Live worm found in Australian woman’s brain
theguardian.com
theguardian.com
But then I see stats from the CDC on infection rates. https://www.cdc.gov/media/releases/2014/p0508-npi.html
- More than 300,000 people living in the United States are infected with Trypanosoma cruzi, the parasite that causes Chagas disease
- At least 14 percent of the U.S. population has been exposed to Toxocara, the parasite that causes toxocariasis
- 60 million U.S. citizens are infected with Toxoplasma Gondii
- The Trichomonas parasite is extremely common, affecting 3.7 million people in the United States
A healthy individual is far more likely to be asymptomatic if they do have a parasite infection. That makes me question the recommendation for healthy individuals to avoid deworming.
Most of the time treatment is fine, but in some people the side effects can be quite severe. This is the root of the recommendation to not do so unless you know you have a reason to.
And honestly I am very pro-science but the “do no harm” bias in medicine makes me fundamentally question a lot of the recommendations. If it was just slightly better to deworm, do you think they’d recommend it? And then face accusations after any side effects (even if it was statistically the right call to do).
IDK whether this is significant to the original question (de-worm or not) because I'm not qualified to speculate, but I think it certainly suggests that at least for some cities, the evidence should be re-evaluated with realistic sanitation conditions in mind.
It's really not that - people have a fundamental desire to take action to mitigate tail risk even when that action poses more actual risk. You have to look at risk-reward tradeoff across the population. Treating the entire population for a disease very few of them have will almost certainly yield more (and potentially more harmful) realized side-effects than the actual primary effects being caused by the disease itself. Especially when patients aren't seeking treatment, so are most likely asymptomatic.
Ditto testing low-risk populations for all sorts of conditions they mostly don't have. Even a test that is 99% accurate in a high-incidence population is going to be utterly ineffective when applied to the general population. Bayes theorem tells us this. The side effects up to and including death of investigating or treating these false positives adds up to a real net-negative situation.
If it was even an eency weency bit better to treat in the US I would say they would overwhelmingly do so because they'd be sued into the ground otherwise.
tl;dr: especially when it comes to treatments, action is not always better than inaction. Generally, the US medical system tends towards action.
I read that sentence a few times. 99% accurate seems quite high. WSJ recently opined about the 1-in-5 cancer misdiagnosis rate.
https://www.wsj.com/articles/are-you-sure-you-have-cancer-di...
"Are You Sure You Have Cancer?"
It's a bit easier to understand if you think of the extreme case: if the disease is completely eliminated than all positives are false-positives.
Second, absent actual testing, the risk/reward of deworming is very much a function of the likelihood that you actually have one or more of these worms. That probability is too low in, say, the US to give routing deworming positive expected value. It’s telling that even routine testing isn’t worth the time/cost.
Thirdly, it’s not like… _exactly_ clear that all of these parasites are a problem in the first place. Many of them are frequently asymptomatic with negligible long term consequences. There are even those who believe that the near eradication of hookworm and its minor gut immunosuppressive effect in the developed world is the explanation for much higher rates of inflammatory bowel disease. I that one, but the general idea is that a lot of these worms just don’t actually cause much harm.
And lastly, deworming medications aren’t exactly a joke. They can have serious risks associated with them. Overall it just doesn’t make any sense to routinely deworm in the developed world.
And worms aren’t all bad. Your body’s immune system likely welcomes its presence. Our th1-th2 balance is supposed to have evolved with an assumption of helminth infections happening over the course of your life, so having a worm or two is likely a good thing. Supposedly. Don’t go around barefoot in feces to get hook worms. Not anymore than trying to deworm once a week destroying kidneys I suppose.
What is the point of making a claim and then walking it back?
You say that, but I've heard at least one story where someone did exactly that (and claimed that it cured their allergies and asthma): https://www.thisamericanlife.org/404/enemy-camp-2010/act-thr...
I'll personally stick to allergy shots, though.
It's not a cure but a marked reduction in symptoms. I used to have to take fexofenadine basically daily. Now I only need it under extreme conditions.
I'm sure the worms have long since died off and I may need to re-up.
The idea of deworming in healthy individuals in developed countries is the domain of alternative medicine, where people tend to use questionable supplements or under dosed pharmaceuticals for peace of mind.
However, even antibiotics aren’t as safe as some of these people think. One of my acquaintances died following complications of antibiotics that he purchased over the internet and self-administered. It was a rare outcome of using the antibiotic, but statistically it was several orders of magnitude more likely to cause problems than the condition he thought he was self-treating.
My recommendation is if you feel like you want piece of mind, to talk to your doctor about it. If your doctor recommends a treatment, follow it. Don’t just buy deworming medication because you fear you might have worms.
