How did we tackle Trichinella?

Daniel and Kelly talk about how public health officials turned "the most serious parasitic disease in New England" into a disease that only afflicts about 15 people per year in the whole of the United States. See omnystudio.com/listener https://omnystudio.com/listener for privacy information.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Daniel Whiteson?

  This is an iHeart Podcast. Guaranteed Human.

• 0:04Speaker 01

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• 1:08Kelly Weinersmith?

  In 1947, Dr. Norman Stoll gave his presidential address to the American Society of Parasitologists. His talk was called "This Wormy World." And if you study parasites, this talk is a real classic. Stoll wanted an estimate for how many people in the world were carrying particular kinds of wormy parasites. So we're talking things like nematodes, tapeworms, and trimatodes, not the kind of things that cause the flu, so not bacteria or viruses. So the context here is that World War II had recently ended, but the problems for US soldiers who participated in the war had not. Soldiers returning home from the war had brought back with them the parasitic diseases that are found all over the world.

• 1:51Kelly Weinersmith?

  U.S. interest in parasites skyrocketed as Americans were suddenly forced to observe how horrible some of these parasitic diseases can be. So, how many wormy infections are out there? Well, Stoll starts by noting how bad the data for an analysis like this are. There's just not great surveys that are comprehensive, but he set out to do his best. What he concludes is that there were 2.2 billion wormy infections in a population of just under 2.2 billion people at the time. So this isn't counting the number of parasites in people. One infection would be like, okay, you have one of a particular kind of nematode in someone. But these infections were not evenly distributed.

• 2:35Kelly Weinersmith?

  On average, one out of every three Americans or Europeans were infected. But in the USSR, that number was up to two out of three people. For every three people in Asia, the Middle East, and South America, there were four infections. So that means out of three people, one of those people is probably harboring two different wormy parasite species. And every person in Africa, on average, was estimated to harbor two helmet parasite species. But Stoll notes a bit of optimism and points out that six out of the seven cases of wormy infections could have been stopped with proper sanitation. So there's some ability to do something about this. So how far have we come since 1947?

• 3:19Kelly Weinersmith?

  Well, in some areas, we've made great progress. For example, Stoll mentioned that a nematode called Trichinellus bryalis was known as the most serious parasitic disease in New England. At the time, 1 in 6 Americans were infected with this parasite. Now, trichinolosis is a rare disease in the United States with only about 15 confirmed cases in the entire country per year. And today, we're going to be talking about this public health success story. But in future episodes, we're also going to talk about some parasites that still plague humans worldwide, including here in the United States. For example, according to the World Health Organization, 1.5 billion people are infected with nematode parasites that are picked up from the soil.

• 4:04Kelly Weinersmith?

  All right, so let's dig in. Welcome to Daniel and Kelly's extraordinarily wormy universe.

• 4:24Daniel Whiteson?

  Hi, I'm Daniel. I'm a particle physicist and I've never been infected by a parasite, to my knowledge.

• 4:30Kelly Weinersmith?

  I'm Kelly Weiner-Smith and I bet Daniel has been infected at some point. And if I had to guess, there'd be a good chance that you would have gotten pinworms from your kids when they were young.

• 4:40Daniel Whiteson?

  Ooh, pinworms. Are those the ones I'm thinking about that make you itchy in a very uncomfortable place?

• 4:45Kelly Weinersmith?

  That's right. I think actually at some point we should have a whole episode on pinworms, cuz why not? But, oh, nope, maybe not. Daniel, it's gonna be a long couple of years working with me if pinworms give you the heebie-jeebies.

• 4:59Daniel Whiteson?

  Itch is that particular itch just really gets me, if you know what I mean.

• 5:04Kelly Weinersmith?

  No, no, I get it. I get it. Actually, the mom nematode sneaks out at night and deposits eggs with like a sticky substance in the spot that you're thinking of because scratching is how the parasite transmits, how it gets under fingernails and then ends up in the environment and then ends up getting eaten. So that itch is very purposefully caused by the parasites.

• 5:22Daniel Whiteson?

  I know, and I use that story as a way to dissuade my kids from biting their fingernails.

• 5:28Kelly Weinersmith?

  Oh, good.

• 5:29Daniel Whiteson?

  Because I'm like, you know what you're doing, you know where you're gonna get itchy if you keep doing that. And it works. It works.

• 5:34Kelly Weinersmith?

  No, I bet, yeah. People feel real gross when you tell them about parasites. It's a good way to dissuade people from certain bad behaviors, no doubt.

• 5:42Daniel Whiteson?

  All right, so since we're being personal, what is the grossest parasite you've been infected by?

• 5:47Kelly Weinersmith?

  Oh, gosh, that I've been infected by. Well, I guess if my parasite were including viruses and bacteria, I guess anything that makes me puke. But I haven't been infected by anything that gross. But no, I had a antibiotic resistant wound near my ankle once, and that was gross, because it just wouldn't go away. And that was kind of scary. And I was super stressed, which I think was like suppressing my immune system, too. And so it was... Bad news. What about you?

• 6:12Daniel Whiteson?

  Well, to me, being infected by a little microbe, isn't that gross? It's like, yeah, that's invisible. The bigger it is, the weirder it is, the more gross it is. Like, being infected by something that's like actually a worm size, to me, is creepy. It's like crawling around inside you. And so like, imagine being infected by something larger, you know, baseball sized or like football sized, that would be like, oh, that's nightmare fuel for me. But yeah, I don't know that I've ever had a worm inside me. But apparently Kelly thinks that I have, so maybe I am a wormy.

• 6:42Kelly Weinersmith?

  I don't actually know that you have. I'm sure your hygiene is impeccable and that has probably kept you safe. But no, there's some pretty nasty like acrid worms, which maybe we'll talk about at some point. They are really big. And when you see surgeries where people are like trying to remove many of them from someone's, that even grosses me out. I can't eat pasta for days.

• 7:03Daniel Whiteson?

  Exactly. Well, I appreciate you giving me the benefit of the doubt, although physicists are not exactly famous for their hygiene. You know, that's not like top 10 ways you become a physicist or things for famous for. But, you know, I appreciate it. I do try to keep clean. Thank you very much.

• 7:19Kelly Weinersmith?

