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PARASITES

 

 

60-foot tapeworm!

 

This extended page is, in effect, a miniature but easy-going textbook.

If you want to be well informed, read it all!

 

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WHIP WORM (Trichuris species)

 

So-called because these intestinal worms look like little whips,

around 1- 2 " long. Its spread is favoured by poor sanitation and a

warm moist climate. In parts of southeastern USA, 25- 30% of the

population, mainly children, are infected, so it is not rare in

Western society. Whip worms suck blood from the intestinal lining and

can cause anaemia and damage to the gut wall leads to leaky gut

syndrome, with resultant food allergies. Infestation can result in

colitis, proctitis, appendicitis and in extreme cases prolapse of the

rectum.

 

You may never have heard of this unpleasant human pathogen, yet you

may be harbouring it, even as you read this. Amongst other symptoms of

infection are insomnia, nervousness, loss of appetite, vomiting,

urticaria (hives), prolonged diarrhea, constipation, flatulence and

feeling " toxic " (Schmidt GD, Roberts LS, Foundations of Parasitology,

Times Mirror/Mosby College Publishing, St. Louis, 1989, p. 418).

 

It is vital that the reader understand the wide variety of conditions

that can present due to parasitic infections. Whip worms in the liver

can wreak so much damage that a toxic overload is created by the

liver's inability to function normally. Thus environmental chemicals

triggers can be apparent that are, in reality, the result of

infestation, rather than chemical intoxication.

 

Nobody is safe

 

I introduce this beast as a way of making the point that many

parasitic diseases masquerade as allergy and environment illnesses.

Doctors so rarely think of parasites as a cause of trouble, yet only

by constantly including them as a differential diagnosis will they be

checked for and diagnosed correctly.

 

Parasites are bad news for humans. Of the 7.8 billion acres of

potential arable land on Earth, only 3.4 billion acres can be farmed;

most of the rest cannot be developed because of parasites (malaria,

trypanosomiasis, schistosomiasis and onchocerciasis). In Africa alone,

an area the size of the USA cannot be farmed because of trypanosomes

and many millions in South America have never had a healthy day in

their lives because of this protozoan parasite. Horses, dogs and

cattle are killed very quickly. Humans may survive but trypanosomes

invade every organ and tissue in the body, having a predilection for

the lymphatic system and the brain, with disastrous consequences

(sleeping sickness). Lymphatic swellings, especially at the base of

the skull, were regarded by slave traders as a sign of certain death

and slaves bearing this mark of trypanosomiasis were routinely thrown

overboard before reaching the Carribean destination.

 

 

 

Death

 

Worldwide, 25% of all deaths result from parasite infections (Malaria,

still the number one killer disease in the world, is classified as a

parasitic disease). International travel has made matters worse by

enabling rapid and uncontrolled spread to areas with low natural

immunity. I produce all these figures to make one important point:

parasites are everywhere, a big problem, dangerous and nobody is safe.

It is unlikely that even a single individual exists who does not have

at least one foreigner living in his or her tissues (by which I mean

one species: there may be dozens or thousands of individual

creatures!) Where the immune system is strong, the infected host

generally remains well. But where immunity is compromised, as with

environmental illness, these infestations can be source of serious

symptoms.

 

Generally it is not in the parasites' interest to kill the host

outright. But severe allergic reactions may be set up, where the cause

is not obvious unless diligently searched for. Fatal anaphylaxis has

been documented. Competition for nutrients from parasites will

inevitably lead to micro- and macro-nutrient deficiency, which in turn

leads to chronic ill health, lowered immunity and the possibility of

succumbing to some other disease.

 

Parasites therefore become part of the clinical ecology picture.

Remember, ecology means our relationship with the outside environment.

This is not a sick body problem but a healthy body being damaged by

extraneous factors. Parasites are just another type of body burden, an

important one at that.

 

The study of parasitology is a vast and growing subject, requiring a

considerable textbook to introduce merely the basics. Here we shall

select some of the common pathogens found in Western society and which

may mimic or cross-over with allergy, nutritional and environmental

disease. Astute physicians will be alert to their ever-present menace

and realize that the majority of cases appear as chronic smoldering

ill-health and not the dramatic unmistakable picture of the full-blown

infestation.

