Poison and poetry - the shocking connection between Pablo Neruda and Clostridium botulinum

Speaker 1: 0:10

This is a podcast about one health the idea that the health of humans, animals, plants and the environment that we all share are intrinsically linked.

Speaker 2: 0:18

Coming to you from the University of Texas Medical Branch in the Galveston National Laboratory.

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This is infectious science. We're enthusiasm for science.

Speaker 2: 0:27

We're going to talk about how to make a science that is contagious. What do politics, poetry and poison have in common? On this episode of Infectious Science, we're going to be talking about a famous poet, pablo Neruda, and the wild possibility that he may have been assassinated by political rivals with a bacterium, of all things. So to help us understand a little bit more about the science, we've invited a special guest speaker, dr Alfredo Torres, who's an associate provost here at UTMB and a professor in the Department of Microbiology and Immunology. It's a crazy episode we've got for you today, so stay tuned. Hey everyone, this is Danielle here, and I'm here with Connie, and we invited Dr Alfredo Torres. He was actually one of my microbiology teachers when I was a grad student, and we're going to talk about this really interesting story about a poet named Pablo Neruda. You probably know him. He is a world-famous poet and a Chilean diplomat, and there's some recent evidence that he may have been murdered, and he may have been murdered by a bacterium. So we're going to talk a little bit about that.

Speaker 3: 1:33

It was really kind of hitting the news last month, and so we invited Dr Torres, because he's just got some expertise in all kinds of areas, but we thought it'd be fun to talk about one of these interesting science mysteries. I guess we would call it.

Speaker 2: 1:46

So, Dr Torres, you are a professor here at UTMB and a provost right. Associate provost yes, Associate provost and you work with a variety of pathogens, some Burldaria Bensimicoli, and we're going to jump into that. But first let's talk about the story. For those of you who don't know who was Pablo Neruda, he's a really famous poet he's actually one of my favorite poets and he was also a Chilean diplomat, so he was really active in the government at that time. So here's the thing when this all happened, everyone thought he died of cancer, but he actually died at this time. That makes us really suspicious. So there's been some suspicion going on for a long time that he may have been murdered. He died two weeks after a major coup in Chile and it was a US backed coup, so it's pretty scandalous. And there was reports that he was going in to get some treatment at the hospital the day before he was supposed to be fleeing the country and moving to Mexico and a doctor that he didn't know came in and injected something into his stomach and then left, and he was fearful at the time that he may have been poisoned. He didn't know what he was injected with and this was something that was reported and came out to light, I think like 10 years ago maybe. So his body was exhumed and has been undergoing testing ever since to determine why he died. Because it was determined it was unlikely to be the cancer that killed him. And some recent evidences come to light that a bacteria called clostridium botulism was detected in his body, and it was actually detected in his bones, which is really, really interesting, because if it was something that he would have been contaminated with in the soil, it would have been on the outside of his body, not on his bones. So this is really interesting. So what do you think about this? Do you think this is possible?

Speaker 4: 3:31

Well, thank you, connie. Thank you for the invitation, but let me put you in perspective what the mystery is all about this poet and this interesting individual. So the historical context is this Chilean individual start writing poems when he was 13 years old, so it was an early bloomer and he was writing poems and he became really famous in Chile when he was 16. And then at that time is when all this explosion of artists in Latin America was happening and he became associated with the Chilean government and he has a prominent family in Chile where he got educated and eventually he became a diplomat. So one of the interesting things that he did is he was struggling representing Chile in different countries. For some time he lived in Spain. He was the diplomat in Spain. He also went to Paris as a diplomat, came back to Chile and then he was sent to Mexico and when he was in Mexico he was connected with the artist in Mexico, somebody called Frida Kahlo and Diego Rivera and C Caroz. So that was the bloom of artists in Mexico and he came and became friend of all of them.

