 Clostridium difficile is one of our most urgent bacterial threats, seconding a quarter million Americans every year and killing thousands to the cost of a billion dollars a year, and it's on the rise. Although uncomplicated cases have been traditionally managed with powerful antibiotics, recent reports suggest that hypervirulent strains are increasingly resistant to medical management. Although surgeons may need to come in and remove our colon entirely to save our lives, although the surgery itself is so risky, the operation alone may kill us half the time. There's been a rise in the percentage of cases that end up under the knife, which could be a marker of the emergence of these hypervirulent strains. Historically, most cases appeared in hospitals, but a landmark study published in the New England Journal of Medicine found that only about a third of cases could be linked to a contact with an infected patient. Another potential source is our food supply. In the US, the frequency of contamination of retail chicken with C. diff has been documented to be up to 1 in 6 packages off-store shelves and didn't seem to matter which parts. Pig-derived C. diff, however, has garnered the greatest attention from public health personnel because the same human strain that's increasingly emerging in the community outside of hospitals is the major strain among pigs. Since the turn of the century, C. diff is increasingly being reported as a major cause of intestinal infections in piglets. C. diff is now one of the most common causes of intestinal infections in baby piglets in the US. Particular attention has been paid to pigs because of high rates of C. diff shedding into their waste, which can lead to contamination of retail pork. In the US, the highest levels of C. diff meat contamination is so far tested anywhere in the world. Carcass contamination by gut contents at slaughter probably contributes most to the presence of C. diff in meat and meat products, but why is the situation so much worse in the United States? Well, slaughter techniques differ from country to country, with those in the US being what they call more of a quick and dirty variety. Colonization or contamination of pigs by superbugs such as C. diff and MRSA, MRSA, at the farm production level may be more important, though, than at the slaughterhouse level. One of the reasons sows in their piglets may have such high rates of C. diff is because of cross-contamination of feces in the farrowing crate, which are these kind of metal cages that mother pigs are kept in. But can you just follow food safety guidelines and cook the meat through? Unfortunately, current food safety guidelines are ineffective against the superbug because it forms these spores that are resistant to heat. To date, most food safety guidelines say cook at an internal temperature is low as 63 Celsius, which is the official USDA recommendation for pork. But recent studies show that these C. diff spores can survive extended heating at 71, therefore the guideline should be raised to take this potentially killer infection into account. See the problem is that sources of C. diff food contamination might include not only fecal contamination on the meat, but transfer of spores from the gut into the actual muscles of the animal inside the meat. Clostridia bacteria like C. diff comprise one of the main groups of bacteria involved in natural carcass degradation. And so by colonizing muscle tissue before death, C. diff cannot like transmit to new hosts that eat the muscles like us, but gives them a head start on carcass breakdown.