 

Remember also that parasites, even when present in significant

numbers, may not be the sole cause of the patient's problems but

merely a contributive overload factor.

 

Reasons to suspect parasites: Tiredness, listless, loss of appetite,

irritability, insomnia, vague aches and pains (not confined to bowel),

swings in bowel habit, flatulence, inappropriate hunger, skin rashes,

itching anus, itching ears.

 

Note that hookworm disease was the cause of one third of all deaths in

Puerto Rico early in the 20th century, yet fewer than 25 worms will

cause no symptoms; 25- 100 worms will produce only " light symptoms " ;

500- 1000 considerable damage but only " moderate " symptoms. If you are

thinking you could be harbouring a bunch of these critters and you

would not know, you are correct. (Schmidt GD, Roberts LS, Foundations

of Parasitology, Times Mirror/Mosby College Publishing, St. Louis,

1989, p. 440).

 

 

 

Other Worms

 

There are an estimated 4.5 billion worms in existence; plenty to go

around, so you may have one or more. Do not suppose that living in a

sanitized environment means that you are safe. An estimated 55 million

children in the USA are infested with worms but, say experts, this is

a gross underestimate, if pinworms (Enterobius vermicularis) are included.

 

The main groups we contend with are tapeworms, round worms, hookworms

and pin worms. A tapeworm may be harboured with little or no

ill-effects, until it drops as a strap from the anus and is felt

flapping between the thighs! Competition for nutrients can be serious

however causing severe protein-energy malnutrition (PEM) and iron

depletion. This is turn leads to immune malfunction. The fish tapeworm

Diphyllobothrium latum has a high affinity for vitamin B12 and may so

deplete supplies for the host that he or she develops debilitating

anaemia. Generally in clinical ecology we meet with less extreme forms

of parasite infestation; but micronutrient deficiency (vitamin and

mineral depletion) is usual and impairs the immune system's ability to

throw out the intruder.

 

Trichinella is related to the whipworm already mentioned. It is one of

the smallest nematode worms to infest humans and yet is arguably one

of the most widespread and clinically important parasites in the

world. The male is around 1.5 mm, the female twice as long. Once

ingested, the sexes copulate and release juveniles, which then migrate

throughout the body. No tissues are free of infestation, including

lungs, brain, heart and kidneys. Fatal myocarditis can result.

 

But once again the usual clinical picture is that of low-grade

grumbling disease, that can mimic all levels of environmental illness,

including allergy and overload symptoms, per target organ. The

original invasion may be dismissed as " food poisoning " (nausea,

abdominal pains, sweating and diarrhea). During the phase of

tissue-migration any of a host of symptoms may develop, from

pericarditis, pneumomnia and meningitis to peritonitis, encephalitis

and severe inflammatory reaction (Schmidt GD, Roberts LS, Foundations

of Parasitology, Times Mirror/Mosby College Publishing, St. Louis,

1989, p. 424). Trichinella therefore often goes un-diagnosed and the

patient remains unwell for years or even life. The worms may die in

situ and all that remains of their presence is calcified nodules in

muscle and organs.

 

Unfortunately, there is no treatment for Trichinella, beyond good

immune care and unburdening, as described in this book. Homotoxicology

adds vital degrees of resistance and may, alone, be sufficient to

dislodge this parasite.

 

 

 

Pinworms(threadworms) are unusual in not being more prevalent in the

tropics. Rather they thrive in temperate climates and often at

surprisingly high socio-economic levels. Whites are more susceptible

than blacks. At least 500 million people are infected with this pest.

 

Pinworms are often asymptomatic, until they reach large numbers. Most

symptoms are centred on the bowel and include cramps and mild

bleeding. Serious damage to the gut lining is yet another cause of

leaky gut syndrome. Itching anus may call attention to the unwelcome

guests, which may also reach the vulva and even vagina and uterus,

setting up sites of bacterial infection.

 

Children with heavy pinworm infestations are often nervous, restless

and irritable and may suffer loss of appetite, nightmares, insomnia

and weight loss.