  You're welcome. I was thinking about you as a human being and not really a physicist in particular, you know?

• 7:26Daniel Whiteson?

  That doesn't work in my favor.

• 7:27Kelly Weinersmith?

  Yeah.

• 7:29Daniel Whiteson?

  All right, but today we are not talking about Daniel's hygiene. We're talking about humans more generally.

• 7:34Kelly Weinersmith?

  Yeah, and we're talking about them because we got a great question from a listener named Patrick, and let's go ahead and listen to that question now.

• 7:41Speaker 04

  How many parasites are living in all of us? How common are the bad ones? And where do we pick them up?

• 7:50Daniel Whiteson?

  Oh, man, it sounds to me like Patrick is looking for nightmares.

• 7:53Kelly Weinersmith?

  Oh, it sounds to me like Patrick is giving me my Christmas present early by allowing me to talk about parasites. And so, you know, at the intro, I talked about how in 1947, there was this estimate that there's 2.2 billion parasitic infections in a population of under 2.2 billion people. So some people are infected by more than one parasite. And I wasn't actually able to find a comparable. Estimate for now. And I think partly that's because the way he grouped parasites together is not really a biologically relevant category that people care about anymore. And so I wasn't able to find a comparable number, but I am going to go through some of the main parasitic infections that have plagued humans in our recent past, but we

• 8:35Kelly Weinersmith?

  managed to get rid of, and then some that are still a problem today in the United States and in other parts of the world. But I figured today we would start with a success story.

• 8:46Daniel Whiteson?

  That's good, because I was afraid that the message of this episode was going to be like, there's parasites everywhere, all up in your eyeballs and in your earballs and in your noseballs and everything.

• 8:55Kelly Weinersmith?

  Wow. No, you know, especially if you live in the United States and you're lucky enough to be in an area where there's really good sanitation, you probably are pretty safe. But, you know, that's not necessarily true in other parts of the world. We're very lucky here.

• 9:11Daniel Whiteson?

  All right, well, let's dive in because I want to know by the end of this episode, how likely am I to have worms living inside me right now?

• 9:18Kelly Weinersmith?

  Well, we're only talking about one worm. And I was interested in figuring out what people know about this worm, because at least in the United States, infections are very uncommon these days. About 15 cases of infection with this parasite are recorded per year for a disease that once infected one out of six Americans. So we've made a lot of progress. And so I was wondering, have people heard about this before? So I asked our audience, what is trichinosis?

• 9:42Daniel Whiteson?

  Right. And if you would like to play on this segment of the podcast in the future, please don't be shy. We'd love to have your voice. Write to us to [email protected]. So before you hear these answers, think to yourself, do you know what trichinosis is?

• 9:57Kelly Weinersmith?

  Also known as trichinosis.

• 10:00Speaker 05

  No idea. The osis at the end, it sounds like it could be some kind of disease or medical condition.

• 10:08Speaker 06

  I'm too excited for words. This isn't about cats and uncertainty and quantum mechanics and things I don't understand. This is a worm. It's a parasite. It grows in pork mainly. I grew up in India and it was a real risk that we'd get this. So we ate pork that was like leather. You could have put it on your feet and worn it as a shoe.

• 10:29Speaker 07

  A disease associated with a parasitic infection of a roundworm from cysts from muscle from undercooked meat, pork and other animals as well, I believe.

• 10:40Speaker 01

  A disease caused by bacteria, worms, goblins? Trichinosis is an infection. Trichinella could be a bacteria or maybe a eukaryotic parasite. I'm not sure. Trichinosis is a human disease caused by a parasitic worm in pork. I think trichinosis is a disease that one can contract from eating undercooked meat. I don't know if it's a parasite.

• 11:14Speaker 06

  If Kelly's involved, I assume that it must be though. No idea. Sounds like a bacterium. Trichinosis sounds like the disease that happens to my third chin and I don't know anything more about it. I have no idea what trichinosis is. However, taking a stab in the dark, I'm going to say parasite, but only because the email asking the question came from Kelly. If the email asking the question had come from Daniel, I would have took a stab in the dark and said a particle. There we go.

• 11:43Speaker 04

  Trichinosis involves a trilobite, a tricycle and tragedy.

• 11:49Kelly Weinersmith?

  So, Daniel, it is so clear to me that our audience has us totally figured out. It is about a parasitic worm.

• 11:57Daniel Whiteson?

  And you know, just because the email didn't come from me doesn't mean it wasn't particles. I mean, I assume these parasites are made of particles. They're not like fundamental parasites in the universe or anything. These aren't string theory parasites, are they?

• 12:08Kelly Weinersmith?

  Not post quantum gravity parasites, nothing like that. These are actual parasites. And I am always so amused by the wonderful answers you all give when you don't know the answer, like probably it's goblins and that was great.

• 12:22Daniel Whiteson?

  All right. So give us the context. Take us back in history. When did we first learn about this particular worm?

• 12:29Kelly Weinersmith?

  Well, the first documented case where someone figured out that this worm was causing an infection was from 1835. So we're in London at St. Bartholomew's Hospital. Back then, the way that a bunch of the medical students learned about infections was that an autopsy or a surgery would be happening in the middle of essentially what looks like a theater, like imagine you're sitting down to watch a play, but instead you're watching an autopsy.

• 12:54Daniel Whiteson?

  The first five rows may be splashed.

• 12:56Kelly Weinersmith?

  Yes. Yeah. And this was back before there was anesthesia. So like amputations were, oh, gruesome. Turns my stomach thinking about it. But it was an autopsy and it was a man who had died of tuberculosis. And the surgeons in the middle of the operating theater, they had their scalpels and they were trying to like get through the body and the scalpels kept dulling and they were feeling really frustrated. And when they finally got inside, they got to the diaphragm and one of the surgeons said, I knew it. A case of sandy diaphragm.

• 13:24Daniel Whiteson?

  Sandy diaphragm.

• 13:26Kelly Weinersmith?

  Sandy diaphragm. And so one of the guys who was in the audience, his name was John Paget. He was a medical student and he said, what causes sandy diaphragm? And this is the thing that was dulling their scalpels. And the surgeons were like, we don't know. Let's go to lunch.

