Ep. 71 | A Clean Break/Look, Don’t Touch

Summary

MrBallen’s Medical Mysteries - Episode 71: A Clean Break/Look, Don’t Touch

Release Date: February 11, 2025

Introduction

In Episode 71 of MrBallen’s Medical Mysteries, host Mr. Ballin delves into two gripping medical stories that highlight the fragility and mystery of the human body. This episode, titled "A Clean Break/Look, Don’t Touch," explores a harrowing incident involving a backpacker in Nepal and a baffling salmonella outbreak at the Denver Zoo. Through masterful storytelling, Mr. Ballin uncovers the intricate details and unexpected turns of these medical mysteries.

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Story 1: A Clean Break

Summer 2023, Kathmandu, Nepal

Setting the Scene

In the quiet nights of Kathmandu, the owner of an all-night medical shop finds solace in the solitude, managing his inventory and handling occasional emergencies. However, one late night introduces chaos when two intoxicated men stagger into his shop.

The Incident

One of the men is severely injured, bleeding from a deep gash in his abdomen. Fortunately, the shop owner possesses basic emergency medical skills. He swiftly cleans and stitches the wound, stabilizing the injured man.

Unexpected Complications

"The shop owner had no idea that by this time tomorrow, that drunk injured man would have much bigger problems than a bleeding wound." [00:45]

The next day, the injured man, Jeff, a 22-year-old backpacker, awakens with excruciating abdominal pain but no memory of how he sustained his injury. Concerned, he seeks medical attention at the Shankarapur Hospital in Kathmandu.

Medical Investigation

Dr. Anil Singh, a specialist in gastrointestinal problems, examines Jeff and discovers a suspicious bandage covering a clean, three-inch cut on his abdomen. Jeff is perplexed, unaware of any recent injuries beyond a punch to the face. An X-ray reveals a shocking twist: a six-inch knife blade is lodged inside Jeff's abdominal cavity.

"You had no idea you had a wound on your stomach?" Dr. Singh [05:30]

Unraveling the Mystery

Through interviews and investigation, it is revealed that during a bar altercation, Jeff was stabbed with a chef's knife. An onlooker, witnessing the event, took Jeff to the medical shop where the owner stitched him up without checking for foreign objects. The knife fragment slowly moved deeper into Jeff's body overnight, causing severe internal damage.

Surgical Intervention and Recovery

Jeff undergoes emergency surgery to remove the knife blade, and miraculously, he recovers fully within five days. Although he leaves Nepal with a scar and no memory of the stabbing, the incident serves as a stark reminder of the unforeseen dangers travelers can face.

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Story 2: Look, Don’t Touch

January 14, 1996, Denver Zoo

A Day at the Zoo

Alana Rugen and her six-year-old son, Jaden, visit the Tropical Discovery Center at the Denver Zoo. Jaden's fascination with snakes leads them to interactive reptile exhibits, including a new display featuring Komodo dragons.

The Outbreak

Several days after their visit, Jaden falls ill with severe symptoms, including a high fever and bloody diarrhea. Alana takes him to the hospital, where he is diagnosed with a rare strain of salmonella enterititis. Soon, seven children in the Denver metro area exhibit the same symptoms, prompting an urgent investigation by Dr. Barbara Rafa of the Colorado Department of Public Health and Environment.

"Kids were actively being exposed to salmonella right now." Dr. Rafa [22:15]

Investigative Efforts

Dr. Rafa collaborates with the CDC to trace the source of the outbreak. Initial suspicions focus on the zoo's reptile exhibits, but all animals appear healthy and contained. The breakthrough comes when stool samples from various reptiles test negative except for the Komodo dragons.

Link to the Komodo Dragons

Further investigation reveals that the Komodo dragons' enclosure, separated by a wooden barrier and a row of bushes, was the contamination source. The dragons, roaming within their mulch-filled habitat, inadvertently transferred salmonella to the wooden fence. Excited children like Jaden, who leaned over the barrier, unknowingly touched contaminated surfaces and contracted the bacteria.

"There has not been a single salmonella outbreak in nearly two decades." Dr. Rafa [34:00]

Resolution and Preventive Measures

Upon identifying the Komodo dragons as carriers of the salmonella strain, the Denver Zoo took immediate action. They constructed a permanent, fully sealed enclosure for the dragons, eliminating public contact and preventing further outbreaks. The swift response ensured all affected children recovered without long-term consequences.