 

 

 

Roundworms are more serious and infestation can reach fatal

proportions if the host's defences are down. Ascaris lumbricoides is

the most common and menacing. Surveys over the years 1956- 1970 showed

between 20 and 60% of children were infected in certain states of the

USA where it is endemic (Derby CP and Westphal M, The Morbidity of

Human Ascaris, J S C Med. Assoc. 1972,68:104-108). Experts do not

consider this position likely to have improved. Ascaris grows to 18

inches in length and walks through our tissues as if lungs and liver

were a mere highway. It's destination is the gut, where it sets up

home in large numbers. As it " walks " around the body, Ascaris can

cause lung bleeding and start up infections in any tissue. In severe

cases it may block the trachea and oesophagus. Sometimes the beasts

crawl out of the nose or mouth, causing predictable dismay. Massive

infestation may cause fatal intestinal blockage before the patient can

be relieved. Large numbers wriggling in the stomach may cause nausea

but when the host vomits up wriggling 18 " worms the diagnosis will not

be missed and this gross pathology is not the concern of the clinical

ecologist.

 

Rather we see milder grumbling abdominal pain, failure to thrive,

rashes, asthma, insomnia and eye pain, triggered by allergic reactions

to the worms. Also large numbers of worms deplete nutritional

resources and cause leaky gut syndrome, which can become a

self-perpetuating cycle. Thus any pre-existing allergy condition can

be made worse.

 

Hookworms include two serious human pathogens: Necator americanus

( " American killer " ) and Ankylostoma duodenale. The former is prevalent

worldwide (380 million plus victims by 1947) but has had major

economic impact in the southern states of the USA, where in 1947 it

was estimated that 1.8 million citizens were infected (it is important

to realize these figures will have increased, not decreased with

time). Ankylostoma is predominant in, but not confined to, Africa,

India, China and south-east Asia.

 

Strongyloides is probably best linked to this group. Juveniles

penetrate the skin and migrate via the lungs to the gut. In the lungs

massive allergic reactions can take place which may wall in the

parasite. Adult Strongyloides stercoralis live in the gut and produce

larvae which penetrate the gut wall and invade the tissues, setting up

a cycle of auto-infection. It can also cause leaky gut syndrome.

 

Download a free chart showing parasites and treatments. Very useful.

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Diagnosis and treatments of worms

 

Diagnosis rests on viewing eggs, cysts, juveniles or other

characteristic forms of the pathogen in stool or other specimens (eg.

sputum). Pin worms and eggs can often be collected live by using

cellotape applied to the anal margins. Biopsy may be required for

species like Giardia.

 

The eosinophil count is often very high (a type of white blood cell

associated with allergic reactions to parasites). Monoclonal antibody

tests and/or ELISA tests can help but this requires guesswork as to

the nature of the beast.

 

Good EAV specialists may be able to identify parasites but on no

account embark on an expensive or distressing parasite cleanse unless

you are sure the practitioner is good. Many are not reliable.

 

Drug treatments have unpleasant side-effects, which are worse in

children and the elderly. These include nausea, vomiting, colic,

diarrhoea, allergic reactions including urticaria, bronchospasm,

angioedema, dizziness, muscular incoordination (worm wobble);

drowsiness and confusion. Care is needed administering anti-parssitics

to patients with poor kidney function and liver disease. Some

(piperazine) may make neurological conditions worse. A second dose is

usually required, to hit those organisms which survived the first dose

or were hidden too deep in the tissues.

 

Simplified worm treatment table

 

PARASITE

TREATMENT (preferred and secondary)

Pinworms Mebendazole, Piperazine

Round worms (Ascaris etc.) Levamisole, Mebenadazole

Hook worms Mebendazole

Strongyloides Thiabendazole, Albendazole

Tape worms Niclosamide, Praziquantel

Trichinella None

 

It may be necessary to treat all members of the household

simultaneously. Pinworms eggs are light and become airborne; they may

be inhaled. Cleaning of carpets, towels and bed linen etc. is

therefore recommended. In all cases improvements in hygiene standards

are demanded, to reduce the pool of re-infection.