Speaker 2: 4:43

A lot of people actually don't know this, but Mexico was really huge at that time and accepting a lot of artists and poets from all over the world that were fleeing their own countries and it really became this beautiful cultural hub where so much interesting art and poetry was kind of happening.

Speaker 4: 4:57

Correct. So the interesting part is the artistic part of Pablo Neruda, the ability of being a diplomat and travel, learn, knowing all these people and get connected with these artists in Mexico. That's the first part of the plot. The second part of the plot is that at that time, when he was traveling and he was going to Mexico, that's where the Communist Party became really prominent, the Soviet Union, and then the Communist Party became an influence in Latin America, in many countries, including Mexico. So a lot of the artists at that time in Mexico they were communists. And then Paulo Neruda got influenced by Joseph Stalin and he was following the philosophy of Joseph Stalin. So in a way he got these ideas of socialism and supporting socialism in different countries, including Chile.

Speaker 2: 5:49

And Chile was socialist right.

Speaker 4: 5:51

At the time yeah, when he was going back exactly the socialist party started getting in power and that's where the transition from democracy to socialism was happening in Chile. So this story okay, you have the artistic part, and then you have the diplomat part, and then you have the socialism happening in Latin America. So he come back. At that time he was already famous for the poems that he was writing and he was very well connected. And then, since he was really prominent in Chile, he was invited to be the president of Chile.

Speaker 2: 6:23

Oh, I didn't know that.

Speaker 4: 6:25

I didn't know any about that he was, and he decided to say no, I don't want to be the president of Chile, I'm going to support this president, which is Salvador Agenda. And Salvador Agenda, which was the socialist party, became the president and it's clear that he was all the support from the government to continue traveling, to continue doing all these things. So he got really attached to the socialist party and Salvador Agenda. Then a dictator in Chile, augusto Pinochet, to a queue in Chile. So they removed the socialist party and they start prosecuting everybody that was associated with the socialist party, including Pablo Neruda.

Speaker 2: 7:02

Yeah, yeah it was like thousands of people.

Speaker 4: 7:05

So that's where the mystery becomes, because one of the practices that this military government because it was a military government was actually doing was eliminating people in no concentration camps, but in camps that people went, they were arrested and suddenly they disappear and it was a belief that the military government was using toxins to actually poison some of these people, especially when they were traveling to other countries, and they were sending people to actually poison these people. So that's where the mystery happens. So Salvador Agenda this situation and then he gets diagnosed with prostate cancer and there was a terminal cancer. And at the same time it's when the government is removed and there's a prosecuting dispute. So the big question is whether he died from terminal cancer, from prostate cancer, or he actually was one of those that was poisoned by the government of Augusto Pinochet.

Speaker 2: 8:03

Right and it's kind of interesting because the government of Pinochet, they killed so many but they really didn't want anyone to know, maybe, that they would have been poisoning Pablo Neruda because he was such an international figure and he was loved by so many people. He was actually a Nobel Prize-winning poet, correct, correct.

Speaker 4: 8:21

He received the Nobel Prize of Literature two years before he died.

Speaker 2: 8:25

Right, exactly, and a lot of people talk about him as being one of the greatest poets of all time. One of the greatest writers was really well beloved internationally, so this would have brought a lot of international attention to this coup.

Speaker 3: 8:36

I have a question on this story. Okay, so this all happened a long time ago, so when did they exhume the body? When did this come back into popular concern or forensic investigation into how he died?

Speaker 4: 8:50

Okay, so let's add a little bit more of the interesting components of this story. Pablo Neruda went to the hospital because of treatment of cancer and since he was so prominent, he even had a driver and he was support people. So the driver, basically, when he was interrogated about how he died and why he was concerned about why he died in the hospital, he said that they inject Pablo Neruda in the hospital even against his will and something happened there and then suddenly he died. So the report in the hospital indicated that he died because cancer and the complications associated with cancer, but this driver always indicated something else was happening. So, one of the prosecutors in Chile once the military government was removed. Eventually they opened the case, and this happened in 1973. So it's not that far away. So then the new prosecution and DA start investigating and they opened the case. They always say, well, we want to know, because this is a prominent figure, it's a national hero, want to make sure that he was not killed. So they opened the investigation, they exhumed the body and they actually put a team of international researchers to try to investigate. They took a couple of years to investigate, and I'm talking about the 1999, the 2000s. So at the time the technology for investigating this was not there.

