Dysentery

[JohnN]

I checked. You have something wrong. There is no bear on the link?

A common mistake. I think the reference must have been an Ed Talk:
[video=youtube;y_PZPpWTRTU]https://www.youtube.com/watch?v=y_PZPpWTRTU[/video]

 

[tridacna]

This thread is now simply FOS.


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[ggunn]

He was referring to a movie about a foul mouthed teddy bear. They showed a trailer during the Super Bowl where they are sneaking into Tom Brady's house to harvest his uh, seeds.

Yes, I know about the movie though I haven't seen it. The reason I posted what I did was (as I said) I did not know if he was kidding or not, though, of course, he usually is.

---------- Post added February 9th, 2015 at 09:01 AM ----------

I checked. You have something wrong. There is no bear on the link?

Try this one:
https://www.ted.com/talks/jon_mooal..._it_reveals_about_our_relationship_to_animals

---------- Post added February 9th, 2015 at 09:02 AM ----------

This thread is now simply FOS.


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That, too has a bear connection:
Fozzie Bear - Wikipedia, the free encyclopedia

 

[Mossman]

You should avoid eating raw or undercooked eggs and meat or unpasteurized milk and cheese. Don't order your hamburgers rare (never, anywhere!) Drink bottled water with intact seals, don't eat salads or fruits in 3rd world countries unless you feel confident that they use clean produce and water and practice good hygiene. Eat fruit that you can peel yourself (or scrub well with bottled water first.) Be careful with iced drinks and ask how the ice was made - if they just freeze the local water then order beer or wine or bottled/canned soft drinks. Sure, it is easier and more fun not to bother with these inconvenient precautions, but the ramifications of blissful ignorance can be serious and long term. It's kind of a Russian roulette game, you may be fine but you might not be so lucky.

If undercooked means not hard-boiled, I always order my eggs undercooked. I prefer my hamburgers medium-rare, not totally red in the center. I have no confidence in how my salads are prepared since I don't go into the restaurant kitchens to inspect. I always trust the ice in Mexican restaurants.

The fact is that there are a lot of tourists, ex-pats, and even "locals" that eat out at the restaurants that serve undercooked eggs and burgers as well as salads with questionable pedigree. So it's not really Russian roulette unless you're playing the game with a fully-loaded gun.

BTW, you must not be a diver. Aside from dive maladies with discernable causation, approximately 1 in 10,000 dives will result in an "undeserved hit". Diving is basically like playing Russian roulette and the odds are relatively the same as eating undercooked eggs and burgers and questionable salads in popular dining establishments.

Heck, walking around town is like Russian roulette in that it's quite possible to get run down by an errant taxi cab. There is the potential for violent crime. I've slipped on wet marble floors and cracked my head - fortunately I have a thick skull, but there's no doubt others would have been done in by the same fall. Airplanes may fall on your head. Tsunamis could wipe out the island. I never thought the latter was an issue until I found myself on a boat in the Andaman Sea during the Boxer Day Tsunami. Who would have thunk?

So my professional recommendation to you is to stay at home in a hermetically sealed steel-reinforced compartment, sterilize everything you eat, drink, and breathe at 800 degrees for 60 minutes, and make sure whoever serves you your food boils his hands for at least 10 minutes or at the least wears a brand-new pair of latex gloves each time after taking a shower in isopropyl alcohol. There's still a risk but at least it will be tolerable.

 

[uncfnp]

Study Shows Lemons Used In Restaurants Contain Dangerous Microbes | Observer

just saying...

 

[KathyV]

Kathy, what are the scientifically documented risks for salmonella infection via fried eggs in Cozumel vs , say, Chicago? I'm asking because you described yourself as a clinical microbiologist. Presumably you base your concerns about eggs on clinical microbiology, specifically not what could happen but what actually fores happen.

There is plenty of Salmonella food contamination in Chicago and world-wide and I don't eat undercooked eggs or meat in Chicago either; and as I have mentioned, I personally contracted a nasty case of Shigella dysentery after swimming in a local fresh-water lake (in Indiana.)

