your poop in a bag. If I had a dollar for every time someone brought me poop in a bag, I'd have $2. You think you'd be more? Actually, I would. I would think every more. Give

29:32

me time. Wait. How's that presented? How does that go down?

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Give us The senator was like, That is how you doing? Um, look what I have. I'm pooping blood. And if you would just pick up my coat and reach into the pocket, what you will find is poop in a bag. And if you take

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it out, you contest like the fact that he's asking or she is asking you to reached into the co poppers. They're not presenting it like hey, over there, Richard. Mr. Smith, continue right now that there is no chance in hell that I'm reaching your pocket to pull out your bag of poop. Is it in like a nice brown paper bag? Double seal turns purple. So, you know, you've linked up the inside happen. Don't do that. You've got plenty more poop. We

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know where to find. I prefer to collect my own sample. Thank you. That's when I snap on my gloves. Paid for that night hunched over the toilet. This episode of this one

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hold of it was written by Jess Mason Day Mason and Mel hoping Praying Music by Matt Echols and sent

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Cecilia promising that I would be a better person if I could just get through whatever it was that

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was happening to me. Produced by C. C. Herbert and Bill Kona Sanders on Bible Kona,

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Can you edit out anything that makes me look anything less than glamorous, sir? Beautiful, please. And a big thanks to the voices who helped make this episode. Sean Collier, Dr Matthews, Emmy, Jeffrey Berra, Brad Shultz, Dr John Queen, Dr Jared Howe, Dr Susie Shimoyama, Dr Greg Moran, Dr Vanessa Cardy and Lynn with lands grow.

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This one hood a bit is a production of fool. Abou incorporated the information you here on this one hood of it should not be taken as actual medical advice. You have actual medical questions that actual medical things. You should see an actual medical practitioner even though we are actually doctors were not your actual doctor. So be sensible and give it real. And this this

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this this this, this viscous suspense, this business out of it.

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