Speaker 3: 10:14

Right.

Speaker 4: 10:14

So all these teams came back, presented the results in Chile and when they concluded this, they couldn't find any toxin, any drugs, anything in the body of Pablo Neruda that indicated that he was poisoned. So you might think, ok, that's the end of the story and that's the conclusion. However, this story has never ended in Chile. There's always this feeling that something else was happening. So a couple of years ago, the investigation was reopened again and a new team was invited to participate, one team led by investigators in McMaster University in Canada, where they have developed this new technology that they actually can sequence small fragments of DNA in bodies or the remains of a body and they can put together these sequences and figure out whether there's a bacteria or something that was causing the infection. The report came back a month ago and what they found is the interesting part they found a bacteria in the remaining teeth of Pablo Neruda and turns out to be Clostridium botulinum.

Speaker 2: 11:15

It's super interesting. So first off, let's talk about Clostridium. We know it's bacteria. What is it? What would you say are the most important things to know about it?

Speaker 4: 11:23

Yeah, so it's not a common bacteria that you hear, but perhaps you do so. This bacteria actually is a rod-shaped bacteria and for those microbiologists and fissionados, these bacteria are an anhydrous. So what that means is the bacteria doesn't like to live in oxygen, so they like to have an environment where there is no oxygen available. So you may assume where that is the place where the bacteria likes to live. Well, it lives in soil, underground, and the bacteria lives in that environment where there is not a lot of oxygen available, and they live with other nutrients and then they survive in that and they form spores because they are surviving the soil.

Speaker 2: 11:59

Because that's a really important thing. That bacteria do is they form spores, and that allows them to persist in the environment, even in hostile conditions, for long periods of time.

Speaker 4: 12:08

Yes, some soil bacteria, not all. They actually form spores. The classical example is sand trucks, basilica and traces. They form spores because they also find in the soil. So some bacteria can actually form this spore.

Speaker 2: 12:20

Is it only soil bacteria? No, there is other bacteria.

Speaker 4: 12:24

But mainly because if the environment in the soil or environmental bacteria is harsh to live in that environment, so they develop these tools that allows them to survive in harsh environments. So these two bacteria that I put as examples, they form these spores. So you might think, well, ok, it's in the soil. How is that important for all of us? What turns out before we start eating food that has been processed? A lot of people were being intoxicated and I don't know if you have ever heard but there is a lot of kids potentially. In one time, during the 1990s, that kids were intoxicated and they were developing botulies. That's why they were giving them honey, and honey can be in the environment and then actually spores can get into the honey and if it's not properly sterilized then you can get the spores, and the spores are clostridium bottom.

Speaker 2: 13:18

Yeah, that's a recommendation that continues Even now. Children under the age of one aren't supposed to have honey just because they're at risk.

Speaker 4: 13:26

And the other thing that perhaps you hear about this bacteria, about botulism, is if you consume a lot of canned food. Canning is a mechanism that has allowed us to preserve food for a long time, but if people are doing canning at home and they don't know how to do this, can properly, botulinum can actually get into the food and survive, because if you once you put the can, there is no oxygen. So what perfect environment for a bacteria to that.

Speaker 1: 13:52

So when.

Speaker 4: 13:52

I was growing up in Mexico. I remember my mother tell us open this can and immediately when you open the can and you hear this noise like air coming out, like a shh, immediately my mom say oh no, forget it, throw it away, because there might be botulism. And that's true. They produce gas and there might not be a good idea to consume anything that is inflated or damaged in one of these.

