Hi, Dr Bernard here. I’m not here to scare you
about food trucks with this video. Sometimes we like to joke that the sketchier the place, the
more likely the food is really good. If you see an unmarked food truck in the back alleyway by
a dumpster, with an operator who’s been seen to scratch between his legs and then touch the food,
you're free to do what you like to do, but that’s a little too sketchy for me. Luckily most trucks
here in the United States are not like that. A Man Ate Pork Tacos From An Illegal Food
Truck. This Is How His Brain Shut Down. CD is a 47 year old man, presenting to the emergency room confused with a massive headache.
His wife Natalie, tells the admitting nurse that she found him collapsed, on the floor, shaking
with his eyes rolling into the back of his head. Several months earlier, behind his office building, CD saw a food truck
that he’d never seen before. He had heard some stories about a mustached man, operating the
truck, dropping by at random places in this small town, to sell food so delicious that most
people had never tasted anything like it before. CD thought this was kinda sketchy. A blank, unmarked truck,
parked in the back alleyway. But he saw the mustached man, and knew that this obviously is
the perfect setting to enjoy the tastiest food.
At the truck now, CD decided to order some pork tacos, on recommendation from the chef.
At first, CD thought the meat felt maybe a little too tender in his mouth, almost as if parts of it
were like chewing the inside of his own cheeks, maybe cooked medium rare. This was also the first
time he had pork.. anything, except for maybe some bacon, since he was a kid, so he didn’t quite
remember exactly what the experience was like. The flavor was bold and unbelievably delicious.
Almost like it was made of something that wasn’t allowed in this country. Immediately after finishing the tacos,
CD felt good. He was ok for the rest of the day. As he was walking to his car on his
way out of work, he thought he felt something weird in his stomach. It didn’t last very
long, so he didn’t think too much of it. As the days passed, CD would feel kind of strange at random times.
Some weeks he’d have a cough that just wouldn’t seem to go away. These would come with itchy and
watery eyes and a low-grade fever. These could be allergies but he didn’t know for sure. One day, a couple months after eating those
tacos, CD used the bathroom. He looked back in the toilet and thought he saw some rectangular
fragments floating around in the bowl, emanating from the mass. He hadn’t seen these before. He
thought they kinda looked like pieces of canned tuna floating around. But he hadn't eaten any
canned tuna recently. He told his wife about this, but he wasn’t going to show her his stool, so
maybe he was just seeing things, he thought. At a regular health checkup, CD asked about his low-grade fever, about his
cough, and about some strange headaches that he would get sometimes. He also asked about the tuna
pieces that appeared in his stool. The physician, after doing some tests told CD that this was
probably allergies, it was springtime anyways, and so he recommended some over the counter medicines
to help with this, as well as recommend CD to chew his food more often. This would just be better
overall for his health. And he was on his way. CD started hearing rumors on how the food truck may have been an unlawful business, mostly
just because their small town had never seen anything like it. The mustached man didn’t seem
like he was from around the town, and it was rare here to have visitors, but other people said that
the man didn’t have permission from the county or the state or any other authority in this area, to
operate a truck like this. Some of CD’s coworkers reported random bouts of not feeling well after
eating at the truck. One even reported that she saw the man scratch between his legs and then
touch the food right after, taking a small sample for himself. But CD didn’t care, he remembered
how delicious those tacos were. Months later, he came across the truck again, got the tacos again,
and his mind was blown at how good they were. But a couple days later, CD thought he felt strange and he didn’t
know why. It was a little bit of a cough, maybe like a fever. When he stood up from his
chair, he felt like his stomach was getting pulled into the ground and heat would radiate
out of his neck, but this was short lived. Over the next several months, CD started feeling a constant throbbing sensation
in his head that started happening everyday. It felt like his head was heavy. One day, it
hurt so bad it brought him down to the ground, and he emptied his stomach from both ends, and
afterwards, he felt even worse. In the other room, CD’s wife Natalie hears commotion, and as she
walks in, she sees her husband on the floor shaking, with his eyes rolling into the back of
his head, as she calls for 911, and he’s brought to the emergency room where we are now.
At examination, the medical team sees CD have a
generalized tonic-clonic seizure, the kind where one shakes and convulses. Typically, these only
last a few moments, but in CD, it wouldn't stop until the pharmacist gave medicine to terminate
it. His blood pressure was high, heart rate was high, his eyes were wide open, but he was unresponsive.
And this gives the medical team some clues as to what’s happening.