 

 

 

General Points Of Treatment

 

Drugs should not be considered the only means of attacking parasites.

Indeed, this approach is a last resort. Re-building the body's defence

mechanisms, to allow it to expel the host naturally, is the preferred

route. This will help to prevent re-infestation which drugs, of

course, do not do.

 

With this in mind, there are general principles of de-infestation of

parasites which must be applied in the clinical ecology situation:

 

Firstly: never attempt to eliminate a parasite without a major change

in diet. Sugar and refined carbohydrates, which are rapidly split to

energy giving glucose, favour the parasite and hamper your immune

system(tests have shown that a single sugary drink, such as a cola,

stuns the leukocytes for up to six hours, before they can resume

normal anti-pathogen activity).

 

Accordingly, remove all refined carbohydrate (and this means all

manufactured foods) from your diet. It is better, short-term, to also

omit fruits and fruit juice, since these too are rapidly split. Avoid

wheat and dairy products short-term, since these are common stressors.

Finally, omit coffee, tea and alcohol. Eat instead high roughage

foods, vegetables, salads, beans and whole non-wheat grains (if you

are not allergic to them). Fowl, meat and fish are fine in this

context. Sprouted seed and beans also help, with active enzymes. Add

good vitamin and mineral supplementation, to help your immune system;

this will not support the parasite, which has already grabbed its

share, without you knowing.

 

Secondly, prepare with a bowel cleanse

 

The theory is that it is hard to hit parasites if the bowel is full of

accretions. Well, the model may or may not be correct but in clinical

situations the cure seems to work better if you apply this principle.

You need to take a gentle laxative over a period and get the bowel

emptying on a regular basis.

 

The one I recommend is NATURAL BALANCE discussed elsewhere on this

website. It consists of Fennel Seed, Psyllium Seed Husk, Rhubarb

Root, Peppermint Leaves, Black Seed, Cumin Seed, Cinnamon Stick,

Ginger Root. It is a 100 year old recipe from an ancient Lebanon

household which helps to cleanse the colon, liver and other digestive

organs, breaking down and removing old putrefactive faecal build up in

the large and small intestines. The programme is gentle yet very

purgative. Taken regularly it accelerates the cleansing process and

helps keep the intestinal system in a state of internal hygiene.

Natural Balance cleanses and re-educates the muscle tone and helps

return healthy peristaltic action to the colon. The fibre in Natural

Balance also helps eliminate heavy metals, toxins and other poisons

from the body's cells.

 

Considered to be `colonics in a capsule', Natural Balance is a safe

alternative to colonic irrigation and is vital for anyone embarking on

an anti-parasite or an anti-Candida programme. Although Natural

Balance can be used on its own as an exceptional detox, anyone wanting

to use Clear to eliminate parasites or Harmony to rebuild the gut

lining should start by using Natural Balance as a primary cleanse.

 

 

 

 

 

Thirdly, many plant sources are anti-parasitic.

 

Aspidium (male fern) or Felix mas, the great fern was once a standard

treatment but is now considered far too toxic.

 

Best known as an antiparasitic is Artemesia annua. It is currently

under study by the World Health Organization as a possible treatment

for chloroquine-resistant malaria. Activity is thought to be due to an

alkaloid with the Chinese name of qinghaosu. A. annua is available as

a bowel preparation take 1 g three times a day for 60 to 90 days.

Better results may come from combining it with some other herbs.

Grapefruit-seed extract, known under several brand names such as

DF100, Parcan and Citrocidal (100 mg three time a day) has a similar

range of activity. The two combine very well. If a short-term course

of metronidazole 400 mgm twice or three times a day, is added, this

makes up just about the best ammunition we have got.

 

Even then, there is no guaranteed cure. Relapses may occur and

life-long maintenance therapy may have to be considered.

 

Other herbs with useful antiparasitic properties to be considered

include the following:

Extract of fresh pumpkin (Curcubita species)

Grapefruit-seed extract (Citricidal, DF100, Parcan)

Artemisia absinthum (wormwood)

Artemisia vulgaris (mugwort)

Black walnut husk (collected while green)

Oil of cloves

 

The above list of compounds can be combined in many ways, to produce

differing proprietary formulas. Just make sure you know what you are

buying and how to take it effectively.