Speaker 2: 14:15

Yeah, my mom was always that way about any cans that were damaged that you might want to be leery of them. And also there's a couple of other things where I've heard of people getting infected with black tar heroin. Actually, because of the way the heroin is prepared, it can create an environment that it can grow. So there was some outbreaks, I want to say in California, where heroin users were actually infecting themselves with contaminated needles and things like that.

Speaker 4: 14:39

I haven't heard that one, but I'm no surprise Again anything that is contaminated by the environmental bacteria, and if the environment contains clostridium, there's a high chance that they can get contaminated. And if the environment is poor in oxygen. That's a perfect environment for the bacteria to grow.

Speaker 2: 14:57

So is it the bacteria that hurts us, or is it the toxin?

Speaker 4: 15:00

That's also important to know. So the toxin is the one that kills you, right? The toxin is the one that has a mechanism to attack some of our cells, the human cells, and damage and cause this neurological damage.

Speaker 2: 15:13

Yeah, it's a neurotoxin. It's a neurotoxin, yeah.

Speaker 4: 15:16

However, in order for you to get intoxicated, you actually have to consume the bacteria.

Speaker 2: 15:21

Oh, okay, so you can't be infected with just the toxin.

Speaker 4: 15:24

Technically, it's harder to believe that the toxin might be able to. So the easiest way is to actually get the bacteria and consume the bacteria, because normally the toxin is produced and there is not only one botulism toxin. There are seven different botulin toxins.

Speaker 2: 15:39

Oh, okay.

Speaker 4: 15:39

And they all are inside the bacteria. So in order for the toxin to be released, the bacteria has to be laced to be open, break it open. So if the bacteria goes inside a human host, we are reaching oxygen, so the bacteria doesn't like to live in there, breaks open and then release the toxin. And that's when the toxin find their way to their target, which in this case are neurons. Right, neurons.

Speaker 2: 16:02

So I've read that botulism toxin is one of the most deadly substances on earth, right, which is pretty crazy because it's also, as the name suggests, it's also used in Botox and it's also used as a drug to treat migraines, and it's also a really effective treatment for people with hyperhydrosis. Hyperhydrosis is basically like excessive sweating and that can either be distributed throughout your body or it can be focal, and if you have hyperhydrosis on your hands and you inject in your hands, they kill the neurons, basically, that are responsible for sweating, and the treatment lasts for like four to six months before the neurons grow back. So it's not only this terrible, horrible toxin. It's actually useful in a lot of therapies as well.

Speaker 4: 16:43

Correct. So the biological explanation of that is the following, and I'm going to put in a mystery type of way yeah. So the toxin goes inside your body and is looking for these particular cells. It's not going to attack all the cells. It's looking for neurons or cells that are found in the central nervous system. Thank you, Central nervous system and because they have a receptor. They have a receptor called NARS and these receptors on the surface of these cells. So what the toxin is going to do is going to bind to that receptor and clip the receptor. And what happened is those cells are important and that receptor is important to secret a component called acetylcholine. And acetylcholine is a molecule that allows us to connect our cells. So the way we connect our ideas and our concepts through this central nervous system is through impulses that go through the cells, and this acetylcholine is the bridge that connects the cells. So if you don't have that acetylcholine being released and in the bridge connecting this signal, then the signal is broken Right and the result is that the muscles get paralyzed. So the people die from paralysis because the muscles don't have the ability to start moving, because they don't have the nervous system telling them you have to contract. Thank you, you have to move, you have to do this.

Speaker 2: 17:59

And this isn't just motor muscles right that are controlled movement. It's also the movement of your lungs to inflate or deflate.

