New Parasite Found In Chronic Fatigue Syndrome (CFIDS)
by Immunesupport.com Staff
Advertisement http://www.immunesupport.com/shop/images/weeklyWebSpecial.gif CFS Radio Program Jan. 16th, 2000. Roger G. Mazlen, M.D. Host with Dr. Larry Klapow. Dr. Mazlen: Dr. Larry Klapow was a guest on this past Sunday's CFS Radio Show and gave a very important and very informative report of the work he has been doing. Dr. Klapow has been finding a new roundworm type of parasite in CFS patients called "Cryptostrongylus pulmoni". I found this show to be of particular interest to me because I have been found to have this particular parasitic infection and was very interested to learn of the immunologic dysfunctions that it can cause. I truly think that this important work definitely plays a part in the complex puzzle that is known as Chronic Fatigue Syndrome.
Dr. Mazlen To kick off the new millennium with a good show that you'll find of great interest and great importance, I'm talking today with Dr. Larry Klapow, a Ph.D. in Invertebrate Biology who's in Burlingame, California near San Francisco. Good morning Larry, welcome to our show.
Dr. Klapow Good morning, Roger, I'm glad to be here.
Dr. Mazlen Can you tell our audience something about the this suspected new parasite that you've found in a percentage of patients with Chronic Fatigue Syndrome? How'd you find it?
Dr. Klapow Well, Roger, it came about as a result of a conversation I was having with an immunologist friend of mine, Dr. Vincent Marinkovich, here in Redwood City, California. He was treating a CFS patient we thought might have a roundworm infection. The patient had a low grade eosinophilia and some unusual rashes on the torso that suggested the possibility of threadworm disease. Antibody tests and stool tests were negative. I thought about this for a while and I know that some chronic parasites migrate between the digestive tract and the respiratory tract and some of them are coughed up in sputum. So I looked at the sputum and that's where I found it. I called the new parasite "Cryptostrongylus pulmoni", that's a provisional name and it means "the hidden lung worm".
Dr. Mazlen That's pretty appropriate in terms of what you say.
Dr. Klapow It definitely is, Roger. It's very difficult to find. And I hope other people will start looking for it. In fact, I've put together some material that I think can help them.
Dr. Mazlen You recently completed a small blinded study in cooperation with a small number of CFS doctors including Dr. Anthony Komaroff in Harvard. You're now doing a larger blinded trial and you're also trying to develop a clinical test for the parasite. But for these other investigators and clinicians, can you tell us what does the parasite look like and how can they find it?
Dr. Klapow You can identify the parasite, the female by its mouth parts and the male by its very intricate reproductive structure. This parasite is very small. The female is less than a millimeter long and the male is about a third that length. So, in addition to being small there's also a lot of difficulties. The specimens I usually pick up are naturally expelled in sputum and they're usually very decayed and rare and because of this you need very specialized imaging techniques to find them. They're not expensive techniques, they're just specialized. In any case I wanted to help people look for this parasite and so I put together a website which describes how to find it in great detail. It also includes anatomical drawings. I can give you the website address if you like. Dr. Mazlen Yes, give us the address right now, that'll be great.
Dr. Klapow OK, I'll give you my own email address and then I can post the other rather longer address for people who contact me. My email address is firstname.lastname@example.org.
Dr. Mazlen Now, this is really important because this introduces a whole new dimension about Chronic Fatigue Syndrome and its possible relationship to roundworm infestation. Can you tell us so far, at least, as you've been looking, what percentages of Chronic Fatigue Syndrome patients are turning out to be positive for this worm?
Dr. Klapow Yes, I find the parasites in about 40% of three-day sputum samples from CFS patients. However, I have to tell you that yields are very low. In fact, they're so low that I think I'm probably missing as many positive patients as I'm finding. The problem here is that over 80% of the positives I get are represented by only one identifiable specimen. So just by chance it looks like I'm missing a fairly high percentage.
Dr. Mazlen So, the prevalence can be a lot higher and this, of course, stirs some very great interest in terms of causation and etiology which we'll go into later. Can you tell us anything about the blinded trials so far?
Dr. Klapow Yes, I did a small blinded trial in cooperation with a number of doctors including Dr. Anthony Komaroff at Harvard and here are the results. I think they're interesting but you judge for yourself. 5 of the 11 patients were positive while all 6 controls were negative. Now, it's a small trial but if you were trying to do as well by guessing, say by just tossing a coin, you'd only do as well as I report here in about 1 in a 100 tests, so it's a very hard thing to do by just guessing. The results of this small trial can be used to devise an experimental design for a large trial that could give a statistically significant result and going through that exercise suggests that between 50 and 80 samples will be needed. Now, it may take some time to process these samples microscopically. It's now taking me somewhere between 50 and 100 hours to find a single positive patient so I think the progress will be slow, that is unless we can get something more rapid going in the form of a PCR test.
Dr. Mazlen Well, I certainly congratulate you though for the effort that you're making because this is totally important to patients for their prognosis and recovery ultimately. There's a lot more to learn and, of course, we're going to go into that and you mentioned the PCR test and that you have some arrangements whereby this can be developed and hopefully you'll get some funding to help this along soon. If anybody in the audience is interested in helping in this regard they can reach me at email@example.com which is my email address and I'll forward it on to Dr. Klapow. Larry where do you think these parasites might be coming from?
Dr. Klapow Well, Roger, they have some specialized anatomical structures that suggest that they're related to parasites of animals that live in the jungles of Southeast Asia. In fact, there's been somewhat of a history of hard to diagnose parasites coming out of that area and being brought back to "Western" countries after periods of warfare. It happened in the Victorian era when French soldiers were returning from this area and brought back the chronic parasite Strongyloides stercoralis to Europe where it was first diagnosed in 1894. It also happened again in World War II. This time British soldiers became infected while they were imprisoned in Burma returned to England and 30 years later, in 1974 they were diagnosed with chronic parasites they had gotten while they were in prison. It's kind of a testament to how difficult some of these parasites are to find and treat. I would like to look at people who've been to Southeast Asia and I think I plan to do that as soon as I finish with the large trial I'm doing on CFS patients now.