• 13:42Daniel Whiteson?

  Well, what was the general state of medical knowledge? Like, was the inside of the human body a total mystery? And we mostly figured out like the circulatory system, the digestive system and all that. What did we sort of know about the workings of the human body almost 200 years ago?

• 13:56Kelly Weinersmith?

  I think that if you went to a surgeon, it was like a 50 50 chance the surgeon made things worse. I'm not a medical historian, so maybe the odds were better or worse. I don't really know. We knew a fair bit, you know, like we knew that if someone had a cancerous growth, you'd try to cut it off real fast. But we didn't have anesthesia. So sometimes you'd get an infection and you'd die from that. It was a dicey time to be someone who needed the help of a professional.

• 14:23Daniel Whiteson?

  And this is before germ theory, right? So we didn't understand there could be microscopic organisms infecting? Or was this after germ theory?

• 14:31Kelly Weinersmith?

  Luan Hook had been able to see his little animacules. So we knew that there were like tiny little organisms in the world. I don't think we had germ theory and Lister hadn't figured out ways to establish antiseptic technique.

• 14:48Kelly Weinersmith?

  That is all off the top of my head. And maybe we should have like Lindsay Fitz Harris, who's this amazing historian of like surgeries and stuff on the show to give some background there.

• 14:59Daniel Whiteson?

  Because I thought that like middle of this century, we still have folks like going from cadavers to delivering babies and wondering like, hey, why are so many women dying in childbirth? What a mystery. And maybe we should wash our hands.

• 15:11Kelly Weinersmith?

  Yeah, no, that is where we were.

• 15:13Daniel Whiteson?

  Yeah, okay.

• 15:14Kelly Weinersmith?

  We're still before the germ theory.

• 15:15Daniel Whiteson?

  Okay.

• 15:16Kelly Weinersmith?

  Yeah, yeah. And I think that, you know, if they amputated someone's limb, they'd kind of like wipe it off with a napkin, maybe, and then amputate the next person's limb. There were lots of microbes being shared between people at this time.

• 15:26Daniel Whiteson?

  All right, but sandy diaphragm is not due to microbes, right? It's due to actual visible worms?

• 15:32Kelly Weinersmith?

  It's due to actual visible worms. They are not easy to see. So what Paget did was he took a sample and he used a hand lens and he squished it between two glass slides and he looked at it with the hand lens and he thought he saw something kind of wormy, but he wanted to get a better look at it. So he brought it over to the British Museum of Natural History and he actually knocked on the door of the guy who came up with Brownie and the idea behind Brownie in Motion. So he knocked on Brown's door and he had a microscope. He let Paget use it and Paget noted that there was actually a worm in there. Some of the worms were moving and some were not. And the ones that were not had been calcified by the human body and that's what was causing the sandy diaphragm.

• 16:12Kelly Weinersmith?

  So when these worms die, the immune system responds by sort of like creating like a calcified casket to like wall it off from everything else. And over time, that creates like hard structures and that is what the scalpels were dwelling on. So he goes and he tells a group of medical students about his finding, but he doesn't take the important next step of publishing and sharing his results more widely. The same cadaver, a sample of it got sent to this other guy named Richard Owen. And we don't need to get into too much detail here, but he also, from the same cadaver, ended up looking and seeing these worms. He wrote it up. He gave a public lecture. He's the one who got the credit. But this one cadaver produced two different people who were the first to notice that actually-

• 16:58Kelly Weinersmith?

  There were these little tiny worms. And so it used to be called Trichina, I think, which is a word for like tiny hair. And spiralis is, you know, like the spiral shape. And so these are hair shaped worms that curl up in a spiral inside of cells, like diaphragm cells. But Trichina also was a genus of flies. And so they went with Trichinella to avoid confusion. So hair like spirally things.

• 17:23Daniel Whiteson?

  And take us back also scientifically, like if you find worms in a body at that point, do you have to assume that somehow the people have eaten them or they've invaded the body? Or are we still in a place where like, we don't understand whether life can be generated spontaneously?

• 17:39Kelly Weinersmith?

  So Weenhock and Pasteur, I think they had already done their experiments at this point where you know that there's little things and you know that those little things aren't generated spontaneously because Pasteur, and I think some other people as well, had done those experiments where they had made those flasks that had the like bendy mouth parts so that the air couldn't sort of get in. And whenever air can't get in and you had like a nutrient broth, nothing would grow in it. But if air could get in, you would get growth. And so it's not arising spontaneously. You have to have something seeding the living things. I'm sure that people had seen parasitic worms before, but I don't think we had a very good handle on life cycles.

• 18:20Daniel Whiteson?

  All right. What exactly was new and novel about this? What did this tell us about parasites and humans and all that kind of stuff?

• 18:28Kelly Weinersmith?

  So I don't think that this is the first parasitic disease that was ever discovered. But I think this is a problem that was attributed to a parasitic disease at this point. So like this person in particular had died of tuberculosis. I think it was a while before we realized that this was something that could kill people as opposed to just something that's a pain in the rear end when you're trying to run a scalpel through a dead person's body. But even today, if you get infected by too many of these all at once, you can die. So let's talk a little bit more about what they actually discovered when we get back from the break.

• 19:08Speaker 02

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• 19:36Speaker 07

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• 20:15Kelly Weinersmith?

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• 20:51Kelly Weinersmith?

  Okay, so what they had discovered was Trichinella sporalis. This is a nematode, so they've got like a hard cuticle. They kind of look like earthworms, but without the segments. And the ones that we're talking about, the ones that cause Trichinosis, they're very tiny, so they're much smaller than normal earthworms. Do you feel like you've got that image in your head?

• 21:10Daniel Whiteson?

  I'm imagining something that looks basically like a human hair and it's curled up.

• 21:14Kelly Weinersmith?

  Yeah.

• 21:15Daniel Whiteson?

  And if you zoom in on it, it looks sort of like a worm.

• 21:17Kelly Weinersmith?

  Yeah, it comes to points at either end, but yes, kind of like a human hair, except points at the ends. And so what happens is if you eat meat that's infected by this parasite and that meat's not cooked through all the way, the parasites burst out of the cells that they've been living in. So as your body is digesting the food, it also digests the cells they've been living in and that releases them.