I don't know anything about worms, but I'm very certain that I could choose a doctor that would recommend treatment or one that would not, depending on what I've already decided I want.
Further, if you do pick your doctor based on the fact that they will give you the treatment you want, at least someone other than you knows that you are taking medications with potentially bad side effects.
Isn’t this how the opioid epidemic started? Going to doctors that would prescribe you OxyContin because you hurt your finger? Or back? Or knee? Or ego?
If you want pain meds, I'm sure it's easy at any of those "pain management clinics" I see advertised.
If you call a few doctors and ask "Does your practice handle worms? I'm worried I might have worms," you'll have at least some of them say "absolutely, all the time, come right in".
If they want a happy customer and they know your expectations and they know the risk of dewormer is low, then they'll probably go along with it to make you a recurring ~~customer~~ patient.
You might not even know you've accidentally guided the doctor in that direction.
30% of Danes have pinworm. Developed countries aren’t immune from parasites. Especially such parasites.
Drugs are effective against the worms, but not the eggs. So you have to deworm once, wait for the eggs to hatch, then deworm again 2 weeks later.
The eggs are small enough to blow around in the wind. And will be all over the bedding and kids clothes if they’re infected (and probably their school environment). So the chances of reinfection, and family wide infection are high.
It used to be the domain of every farm kid in flyover country. Deworming was a once-a-month thing because you're working with animals, animal poop, and generally around things that might have parasites in them.
Intestinal parasites aren't as big of a concern as far as the danger of treating yourself at home. You do want to know what you're dealing with and the appropriate handling of the parasite though.
Looking at Wikipedia it seems she was taking it after it was approved for animals, but before it was for humans. I don’t know if she’s mistaken it for another medication or if that’s just what was done then. I know when a friend of mine thought he had worms she suggested he take the dog form of it, and this was well before all of the recent press, so I’m inclined to think it’s the latter.
We really should come up with something in reverse. "The arrogant coasts," perhaps ;)
Firstly, gross.
Secondly, I'm surprised I've never heard about it before as we raised two kids through daycares, then pre-schools, and elementary school seemingly without ever getting it and not ever even hearing about it.
https://focus.science.ubc.ca/worms-ae3a1579c58c
Humanity evolved with parasites. Like gut bacteria, excessive focus on hygeine may be more harmful than helpful.
And, this was most of India not just us.
US 2023 pop >> 340M .. so about 1 in 4 people you randomly interact with are allied beings.
You quote something but provide no source. I believe the quote is at least not wise and probably is incorrect. People should periodically be checked for parasites. Otherwise they may be writing posts to YC under the influence of a worm!8-)
Butt seriously, many individuals in the USA have worms. When I was a child in the southwest USA we were tested at least once a year for parasites including worms. That was decades ago. Yet today the topsoil is the same, the plants and animals are the same and the parasites remain. Children still put their hands into dirt, eat dirt and sand, and touch everything. Gardeners are just as bad. I had worms as a child and I likely catch them now and again. I take care of it.
Some people "deworm" themselves in their work: e.g., ivermectin products are often applied to animals' skin. That ivermectin clears many parasites from the cowboy as well as from the cow.
After reading this, it got me wondering how parasites actually get into the human body if not directly ingested, as that seems fairly straightforward. That led me to this interesting snippet[0]:
> Parasites usually enter the body through the
- Mouth
- Skin
> Parasites that enter through the mouth are swallowed and can remain in the intestine or burrow through the intestinal wall and invade other organs. Often parasites enter the mouth through fecal-oral transmission.
> Some parasites can enter directly through the skin. Others are transmitted by insect bites.
> Rarely, parasites are spread through blood transfusions, in transplanted organs, through injections with a needle previously used by an infected person, or from a pregnant woman to her fetus.
Now, my remaining questions: how and why does a parasite navigate the body? For example, how did the parasite in this article likely begin in her digestive system and end up in the brain? Do they swim aggressively (yuck)? If so, does their destination matter to them?
[0] https://www.merckmanuals.com/home/infections/parasitic-infec...
Looks like it is referred to as Neurocysticercosis [0].
The parasite does not necessarily chose where it might end up, so it is up to luck. The victim probably ingest a bunch of eggs, which will find their way into different parts of the body, with different level of survivability. The brain does look like a cosy place to survive.
[0] https://www.who.int/news-room/facts-in-pictures/detail/neuro...