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Conclusion

Episode 71 of MrBallen’s Medical Mysteries masterfully illustrates how seemingly minor incidents can escalate into life-threatening medical emergencies. Whether it's an embedded knife in a backpacker's abdomen or a salmonella outbreak linked to exotic animals, these stories emphasize the importance of prompt medical intervention and thorough investigative procedures. Through engaging narratives and detailed examinations, Mr. Ballin sheds light on the intricate and often unpredictable nature of the human body and its interactions with the world around us.

For more intriguing medical mysteries, follow Mr. Ballin’s Medical Mysteries on Amazon Music or your preferred podcast platform.

Transcript

[Mr. Ballin]

Hey prime members. You can binge episodes 6572 right now and ad free on Amazon Music. Download the app today. In the summer of 2023, the owner of an all night medical shop in Kathmandu was busy restocking shelves. It was late, sometime after midnight, but the man didn't mind. He liked working the overnight shift. It was quiet and some nights nobody came in at all, which gave him time to do the accounting. But the peace and quiet was shattered when two drunken men in their 20s stumbled inside. One of them was covered in blood and leaning hard on the other, barely conscious. The uninjured man explained that his companion needed to be stitched up quick. The shop owner happened to know basic emergency medicine, so he jumped into action. He cleared off the table in the corner of a store and then told the friend to lay the injured man out on the table. Then he went to the back to get his sutures kit. By the time the shop owner returned to the front of the shop, the injured man was lying there babbling drunken nonsense and clutching his stomach. The owner wasted no time though. He rolled a stool up to the table and lifted up the man's shirt. There was this nasty gash in the man's abdomen. It took him a few minutes to clean the wound and staunch the bleeding with gauze. After that, he worked quickly to stitch the edges of the cut back together. After he was done, the friend thanked the shop owner and paid him what little cash he had in his pocket. And then he assured the shop owner he would get his injured friend back home safely. Once the two men left and the shop owner began cleaning up the blood stained table, he also began thinking to himself how glad he was that he was able to help. That man could have easily bled to death, but now he'd be just fine once he sobered up. But the shop owner had no idea that by this time tomorrow, that drunk injured man would have much bigger problems than a bleeding wound.

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[Mr. Ballin]