• 21:37Daniel Whiteson?

  So they've been living inside the cells, like I'm eating pork, then these worms are inside the cells of the pig, not swimming around between the cells?

• 21:44Kelly Weinersmith?

  Yeah, and this is not something that's super common for wormy parasites to do, but this is something that this particular species does. They live inside the cells and they can live inside the cells for like 30 years, like incredible amounts of time.

• 21:57Daniel Whiteson?

  So they're smaller than like a pig cell?

• 22:00Kelly Weinersmith?

  And they get into the pig's cell, they expand the size of that cell. We'll get there. I'm so sorry about the next few years of your life, Daniel. And so they burst out of the cells, they find mates, they produce live, smaller worms. And the smaller worms get into your bloodstream or the circulation for your lymph. And then they end up all over your body. But they can only move in and live into skeletal muscle cells. And so when they end up in like your heart or your brain, they try burrowing into those cells and then they're like, oh, this isn't home and they burrow back out again.

• 22:38Daniel Whiteson?

  Because we have two different kinds of muscle cells, right? Smooth and skeletal, is that right?

• 22:42Kelly Weinersmith?

  Three types: cardiac, skeletal, and smooth.

• 22:46Daniel Whiteson?

  Oh, all right, cool. So why can they only live in one particular kind of muscle? Is it the shape of the cell, the size of the cell, the kind of food they get inside, or?

• 22:54Kelly Weinersmith?

  I don't think we know the answer to that, but they do end up manipulating these cells. They are born about a week after you eat the infected meat and they're going on this journey. And so about a week after you eat the infected meat, this is when you're at the highest risk of dying, because if you ate a lot of parasites in that meat, they're all having babies, they're all releasing babies and those babies are like, maybe if they end up in your brain, destroying a bunch of brain cells or destroying a bunch of cardiac cells. And at this point, you're often given medication to reduce inflammation, because that's a big part of what is causing trouble here, the inflammation as a result of the parasites moving around. And sometimes you're given anti-parasite medication. But this is the most dangerous phase of the process.

• 23:36Daniel Whiteson?

  And in order to be at risk of like dying, you must need to have lots and lots of these parasites. Can one worm or two worms generate like an avalanche of these things? Or do you need to eat a lot of the meats? You have like a big initial population.

• 23:49Kelly Weinersmith?

  Yeah, the more that you eat initially, the worse shape you're going to be in. So if you just happen to eat one or two cells that have the parasite, you're probably going to be fine.

• 23:58Daniel Whiteson?

  You're still going to have parasites inside you. You're just not going to die. That's what you call a fine.

• 24:03Kelly Weinersmith?

  I mean, for most of our evolutionary history, that would have been lucky. Just one or two parasites in you. But yes, it won't be a dire situation, I guess.

• 24:11Daniel Whiteson?

  All right.

• 24:12Kelly Weinersmith?

  But so when these parasites do find the cells they're looking for, the skeletal muscles, they burrow in and now this is when they start manipulating the cell. So they call the cell a nurse cell. They like secrete some stuff that gets rid of the parts of the cell that they don't need. They start growing and expanding. The cell starts getting bigger. And then around the cell, I think it doesn't recruit the kind of vessels that bring oxygenated blood because inside the cell you end up with an anaerobic environment. I don't know why that's necessary. But so they start bringing the kinds of cells that take deoxygenated blood away. But in this way, the nurse cell delivers nutrients and removes waste. And so the parasites are able to manipulate the cells to become nice homes

• 24:57Kelly Weinersmith?

  and to do things like remove waste and feed them. So we don't really understand how this happens, but it does. And Dixon de Pommier wrote this book called Parasites, People and Plowshares, where he argues that if we could understand how nurse cells work, we could maybe understand like better ways of like delivering insulin and stuff like that. And so he's really interested in trying to like physiologically understand what's happening here, but it's a complicated system.

• 25:20Daniel Whiteson?

  So they really have taken over the cell and refashioned it for their own use. It's no longer doing the original thing you had that cell for. It's now basically just like a homestead for these worms.

• 25:30Kelly Weinersmith?

  Yep, it's kind of amazing, I think, that they've managed to like, you know, evolve to do this.

• 25:34Daniel Whiteson?

  I think it's super amazing when they manipulate their environment to respond in a certain way, to take advantage of it. Obviously, you know, this is just evolution, right? There's no like intentional. Design here. They're not like engineers where they're thinking about what to do. But they found this strategy. Why haven't humans responded in evolutionary sort of way to create new defenses? Like, obviously, this is bad if it kills you, or even if it doesn't kill you, it must be bad for you because it's sapping your energy. Do humans have defenses against this? Or are we just like total suckers for these worms?

• 26:05Kelly Weinersmith?

  Well, so some of the worms die, and the ones that die, they get calcified. And I think probably some of them are dying because of an appropriate immune response.

• 26:14Daniel Whiteson?

  I'm glad to hear something's happening in the inside to push back.

• 26:16Kelly Weinersmith?

  Yeah, yeah, we're doing something. But, you know, so for a lot of parasites, the deal is that they, through this evolutionary arms race, have just found ways to evade the immune system, to just make the immune system think it's not even there. And then other times, it's more about like, and I'm gonna make this sound super anthropomorphic. And it's not like a decision that the body's making, like it's thinking about it like a person, but this is a process over evolutionary time. But so these worms that are living in the nurse cells, is it worse for the body to deliver a tiny amount of energy to these teeny tiny little worms? Or to kill the worms and calcify it? And if it's in your diaphragm, you know, so like that sandy diaphragm, yeah, it's a problem for the scalpel. But probably a diaphragm that's that hard isn't doing a very good job of like helping you breathe.

• 27:00Kelly Weinersmith?

  And so if you end up with all of these calcified muscles, and when a parasite dies, it usually kicks off an inflammatory response. And so I think over evolutionary time, the trick isn't attack all the parasites that you have with your maximum ability, because when you initiate an immune response, that often causes damage to the host as well. And so I think it's a balancing act between what do I just ignore and what do I have all out war against?

• 27:25Daniel Whiteson?

