_http://www.telegraph.co.uk/health/8626767/Morgellons-Disease-continues-to-d
efeat-scientists.html_
(http://www.telegraph.co.uk/health/8626767/Morgellons-Disease-continues-to-defeat-scientists.html)
Morgellons Disease continues to defeat scientists
Burrowing bugs, delusions or a nervous disorder? Why can't medical
scientists get to the bottom of Morgellons Disease.
By Will Storr
7:30AM BST 11 Jul 2011
Nick Mann was convinced that something was burrowing into his skin. The
48-year-old father of two had been for a walk in the beautiful grounds
of Abney Park Cemetery, down the road from his home in Hackney, east
London.
It was sunny and he'd been wearing shorts and sandals. That evening, his
legs began itching. Marks sprang up all over his body. "I just knew
something was on me," he remembers. "Something digging or biting into my
skin."
Over the coming days, lesions opened up on his body. Running his
fingertips over them, he could feel something inside: it felt like
spines or fibres, he says. He began to feel tormented. What were these
bugs? How many were there? Would he ever be rid of them?
One afternoon, in desperation, Nick stripped naked in his kitchen and
determined to dig one out as soon as felt it 'bite'. "I stood there for
three or four hours, waiting," he says. "As soon as it did, I went for
it with a hypodermic needle. There was one on my nipple."
He pales slightly. "You know, I can't get that out of my head. It was so
painful. I dug the needle in and felt it flicking against something that
wasn't me. And I just carried on digging and scooping." It took nearly
four hours. "At one point my wife came in and saw blood dripping down my
leg."
By the end of the afternoon, Nick had dug out three of the mysterious
entities from his body. They were so small, he says, you could only see
them when they moved. Having managed to transfer them into a jar, he
proudly showed his wife. Karen peered into the pot. She could see
nothing. Nick, however, knew he was on the verge of discovering what
this strange and maddening condition was.
It was back in 2001 that the first modern-day reports of a mysterious
"fibre disease" began to emerge from the US. When Mary Leitao's
two-year-old son complained of "bugs in his skin" and subsequently broke
out in lesions, the worried mother examined him with a toy microscope.
Under the lens, she found bizarre, many-coloured fibres. Leitao
christened the condition Morgellons Disease, after a similar bizarre
outbreak of "harsh hairs" on children that was reported in the 17th
century.
She was compelled to name it herself for a simple, but surprising
reason: doctor after doctor dismissed her concerns. They said she was
neurotic; that it was a figment of her imagination.
A decade later, Leitao's Morgellons Research Foundation claims to have
been contacted by more than 12,000 families from all over the world. All
of them claim to have the itch, the lesions and the fibres. But the vast
majority of sufferers had been dismissed by medical professionals as
being mentally ill, with a condition known as Delusions of Parasitosis,
in which sufferers are falsely convinced that they are infested.
Despite this, in 2006, there was enough pressure put on the American
government for the Centers for Disease Control and Prevention [CDC] to
form a task force to look into the matter. "We're not ready to concede
there's a new disease," a spokesman said at the time. "But the volume of
concern has stepped up because a lot of people are writing or calling
their congressmen about it."
One of the few academics to accept that Morgellons might be real is
Randy Wymore, associate professor of pharmacology at Oklahoma State
University. "I thought it sounded crazy," he remembers.
"I knew it was thought to be delusional, so I asked some Morgellons
sufferers to send samples of the fibres, figuring if it was delusional,
they would never show up. But 48 hours later, Fed Ex packages started
arriving. I borrowed a microscope to examine them. And they looked a
little odd."
Wymore asked agents in the forensics department of the Tulsa police
department for a second opinion. "Within about 30 seconds, one of them
said, 'Uh, I don't think I've ever seen anything like this'."
The fibres didn't match any of the 85,000 organic substances they had on
their files. "I was both shocked and not shocked," recalls Wymore. "I
already thought these fibres were kind of unusual, and this just
validated it."
Wymore has now been working on the DNA of the fibres for five years. So
far, none of the samples he has sent into the laboratory has proved to
be anything mysterious. Results have included nylon, cotton, a human
hair, a fungal fibre and a rodent hair.