 

You may need a strong stomach in the metaphorical as well as

physiological sense. Treatments often lead to coughing up live worms

or parts and seeing a flush of dead worms in your stool is only

slightly less horrifying. Be warned!

 

 

 

Fourthly, it makes no sense to try and eliminate parasites, unless you

take steps to prevent recurrence. Parasites are often contacted

through unhygienic habits. However many, such as hook worms and pin

worms, can pass through the unbroken skin. Merely touching something

that has been handled by a parasite victim could pass it onto you or

your family. There is absolutely no point in feeling ashamed or trying

to pretend it couldn't happen to you. Just face facts and get to work

on an effective cleansing programme. Before or while you take the

anti-parasitic remedy, whether allopathic or herbal, consider sources

of infection:

 

People may infect each other in a " ping pong " fashion. Treat everyone

in the household at once.

 

Remember pets are the main source of human infestations. Worm your

pets regularly and never allow a pet to lick your face around the mouth.

 

Always wash your hands thoroughly before handling raw food (salads

etc). Never taste uncooked foods, even one lick can produce fatal

Trichinella (if you are very very unlucky, that is)

 

Cook all meat products thoroughly. If you have a predilection for

rare-cooked steak and pork etc. YOU MUST FREEZE IT FOR A MINIMUM OF 20

DAYS. This will kill the tapeworm scolex. Remember offal is just as

dangerous as muscle meat.

 

Fourth, as well as cleaning up your outer environment, change your

inner terrain to make it very hostile for parasites. I am talking now

about homotoxicology. This means to cleanse your tissues and remove

toxins, so that the body's nutrition and defence systems work well.

 

 

 

HOMOTOXICOLOGY AND PARASITES

 

If you have not already visited the homotoxicology section, do so now,

to gain a general understanding of this remarkable advance in detoxing

and fortifying body defense mechanisms.

 

Homotoxicology is really about terrain. It is about the physiology and

function of your body. When it is healthy and functioning well, it is

death to a parasite to walk in your front door! Your immune system

will attack it and the system we call the mesenchyme matrix will make

it absolute hell for the parasite to set up home.

 

Parasites are what we call " opportunists " , meaning they move in when

there is trouble in the neighborhood. They are rarely the cause of the

trouble but the result of trouble. That is where allopathic medicine

gets it wrong yet again. Your body health and defence mechanisms have

already failed in protecting you by the time you get a parasite

installed. The main road back then is to change your body terrain back

to how it should be. Nutrition is paramount, removing food allergens

which stress up the system helps, chemical detox helps, taking

plant-based anti-parasite remedies undoubtedly helps.

 

Now you must put your attention on de-polluting the lake of

intracelleular fluids which bathes and nurture our cells and tissues,

as explained in the section on page 000. Consider the function of the

following remedies:

 

Echinacea compositum (HEEL or BHI). This is not an Echincaea herbal

product but a fortified homeopathic version, which is much more

powerful. It contains, among a total of 26 remedies in the mixture:

Echinacea, aconite, sanguinarea, Lachesis, Bryonia, Pulsatilla,

Influenzinum-nosode, strepto-coccus nosode, staphylococcus-nosode,

arnica and argentum nitricum. It is designed to fortify the immune

system in over a dozen different ways, herbal, mineral and detoxers

(nosodes).

 

Lymphomyosot (also HEEL or BHI). Been well studied scientifically in

hospital trials. This cleans out the lymphatic system, which is a

major de-tox pathway totally ignored by allopathic doctors, unless it

becomes completely blocked by worms (filiariasis). Lymphomyosot

strikes at the toxic residues lingering in the body from past

illnesses, such as influenza and childhood fevers. A must on an

anti-parasitic programme, for the first 6 weeks.

 

Hepar compositum (HEEL and BHI). Vital liver support, including

well-known liver herbs such as milk-thistle, Peruvian bark and

chelidonium. But also healthy liver potentized, thymus gland extract,

gall-bladder and histamine. This remarkable proprietary product also

includes intermediates from the Kreb's or citric acid cycle, which

drives the body's energy system. I have to point out over and over

that cells with poor mitochondrial energy function cannot detox

easily; it takes a lot of energy to push out poisons!