It is not feasible to compare the incidence of infection and contamination between 1st world countries and 3rd world countries, because industrialized countries have much more sophisticated disease surveillance and reporting programs and so the data are not comparable. However, there are many documented studies showing that poor hygiene and sanitation, fecal contamination of food and of drinking and irrigation water, use of manure as fertilizer, and improper cooking and food handling does increase the risks of contracting an infectious gastroenteritis; and these conditions are more likely to exist in poorer countries.

Below are excerpts from a article published in the Oxford Journal that you may find of interest. It is an older article (published in 2006) but I've selected it because the researchers are located in Mexico and they specifically studied the Salmonella contamination of retail meats, and the incidence of asymptomatic infection in children, and antibiotic resistance in the Yucatan.

The study found a high rate of Salmonella-contaminated retail meat and significant incidence of asymptomatic carriers among children - indicating frequent exposure to live Salmonella bacteria in the local food chain. They also found greater resistance to antibiotics among strains of Salmonella in the Yucatan as compared to industrialized countries like the US and Canada.

In response to your post, I am a clinical laboratory scientist and a certified microbiology specialist and I have a graduate degree in public health. I managed a clinical hospital microbiology laboratory for many years and I taught classes (both lab and lecture) to 4th year university students on bacteriology, virology, mycology, parasitology, and immunology. I am not a doctor and I certainly don't know everything there is to know about infectious diseases, but I do have some experience and expertise on this topic.

In sharing information about dysentery and actions that can be taken to reduce the risks of infection in this thread, it was not my intention to anger others - but just to share information with individuals that had asked questions and expressed an interest in the subject.

Individuals are certainly free to follow or disregard the advice of scientists, physicians, epidemiologists, and infectious disease specialists; it's totally up to them. And as I have said several times already, there are risks everywhere, you can get sick any place, so you just have to make the decisions that seem best to you and move forward with your life. I choose to try and reduce the risks of contracting an infection both at home and abroad, but there are no guarantees.

By the way, it was also my job to fill out paper work for the Chicago and Cook County Public Health Departments whenever we isolated a reportable infection like Salmonella - I can't tell you how many times I wrote the phrase "recent travel to Mexico" on those documents - it was by far the most frequently mentioned place of foreign travel on the cases that I reported.

Nontyphoidal Salmonella from Human Clinical Cases, Asymptomatic Children, and Raw Retail Meats in Yucatan, Mexico

Mussaret B. Zaidi, et al

… Our study found a high prevalence of Salmonella in retail meats and persons with enteric infection; many of these isolates were resistant to clinically important antimicrobials. A random selection of isolates from people and retail meat showed genetic relatedness, which suggests that, in Yucatan, considerable transfer of Salmonella occurs through the food chain…

…Although developing countries carry most of the global burden of diarrheal disease [5], very few have established intersectoral monitoring programs for Salmonella. In Latin America, monitoring networks are usually limited to samples obtained from people, and most networks rely on deficient passive surveillance systems. Thus, there is little information on the main food-animal reservoirs for Salmonella and the modes of transmission. Even less is known about antimicrobial resistance in Salmonella strains of food-animal origin, the extent of its transmission to humans, and the public health burden of illness due to Salmonella infection.

Yucatan, among the poorest states in Mexico, has one of the highest morbidity rates for infectious intestinal disease in children <5 years of age (322 cases of infectious intestinal disease per 1000 children per year; D. Ruiz, Yucatan State Health Department, personal communication). Food-animal production is one of the major economic activities in Yucatan, and &#8764; 95% of all retail meat sold in the state is locally produced.

In view of the public health importance of zoonotic foodborne disease, an active surveillance program was established in 2000. The objectives and structure of the surveillance program were based on recommendations from a World Health Organization technical expert committee and adapted to local needs and infrastructure [3]. The main objectives of the program were (1) to determine the prevalence of Salmonella in both ill and healthy people and in retail pork, chicken, and beef; (2) to determine the main serovars isolated from each source and their antimicrobial susceptibility patterns; and (3) to determine the genetic relatedness of isolates from people and retail meat. This article describes the results obtained from 2000 to 2002 and their implications for public health and future research&#8230;

...An equally significant finding was the high rate of asymptomatic carriage in children, which is most likely the result of continuous exposure via foods. This strongly suggests that humans constitute a very large and important reservoir for this zoonotic organism and have a higher degree of immunity than is seen in more developed countries...