  I don't know, Kelly. I think you're just a shill for big parasite. I mean, you're telling me I should happily live along with these things that have like squatting in my cells. You're like, isn't it just best for everybody if you just give in and give up some of your energy? Like, I don't know. I think we're in all out war with these things.

• 27:43Kelly Weinersmith?

  There are some unpleasant people in my life, and I think my life is better for ignoring them than for like trying to attack back. And, you know, I don't think it's that different with the worms and, you know, we Should have a whole episode one day on this old friends or hygiene hypothesis. Are you familiar with this idea?

• 27:58Daniel Whiteson?

  Yeah.

• 27:59Kelly Weinersmith?

  The idea is basically that like we've had these organisms in our body through enough evolutionary time that our immune systems have come to sort of like expect them to be there. And now they're sort of used as cues for how our immune system should work and how our immune system identifies self from not self. These things don't always go in the direction you'd think. I wouldn't want to have any worms in my body, but you know, it's also possible my body is just like, it's not worth the effort. You just ignore.

• 28:23Daniel Whiteson?

  Yeah. And Katrina is big on not classifying microbes, some of them as good or bad, because they all play different roles and it's complicated. And you know, you might imagine you don't want to be infected, but obviously lots of microbes are essential for your life. The fermentation that happens in your gut, all that kind of stuff. Is it possible that parasites like these worms are playing some positive role that we're benefiting from? I mean, you call them a parasite, which implies that we're not getting anything. There's no commensal reaction here, but are there any benefits to having these worms live inside of us?

• 28:55Kelly Weinersmith?

  I don't think there's any documented benefit from having Trichinella sporalis inside of you. There are some other parasites that people have been experimenting with where when you infect people like their hay fever symptoms go away or their Crohn's disease symptoms become less severe or their MS goes into like remission or whatever the right word is for that. But those studies are super complicated. Sometimes you get good results, sometimes you don't. It seems to depend on the parasite genome or maybe the exact person's genome and the exact kind of problem they have. And I think science is like really working through digging through that right now. And right now we're at a like, what is happening phase? But we should invite an expert on one day to talk about that.

• 29:39Daniel Whiteson?

  I'm just trying to get mentally prepared because you know, I've learned now that bacteria can be good for you and even leeches can be good for you. So, hey, maybe in the future we'll all be intentionally injecting worms into our children.

• 29:50Kelly Weinersmith?

  There are a community of people who are intentionally infecting themselves with parasites right now. I think most of them are not doing that to their children, I hope. But in my mind, the ideal thing isn't that we all take like five hookworms for breakfast. And call it a day, but that we figure out what cues the parasites are giving our immune system and then we can like take a probiotic pill or something that like replicates those cues. So we don't actually have to have the parasites there. But I agree with Katrina that I think we are at a point where dichotomizing things as good and bad, we're realizing sometimes it's a little bit more complicated and it depends on context.

• 30:24Daniel Whiteson?

  And I think the point you made is really interesting that we can learn from them how to manipulate our own bodies. Like if they have spent millions of years evolving strategies to pull chemical levers inside the body, we can take advantage of that, right? If we understand the techniques that they have stumbled into, we can maybe use them intentionally to understand the workings of our own system.

• 30:45Kelly Weinersmith?

  Yeah, yeah. Sometimes the parasites that manipulate host behavior, we sometimes refer to them as evolutionary neuroscientists. And there's, you know, like a whole group of people like me who write our NSF grants about how we can understand host behavior better by trying to figure out what parasites have quote unquote, learned through natural selection, all of this across all these years.

• 31:03Daniel Whiteson?

  So these guys set up a home in these nurse cells, make them work for them. How long do they hang out? Like, do they live as long as the cells live? Do they have like generations and generations of worms inside one cell? Or is the single worm last a long time?

• 31:19Kelly Weinersmith?

  Yeah. So there's no reproduction happening at this stage, but worms can live, it looks like for 25 plus years.

• 31:24Daniel Whiteson?

  25 years?

• 31:26Kelly Weinersmith?

  Yeah.

• 31:26Daniel Whiteson?

  Oh, my gosh. So they can vote and, you know, buy alcohol and stuff like this?

• 31:30Kelly Weinersmith?

  Yeah, absolutely. Because that's what they're doing. But no, they live for a really long time. And I mean, they've got like a nice setup, you know, food is being delivered to them, their waists are being removed. So yeah, they can live for a really long time, but they're not reproducing. They're just like biding their time until the muscles that they live in get eaten by something else.

• 31:46Daniel Whiteson?

  And are they squirming around a lot? Because for some reason, that makes them a lot worse. Like, if you're just quietly hanging out inside my cell and stealing some food, okay. But if you're like squirming around, then it's, ooh, I just can't tolerate that.

• 31:58Kelly Weinersmith?

  You know, I would like to exercise every day. So I guess I hope that they're like running laps in their little nurse cells. But I think they're generally not moving much. And if they are, you're not feeling it.

• 32:07Daniel Whiteson?

  See, you're pro parasite. There you are again. Like advising the parasites how to live their best life inside people.

• 32:13Kelly Weinersmith?

  Well, you know, we all need to stay healthy.

• 32:17Kelly Weinersmith?

  So you know, you might be asking yourself, if you want to avoid being a track for parasites, how do you do that?

• 32:23Daniel Whiteson?

  Yes, tell me.

• 32:24Kelly Weinersmith?

  For a long time, it was difficult. So most of us get this parasite from pork. And so pigs get infected. It's in the pigs' muscles. And if you eat pork that hasn't been cooked through enough, that's how you get infected. And pork, you know, in the 1880s, the United States was like a world exporter of pork. It was a huge industry for us. And it ended up being a big problem for us because Europeans decided that because we weren't checking for Trichinella, we weren't checking for this parasite, that we were causing a bunch of Trichinosis outbreaks in Europe. And so for a while, they stopped importing pork from us. And this was a big problem for our industry. Some Americans went over there and they were like, no. And they they figured out that like, no, it's not necessarily our pork that's causing

• 33:09Kelly Weinersmith?

  the problem. Like, maybe, maybe sometimes it's American pork that's the problem. But like, it's not like all of our pork is wormy. But, you know, it was a good goal to try to reduce the worminess of our meat. And so how did we do that?

• 33:21Daniel Whiteson?