 

Liver support if this kind is absolutely vital for protecting the

liver from damage by parasites.

 

Tanacet (Tansy) is a traditional antiworm treatment for tics, nervous

irritability and restlessness in children, here potentized to make a

homeopathic compound with Artemisia vulgaris, Artemisia absinthum and

wild thyme and goosefoot to protect the liver.

 

Schwef-Heel is from the same stable and contains 5 different potencies

of sulphur. Older readers will remember rhubarb and soda as a worming

mix in country practice up until the end of World War 11.

 

Traumeel is another good choice. Apart from being soothing to inflamed

tissues it has a strong sulphurous property.

 

Nux vomica is another good choice to settle the bowel disturbance of

shedding worms and flukes. I like to give it as a range of potencies

called a chord (D12, D30 and D200).

 

More general advice on rebuilding health through deep tissue cleansing

is given in the homotoxicology section.

 

A historical note

 

A fearsome parasite, the guinea worm, uses a human host. It migrates

under the skin where it is quite visible, wriggling, and can grow to

many feet in length, causing great pain and damage. The traditional

way to get rid of these worms is to grab one end through a cut in the

skin and wrap it round a stick; by winding the stick over a period of

days, the worm is gradually drawn out.

 

The reader may know that the traditional symbol for a doctor is the

serpent wound round a stick. This has always been supposed to be a

snake but a more serious suggestion is that the creature is the guinea

worm and the sign of a healer is a man who can get rid of this

burdensome pest! I go along with this suggestion. It would also make

good sense of a quote from the Bible, concerning the Israelites on

their migration back from Egypt: " And the Lord sent fiery serpents

among the people, and they bit the people; and much people of Israel

died.. And the Lord said unto Moses, `Make thee a fiery serpent and

set it upon a pole; and it shall come to pass that everyone that is

bitten, when he looketh upon it, shall live'. "

NUMBERS 21:6

 

AMA seal, with the rod of Aesculapius.

 

Does the serpent depict the guinea worm (Dracunculus medinensis)?

 

Other worms and flukes

 

It need hardly be said that this list is not comprehensive and

contains an overview of only the main worms that infest humans. Other

important parasite groups include the flukes and amebas, which again

flourish in the nutritionally compromised or immune deficient

patients, such as has AIDS or environmental overload.

 

AMEBAS. Entamoeba Histolytica

 

This well-know tropical protozoan infection is surprisingly widespread

in temperate zone (as high as 5 per cent of the population in the US).

People are largely symptom-free because they are healthy and

well-nourished – it is probably responsible for a lot of chronic mild

complaints but goes undiagnozed. 'Carriers' may exceed 50 per cent of

the population in poorly sanitized areas.

 

E. histolytica probably only attains its killer dysentery form in an

immune-compromised host. There seem to be some strains more virulent

than others. Except in these special cases the dangerous spread to the

liver and brain, causing amoebic abscesses, is very rare.

 

Diagnosis of amoeba

 

Stools are characteristic and may show specks of blood. The organism

or its cysts can be found on microscopy. Serological tests are almost

always positive when the disease is present, but since antibody levels

stay high long after infection this isn't a good guide to current disease.

 

Immunofluorescent techniques are better.

 

 

OTHER SUSPECTS

 

There are many other such organisms and the list is growing

constantly. Blastocystis hominis is an example. This organism was

formerly considered to be a yeast but is now re-classified as a

protozoan. Its frequent pleomorphic forms (odd, changing shapes) make

diagnosis exasperatingly difficult. Endolymax nana is another type of

ameba. Formerly thought to be nonpathogenic, it is now realized that

it may be, given a weakened host. It is often present with other

organisms. It may be associated with inflammatory arthritis.

Dientamoeba is still considered an amoeba by most parasitologists.

 

It is quite common to find these organisms but care must be taken not

to presume that its presence is pathogenic. Even if one is

flourishing, the real problem still lies with the host susceptibility.