I'm Mr. Ballin and this is Mr. Ballin's Medical Mysteries, where every week we will explore a new baffling mystery originating from the one place we all can't escape our own bodies. So if you liked today's story, tell the follow button. You'd be happy to fix their broken air conditioner. But when you actually work on it, just smash it repeatedly with a hammer and then leave. When it comes to medical problems, there's nothing quite as mysterious as abdominal pain. And it's not just because of the discomfort it causes. It's because our abdomens have a ton of organs. So that pain could be coming from anywhere. Whether it's our stomachs, our intestines, our livers, our kidneys, there are so many vital components that can go haywire. And so, on that note, today's episode features two stories about patients with horrible abdominal pain that ends up being caused by something totally unbelievable. The first story is about a young man backpacking through Nepal whose trip is derailed by a shocking trip to the hospital. And the second story is about a mysterious salmonella outbreak that sickened children all around Denver, Colorado, with one strange connection between all of them. And now, here is our first episode called A Clean Break. In the summer of 2023, a 22 year old backpacker named Jeff was out late drinking at a bar in Kathmandu, Nepal. Jeff had been traveling alone through South Asia over the past few weeks, and he just arrived in Kathmandu from India. So far, he loved Nepal. Over the past two days, he'd been exploring all the temples, markets, and food stalls that filled the bustling 2,000-year-old capital. He'd been going out to bars every night after dinner, hanging with locals and fellow tourists alike. Tonight, he'd chosen a bar that was full of people about his age, and the music was all western pop tunes, so it sort of reminded him of being home. Jeff ordered a potent Nepalese drink called Roxy and struck up a conversation with the man on the next bar stool. He bought his new friend a Roxy as well, and they talked about Jeff's travels for a while. Then someone else joined the conversation, at which point Jeff decided it was time to buy some shots. By the time he paid his bar tab a few hours later, Jeff could barely see straight. He stood up from his bar stool, but he could hardly feel his feet. He only knew he was standing upright because he felt so dizzy. He staggered his way through the crowd. It felt like he was trudging through peanut butter. He swayed a little and stumbled backwards into the group of guys he'd been talking to all evening. They laughed at him, and one of the men gave him a playful push in the back, which sent him spinning into another group of men he didn't know. And these guys did not think the drunken man was so funny. They shoved Jeff back into his original group of friends, but a lot less gently this time. Soon enough, both groups were shoving and pushing, and the last thing Jeff remembered was the feel of someone's fist exploding against his cheekbone. The next morning, Jeff woke up in his hostile bed with the worst headache of his life. It felt like his head had been stuffed in a vise grip. He remembered getting punched the night before, but had no memory of what happened next or how he got home. Frankly, he was just glad to be back in his hostel bed and in one piece, even if his head was pounding. Jeff knew he had some painkillers in his bag somewhere, but the idea of just rifling through his belongings made him feel dizzy. So instead, he just reached for the half empty bottle of water on his bedside and chugged it down in a single gulp. He felt better for about 30 seconds, but then vomit surged up his throat and he had to dive for the trash can on the far side of the room. He spent the next five minutes with his arms wrapped around the trash can, purging the contents of his stomach. It made him feel better, but he was still very achy and nauseous. And he also now had a sharp pain in his gut. It almost felt like he'd pulled a muscle in there or something. Jeff crawled back to his bed and flopped onto the mattress. He decided he would spend the rest of the day in bed, sleeping off this hangover. When Jeff finally woke up again later that day, the sun was setting outside his window. His headache was dull now, and the room had stopped spinning, but the pain in his gut felt sharper, and there was an edge to it that he'd never felt before. Now, Jeff didn't want to be alarmist, but he was all alone in a foreign country, very far from home, and so he had this feeling that he should just go to the local emergency room and make sure everything was okay. After a quick dinner break, Dr. Anil Singh walked into the waiting room of the emergency department at the Shankarapur hospital in Kathmandu. He called his next patient, a foreign tourist named Jeff. Dr. Singh specialized in gastrointestinal problems, and he'd been called down to take a look at Jeff's stomach. He led Jeff to a small examination room, and as they walked there, the doctor immediately noticed the smell of stale alcohol radiating off of Jeff. But he didn't say anything. Instead, once they got to the room, they the doctor asked Jeff if he'd been experiencing any symptoms like constipation or stomach distention, and Jeff shook his head and said no. He said he had been hungover and he felt nauseous from it, but that was not why he was at the hospital. The reason he was at the hospital was because of this new shooting pain in his stomach. Dr. Sting nodded and then put on a fresh pair of latex gloves and told Jeff to lie down on the table. After he had, the doctor lifted