  But wait, hold on a second. Why pork? Like, do these parasites prefer pig cells to cow cells for some reason? Do cows have the kind of muscles that they can't get inside? Why pork?

• 33:32Kelly Weinersmith?

  OK, so part of it has to do with the animal's diet. So pigs eat everything. Like, we are thinking of getting pigs on our farm so that all of our food waste goes into pigs. But then I couldn't turn them into bacon because they'd be like friends. I'd probably name them Wilbur. So pigs eat everything, including other pigs.

• 33:48Daniel Whiteson?

  Pigs are cannibals?

• 33:49Kelly Weinersmith?

  Yep, pigs are cannibals. Yep, I knew you'd be excited about that. So when a pig dies, another pig will eat its infected muscles and then they'll get infected. So part of it has to do with diet. There were also some like rodents who would eat dead pigs and then other pigs would eat the rodents. And so for a while, rodents were part of the transmission cycle here. Cows tend to not eat meat. But like, horses can get infected. And horses don't usually eat meat. But sometimes they will. So like a lot of animals that we think of as non-meat eaters will eat meat every once in a while if you give it to them and they're in the right mood. And so there have been cases of horses getting infected.

• 34:27Daniel Whiteson?

  We even learned on the podcast recently that bees sometimes eat meat, right?

• 34:31Kelly Weinersmith?

  That's right. Yes, yes. Meat, honey. Mmm. Yeah. And so I think the reason that cows often don't get infected is because they're just not eating meat.

• 34:39Daniel Whiteson?

  I see.

• 34:39Kelly Weinersmith?

  So Trichinella sporalis is one Trichinella species. There are other Trichinella species that seem to specialize on other animals. There's like in the United States, bears and moose and wild boars. Some of them can get infected by Trichinella sporalis, but there's also other Trichinella species that are more common in nature that they can get infected with, but then we can get infected by those if we don't cook the meat through. And so there is some chance that I carry some Trichinella in me because I ate bear once that I don't think was cooked through all the way.

• 35:13Daniel Whiteson?

  You ate a bear? What? I have to hear that story. When did you have a bear?

• 35:18Kelly Weinersmith?

  Not a whole bear. I was working with some folks in the Wisconsin Department of Natural Resources and they were nice enough to invite us to their annual social gathering and a bunch of people brought stuff that they had hunted and there was barbecue bear. And so, I mean, I've eaten bear. I'm gonna assume they cooked it through all the way, but I've also eaten smoked moose hearts. Oh, but it shouldn't be in the cardiac muscles. So that should be fine because it's in skeletal muscles.

• 35:47Daniel Whiteson?

  Yeah.

• 35:47Kelly Weinersmith?

  There you go.

• 35:47Daniel Whiteson?

  That's not weird at all, smoked moose heart.

• 35:49Kelly Weinersmith?

  Knowing is half the battle. No, the smoked moose heart was gross. Like when it got pulled out of the bag, it still had like fat on top of the heart, but it was like a collaborator of mine who was from a part of the world where this was... Anyway, I pushed through.

• 36:03Daniel Whiteson?

  You're gonna turn me into a vegetarian, Kelly.

• 36:05Kelly Weinersmith?

  Again, right? Back to your vegetarian roots.

• 36:07Daniel Whiteson?

  Exactly. Here we go.

• 36:10Kelly Weinersmith?

  So let's back up. Okay. So you know, you can get it from pork, but you don't get it from pork in the United States much anymore. So what's changed? So in the 1950s, we made it so that people were no longer allowed to feed their farmed pigs uncooked Garbage, which is such a gross phrase to hear, I think.

• 36:30Daniel Whiteson?

  You have to cook your garbage if you're gonna feed it to pigs?

• 36:32Kelly Weinersmith?

  Yeah, so like, you know, nowadays, factory farms don't feed pigs anything you would just call garbage. I mean, I guess maybe people would want to call it garbage, but it's not actually garbage the way these animals were being fed garbage before. But for a while, the change was just you had to cook it through, and if you cook it through enough, then any of the infective stages of the parasites are dead. And so that was a stage of improvement.

• 36:52Daniel Whiteson?

  All right, so barbecued garbage is okay, or slow roasted garbage?

• 36:56Kelly Weinersmith?

  As long as the internal temperature in the middle of the garbage reaches 165 degrees Fahrenheit, yes, you're probably fine.

• 37:02Daniel Whiteson?

  Maybe a sous vide then, because that's really good temperature control. Sous vide garbage, that's what they serve at pig restaurants.

• 37:08Kelly Weinersmith?

  Oh, so disgusting. So like, up until 1985, we weren't really sure how pigs were mostly getting infected. But, you know, we've talked about how cannibalism and rats contribute to infection. There was also like, sometimes if pigs and wildlife were interacting. I think most often the pigs were infecting the wildlife, but sometimes the wildlife could infect the pigs. But once we sort of figured all of this stuff out, we were able to say like, okay, first of all, you have to make sure your pigs aren't able to eat the other pigs if they die. You have to make sure you don't have any rats in with your pigs, which I'm sure is hard.

• 37:43Daniel Whiteson?

  Yeah, that sounds hard because rats are everywhere.

• 37:45Kelly Weinersmith?

  Oh, my gosh, yes, we live on a farm, rats are everywhere. It's hard to keep them out, but you need to make a good effort to do it.

• 37:51Daniel Whiteson?

  Well, let me ask you, how do you feel about the rats? Because I have this policy, no rats inside the house. But outside the house, like, hey, you guys were here before us, what am I gonna do? Kill all the rats? That's impossible.

• 38:02Kelly Weinersmith?

  Well, okay, so the rats that we had in our chicken coop were an invasive species. So they didn't really belong there. These were like the lab rats, Norwegian rats that had gotten out. And rats, like, usually I agree, but so that we have really stupid chickens. And like, the chickens would be eating at their feeder and the rats would be like, right next to them eating. And they'd just kind of look at them and be like, hey, Frank. And they wouldn't do anything. But so then the rats were living in the rafters above and they were just like, defecating an incredible amount.

• 38:32Daniel Whiteson?

  They do that.

• 38:32Kelly Weinersmith?

  They do that. And there are some diseases you can get from rat feces and from mouse feces.

• 38:37Daniel Whiteson?

