July 2007

Morgellons in the “Atlas of Human Parasitology”

From: Atlas of Human Parasitology, 5th Edition, 2007, Ash & Orihel, pages 386-387

There appears to be a marked increase in cases of delusional parasitosis recently. This appears to correlate with increasing availability of internet sites that are devoted to this or similar conditions. By using online resources (especially web chatrooms), patients will come away with a conviction that they have identified the specific parasite that they have acquired, …

Within the past few years, individuals who often exhibit manifestations of what many consider to be delusional parasitosis have referred to their condition as Morgellons disease. Given the large number of individuals involved who feel this is an as yet undefined medical problem, the Centers for disease Control and Prevention (CDC) began in late 2006 an investigation into the validity of this as an actual disease. …

Many dermatologists refute the suggestion that this is an actual disease but instead indicate that many of these patients have psychological problems or other common skin disorders. Given the large numbers of individuals who feel they have this affliction, it will be most helpful over the coming years to have a valid scientific assessment of Morgellons disease and its possible etiology (or etiologies). One of the chief criticisms by many patients has been that they feel the medical community and other scientists consulted have not been open to the idea that there is possibly an as yet undescribed infectious or physiologic causation for the disease. However it is certainly true that in fact many expert parasitologists, medical entomologists and other microbiologists have in fact carefully examined fibers and other materials expressed or extracted from such patients and found that biological organisms are not present. Although an apparent association of the condition with the presence of Lyme disease has been reported (Savely et al, 2006, Aj J Clin Drematol., 7:1-6), further research will be needed to help resolve the validity of Morgellons disease. Until then, whether Morgellons disease is another name for delusional parasitosis, or a real disease entity with a biological or physiologic basis will remain up in the air.

July 24, 2007 by Science

CDC – Federal Business Opportunity to Study Morgellons

http://www.fbo.gov/servlet/Documents/R/1771563

The Centers for Disease Control and Prevention (CDC), Coordinating Center for Infectious Diseases (CCID), National Center for Zoonotic, Vectorborne, and Enteric Diseases (NCZVED), Division of Parasitic Diseases is seeking to award a sole source commercial contract for investigation in California of an unexplained dermopathy (Skin Condition) which some refer to as Morgellons.

The Government has determined that Kaiser Permanente (KP), Northern California is the only responsible source to meet the Government’s needs. Morgellons is a rare condition with a heavy concentration in California, and KP is the only organization that has the location, coverage area, and membership size to provide the large sample size required for the study. Minimum managed care organization membership required to satisfy this study is 25% of the population in the region selected. Other minimum vendor qualifications for this requirement are: electronic health records that have been implemented in the organization at least since January 2006; ability to conduct electronic queries of medical records, including progress notes, to identify clinical conditions and complaints; health maintenance organization with at least 3 million enrollees and coverage of at least 25% of the population in the chosen geographic area; location in a geographic area with a large number of suspected cases; experience in conducting clinical and epidemiologic studies; adequate qualified personnel to successfully perform the requested services by the date required.

The proposed effort will involve the following: describing the clinical and epidemiologic features of persons who have reported themselves as having this unexplained skin condition, including assessing the frequency of co-morbid conditions (e.g., neurocognitive deficits, neurologic conditions, major psychiatric disorders); collecting information to generate hypotheses about possible risk factors for this condition; collecting skin biopsies to assess the histopathologic features of the skin condition ; obtaining fibers or threads from patients with the condition to determine their potential etiology; describing the geographic distribution of this condition; estimating rates of illness in the population; and describing health care utilization among persons with the condition.

Total period of performance will be seven (9) months from date of award. The Government intends to issue a Request for Quotation (RFQ) on 31 July 2007, with award anticipated by 31 August 2007. All responsible sources may submit a bid, proposal, or quotation which shall be considered by the agency.

Well, I guess we’ll just have to wait until March (or May?) 2008 for the results. It certainly will be very interesting though.

July 23, 2007 by CDC

Pathogens & People

Here’s an interesting article that illustrates some of what I was discussing in the previous post.

http://www.hometownannapolis.com/cgi-bin/read/2007/07_01-25/COL

The problem is, McSweegan makes no mention of underlying physical conditions, which again sweeps the whole situation into the false dichotomy of “delusion or disease”.

A patient is quoted as saying “I was feeling things moving under my skin”, and then the gist of the article is that they were imagining it. When actually formication is a real physical symptom triggered by various physical circumstances from Meth to Menopause.

So while McSweegan characterizes the circumstances of Morgellons fairly well, he’s not telling the whole story, and he is reinforcing a polarization that inhibits communication.

July 1, 2007 by Media

The Evidence Indicates:

1. The fibers are environmental and unrelated to any illness
2. Morgellons is not a distinct disease
3. People who think they have "Morgellons" probably have a mixed variety of physical and/or mental illnesses.

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