up Jeff's shirt and instantly saw a large bandage taped over Jeff's abdomen. And then beneath it was a 3 inch long cut with fresh sutures stitching up his skin. Whoever had done the sutures had done a good job, but Dr. Singh was pretty certain this was why Jeff's stomach hurt. He told Jeff that his sutures looked clean and asked where he got the injury. But Jeff looked so confused. He looked at his stomach and then back up at Dr. Singh with this horrified look on his face. Jeff said he had no idea where that injury even came from. He said he remembered getting punched in the face last night at the bar, but had no memory of anything after that, Certainly didn't recall getting cut or seeing any kind of doctor who might have stitched him up. Dr. Singh cocked an eyebrow and looked at Jeff like, really, you had no idea you had a wound on your stomach? But as Jeff continued to look totally shocked by this wound, the doctor concluded that maybe Jeff really was telling the truth, that he really didn't know about this cut. And so Dr. Singh examined the wound more closely and told Jeff that it looked like someone had cut him open, like that's what the Injury was, you've been cut. And so Dr. Singh ordered an X ray just to see what was going on in there. Jeff nodded like he understood, but his eyes were staring off into the distance and he had a totally frightened look on his face. He asked the doctor if it was possible and that someone had stolen an organ from him while he was blacked out drunk. He'd always heard that in some countries there was a black market for kidneys, but Dr. Singh smiled and told him that that probably did not happen to him. An hour later, Dr. Singh received Jeff's X ray. And when he pulled it up on his computer to take a look, he was absolutely floored. And so he rushed back to Jeff's hospital room and asked him to tell him whatever he could remember about the night before. And so Jeff saw the urgency on the doctor's face, but admitted that as much as he wanted to remember, it really was all a blur. He remembered drinking way too much and getting punched in the face at some point, but he had no idea how he had gotten back to his hostel room after that. Dr. Singh was in awe of how drunk Jeff must have been to have basically no memory of the night before. But he told Jeff that ultimately he would be okay, but based on his X ray, he would have to get in the operating room right away. He needed immediate surgery. Jeff, who was already pale, got even paler and asked Dr. Singh to explain what was wrong with him. What did he find? Dr. Singh sighed, sat down next to Jeff, and then broke the incredible news. The moment those X ray Images came back, Dr. Singh knew exactly what was causing Jeff's discomfort. There was a six inch long knife blade lodged inside of Jeff's body. Dr. Singh told Jeff that at some point the night before, he must have been stabbed. And apparently stabbed so hard that the knife blade had broken off inside of his abdomen. And somehow Jeff was so drunk, he didn't remember any of it. Dr. Singh decided to call the bar, hoping that somebody there would know the whole story. And luckily, the bartender who answered the phone had been working there the night before and had seen the whole thing. Jeff had made some friends at the bar last night, but apparently he had made some enemies, too. And during the physical altercation that ensued with these enemies, someone stabbed Jeff with what looked like a chef's knife. And then one of the onlookers took Jeff to the nearest medical shop, which are these 24 hour pharmacies that can be found all over Kathmandu. And so once they got there, the onlooker begged the shop owner to sew Jeff up. And the shop owner did, even though he was not a doctor. And because he was not a doctor, the shop owner, before stitching him up, didn't think to check whether there were any foreign objects inside of Jeff first, hence the knife being left inside of Jeff. And then afterwards, when Jeff was sleeping off his hangover back at his hostel, that knife blade traveled inside of him through his innards until it was lodged deep inside of Jeff's torso. It was a miracle that it didn't cause further damage to Jeff's internal organs as it worked its way deeper into the muscle of his abdominal cavity. And so it was no wonder Jeff was in extreme pain by the time he got to the error. Jeff was taken to the operating room where surgeons were able to extract the knife blade from his abdominal cavity. Then they patched him up and he was discharged from the hospital five days later. Ultimately, Jeff would travel back to his home country once he was healthy enough to travel, and although he couldn't remember the most exciting part of his trip, getting stabbed, he would always have the scar as a souvenir. Shopping around for car insurance is just the worst. There are so many things you have to understand, deductibles and all the different types of coverages that exist. It's hard enough just to find the right protection for my family and I, but it's even harder to feel like I'm not getting overcharged. Well, Insurify is an insurance comparison site that has the top insurers compete for your business, driving prices down. Insurify lets you compare real time quotes from dozens of insurers, including names you know and trust. The entire Insurify process is handled completely online. That means no annoying phone calls, no ridiculous fees, and no spam, ever. Your data is always safe with Insurify too. They'll never sell your information so you can shop with confidence. 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[Mr. Ballin]