CD’s wife started talking about the headaches
that he had been experiencing over the last several months. Taking over the counter medicines
sometimes didn’t help. Both the seizures happening now, and the headache developing over time, means
that something has been happening to his brain, but what could it be?
CD didn’t have any recent insomnia, which
could suggest a psychiatric problem, or something like a nutritional deficiency, or a
tumor. He didn’t have any recent personality changes and he didn’t have any sudden neck
stiffness either, which could mean meningitis. A blood test finds that CD has leukocytosis. Leuk from Greek Leukos meaning white, cyte referring
to cell, and -osis meaning a disorder of. White blood cell disorder, and in this case meaning that
there’s more white blood cells floating around than normal. This could be because CD might have
a brain infection, but having just had a seizure, adrenaline was getting released into his body,
causing white blood cells that typically stick to the lining of his blood vessels to detach, maybe
causing that leukocytosis and meaning meningitis would be unlikely. But what wouldn’t be out of the
question is maybe some other kind of infection. CD told his wife about the pork tacos from the food truck, but he didn’t tell her some
of the other details about the truck. That some of his coworkers had recently gotten sick after
eating there. That he found the unmarked truck hidden in the back alleyway. He told her about a
weird “tuna fish” like appearance in his stool. She tells the medical team about this and it
gives them a more clear idea of what’s happening. Pigs and humans have lived together throughout much of history. This proximity has
made for some special developments. Human stomachs are a definitive host for a tapeworm called Taenia
solium. The worms have a scolex that attaches to our intestines, and they survive and feed off
our diet while growing to be 20 to 40 feet long. As time passes, their segments break off
and appear in the person’s stool. Some of these segments contain eggs and they’re called gravid
proglottids. Remnants of this contaminated human waste can get into pigs’ food supply. Pig stomach
is similar to human stomach. Inside the pig, Taenia solium oncospheres hatch and penetrate the
intestinal wall, circulating into muscle tissue. And when we eat meat, we’re eating muscle, this
is where the exposure and then infection happens. As the medical team takes a stool sample from CD, they confirm, he
has Taenia solium tapeworm segments in there. It wasn’t canned tuna that he saw that day, it was
pork tapeworm. And if he usually never ate pork except for those 2 times at the unmarked
food truck, then how did this happen? In the United States, agricultural policy, standards, and enforcement has helped to prevent
Taenia solium from infecting pigs. Sanitation, hygiene standards, and slaughterhouse inspection
have made it so anyone living in the US, buying USDA inspected pork, shouldn’t come into contact
with Taenia solium. A different species of Taenia, called Taenia saginata is known as beef tapeworm,
comes from cows, different because of how cow stomachs are different from humans and pigs.
This is also something that you’re not going to find with legal foods. Food trucks in the
United States overwhelmingly are fine and not at all like this.
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that I prefer. They offered to sponsor this video Head to Factor75.com or click the link in the description below and use code EMU50 to get 50% off your first Factor box. I highly recommend it. The Taenia that CD has, is Taenia solium, specifically from undercooked pork. Cooking it well helps against infection. And he’s a person who doesn’t eat pork, except for those 2 specific times. In his workspace, another coworker who had eaten
food from the same truck had also reported similar symptoms. Reported what looked like canned tuna
pieces inside their stool after feeling a low grade fever over the span of several weeks.
But this still doesn’t explain CD’s seizures. A Brain MRI for CD reveals multiple lesions representing viable cysts. The Taenia solium
parasite, wasn’t just in his gut, but multiple oncospheres had lodged into his brain and have
been living there, for at least the last several months. They passed through his stomach wall,
got into small blood vessels, and crossed his blood-brain barrier causing neurocysticercosis.
Multiple cysts were found at different stages of
disease. When the larva cross in to the brain, they’re small. They evade the immune system.
At this vesicular stage, they make the brain look like it has holes everywhere. But
as time passes, these cysts start to change. As the larva start to degenerate and shrink, the immune system starts to react. Cysts enter the
colloidal vesicular stage, and the brain starts to swell from the extra immune response. The brain
keeps expanding inside a closed space, the skull, but those cysts aren’t going anywhere.
Then the cysts continue to degenerate. At first,
they’re still active in the granular nodular stage, but eventually, they become mineralized
and inactive, with no swelling nearby. But this nodular calcified stage can cause recurrent
seizures due to the fact that a calcified, dead parasite is lodged in and stuck in the brain.