  Hauntovirus.

• 38:38Kelly Weinersmith?

  Yeah, right, exactly. And so if it's just like, yeah, I try to never kill. Wildlife, because I agree you were here first. But when it's like, well, if my daughter goes out to bring the chickens food and she's going to get hantavirus, like, we've crossed a line and we have to get rid of the rats.

• 38:53Daniel Whiteson?

  Also, you live in Virginia, which is not that far from the NIH, right? And you're talking about rats that have escaped from labs. Are you basically living the rats of NIM?

• 39:05Kelly Weinersmith?

  That was a great movie. These rats, they are the species that we use in the lab. I don't know that they escaped from the lab. They could have just like come off of ships or something.

• 39:14Daniel Whiteson?

  Keep telling yourself that.

• 39:16Kelly Weinersmith?

  Science has made some mistakes, no doubt about it. I'll own up to that.

• 39:20Daniel Whiteson?

  Well, we had rats as pets once, and rats are wonderful, wonderful pets. They're smart, they're affectionate, they're really cute. They do poop everywhere, though. Yeah, that is definitely a problem.

• 39:30Kelly Weinersmith?

  I also had rats as pets when I was a kid, and I thought about getting one again the other day because I did used to love just having like a little rat on my shoulder. They make this cute little noises when, yeah, I like rats a lot.

• 39:41Daniel Whiteson?

  My daughter would bike around the neighborhood with a rat in her hood of her hoodie, riding along with her. It was super cute.

• 39:47Kelly Weinersmith?

  Yeah.

• 39:48Daniel Whiteson?

  Anyway, you're saying if you have pigs and rats, try to keep the pigs from eating the rats.

• 39:52Kelly Weinersmith?

  Yes, try to keep the pigs from eating the rats. And so, once we figured this stuff out, it became clear what you needed to do to keep the pigs from getting infected. And once you knew what you needed to do, you could pass laws to make sure that people are doing these things. And by putting in the right sort of like procedures in place and then coming up with some better ways to test meat to see if it's working, we have managed to mostly eradicate this parasite in pork from factory farm.

• 40:21Daniel Whiteson?

  Amazing.

• 40:22Kelly Weinersmith?

  But there's still some ways that you can get it, which we'll talk about after the break.

• 40:27Daniel Whiteson?

  More nightmare fuel, don't worry.

• 40:29Kelly Weinersmith?

  That's right.

• 40:38Speaker 02

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• 41:08Speaker 01

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• 41:49Daniel Whiteson?

  So, everyone on board? Yeah, I think so. You can't see it, but everyone in this room is nodding. They all agree the launch plan's perfect. But Julie has an idea how it can be even better. So she asks Copilot Cowork to help her overnight. Hey, Copilot. Gather the past three months of retail sales reports, surface key insights, and build a deck outlining a partner strategy by tomorrow morning.

• 42:11Daniel Whiteson?

  Morning, team. I found a way to improve the plan. Check Slide 4. Get help with complex tasks with Copilot Cowork. Microsoft Copilot, work lives on.

• 42:28Kelly Weinersmith?

  We were just talking about how pigs from factory farms in the United States tend to not have this parasite anymore. And actually, in 2024, there was a study where they sampled 3 million pigs, and none of those pigs from factory farms had Trichinella.

• 42:43Daniel Whiteson?

  Amazing. Wow.

• 42:45Kelly Weinersmith?

  That is incredible. Like, if you think that we have gone from 1 in 6 people in New England having this parasite infection, which can kill you sometimes... To testing 3 million pigs and none of them have it. That's an incredible decline.

• 42:59Daniel Whiteson?

  That means all those people who were infected, when they died, nobody ate them and then absorbed the infection, right, including the pigs?

• 43:07Kelly Weinersmith?

  That's right. Yes, I should have known you were gonna go there. My bad. But yes, that means that there's not a lot of human cannibalism going on. Good news.

• 43:15Daniel Whiteson?

  And of course, I'm gonna ask, if pigs can get it from eating other pigs, that means humans could get it from eating other humans, right?

• 43:20Kelly Weinersmith?

  Yep.

• 43:21Daniel Whiteson?

  Yeah, okay. One more reason not to eat your children, yes.

• 43:24Kelly Weinersmith?

  Yeah, well, you know, if they're young enough, maybe they haven't been exposed. Move it on.

• 43:29Daniel Whiteson?

  When their meat is still so tender.

• 43:31Kelly Weinersmith?

  Oh, God. Why do we do this? All right, so now there's about 15 confirmed cases in the United States a year, which is an incredible drop. And there's about 10,000 cases recorded throughout the world per year. And I think a lot of those cases are in places like China where they eat a lot of pork, but maybe they don't have the same sort of procedures in place to make sure that the pigs aren't eating each other or aren't being exposed to rats. And so there are other places in the world that you can go where if you eat pork, you could get infected.

• 44:04Daniel Whiteson?

  So how is it happening in the US if there were no examples in all of those pigs? Where are people getting it? They're just getting it from the wild again? Or they're eating weird smoked moose hearts or something?

• 44:16Kelly Weinersmith?

  So I think a lot of people do get it from animals that they hunt. So you can get it from bears, you can get it from moose, you can get it from wild boar. And also, you know, if people have pigs in their backyard, they are not necessarily following all of the rules that like the USDA mandates. So it could be that their pigs are encountering wild animals that they're eating or then eating each other. And so you could get it from like backyard pigs. The good news is, if you cook your meat where the inside reaches, I think it's 145 degrees Fahrenheit, then the parasite dies. The bad news is, if you freeze the meat, even for something like two months, that doesn't necessarily kill Trichinella.

• 44:59Daniel Whiteson?

  What? They can survive freezing?

• 45:01Kelly Weinersmith?

  It's amazing. Yeah. So like, there have been cases where- Meat has been frozen and two months later it's come out of the freezer and when it thaws, those worms start moving around again. This is mostly the wild strains or the wild species. Maybe it's not too surprising because like bears can hibernate, they get really cold. But still, the fact that they can freeze, that's amazing because bears aren't freezing through when they're hibernating.

• 45:23Daniel Whiteson?

  Yeah, and I thought that most cells when they freeze, they burst because water expands as it freezes. So how do these guys survive it?