And now here's our second story called Look, Don't Touch. On the morning of January 14th, 1996, Alana Rugen carried her six year old son Jaden as they walked towards the Tropical Discovery center at the Denver Zoo. She was eager to get out of the cold, especially since most of the exhibits they'd visited so far had been outside. They'd seen the penguins, the tigers and the gorillas, but Jaden loved snakes. So the reptiles at the Discovery center were like the main event. Alana let Jayden run ahead of her as they entered the building and then after going inside and collecting her son, they went to sit in a little auditorium that normally showed a short reptile documentary. But this afternoon the movie was turned off and two zookeepers were welcoming a small crowd to fill the seats. After the audience was seated, the zookeepers began bringing out all kinds of snakes and lizards and tortoises, holding them up for the kids to see, and also telling the audience all about the animals and where they came from. Alana watched her son's eyes light up when they brought out a massive 12 foot long boa constrictor and stretched him out on the floor, his forked tongue flicking in and out of his mouth. Alana was thrilled that she'd signed her son up for this little excursion. He seemed to be really enjoying it so far. Just then, one of the zookeepers carried a lizard into the bleachers so the kids could get a closer look. Jaden immediately reached out his hand to try and pet the lizard, but Alana grabbed him and pulled his hand back before he could make contact. The zookeepers had been very clear that this event was a reptile meet and greet, not a meet and touch. By the time the show was over, Jaden was buzzing. He was jumping up and down and telling his mom all about his favorite animals and what he remembered about each one. She smiled as she led him to the next exhibit called Komodo Days. It was a limited time indoor exhibit that had just opened a few days earlier showcasing four of the largest lizards on earth called Komodo Dragons. Each of the animals was bigger than Jaden and that was actually still small for a Komodo dragon. Alana overheard someone reading from a plaque that said these animals could grow up to 10ft long and weigh about 350 pounds. The zoo was hoping to raise enough funds to build a large permanent enclosure for these new arrivals to the zoo. For the time being though, these giant lizards were being kept in a temporary exhibit enclosed by a two foot tall wooden barrier which the lizards were not capable of climbing over to make sure nobody got too close. There was a line of plants in front of the barrier, all surrounded by a chain and post fence. Alana was more than happy to keep her distance. She had to admit that the Komodo dragons were cool, although their exhibits smelled horrible, like damp mulch and manure. But Jaden was so excited he barely seemed to notice. Alana stood with Jaden right behind the fence, and from where they were standing, they had a good view into the enclosure. Alana thought the dragons looked a bit like alligators, with big heads and short stubby legs and long muscular tails. She then leaned over and began to read from the plaque of animal facts fastened to the barrier. She told Jaden that apparently these dragons were poisonous and had razor sharp teeth and they eat almost any kind of meat, from rodents to water buffaloes. Jaden listened and watched in fascination as the dragons lumbered around their enclosure, their big nails crunching on the mulch that had been put on the floor. He giggled as one of the dragons stood up on a rock and stuck its big yellow tongue out, out, hissing at the crowd. Jaden was so entranced by these dragons that he leaned over the fence to get a better look and actually reached towards a Komodo dragon that was only a few feet away, near the edge of its enclosure. And as this happened, that same dragon put its paws up on the two foot wooden wall to get a better look at Jaden. Alana saw this and gasped and grabbed her son and pulled him back. All that was separating him from one of the deadliest predators on earth was a line of decorative bushes. Thankfully, she had pulled him away in time, although it felt way too close for comfort. Alana let Jaden continue to watch the Komodo dragons, but this time a little bit farther back from the barrier. And then after about 15 minutes, Alana's stomach began to rumble. So she told her son they needed to leave now, but they would stop at the cafeteria and grab some food before heading home. A few mornings later, Alana went upstairs to wake her son for school. But when she entered Jaden's room, he complained that his stomach hurt and he was afraid that he was going to throw up. Now, normally, Jaden was pretty enthusiastic about school, so Alana decided he must really be sick. So she told him he would stay home today and rest up. And then she went and got him some Gatorade. A few hours later, Alana. Alana was in the kitchen grabbing saltine crackers for Jayden when she heard him cry upstairs, she ran upstairs and found him still in bed, but now sweating with a fever and shivering with chills at the same time. When she took his temperature, it read 104 degrees. Alana was shocked. This seemed more serious than just a 24 hour bug, and so she decided to bring him to the doctor. But before they left to go see the doctor, she had Jayden use the bathroom and discovered he was passing bloody diarrhea, which really scared her. Once he was cleaned up, she rushed him out the front door and sped to the hospital as fast as she could. About 10 days later, on January 26, Dr. Barbara Rafa knocked on Alana's front door. Dr. Rafa was an investigator with the Colorado Department of Public Health and Environment and