Missouri Articles: BACK
`Disease' creates medical mystery
Though many doctors dismiss Morgellons as a delusion,
for those who suffer it, the pain is real.
Alan Bavley
The Kansas City Star
Kansas City, MO
November 25, 2006
It started last year with what Cindy Wick thinks was a tick bite.
Then came the sensation of biting insects from red spots all over her body.
When Wick rubbed the spots, they burst open. From these sores, she pulled white fibers a half-inch long. The pain subsided, but the ordeal wasn't over. The painful red spots continue to appear.
"This is the scariest thing that has ever happened to me," said Wick, 49, of Kansas City. "I wouldn't wish this on my worst enemy."
Wick is convinced she has Morgellons disease, a mysterious condition marked by the sensation of insects crawling under the skin and sores that erupt and release black specks or fibers that are white or clear, or even blue or red.
Sufferers also complain of memory loss, poor balance and difficulty paying attention.
Thousands of people across the country think they have Morgellons, and their numbers have grown rapidly.
Although the medical community is far from convinced, the Centers for Disease Control and Prevention will investigate.
Morgellons is not a recognized disease but a condition named just a few years ago by the mother of a boy who suffers the symptoms.
Many doctors dismiss patient complaints as simple insect bites or delusions of being infested with parasites. The fibers are nothing but bits of skin or lint from clothing, they say.
"Until someone can prove it to me, I'm not going to believe it," said Stacy Beaty, a dermatologist at St. Louis University.
"I usually diagnose these patients with delusions of parasitosis."
But a small number of doctors and scientists have begun to take Morgellons seriously. Their preliminary findings suggest at least some sufferers have real symptoms that don't fit doctors' usual explanations.
The CDC announced its investigation after a barrage of phone calls, and even inquiries from members of Congress.
"Our mind is open to all possibilities," said CDC spokesman Dan Rutz. "We know that people are suffering, but we don't know why."
Wick's problems started after she moved from Kansas City to a house in South Carolina last year. One night, she said, "I could feel biting all over me."
Wick went to doctors, who told her she had a spider bite, or scabies, or flea bites. She hired an exterminator and used bug bombs. Nothing helped.
She said she saved fibers and took them to a doctor. "He would totally disregard them," she said.
One time, as a doctor watched, Wick said, she pushed a fiber from one of her fingers. The doctor pulled it out with tweezers and left the examination room. "He came back and said it was nothing, just skin," she said. "I sat outside in my truck and cried for a while."
Covered with sores, Wick could no longer keep her sales job. Medical bills exhausted her savings. In August, she returned to Kansas City, where her son takes care of her.
"I told him something is so wrong with me and nobody believes me," she said.
Many medical conditions, from insect infestations to strokes or drug abuse, can cause the kinds of itching and skin-crawling sensations associated with Morgellons, said Thelda Kestenbaum, a dermatologist at the University of Kansas Hospital.
Beaty said she thinks a lot of the patients' issues are psychological. Skin problems and psychiatric disorders often go hand in hand.
About 14 percent of dermatology patients who complained of persistent itching had undiagnosed obsessive-compulsive disorder, researchers in New York found.
In another study, more than a fourth of 2,600 dermatology outpatients surveyed reported psychiatric symptoms such as depression and anxiety.
Morgellons disease is named after a similar-sounding condition described in 17th century France. The name was applied to modern-day cases by Mary Leitao, founder of the Morgellons Research Foundation.
Leitao's organization, which has about 8,000 families in its registry, has been instrumental in getting Morgellons large amounts of publicity, primarily on television and through the Internet.
"The focus should be on what's causing this, who's at risk," Leitao said. "Research is the key, but in the meantime, patients need support."
Some doctors, including Raphael Stricker of San Francisco, are beginning to offer support.
"I think it's a real disease. It's really quite a strange disease," Stricker said. "Writing everyone off as delusions of parasites is wrong. … These are people who were perfectly sane before they developed these symptoms."
Stricker is an expert on infections such as Lyme disease that are carried by ticks. Some of his Lyme disease patients later developed Morgellons symptoms. That suggests that Morgellons also may be carried by ticks, he said.
Stricker has sent biopsies of his Morgellons patients to researchers at Stony Brook University in New York. Some were found to carry bacteria that attack plants.
"Ticks can carry plant bacteria," Stricker said.
Randy Wymore, a scientist who teaches pharmacology and physiology at Oklahoma State University, has worked with a staff physician who inspected the skin of about 25 patients who complained of Morgellons. In every patient, the doctor found clumps of fibers under the skin, even where there were no sores.
Wymore took Morgellons fibers to the Tulsa, Okla., police crime lab for analysis. It determined that the fibers weren't from any known textiles, nor did they match anything in a database of 900 fibers.
"We don't know what this is yet," he said. "But I think most people would agree they shouldn't be under a person's skin."TWO SIDES
•Raphael Stricker, a San Francisco doctor: "I think it's a real disease. It's really quite a strange disease."
•Stacy Beaty, a St. Louis University dermatologist: "Until someone can prove it to me, I'm not going to believe it."
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July perfect time to remember, practice summer protection against ticks and mosquitoes
California Democrat
California, MO
July 9, 2006
The Missouri Department of Health and Senior Services (DHSS) urges everyone to remember to plan for protection against ticks and mosquitoes during outdoor activities now and through the late fall and early winter.
Ticks can carry diseases like Rocky Mountain spotted fever, Lyme and Lyme-like disease, ehrlichiosis, and tularemia, while mosquitoes can carry West Nile virus, St. Louis Encephalitis, and Eastern Equine Encephalitis. Though risk is low, these diseases can cause serious illness and even death if precautions against bites from infected insects are not taken.