• 45:30Kelly Weinersmith?

  I mean, I'm guessing some of them do have nurse cells that burst and they die. But most of the food that we plan on eating, we freeze quickly because when those cells burst, that food doesn't taste as good. And so like you want to freeze your food quickly so the cells don't burst because that's a better way to eat a hamburger or a bear steak. So I think, you know, the parasites are benefiting from that and they can survive. And then also if you prepare jerky out of bear meat, that process of preparing the jerky doesn't always kill the parasites. These parasites, you think about it, like they transmit when the animal that they die in gets eaten by something else. And that doesn't always happen immediately. So they need to be able to like survive the death of the animal for a while and persist in the environment

• 46:15Kelly Weinersmith?

  to increase the probability that they get eaten by something gross.

• 46:18Daniel Whiteson?

  Yes.

• 46:19Kelly Weinersmith?

  Yeah, so most of the cases in the United States come from wild animals that have been killed and then not cooked through all the way. In other parts of the world, you can get it from pork because they don't have the like public health procedures that we have in place here in the United States. But I'm excited about this system because it's a pretty clear example where doing the basic work to understand the life cycle of the parasite and then putting that information in the hands of people who can like set up procedures was able to save, I think, many, many lives.

• 46:49Daniel Whiteson?

  Yeah.

• 46:49Kelly Weinersmith?

  And also just be less creepy, like maybe not a lot of people were going to die, but it's really nice to know that we don't have like parasites running laps in our diaphragms in the United States.

• 47:01Daniel Whiteson?

  So you're a parasitologist. You know, the cutting edge of parasite science. We've mostly told the historical story today, but like, what are people working on right now? If you go to Trichinosis conference, what are the presentations about? What are the questions that people are asking?

• 47:17Kelly Weinersmith?

  Yeah, so one of the main topics here is trying to figure out when an outbreak happens. So there are still outbreaks. I was listening to someone's talk the other day and it was somewhere in Scandinavia. There was an outbreak on farms and it showed up in a couple of different farms. And so they were collecting samples of the parasite and then they were genotyping it. So they were getting like the whole genome of the parasite and they were trying to use that information to find out, did the parasite jump from a wild animal? You know, were the pigs able to go out in the fields one day and they ate a wild animal? And that's how they got infected. But by figuring out what species or strain, then they can try to figure out like where the procedure for keeping this parasite out of our food system,

• 48:01Kelly Weinersmith?

  like where that broke down. And so they're using genetic information to sort of do the tracing stuff here. They're also still trying to figure out how this nurse cell works. And you know, how does it manage to manipulate the human body into essentially like waiting on it hand and foot without killing it? And you know, also like wildlife ecologists are probably interested in what Trichinella is doing to like wild bear populations and stuff like that. So I think those are the main topics we're dealing with right now.

• 48:28Daniel Whiteson?

  So this all sounds surprisingly positive. You're saying this is a success story. Is this typical, Kelly, or is the wider world of parasites a darker world?

• 48:37Kelly Weinersmith?

  Well, the wider world of parasites can be pretty dark. So this was a nice case where we figured out how the parasite was transmitted. It was pretty clear what we needed to do and it wasn't that hard to implement the changes. But there's other parasites where we know what it would take to eradicate the infection. But like, for example, bringing the appropriate sanitation measures to the people who need it has just proven to be something that we can't seem to do yet. And so the next time we talk about this wormy world of ours, we're going to be talking about nematodes. And today we talked about a nematode too, but we're going to be talking About nematodes that you can get because they burrow through your skin when you're walking in soil that's carrying these infective stages.

• 49:17Daniel Whiteson?

  Oh, no. So you don't even need to make bad eating decisions. You can just be going for a walk.

• 49:22Kelly Weinersmith?

  Or you can be gardening. They're able to just sort of burrow through your skin. So we will talk about soil transmitted helmets, which have been stubborn and hard to eradicate the next time we visit this wormy world.

• 49:34Daniel Whiteson?

  There's always more nightmare fuel waiting for you in biology.

• 49:38Kelly Weinersmith?

  And Kelly's got it ready for you.

• 49:40Daniel Whiteson?

  Thanks, everyone. Tune in next time.

• 49:50Kelly Weinersmith?

  Daniel and Kelly's Extraordinary Universe is produced by iHeartRadio. We would love to hear from you.

• 49:56Daniel Whiteson?

  We really would. We want to know what questions you have about this extraordinary universe.

• 50:02Kelly Weinersmith?

  We want to know your thoughts on recent shows, suggestions for future shows. If you contact us, we will get back to you.

• 50:08Daniel Whiteson?

  We really mean it. We answer every message. Email us at [email protected].

• 50:15Kelly Weinersmith?

  Or you can find us on social media. We have accounts on X, Instagram, Blue Sky, and on all of those platforms, you can find us at D and K Universe.

• 50:24Daniel Whiteson?

  Don't be shy. Write to us.

• 50:29Speaker 01

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• 50:58Speaker 06

  Hey, it's Lunchbox from the Bobby Bones Show. Buy smart, drive for less, and trade for more. That's Toyota affordability, and it starts with a great deal on an all-wheel-drive Camry, Corolla Cross, or a Corolla Sedan with the latest features in tech. Or test drive a spacious Grand Highlander or an adventure-ready RAV4. And with so many hybrid models available, you can enjoy longer trips without all the stops. While Toyota's legendary resale value means you could get more at trade-in, get a deal today and great value tomorrow. Shop toyota.com for deals and details. Toyota, let's go places.

• 51:39Speaker 06

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• 52:05Daniel Whiteson?

  So, everyone on board? Yeah, I think so. You can't see it, but everyone in this room is nodding. They all agree the launch plan's perfect. But Julie has an idea how it can be even better. So she asks Copilot Cowork to help her overnight. Hey, Copilot. Gather the past three months of retail sales reports, surface key insights, and build a deck outlining a partner strategy by tomorrow morning.

• 52:27Daniel Whiteson?

  Morning, team. I found a way to improve the plan. Check Slide 4. Get help with complex tasks with Copilot Cowork. Microsoft Copilot: Work Lives On. This is an iHeart Podcast. Guaranteed Human.