 

***

 

It remains to consider three other important human pathogens that are

a common part of environmental illness and cross-over with allergy and

overload. These are Gardia, Toxoplasma and Cryptosporidia species.

Giardia and Cryptosporidia are notorious in that they both by-pass

normal water treatment and filtration systems.

 

 

GIARDIASIS (Giardia lamblia and G. Intestinalis)

 

It is now realized that as many as 15 per cent of us may be carrying

Giardia, a minute flagellated protozoan that causes severe fatigue and

bowel disturbance. That's 1 in 6 of the population. Prevalence is high

throughout the tropics; modern travel has spread it to more temperate

zones. It is an important cause of traveller's diarrhoea and chronic

fatigue states. Patients with irritable bowel or 'food allergy' can

often due the onset of their symptoms to an episode of tummy upset on

a holiday abroad.

 

A single Giardia cyst can cause infection, and studies show 100%

infection with exposure to only 10 cysts. By contrast, most bacterial

illnesses require hundreds to thousands of organisms to produce

illness. Giardia causes as much as 25% of all diarrhea cases in North

America, making it the most common non-bacterial cause of diarrhea.

 

Person-to-person spread is more common in day nurseries, residential

institutions and between male homosexuals. It exists in a free

swimming form and as a cyst, the latter being the form in which it is

transmitted. Symptom-free carrier states are common. These individuals

may pass on the infection while being unaware that they are carrying it.

 

Typical symptoms other than diarrhea include nausea, anorexia,

abdominal discomfort and distension. Severe malabsorption may occur,

not unlike the changes of celiac disease, from mild to total atrophy

of the gut lining. Stools may be bulky, float and stick to the pan

(steatorrhoea). If the illness is prolonged, weight loss can be quite

pronounced.

 

It is common for patients with Giardiasis to have secondary deficiency

of the enzyme lactase and they may also fail to absorb folic acid and

vitamin B12, leading to anaemia.

Diagnosis

 

Detecting Giardiasis is very difficult. Most labs do not have the

requisite detection skills. The 'gold standard' for giardia is jejunal

biopsy, where a capsule is passed through the stomach and a small

specimen of mucous epithelium is sampled. The parasite is visible with

microscopy. Unfortunately this test is rarely carried out.

 

Routine hospital screening of feces for the presence of cysts misses

the diagnosis 98 per cent of the time. A newer and probably better

method, described by the researchers Bueno and Parrish in the US,

consists of a superficial biopsy of rectal mucosa taken by means of

small cotton bud swab pressed firmly into the mucosal lining. The

specimen is centrifuged and examined immediately under a microscope

or, if this is not possible, it is held in an incubator at 98.6° F/37°

C until ready. A positive result would include visualization of the

protozoa, which are actively mobile for up to 24 hours. Cysts may also

be present and can be recognized by their form.

Treatment

 

Originally mepacrine, an anti-malarial drug, was used. Co-trimoxazole

(a combination of sulphonamide and trimethoprim, also known as

Septrin) and metronidazole (Flagyl) have been the most widely used

drugs to date. Unfortunately the relapse rate is very high and

treatment may need to be repeated, showing that the organism was not

eradicated properly in the first place.

 

A new drug, tindazole (Fasigyn) has become available and appears to be

effective. It may cause short-lived abdominal discomfort and

drowsiness. The usual dose is 2 g as 4 tablets taken on a single

occasion. Treatment should be avoided if the patient is pregnant or

breastfeeding; patients may feel ill if they consume alcohol

concurrently with the treatment.

TOXOPLASMOSIS

 

Toxoplasmosis is an infection caused by Toxoplasma gondii, an

intracellular protozoan which requires for its life cycle a definitive

host such as a cat, sheep or pig and an intermediate host, e.g., a

human. Infection of humans occurs either congenitally (passed on from

the mother) or by ingestion of foods contaminated by infected cat,

lamb or pork feces, or by eating lamb or pork contaminated with T.

gondii cysts.

 

Toxoplasmosis is rare in the UK but not in the southern US. Five major

clinical forms are recognized:

 

1. A mild asymptomatic form with only swollen lymph glands which is

occasionally found by chance.