Yet more evidence that Morgellons patients are merely delusional?
World-renowned neurologist Dr Anne Louise Oaklander is not so sure.
Oaklander, an associate professor of neurology at Harvard Medical
School, is an expert in itching. She believes that sufferers might have
developed nerve disorders that are being misdiagnosed.
"Morgellons is not a disease with a unifying cause, but a constellation
of symptoms that can be caused by different underlying diagnoses," she
says. "In my experience, these patients have a severe itch disorder
that's unexplained, and because itch is the sensation that we feel when
an insect lands on our skin, or grubbing about among the hairs of our
body, these patients make a logical conclusion: which is that there must
be insects here, causing these insect-like sensations."
She explains that the brain can mistakenly experience the feeling of
insects if the nervous system was damaged following shingles and
sciatica, or by the growth of spinal cord tumours.
"What often happens, though, is a physician does not find a skin
disorder, so jumps to a psychiatric conclusion. But what they should be
doing is looking for underlying neurological explanations."
So what all does this mean for Nick Mann? Are the fibres in his skin
real? Is he delusional? Or does he have an undiagnosed nerve disorder?
In fact, Nick turned out to be an extraordinary case. While it's common
for GPs to diagnose patients claiming to suffer from unexplained itching
as delusional, this was unlikely in his case, because Nick himself is a GP.
"I took the three mites I'd caught to our local Homerton Hospital," he
says. "A technician mounted one on a slide, put it under a microscope
and said 'Beautiful'. Everyone gathered around saying 'Ooh, look at that'."
It was definitely something. But they didn't know what. "They sent it to
the Natural History Museum, which identified it within a day," says
Nick, "as a Tropical Rat Mite."
Although museum experts doubted the mites could live on the skin, the GP
has no doubt that is what they were doing. "What these mites do is go in
through the hair follicles and find a blood vessel at the bottom. That's
where they sit and that's what the 'fibres' are -- their legs folded back."
Nick, who treated himself with an antiparasitic drug to eradicate the
infection, can only guess that he picked up the mites walking in the
cemetery. Despite the name, they are not exclusive to hot climates.
Nick believes it likely that many patients who claim to have Morgellons
are actually infected by Tropical Rat Mites. However, he agrees with Dr
Oaklander that this diagnosis is unlikely to explain all cases. "There
doesn't appear to be a single explanation for it," he says.
Perhaps the mystery will finally be solved when the Centers for Disease
Control release their report. Currently in the peer-review process,
publication is thought to be imminent.
Causes and cures: starting from scratch
Itching is a common symptom but can be severe and frustrating. It can be
localised, or all over the body and there are numerous causes and
various treatments.
Causes
A non-infectious skin condition -- eczema, psoriasis or prurigo (fluid
filled blisters).
Allergies -- nickel, medication, washing powder, cosmetics or food.
An insect or parasite -- bites, scabies, head lice, bed bugs or ticks.
Fungal and viral infections, such as measles, athlete's foot, ringworm
and thrush.
Chronic conditions
Some types of cancer, thyroid problems, hepatitis and liver disease.
Hormonal changes in the body during the menopause and pregnancy.
Diagnosis
Visit your GP for a diagnosis if your itching is severe, prolonged or
recurring. Seek medical advice if itching is associated with other
symptoms, such as breathing problems, inflammation or yellowing of the
skin and eyes.
A physical assessment may be able to determine the cause of the itching,
but your doctor may
also carry out a blood test, skin scraping, swab or biopsy to diagnose
the underlying cause of the problem.
Treatment
Treatment will depend on the cause of the itching. Bathing skin in
lukewarm water and avoiding skin irritants, such as certain fabrics,
tight fitting clothing and perfumed cosmetics.
Medication or creams may be prescribed. Antihistamines may be advisable
for insect bites or if an allergy has been diagnosed.
For more information, see, _http://www.cdc.gov/unexplaineddermopathy/_
(http://www.cdc.gov/unexplaineddermopathy/)
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