&#8230;In addition to the high prevalence of Salmonella serotypes in both meats and humans, our study also found that the rates of antimicrobial resistance in Yucatan were significantly higher than rates in industrialized countries. For example, rates of resistance to nalidixic acid among S. Enteritidis isolates from chicken meat in Denmark and the United States during 2002 were 23% and 0%, respectively, and &#8764; 4% among isolates from ill humans from both countries, compared with the resistance rates of 62.5% and 47% among isolates from chicken meat and humans, respectively, found in our study [13, 39]. Likewise, as shown in table 4, the rates of resistance to trimethoprim-sulfamethoxazole and nalidixic acid of S. Typhimurium from humans and from food appear to be higher in Latin American countries than in the United States and Canada. The differences in antimicrobial resistance patterns among serotypes demonstrate the need for more thorough investigation of antimicrobial use at the human and veterinary levels and the modes of transmission through the food chain&#8230;

---------- Post added February 9th, 2015 at 10:20 PM ----------

...So my professional recommendation to you is to stay at home in a hermetically sealed steel-reinforced compartment, sterilize everything you eat, drink, and breathe at 800 degrees for 60 minutes, and make sure whoever serves you your food boils his hands for at least 10 minutes or at the least wears a brand-new pair of latex gloves each time after taking a shower in isopropyl alcohol. There's still a risk but at least it will be tolerable.

You have chosen to take my comments out of context. I have said a number of times that there are risks everywhere and no guarantees. I shared information about preventative behaviors endorsed by public health experts to reduce the risks of infection - but as I have also said several times - it's your decision to do what you want.

 

[txtroop07]

I've never been sick during VACATION travels, knock on wood, however I have had substantial experience in dealing with dysentery as a young man on the Oregon trail...

 

[Lorenzoid]

It's a good thing to have experts like KathyV carefully explaining the risks. They are real. We should read all the information we can and then make our own decisions.

One thought that occurred to me as read some of that: Is it fair to lump Cozumel in with all of Yucatan? This discussion originally focused on Cozumel. I'm sure there are places in Yucatan where even I would be cautious with what I eat.

If Cozumel is the "third world," I shudder to think what worlds I have eaten in.

 

[KathyV]

I've never been sick during VACATION travels, knock on wood, however I have had substantial experience in dealing with dysentery as a young man on the Oregon trail...

Did you drink untreated water from lakes and streams? There are been many reports of Giardia (a protozoan parasite similar to amoeba) and Norovirus infections contracted by drinking water from lakes and streams in the western US states.

---------- Post added February 10th, 2015 at 06:56 AM ----------

...One thought that occurred to me as read some of that: Is it fair to lump Cozumel in with all of Yucatan? This discussion originally focused on Cozumel. I'm sure there are places in Yucatan where even I would be cautious with what I eat. If Cozumel is the "third world," I shudder to think what worlds I have eaten in.

You would expect sanitation systems and public health practices to be more sophisticated in urban areas. There are high levels of Salmonella contamination in poultry in the US but the risks are reduced by cooking thoroughly, preventing cross-contamination in the kitchen, and washing hands. Again you would expect such practices to be in place in urban restaurants so I would think that the risks are lower in Cozumel as compared to rural Yucatan.

However the article said that 95% of retail meats consumed in Yucatan are produced locally so caution and good hygiene are indicated. Frankly I was shocked at the incidence of intestinal infectious disease reported in young children:

"Yucatan, among the poorest states in Mexico, has one of the highest morbidity rates for infectious intestinal disease in children <5 years of age (322 cases of infectious intestinal disease per 1000 children per year; D. Ruiz, Yucatan State Health Department..."). Yikes!

As infected children get older and have repeated exposure they often develop immunity and become carriers - and so the cycle continues. It would not be a surprise if some of these carriers are working in restaurants in Cozumel preparing and serving food after they grow up. Hopefully, they "wash hands well before returning to work."

 

[cvchief]

Well, remember we are not in the the Yucatan, we are in Quintana Roo. That being said I had some really good motulenos in Merida Yucatan.

But since you scared me, I had Huevos con Nopal this morning at the Museo. It was cold as crap... Not the food, the wind. Food was terrific.

And I think there is certain variety in restaurants, however, Capitan Carlos started some amoeba-cide yesterday and is on the wagon.



Oh and don't mind Moss. He is a contrarian.