The Taenia solium worm in the gut is from eating
pork meat that has the oncospheres. Just eating pork, doesn’t give brain cysts. The pigs were
infected by eating human waste that has the Taenia eggs and gravid proglottids. When the
undercooked, infected, pork meat is consumed, that part of the lifecycle causes the tapeworm
in humans. But brain cysts come from a slight deviation in the lifecycle, where humans
come into contact with food that may have been in indirect contact with human waste. So
rather than the pigs eating the oncospheres, humans eat them directly. This parasite, would
have migrated in pigs to pig muscle, instead, in humans, it migrates to the brain.
The owner-operator of the suspicious food truck
had pork tapeworm himself. When he prepared CD’s pork tacos, which he undercooked, hands that
touched parts of the body containing Taenia eggs, touched food that ended up in CD’s stomach. It’s
not enough that CD just ate undercooked pork that had Taenia oncoshperes from the pigs, but his
brain infection was from consuming Taenia eggs directly as if he were the pig, meaning that CD
was infected twice by different forms of the tapeworm.
This is an important point. The intestinal
tape worm version of Taenia solium is from eating undercooked pig meat. The brain infection,
neurocysticercosis, is from eating parasite eggs from a human who has the intestinal tape worm.
That is, somehow, you are coming into indirect contact with their feces, and ingesting it.
Or they touched around their butt where Taenia eggs can sometimes be found sometimes, and they touched
something, that you happened to touch, and then you make contact hand to mouth. And knowing that this happens, it should make sense as to why some traditions
discourage the consumption of pork, if it’s not for other reasons as well.
This isnt uncommmon. Around the world,
neurocysticercosis is a common cause of seizures. In some countries around the world,
people get infected because they live in a household where someone has a Taenia tapeworm
infection. The infected person might use the bathroom. They’ll wipe, or do whichever hygienic
ritual they normally conduct post bowel-movement, and they may not have washed off the Taenia
eggs on their hands. They touch food, eaten by others in the house, infecting
them. As the oncospheres absorb into the gut, they don’t form tapeworms in this case, they
float around in the blood, sometimes crossing the blood brain barrier and embed in. Over months
to years, they form calcified masses in the brain, and because you can’t just easily go into the
brain to cut out whatever parts you want, these aren’t easy to remove. At best, they don’t cause
any problems, and people don’t even know they have it. But at worst, they get into other parts
of the brain. They can get into the eyes. The spinal cord. The subarachnoid space. And they can
cause seizures sometimes refractory to treatment, all of this bringing us to the final point.
USDA inspected pork isn’t going to have this,
so where did the truck get their meat? Well, it’s been well documented that there exists an
issue, whereby contraband meat is smuggled in to this country, through various routes. Sometimes,
you can find these unlawful products for sale, no further than listings on local websites and
on social media. These are meat products that are banned likely for the reason of possibly
spreading disease to humans and farm animals in this realm. And while we may never know where
the moustached man really got his pork from, we know CD is a person whos only time eating pork was
allegedly from the truck. And others also got sick from this truck. In this case, we go with what
the patient says. His wife didn’t appear to have the tapeworm. And because the truck was mobile,
operating in a small town that maybe hasn’t had a need to handle food trucks, then we have a
good guess as to where CD’s problem came from. Food trucks, are almost never like this. If you’re in an outdoor event, in warm weather in the US,
it’s typically full of trucks, every which one has been vetted. Probably inspected more often than
most restaurants. The mobile medium, allows the seller to set up shop quickly, make some sales,
and they could disappear quickly, potentially without any accountability should something go
wrong. That’s why some places are super strict, maybe a little too strict on food trucks, but the
mobility of the truck is what sets it apart from a stationary restaurant. Extra moving parts are
always added, possible, points of malfunction. As the medical team evaluate CD’s situation, they start
him on 2 antiparasitic medicines for both the worms in his gut and the cysts in his brain. One
medicine, praziquantel, forces calcium to enter into the worm to force its muscles to contract,
paralyzing it and getting its suckers to detach and to dislodge. The other medicine, albendazole,
destabilizes the parasite and begins to starve it, depleting its energy. When the parasites start
reacting to therapy, it can trigger an immune response. Because we’re dealing with neurologic
tissue, CD was started on corticosteroids to limit that inflammatory response. He was also started on
anti-seizure medicine to prevent another seizure from happening again. As CD was observed in the hospital for a few more
days, he no longer had any more seizures and his neurologic exam appeared to be normal. Everything
else with his brain appeared to be ok. And when he was discharged to go home, for several months
after, he was noted to no longer have seizures anymore, as it appeared he made a full recovery.
Thanks to Angie Burger for letting us film at
her truck. Her burgers are DELICIOUS if you get a chance, try them. Thank you so much for
watching. Take care of yourself. And be well.
