The People's Court: Strudel v. Cheese

Apparently, I may have been too quick to blame the cheese (cow stomach). Below is a completely unedited medical opinion care of Mrs. Colette Ross of the Calgary Health Region's Infection Prevention (Unit). While you may all continue to form your own opinion, I should point out that Mrs. Colette Ross did not taste, smell, or see the horrendous cow stomach cheese or the delicious strudel. She does raise a good point about dear Hector, though...

Subject: Medical Opinion

I feel it is my duty (being in the profession and all) to respond to the challenge presented to all readers of the blog to determine which food item would be most probably the culprit in the index case of GI distress. There was no mention of a prize or award for that matter, but I will assume that being granted the virtual prize of undying gratitude for assisting in the PREVENTION of this would be prize enough.

In a clinical situation, I would address this in a S.B.A.R. format...Situation, Background, Assessment and Resolution...but since this is a friendly exercise, I will dispense with the formalities.

As you are aware there are a few "causative agents" that could be responsible for this type of intense upset...bacteria, viruses, ova and parasites (my older daughter has had this experience) to name a few of the common ones. Different incubation periods and different times to resolution assist in determining the probable cause in the absence of laboratory diagnosis (this could be the suspect food item or the contents of the body's expulsion that would find their way to an accredited lab).

Since you are a lovely young man from a developed country who has recently travelled to a "somewhat" less developed country... I would have to go with the bacterial cause (assuming you are fully recovered).

Therefore I tend to agree with the lady of the house and the following supports my decision.

Baked goods require lots of handling by people whose level of hygiene is undetermined (I'm thinking of E coli strains here in situations where people are not so fastidious about handwashing) and whose level of cleanliness in the kitchen prep area is also unknown (more bacteria). E coli (the main culprit of travellers' diarrhea ... contaminated food items by bowel flora of those doing the preparing of said food) can cause VIOLENT episodes with cramping etc. and as you are well versed in the symptoms, you recognize that they disappear once the offending organism has been expelled.

However if you have been eating food prepared by this lady for over a month and have not become ill, then I would assume that her hygiene in the kitchen is pretty good (the fact that no one else in the house was not ill is not a good reason to blame the struedle) Those who live there are accustomed to the level of bacteria that they are exposed to on a daily basis.

Having said that, if you have a 3 year old resident of the house who goes around peeing on the couch, where would he rid himself of bowel contents ???? What is his hand hygiene like and does he help his mom in the kitchen? Perhaps he is adding contents to the cheese delicacy??? Not a pretty picture!!

I am pleased that this situation has resolved and hopefully there will not be a recurrence.