Australian Strongyloides parasite parallels to Lyme

Cartoon from site: http://farm1.static.flickr.com/77/203046826_96475380c0_o.gif

An online BLOG site (5 Aug 2008) by U.S. Doctor known as "LymeMD" confirms that "...doctors are afraid to treat this disease appropriately." He recently (11 October, 2009) described how patients are suffering from LYME DISEASE and are being given inadequate antibiotic therapy (if diagnosed) as per current IDSA Treatment Guidelines with devastating consequences:


THREE WEEKS OF DOXYCYCLINE

"Childhood friend's daughter in ICU for two weeks with-- Lyme disease---It is one thing after the next."
Keith Olbermann on health care.
THREE WEEKS OF DOXYCYCLINE.
"I just saved your life (diagnosing Lyme disease in friend's wife)." Larry David.
THREE WEEKS OF DOXYCYCLINE.
"I heard you never get over Lyme disease; I have a friend in a wheel chair; so many people are so sick, its a very scary disease." A patient.
THREE WEEKS OF DOXYCYCLINE.
"I used to function at a high level (computer engineer), now I can no longer do my job" A patient.
THREE WEEKS OF DOXYCYCLINE.
"I have been to 40 doctors. No one ever took me seriously--thank God you are listening to me."
THREE WEEKS OF DOXYCYCLINE.
" I would like to help you--but we have a two tier test--you never had a rash--NIH studies--
IDSA recommendations--and CDC--I can't treat you I might get in trouble--those ILADS, LLMDS are--I don't know, out there--you don't want to miss another "real" diagnosis like fibromyalgia or depression."
THREE WEEKS OF DOXYCYCLINE."

DOCTORS 'INTERFERED WITH' OVER PARASITE TREATMENT
By Katrina Bolton
Posted Tue Oct 13, 2009 10:30am AEDT

Dangerous parasite rife in NT

"It's an easy enough test ... but I was told not to do that too often" ... Dr Len van Ingen.
Two doctors say the Northern Territory health department stopped them from treating people who tested positive to a parasite that can breed in the body indefinitely.
One doctor, who asked not to be named, says their clinic was told it could no longer prescribe the drug for treating strongyloides.
Another doctor, Len van Ingen, who used to be the medical superintendent at Gove Hospital, says he was told he could not test people for the parasite unless they were already clearly sick.
He says he felt his professional judgement was interfered with.
"It's an easy enough test to check for strongyloides but I was told not to do that too often," he said.
"Basically the line was there are other more significant diseases that they want to concentrate on."
He says he decided to start actively testing people for strongyloides because of the sheer number of people who seemed to be sick with with it.
"[They had] symptoms of unexplained cough, abdominal pain or general ill health," he said.
When he tested them, more than 50 percent of people returned positive samples and when he treated them, he says the community became a lot healthier.
He says the department's instructions not to give treatment until people are visibly sick goes against the policy of the federal immigration department.
"I'm aware that if people come in from overseas, like refugees, the public health department specifically looks for infestation with strongyloides and treats them," he said.
"This of course is a totally different situation in the Northern Territory where they [do] not look and [do] not treat if they don't have to."
The health department has issued a statement saying that people judged to be ill with strongyloides are given the appropriate treatment, and cost is not a factor.

Quoted direct from ABC Website: http://www.abc.net.au/news/stories/2009/10/13/2712432.htm?section=justin

DEADLY PARASITE 'HYPE'BEMUSES AMA
By Gina Marich

Posted Mon Oct 12, 2009 10:43am AEDT
Updated Mon Oct 12, 2009 10:48am AEDT
Strongyloides parasite
'Silent killer' ... the Strongyloides parasite as seen through a microscope. (ABC TV)

The Australian Medical Association says the issue of a deadly parasite common in Northern Territory Aboriginal communities has been blown out of proportion.
Strongyloides is a small parasitic worm that burrows under people's skin and into the heart, lungs and gut and can cause serious illness or death.
Doctors and Aboriginal groups have raised concerns that the parasite is being ignored.
But the AMA's Northern Territory president, Dr Paul Bauert, says medical professionals have been aware of the parasite for a long time now and routinely treat people who have it.
"People who have been here a long time who are aware of the parasite and have been not only treating the parasite but using prophylactic medications to prevent infection are a little bit bemused by all the hype about it at the moment because we are aware of it, we do treat it," he said.