 

2. A more severe disturbance with swelling of lymph nodes and a mild

fever. This is the form that can mimic ME or infectious mononucleosis

(Epstein-Barr Virus) but the Paul-Bunnell test for the latter will be

negative and remain negative.

 

3. Neurological abnormalities which include neck stiffness and

headache, sore throat and rashes. The cerebral spinal fluid has a

raised pressure and its protein level is elevated.

 

4. An acute febrile illness with widespread rash, swollen liver and

spleen. The complications of this form include inflammations of the

eye, the myocardium and the liver. The latter tow forms are more

common in those with a poor immune system, such as AIDS sufferers.

 

5. Congenital toxoplasmosis, which often leads to mental retardation,

epilepsy and even spasticity or paralysis.

Diagnosis

 

Diagnosis is made chiefly from serological tests for IgG antibodies to

T. gondii. Other antibody tests include indirect fluorescence or

haemagglutionation. Raised antibody levels are not rare in the general

population, and only an increasing level is suggestive of active

toxoplasmosis.

Treatment

 

Most patients require no therapy as the disease is mild. Good general

measures as described above will be sufficient to shrug it off. For

those with the more severe form, pyrimethamine (25 to 50 mg three

times day) and sulphadiazine (4 to 5g daily) are used in combination.

Therapy needs to be continued for at least one month. Since

pyrimethamine causes fetal abnormalities it should not be used during

pregnancy or if a woman might be pregnant. Steroids are occasionally

used to dampen down any inflammation in the eye.

 

Prevention is better than cure. Domestic cats that kill mice and birds

are the chief source of infection and strict codes of hygiene should

always be observed around pets.

 

 

CRYPTOSPORIDIA

 

In the last decade, Cryptosporidia species have become recognized as

one of the most frequent causes of acute gastroenteritis caused by a

parasite. Cryptosporidium is a spherical, single-celled protozoa found

in contaminated water and foods. It occurs as spherical cysts about 4

to 6 microns in diameter. It is not killed by water chlorination.

According to the Food and Drug Administration (FDA), ingesting 137

cysts infects 50% of the people exposed, and ingesting 300 cysts

infects 66%.

 

It is common in farm workers but affects the population generally.

Surveys indicate that about 2% of the population in North America are

infected and 80% have had cryptosporidiosis at one time or another.

 

Six species are known which infect mammals, birds, reptiles, fish and

humans. C. parvum is the major species responsible for clinical

disease in humans and domestic animals. Transmission is direct

transfer (fecal-oral route). That is to say, cysts are excreted in the

feces and, due to inadequate hygiene, eventually find their way into

the mouth of uninfected hosts.

 

Usually cryptosporidiosis is a mild self-limiting attack which lasts

no more than a few weeks. Immune-compromised patients, with allergies

and chemical overload as much more at risk and infection may linger to

become on of the many causes of chronic fatigue. But it is

particularly disastrous for AIDS victims who cannot fight it off and

suffer a severe life-threatening diarrhea with dehydration. Secondary

symptoms include fatigue, headache, joint pains and general debility.

The antibody response to Cryptosporidia may interfere with treatments

being attempted, such as enzyme potentiated desensitization (Page 000)

or Miller's method (page 000).

 

 

Treatment

 

To date, there is no really successful treatment for Cryptosporidium

infections. Metronidazole (Flagyl) can be tried. The general defense

measures above are the best approach to ridding one's self of the problem.

 

Because many cities are unable completely remove Giardia and

Cryptosporidia cysts from their water supplies, even drinking water

direct from the faucet may be infected. In fact, cysts have been found

in most major municipal water supplies in the United States, and more

than 63% of water problems in the United States may be caused by

Giardia and Cryptosporidia. Milwaukee had a huge Cryptosporidia

outbreak in 1993 that infected half a million people and resulted in

100 deaths.

 

Prevention is much more effective than treatment.

 

drink only filtered water outdoors

 

avoid swallowing water when swimming in lakes, ponds, and rivers

 

avoid drinking unpasteurized milk and cider

 

wash your hands, especially after exposure to diapers and livestock

 

if you are at risk, add thoroughly washing all fruits and vegetables