had recently learned that Jaden was one of seven children in the Denver metro area who had been infected with a strain of salmonella called salmonella enterititis that's commonly found in poultry and other animals. Dr. Raffa and her team were trying to figure out where the children had picked up the salmonella bacteria, which is usually spread by consuming contaminated food or water or having contact with infected animals. The doctor reassured Alana that most people recover from a salmonella infection, but it can be dangerous to young kids. In fact, if kids go untreated for salmonella, they can die. Dr. Rafa had spent the past few days interviewing the families with the kids who were sick with salmonella and had asked hospitals to report any new cases. She had the sinking feeling that this was the beginning of an outbreak, so she and her team needed to act fast to figure out what was going on here. Alana knew her son had salmonella poisoning, but had no idea that other kids were also getting salmonella poisoning, too. Dr. Rapha followed Alana to the kitchen, and the pair sat down at the kitchen table, and Dr. Rafa asked how Jayden was doing. Alana said her son was upstairs sleeping and still was a bit tired and weak, but he seemed to be recovering. She had taken him to the emergency room last week, where he was diagnosed with salmonella. Based on his symptoms, he'd been given fluids and antibiotics, which had definitely helped him get better. The hospital monitored him for a few days until the salmonella had passed through his body. Dr. Rapha told Alana how relieved she was that Jayden was okay, but now she was hoping to try to stop the spread of this salmonella strain before it affected more kids. And so she said she had a list of questions she wanted to ask Alana in the hopes that maybe she could help her figure out exactly how Jayden got sick. Alanna nodded and said she was eager to help. Dr. Rafa began by asking if she and her son had gone anywhere unusual over the past two weeks. Alana shrugged and said, not really. Except they did go to the zoo the weekend before last. She said they'd gone to see the reptiles. By now, Dr. Rapha had been expecting this answer. Every other family she'd spoken to whose kid was sick with salmonella told her they had gone to the Discovery center at the zoo, which made it obvious to Dr. Raphael that this particular strain of salmonella had to be stemming from something in that building. So now it was time to head to the zoo and figure out what that might be. The next day, Dr. Rapha and her colleagues arrived at the Tropical Discovery Center. As a zookeeper led her and her colleagues through the employees only area of the exhibit, Dr. Rapha felt a sense of urgency. By now, Dr. Rafa had identified 33 children who had contracted the same strain of salmonella as Jayden over the past two weeks. And each family had this one thing in common. They had all visited this Discovery Center. And so now it was extremely apparent that something in this building was behind the kids getting sick. And for all Dr. Raffa knew, kids were actively being exposed to salmonella right now. So far, they'd been lucky. All 33 families of the sick kids had taken their children to a hospital, so they were all going to be fine. However, Dr. Rapha worried that eventually, if this outbreak continued, that a family would think whatever was going on with their kids was just a mild stomach bug. And then by the time they realized their mistake, it would be too late for their child. She pushed that thought from her mind and went back to work. She had to figure out which animal or exhibit was carrying the salmonella bacteria, and most importantly, how the kids were coming into contact with it. And that was proving to be a real mystery. As Dr. Rapha walked through the Discovery center, she noticed that almost all of the exhibits were completely sealed off. There was no way for the public to come in contact directly with any of the reptiles or any of their environments. She asked the zookeeper about the animals they used in their daily education shows. She wondered if maybe the kids were allowed to touch any of them. But the zookeeper shook his head. He told her that the public never touched any of the animals because that was unsafe for both the people and the animals. But Dr. Rapha wasn't convinced. She said she wanted stool samples from all of the education animals just to make sure they weren't carrying the salmonella bacteria. She also wanted samples from the rodents that were used to feed those animals, because she was not going to take any chances. About 20 minutes later, Dr. Rapha scooped up a bit of fecal matter from a blue tongued skink and dropped it into a tiny plastic tube. Then she labeled it for testing. Back in the lab, along the back hallway, her teammates were collecting stool samples from corn snakes, the big boa constrictor, and all the other reptiles used in the Daily Show. And they were making good progress, which she was glad for. She kept imagining a sick child in bed at home, their parents unaware that their stomach bug was actually a potentially deadly disease from their trip to the zoo. She hurried the sample she had just collected to a small examination room down the hallway, an area that was usually for veterinary visits, but that her team was using now as a home base while they examined the Discovery center. And when she got there, it was then that Dr. Rapha remembered the Komodo dragon exhibit that they had passed. On the way in, she had a the Komodo dragons were a new exhibit. And even though the Komodo dragons were kept out of reach of the public, the timing of their arrival and the outbreak of this disease was too close to ignore. Curious, she went to find the zookeeper. She