Speaker 4: 18:06

Any part of the body, any part of the body that is controlled by the by these neurons are affected. Right so every. Basically, it can go any place. So you might think okay, you don't need a lot, so you just need to clip the receptor. You need one molecule to clip the receptor, and that's it. The cell is not functional anymore. You cannot remake the receptor Right, so that's why you need very tiny, tiny amounts of the toxin. However, now the interesting part this is the first toxin that has ever been used to treat human disease. You might think how is it? possible that a toxin that kills humans now is used to treat human disease? Well, it turns out that they figure out that if you control the amount of toxin and the way you deliver the toxin, then you target these neurons that you are affecting and it's transient, so they modify the toxins, they can inject it to a muscle and then, for example, people that has a uncontrolled paralysis or movement that they cannot control, they injected in the muscle and then this prevents this. No, control muscle movement and then therefore, they can control it.

Speaker 3: 19:11

This is interesting. So would these have some kind of an impact on Parkinson's or, like Alzheimer's, you mentioned the neurons that control how you breathe and how your lungs work and everything we know. Botulism is used in Botox and you're talking about paralyzing muscles and then, on the flip side the positive side, being able to help somebody with uncontrolled movements. So is there active research with botulism right now as a therapy for any of these types of diseases?

Speaker 4: 19:43

So the first use of this toxin was developing a. You want to get a medication, you want to call it that called oculinum and that oculinum was to try to treat estrovism. So crossing eyes of kids is called estrovism and so that's an uncontrolled movement of the muscle. So they start testing this toxin and they realize that affecting the muscle, then kids will not start crossing the eyes anymore and that developed into finding out that accidentally you can actually inject the toxin in other parts of the face and turns out that the wrinkles disappear and they start looking for disappear. So instead of calling oculinum, which I don't think is a brand to sell anything, they call it Botox and they start selling Botox. And then the cosmetic application of this toxin is astronomical, the millions of dollars that men and female and everybody use it to remove wrinkles. Well, turns out that people has been doing investigation and they realize that people using Botox they start having less migraines. So one of the things now that they are trying to use is to Botox to treat migrants and obviously anything that has to do with muscle contraction that you can control now is being used. So back pain, for example, that is being treated by Botox or some other names that they use now for the Botox derivatives that they have. Perhaps some neurological problems that you might be experiencing or somebody might be experiencing might be also be treated by this type of treatment.

Speaker 2: 21:16

Interesting. So what do you think the best way is for us to protect ourselves from accidentally getting infected with botulism, with clasrenium botulism? That's a really good question.

Speaker 4: 21:28

I guess my mother was always true. She was right about the advice when she told you do not anything that is a can is damaged, and plus, she never encouraged us to eat anything in canned food. You always like to fresh things, so you just need to be careful. Right, there are some areas where they might be more risky to consume a clasrenium botulinum, and again that you try to prevent that.

Speaker 2: 21:54

Right, and I think it's also popping up now with people who are doing a lot of their own fermentation. I think I've also seen that in the news too.

Speaker 4: 22:01

Yeah, exactly so. We're in Texas, so it's very common to start driving around the state and then you go to these pop and mom shops and they have their own brand of canning strawberries or preserves or you name it. Yeah, you never know if they are. The process of canning that they are using is the perfect one.

Speaker 2: 22:20

Yeah, yeah so.

Speaker 4: 22:21

I have had my surprises. Sometimes when you buy these in these places and you go home, you open it and some extra organisms are growing in there, if you want to call it like that they should not be there, so yeah.

Speaker 2: 22:34

You're right. So what are the symptoms then? What if you had accidentally consumed?

Speaker 4: 22:39

So it's definitely a terrible death because it's paralysis.

Speaker 2: 22:44

Okay.

Speaker 4: 22:44

And describing how the toxin works indicates that as soon as they found a neuron or a cell that is associated in the central nervous system, basically they will cleave and then you will not have that function back Again. So that means basically total paralysis. You start asphyxiation because you cannot breathe, because your muscles in the lungs will not move, and then you die from paralysis.

Speaker 2: 23:08

So does that happen right away?

