Mick West

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.

I wrote two articles inspired by Occam’s dictum to not multiply entities beyond necessity. The first, Occam’s Hot Tub simply proposed one particular possible cause of the symptoms that people claim are a new disease called Morgellons. The second, Occam’s Menopause, noted that all the symptoms of Morgellons are also caused by menopause, and since there are a lot of middled aged women in the Morgellons demographic, that probably explains a lot of cases.

People who think they are infested with something often look through a microscope, and sometimes they see things they cannot identify. One of the more interesting and common things is the “starfish“, which looks like this:

and here’s another:

Rather unusual little things that’s for sure. If you found those emerging from your body, then you’d be forgiven for being a bit suspicious. So what the heck are they?

As it turns out, nothing at all unusual. They are stellate trichomes, also known as stellate hairs or star hairs. Stellate hairs are star shaped hairs found on the leaves of plants. Here’s two from oak leaves:

They float around in the air, and get stuck in things, just like lint does. If you live close to oak trees, you’ll probably find them on your skin, and certainly in nasal mucus. They get stuck in amber:

So what is this to do with Occam? Well, it’s a lesson in hindsight. If you find something unusual looking on your skin, something that looks like a weird gelatinous spider or starfish, what explanation should you favor? You don’t know what it is, so either way you’d be introducing a new entity. But “a bit of plant matter I’ve never seen before” is a lot simpler than “a fiber producing pathogen new to science”.

But the real test of Occam for the person who thinks they have Morgellons is when they ask “so, I can see that’s a Stellate Trichome, so why are plants growing inside my body?”. Here again, there are two explanations: some stellate hairs were carried by the wind into your sore, and you found them later with your microscope, or there is some parasitic plant growing inside your body. To the person who wants to be diagnosed with Morgellons, the second answer, although perhaps infinitely less likely, is more attractive.

There’s a little more on trichomes, they can produce allergic reactions. eMedicine says of sunflowers: “An occupational allergic contact dermatitis is often found in individuals who harvest this flower. The major allergen is known as 1-0-methyl 1-4,5-dihydroniveusin A. The pollen is said to be a minor allergen. Trichomes, or small hairs, on the surfaces of the leaf secrete the allergens. Windblown trichomes from dry plants can cause airborne contact dermatitis.”

Morgellons is not a distinct disease, it’s just a list of symptoms that are caused by many other diseases and conditions. Some people who think they have Morgellons probably have skin allergies that gives them contact dermatitis. In this particular case, they may well examine their lesions and find the cause of their problems is a translucent starfish. In this case, they would be correct. But it’s not “Morgellons”.

2016 Update, see:
Photos in Middelveen’s & Stricker’s Morgellons papers that look like Stellate Trichomes.

Why does the Morgellons idea persist, when there is no evidence to support it? Medical professionals say that people who self-diagnose with “Morgellons” actually have a variety of illnesses, and many have some kind of mistaken belief regarding fibers emerging from their skin. After years of people making claims of fibers, no dermatologist has ever seen these fibers emerging. Yet the idea persists.

Will it continue to persist? How will the idea evolve? We can get some insight here by looking at a similar idea, that of “chemtrails“.

Both ideas had a very similar start. People noticed something that seemed unusual to them. With Morgellons, they found if they looked very closely at their skin, then they would find tiny fibers, which they could not recall finding before. With chemtrails, they noticed that some vapor trails behind planes lasted a lot longer than other, which they could not recall seeing happen before.

Then they noticed a connection with their health. With Morgellons, they found the fibers in their excoriations, so assumed they must be connected. With chemtrails, they noticed that sometimes when the trails lasted a long time, they felt unwell, so they must be connected. Quacks move in, and begin to encourage the belief in Morgellons (or Chemtrails), so they can sell their snake-oil.

Then the theories started, with Morgellons it was a new disease, or escaped nano-technology, or genetic modification. With chemtrails, it was a secret population reduction program, or a mass inoculation, or experiment, or weather modification.

Both ideas grew on the internet. With a hundred million people on the internet, if only one in a million people agree with you, that’s a hundred people. Like-minded people group together, and discuss their experiences and theories. Eventually enough people write to their local TV station, and they get some media coverage.

Then comes science. With Morgellons, it is noted that fibers are everywhere, and you will inevitably get them on your skin and in your lesions. It is noted that the hundreds of medical conditions can give a set of symptoms that fit Morgellons, and there is no evidence of a distinct disease. With chemtrails, it is noted that it’s perfectly normal for some trails to persist, depending on the weather, and that trails just like these have been observed since the 1940s.

So, once it was explained, did people stop believing in these ideas? Some did, but the ideas live on. Hard-core believers simply rejected the evidence presented, claiming the scientists were either stupid, or part of a conspiracy. More level-headed believers simply modified their belief – now just SOME of the trails looked suspicious, or SOME of the fibers were a minor side effect. The pages describing the theories remain up on the internet, and new believers find them every day. The ideas live on.

Chemtrails is a little more advanced in its progression as an idea, and we can predict what will happen with Morgellons by looking at Chemtrails. Specifically, the CDC investigation. With chemtrails, the air-force looked into chemtrail theory, and put out a document explaining exactly what is going on. This had no impact. People simply ignored the science in the document, and claimed it was part of a conspiracy. With Morgellons, the CDC will produce a report, basically saying there is no new disease, but there is a lot of Delusions of Parasitosis, triggered by various physical ailments, and they will explain this and recommend what doctors should do. This will have NO EFFECT on the belief in Morgellons. People will either ignore it, or say it’s part of a conspiracy, or simply say the CDC was wrong.

A while ago I created this fake CDC paper on Morgellons. Nobody really batted an eye. It was discussed briefly on Morgellons discussion boards, but the actual implications of the paper were basically ignored. The problem is that the actual CDC report on Morgellons, that will probably be written in 2008, is going to look very similar to this fake paper. The reaction amongst believers is going to be the same, and the same as the reactions that chemtrail believers had to official explanations of their observations.

People who think they have “Morgellons” have usually self-diagnosed. There is no diagnostic criteria for Morgellons, and the case definition is overly broad, allowing anyone with general malaise to claim some of the many symptoms. But the people who end up convincing themselves of their Morgellons are generally people who have rejected their doctors diagnoses, and turn to “alternative” medicine. Given the mental issues that often accompany a self-diagnosis of Morgellons, it is not surprising that these people have become an easy target for many forms of quackery.
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