wanted samples from all four of the dragons, hoping that her gut feeling would solve this mystery. On the morning of February 1st, so about two weeks after Jaden got sick, Dr. Paul Nelson arrived at the Denver Zoo alongside a small team of fellow investigators from the Centers for disease control, or CDC. A few days earlier, all the samples that Dr. Rafa had collected came back from the lab, and all of the animals were salmonella free except one, a Komodo dragon. And it tested positive for the exact strain of salmonella that had infected all the children. So now Dr. Rafa had clearly identified the source of the Salmonella outbreak. But an equally important question was looming. How could the kids come into contact with the bacteria that was on this Komodo dragon when they and the public were not allowed to touch the Komodo dragons in the first place? The dragons and the public were clearly separated by a low plywood wall, a row of bushes and a fence. And so Dr. Rapha was stumped. And that's why she had called the CDC to take over the case. A zoo administrator welcomed Dr. Nelson and his colleagues into the Discovery center and then led them into a back room where six other zoo employees were waiting. Most of them Were the zookeepers who worked directly with the infected komodo dragon. And so Dr. Nelson said he needed stool samples from all of them to make sure that none of them were sick and spreading the salmonella strain themselves when they interacted with the public. Dr. Nelson also said they would need additional fecal samples from some of the animals at the center just to play it safe. And then after that, Dr. Nelson's teammates spread out all across the discovery center and began collecting samples of their own. Not fecal samples, but surface samples. They were swabbing basically every surface they possibly could, Everything from the plants to the fences to the mulch on the ground. By the time Dr. Nelson and his team left the zoo an hour later, they had this massive bag full of samples to test. About five days later, Dr. Nelson returned to the discovery center with surprising news about the CDC's analysis of all the samples they had taken. In addition to finding the salmonella strain in the komodo dragon stool, they had also found the salmonella strain in a very unlikely place. It was sitting on top of the wooden barrier that was supposed to keep the dragons away from the public. Dr. Nelson admitted to the zoo officials that he was really confused, and so he just kind of began walking around near the komodo dragon enclosure, wondering, you know, how could the salmonella get there? And right as he walked over to the fence, he noticed one of the dragons walking over to him to kind of check him out. And a second later, the dragon stood up on its hind legs and propped its paws right on the wooden barrier. And suddenly, it all made sense. It would turn out the komodo dragon enclosure was covered with mulch. The komodo dragons slept in that mulch, Walked in that mulch, and went to the bathroom in that mulch. Then they occasionally put their feet up on the wooden barrier to get a better look at their guests, Transferring bits of salmonella infected mulch and fecal matter onto the wooden fence in the process. The children, meanwhile, were so excited to see these giant lizards that they were leaning way over the security fence and sometimes actually touching the top of the wooden barrier. They didn't know it, but they were actually getting salmonella on their hands. And so at that point, if the kids didn't wash their hands, all they would have to do to get infected with the salmonella Would be to just brush their nose or rub their eyes, or, in Jaden's case, eat some food with their bare hands. Thankfully, the salmonella outbreak was treated fast enough that all 33 infected children made full recoveries and the Denver Zoo managed to raise enough money for the Komodo Dragon exhibit that they could build a permanent enclosure, this one completely sealed off from the public. It's actually still at the Denver Zoo today, and there has not been a single salmonella outbreak in nearly two decades. Hey prime members, you can listen to new episodes of Mr. Ballin's Medical Mysteries early and ad free on Amazon Music. Download the app today and also Wondry subscribers can listen to Mr. Ballin's medical mysteries ad free. Join Wondry today. Before you go, tell us about yourself by completing a short [e-mail] from Ballin Studios and Wondery this is Mr. Ballin's Medical Mysteries hosted by me, Mr. Ballin, a quick note about our stories. They are all inspired by true events, but we do sometimes use pseudonyms to protect the people involved and also some details are fictionalized for dramatic purposes. And a reminder, the content in this episode is not intended to be a substitute for professional medical advice, diagnosis or treatment. This episode was written by Aaron Lam. Our editor is Heather Dundas. Sound design is by Ryan Patesta. Our senior managing producer is Nick Ryan and our coordinating producer is Taylor Sniffin. Our senior producer is Alex Benedon. Our associate producers and researchers are Sarah Bytak and Teja Pelikonda. Fact checking was done by Sheila Patterson for Ballin Studios. Our head of production is Zach Levitt. Script editing by Scott Allen and Evan Allen. Our coordinating producer is Samantha Collins. Production support by Avery Siegel. Executive producers are myself, Mr. Ballin and also Nick Witters for Wondry. Our head of Sound is Marcelino Villapando. Senior producers are Lora, Donna Palavoda and Dave Schilling. Senior managing producer is Ryan Lohr. Our executive producers are Aaron O'Flaherty and Marshall Louie for Wondry.

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