The good news is that precautions against the bugs that carry these diseases are easy and effective, according to Dr. Howard Pue, State Public Health Veterinarian. "It is very important for people to protect themselves against tick and mosquito bites every time they go outside and into areas where these bugs live. Fortunately that's easy to do and very effective if done properly," Pue said.
Following are simple, effective actions people can take to avoid tick and mosquito bites.
For Mosquitoes:
* Use of repellent containing DEET or picaridin is the most effective way to repel mosquitoes. Follow label instructions when applying to bare skin areas.
* Wear long sleeves and pants when outdoors.
* Take extra care to use repellent and protective clothing during evening and early morning - peak biting times for many species of mosquitoes
* Remove trash and debris around the house and property to reduce breeding areas.
* Empty and/or freshen items that hold water (flower pots, bird baths, wading pools) every four days.
* Check and repair any holes in window and door screens.
* Clean house gutters to prevent standing water where mosquitoes can breed.
For Ticks:
* Apply insect repellent containing DEET to exposed skin areas as directed.
* Apply repellents with permethrin on clothing only, not directly to skin.
* Walk in the center of trails to avoid overhanging grass and brush.
* Wear light-colored clothing to make ticks easier to see and tuck pants into socks.
* Do daily tick checks on yourself, children and pets.
* Carefully remove attached ticks immediately (see DHSS web site for details); an infected tick can pass disease through a bite in as little as four hours.
"While the overall risk of human disease from ticks and mosquitoes is relatively low, insect-borne diseases can cause serious long-term health effects and even death if not recognized and treated appropriately. We encourage people to take the simple, effective steps to protect themselves against bug bites that can harm them and their families, Pue said."
Pue added that if people think they are becoming ill after being bitten by a tick or mosquito, they are urged to contact their healthcare provider immediately. Flu-like symptoms in the summer probably do not indicate influenza and the person should seek medical care as soon as symptoms appear.
In 2005, there were 17 cases of Lyme disease, 128 cases of Rocky Mountain spotted fever, and 41 cases of ehrlichiosis. There were also 30 cases of West Nile virus, and three of these were fatal.
More information on diseases carried by ticks and mosquitoes can be accessed on the DHSS web site at www.dhss.mo.gov.
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New tick-borne illness has researchers scratching heads
Columbia Daily Tribune
Columbia, MO
August 21, 2006
ST. LOUIS COUNTY - It's a miserably muggy morning, and Brian Allan is tucking the pant legs of his white cotton jumpsuit into his socks.
A mysterious new tick-borne disease has sickened people and puzzled doctors, and Allan, a Washington University graduate student, is out to track down its source.
Trudging through woods at the Tyson Research Center, he pauses every 20 feet to inspect a white cotton cloth about the size of an American flag that he's dragging. He also inspects himself.
On this particular July morning, the search so far is not very tickful for Allan, who can usually find a tick within one minute.
He has traveled throughout the Midwest to collect ticks. He's been all over Missouri, southern Indiana and to Land Between the Lakes in Kentucky and Tennessee. This month, he'll have a tick collecting spree in southern Missouri.
Allan is part of a Washington University effort to find which animals are passing on tick-borne diseases, including the new elusive one.
Last year, Missouri had 213 reports of tick-borne diseases, including Lyme disease, erhlichiosis and Rocky Mountain spotted fever. The actual number of cases is most likely higher because these diseases can be difficult to diagnose.
Missouri long has been considered a hot spot for tick-borne diseases.
"Rural Missouri is a hazardous place to be in the summer," said Gregory Storch, an infectious disease expert at Washington University. The most tick bites occur in April through September, he said.
The new pathogen, which causes rashes and flu-like symptoms, has Storch and his fellow researchers on a mission.
"It's out there in nature, but no one knows where," said Robert Thach, one of the study's collaborators. "Why are people in St. Louis coming down with this disease? Where are they getting it? Where are the ticks getting it?"
The disease is considered an emerging infection, and too little is known about its causes to be classified by the Centers for Disease Control and Prevention as a nationally reportable disease.
But the disease does have a name: Southern tick-associated rash illness.
Donald Kennedy, professor of internal medicine at St. Louis University School of Medicine, treated two patients with the illness in May. He said that for now, the illness is considered a clinical syndrome because the pathogen that causes it has not been identified.
"Some of these techniques in identification lag the presentation of the clinical illness," Kennedy said.
The same was true for other infectious diseases, including AIDS, polio and smallpox, he said.
Part of the new disease's mystery is that its victims show symptoms similar to those of people with Lyme disease. Both cause a bull's-eye rash, and victims complain of headaches, muscle aches and fatigue. But tests for the organism causing Lyme disease come back negative for patients with the new illness.
Although some researchers suspect that the organism causing the new tick disease is related to the bacterium that causes Lyme disease, they're also convinced that this new disease is not Lyme.
What is known is the type of tick that transmits the illness: the lonestar tick. Named for the white spot on the adult female's back, the lonestar tick is the most frequently encountered tick in Missouri. This spider relative's habitat stretches from Florida to Texas to Maine.
Most ticks seek their blood meals by clinging to tall grasses with their six rear legs and waving their front two as they wait for a host - such as a human, deer, chipmunk or bird - to brush by it. Not so for the lonestar tick.
"A lonestar will actually run toward a host and try getting on that way," said Karen Yates, an ecologist at the Missouri Department of Conservation. "It's a supertick."
When Allan scores ticks on his cloth, he plucks them off with tweezers and places them in small vials containing ethanol. The ethanol preserves the ticks so that Lisa Goessing, a Washington University researcher, can isolate a tick's last blood meal, which might have been eight months before.
The blood meal contains DNA that identifies the animal that the tick fed on, as well as any pathogens the animal was carrying. This information will show the researchers which animals are more likely to pass on disease.
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