Probably a good way to find more: https://house.fandom.com/wiki/List_of_medical_diagnoses
Not an expert, but it definitely does. They can be incredibly specific in how they do things. I got a bad case of swimmer's itch after kayaking and it turns out it's from a parasite's larva. In a bird, it would go in through the feet, get into the circulatory system, mate inside the circulatory system, get their eggs into the bird's gut and let them be pooped out where they then need to do another process in a snail. In a human, they just get stuck in your skin and cause an immune reaction.
Therefore when they find themselves in a new animal, like a human, they're not in a "shit I'm lost!" situation, they'll just act based on the same stimuli as normal, wherever that takes them.
So, in other words, parasites can enter the body through just about any tissue.
It's from raw/undercooked pork and beef.
Do you have a source? It is my understanding that pork in the US is very safe since the late 2000's (or maybe even earlier).
https://news.sky.com/story/man-18-dies-from-tapeworm-larvae-...
We had (have?) a scare too; at christmas our company did a fancy gala dinner party, and the starter was a fish tartare of sorts. A few days later my GF had diarrhea, turns out there's a parasite in that type of fish that causes it days later.
It's safe to assume all fish are a parasite risk (for instance due to nematode worms or cod worms) - with the notable exception of tuna, and most farmed salmon. However! In the US, all non-tuna fish is required to be frozen to -4F for at least 7 days or -31F for 15 hours to kill parasites. [1]
You can make sushi - or tartare - out of any US frozen fish.
If you caught parasites it would have either been fresh fish, which (except for tuna) is never ok to use according to the FDA - or the cold chain was improperly maintained. In either case it could even be worth a report to local health authorities. However tartare or ceviche or any other kind of raw fish preparation in the US is safe if it's made from tuna or (properly) frozen fish.
[1] https://www.fda.gov/files/food/published/Fish-and-Fishery-Pr...
I would imagine that tuna, being near the top of the food chain, would accumulate an awful lot of things in their bodies, not just mercury as commonly feared.
> Exempted from the FDA's freezing requirements are, as Herron mentions, large species of tuna—deemed safe based on the frequency with which they are eaten in raw form and the infrequency of related, documented parasitic infection—as well as aquacultured fish, like salmon, given verification that the feed it's raised on is parasite-free.
> To meet FDA guidelines, every other type of fish must be frozen to those temperatures, even if the table does not indicate that it carries a parasite risk, because it "may have a parasite hazard that has not been identified if these fish are not customarily consumed raw or undercooked."
[1] https://www.seriouseats.com/how-to-prepare-raw-fish-at-home-...
You can still get hepatitis E, among other things, from raw pork though so you know, be careful.
Some high-end restaurants are serving raw pork now though [1], but personally, I wouldn't - and I'm an adventurous eater.
[1] https://www.seriouseats.com/case-for-raw-rare-pink-pork-food...
Or at least, that's most likely how I got e.coli back in 2016 or so. Undercooked pork from a pork roast at a wedding.
> Based on analysis of U.S. foodborne disease outbreaks, pork may be responsible for between 8 and 13 percent of roughly 1 million foodborne human salmonellosis cases each year. [1]
[1] https://www.fsis.usda.gov/news-events/publications/pork-salm...
Perhaps the curing and smoking might somewhat reduce whatever risk remains today?
I cooked a pork chop when I was very young and came back to find many worms trying to escape as it cooked. This is the default for pork and is considered mitigated by certain drugs that must be given to the pigs.
And yes, large worms have been pulled from people's brains in the US--resulting from pork. They appeared to have displaced or feasted on brain matter.
I don't need pork.
I really wish this bit of the article was better written! Are they finding out whether she was immunocompromised? Or are they investigating the role a known pre-existing immunocompromising condition may have played in the infection?
I was reading the article the whole time waiting for a compromised immune system to be mentioned, and the one time that they did mention it, it was ambiguous!
edit: and they note in the conclusion that the immunosuppression may be what allowed the migration to the brain
If you are eating undercooked/raw meat or fish and stuff, if you're eating at restaurants, etc... there's no reason not to.
It blows my mind people don't disinfect, not just wash, produce in the US.
They rarely talk about what happens when the worms go their own way, as living things often do.
Helminth therapy, also known as helminthic therapy, is an experimental therapy in which people intentionally infect themselves with live helminth parasites. As helminths can alter a person’s immune response, some people believe that helminthic therapy may, one day, help doctors treat some autoimmune and allergic diseases.
Most of my contact with soil / decomposing matter is just by turning my compost pile and casually farming black soldier fly larvae. Even though I wear two layers of gloves and a respirator when working around this it just seems like a good idea.
Cook your meat and seafood folks!
https://www.9news.com.au/national/news-melbourne-tullamarine...
No kidding!
Next time someone says "touch grass", I'll remember this, and say "No thanks, I don't want brain worms."