Although I grew up in developing nations and thought I knew the risks associated with travel to such countries, I let my guard down in Bangladesh when I traveled there in 2013 with my 21-year-old son to install solar panels on a hospital in a remote region of the country. When we arrived at the hospital after an eight-hour drive from the capital, Dhaka, we were greeted by our host, a wise and worldly physician named Edric Baker who founded the hospital decades earlier. As a precaution, he counseled us not to eat anything except food prepared by the hospital cooks. Nonetheless, three days later, to celebrate completion of the solar array installation, my son and I decided to eat a locally grown pineapple that a hospital employee gave us as a gift. We made sure to wash the pineapple with clean water from a well before slicing it with our pocket knife.
In the middle of the night, about eight hours after eating the deliciously sweet fruit, my son and I both came down with abdominal pain, vomiting, and diarrhea which we were sure resulted from eating the pineapple. As the photo shows, ample opportunities exist for pineapples to contact dirt, manure, and other pathogen-laden surfaces and equipment, making it plausible the pineapple made us sick even though we’d washed it (inadequately). To complicate matters, while my son and I took turns in a latrine throughout the night, a snake came into the cramped space to join us. By flashlight, we took care to avoid stepping on it, but the next morning when my son arose from a sleep-deprived night, the snake was at the foot of his bed. When we notified a gardener about the visitor, he took one look at it and, alas, disposed of it with a machete.
Acquiring a foodborne diarrheal disease was ironic given that our next mission in Bangladesh was to spend five weeks in the capital at the International Center for Diarrheal Disease Research, Bangladesh (ICDDR-B) researching cholera. Dehydrated albeit recovering while we motored from the remote hospital to the capital, my son rode the distance with an intravenous line in one arm flowing with saline. We both recovered relatively quickly, suggesting to me the cause of our illness was a self-limiting toxin-mediated infection such as that produced by E. coli acquired from, yes, our friend, the pineapple.