Speaker 4: 23:10

It happens within 12 to 13 hours, again depending on the dose. Normally, if you have been intoxicated by the bacteria, it takes time for the bacteria to start lysine and then releasing the toxin. If you think about somebody that is doing purposely to try to inject the toxin, the effect will be immediate because the toxin, once it goes in the blood and then find neurons, that's it. That's the end of the game. But normally a natural infection takes about 12 to 13 hours, depending, again, the amount of toxin that you get.

Speaker 2: 23:45

Are there any treatments?

Speaker 4: 23:46

Yes, absolutely. So what is known is you can actually have antibodies, that monoclonal antibodies that potentially bind the toxin and prevent the toxin. One again interesting fact about people using Botox is after so many times that you use Botox, you develop antibodies against the botulinum toxin. Oh, really so it's not good anymore, then you can have an immune reaction against the Botox.

Speaker 2: 24:11

Right.

Speaker 4: 24:12

So those ladies or men that are using Botox just to look good, that's very risky. You have to have a physician that actually supervises the use of this treatment so you can have it. But think about the window of opportunity that you have. So if you get intoxicated and then you wait 12 hours and just start developing symptoms, by the time you go to the hospital they diagnose you and they try to treat you, it's probably too late, because once the toxin starts leaving the receptors that's point of no return.

Speaker 2: 24:43

Yeah, ah, goodness, gracious, all right. Well, I think this was a really interesting story. Thank you so much for helping us.

Speaker 3: 24:50

I have a question though. So what's going to happen now? So, going back to the Chilean poet and the fact that there's this mystery, is there any news about where this is headed?

Speaker 4: 25:02

That's an excellent question. So let's go back to the mystery part of the story. So what happened now with the information that was released? So, trying to summarize what I told you, what they found was DNA pieces in the teeth of Pablo Neruda's body, or the remains of the body that they have that look like clostridium botulinum. So you might think well, was he purposely intoxicated giving them? Or somebody gave him the clostridium botulinum bacteria, or he accidentally consumed a food product that was contaminated with the bacteria? That's one option. Option two is that clearly he was poisoned. And now the question is what is going to happen next? Are they going to really investigate Because they cannot find the toxin? They already did the screen for toxins. The toxin is not there, so what else can they be? So there's two things here. One is obviously the political aspect and how a national hero was killed, so that's Chileans will decide what is the end of the story. And the other part is the interesting part, the scientific part. What other tools can they develop to actually further investigate these type of things? Because again, there is an area very interesting called microbial paleontology, which they are actually using these new technologies to actually try to investigate, for example, how people die from colonization, from the Spaniards, or from the Portuguese, or from the Americans. And just to give you a clue, in Mexico and in Central America, a lot of the indigenous people that die that they thought they were, they died from plague that was brought by the Spaniards. Turns out there was no plague, it was Salmonella. They died from typhoid. They died from typhoid because they didn't know that Salmonella exists in the American continent. So it was brought. Spaniards were having all these typhoid fever infections, passed it to the people that had never seen this bacteria and wiped millions of indigenous people. So how do they figure this out? Using these new technologies of sequencing that they are developing. So that's a scientific component that I think is very interesting that we can do.

Speaker 3: 27:18

Yeah, it's super interesting and this whole story has put a human face on botulism botulism poisoning and seen the mystery shows on TV where it's the crime, it's the culprit in the crime. But this is a great story, danielle, thanks for bringing it to our attention, and it's great that Dr Torres knew so much about all the history of the Chilean poet, who traveled and was a diplomat and may have had an early demise at somebody's evil hands.

Speaker 2: 27:50

Yeah, so I'll definitely keep my eye out on the news and we'll let everyone know if any other new developments come up. So thanks for listening. Thanks for listening to the Infectious Science podcast. Be sure to hit subscribe and visit infectiousscienceorg to join the conversation, access the show notes and to sign up for our newsletter and receive our free materials.

Speaker 1: 28:09

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Speaker 2: 28:18

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Speaker 1: 28:27

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