Quoted direct from ABC Website: http://www.abc.net.au/news/stories/2009/10/12/2711241.htm

HEALTH DEPT WARNED TO TAKE DEADLY PARASITE SERIOUSLY

Posted Sun Oct 11, 2009 10:08am AEDT
Updated Sun Oct 11, 2009 11:24am AEDT
Strongyloides parasite

Richard Trudgen says the parasite is common among Indigenous people living in the Territory, but many do not realise they have it. (ABC TV)
The Aboriginal Resource and Development Service in the Northern Territory says a deadly parasite is going undetected, partly because Territory Heath Department lab technicians do not want to carry out the test.
Strongyloides is a small parasitic worm that burrows under people's skin and moves into the heart, lungs and gut.
The service's Richard Trudgen says the parasite is common among Indigenous people living in the Territory, but many do not realise they have it because there is no routine testing.
He says his organisation has been lobbying the Territory Government to do something about it for many years, to no effect.
"We're asking the professionals in the Health Department to take strongyloides seriously, to do exactly what they would do if this was a disease in the northern suburbs of Darwin," he said.
"Aboriginal citizens are sick of being sick, and they're sick of dying."
Mr Trudgen says the Health Department refuses to take the issue seriously.
"Blood tests will show you a positive reading or a semi-positive and there's all sorts of arguments that that's not conclusive, but as far as I'm concerned if someone comes back with a positive blood test or any elevated antibody test you can go on and test faeces and all that but that person should just be treated," he said.
"We know that it is affecting people in central Australia and is in Alice Springs and so on.
"We've also heard that tourists now coming to the Northern Territory have contracted it and it'll probably become an issue then soon as we say that.
"But until it's a notifiable disease also we don't know just how many people are dying of this disease."
The Territory Health Department says it is waiting on federal funding to do a pilot screening program.
The department says it is in the process of changing its guidelines, and that other diseases are more pressing.

Quoted direct from ABC Website: http://www.abc.net.au/news/stories/2009/10/11/2710662.htm

DOCTORS CONCERNED OVER KILLER PARASITE

By Katrina Bolton
Posted Sat Oct 10, 2009 6:00am AEDT
Updated Sat Oct 10, 2009 9:16am AEDT
Strongyloides parasite
'Silent killer' ... the Strongyloides parasite as seen through a microscope. (ABC TV)

Doctors are alarmed about a "silent killer" infecting people in Australia's north amid claims authorities are failing to take the threat seriously.
Strongyloides is a parasite that crawls in through intact skin and breeds in the body indefinitely.
The available evidence suggests more than a third of people in some remote Northern Territory communities have it.
It makes people sick, and if they are given the wrong drugs it can be fatal.
The Immigration Department says it tests refugees and humanitarian migrants before and after they come to Australia, and if they test positive, they are treated.
But the current manual the Northern Territory Health Department gives doctors says to treat people with the parasite once they show symptoms.
It is advice that goes against instructions given in the medical textbook Harrison's, which says "even in the asymptomatic state" it must be treated because of the potential for fatal "hyperinfection".
The territory's guidelines are in the process of being changed, but Professor Rick Speare from James Cook University feels the lack of action on strongyloides amounts to institutional racism.
"I think that would be quite hard to defend against to say there hasn't been," he said.
"The evidence is there."

Silent killer

Elcho Island elder Djiniyini Gondarra says he was hospitalised several times before doctors tested for strongyloides.
"This is another disease, a silent killer that is happening now," he said.
He later found two other members of his family were infected.
"What's wrong with us that this is not being really seen seriously?"
The territory's Health Department believes other diseases are more important, and that limited health dollars are better spent elsewhere.
"There are other, more important priorities," the Health Department's Dr Peter Markey said.
"There's diabetes, there's heart disease, there's rheumatic heart disease which kills people."
Blood tests from government clinics do not routinely test for strongyloides, and post mortems do not either.
Deaths associated with the disease have been documented in Central Australia.

Burrows through skin

Dr Wendy Page who has worked in communities for years says there is a culture within the department of "don't look, don't find".
Data she has collected at the Miwatj Health Clinic at Nhulunbuy suggests the prevalence is near 40 per cent.
Strongyloides travels in faeces and in the soil or grass where sanitation is bad.
It burrows through intact skin and crawls up into the heart and lungs, before being coughed and swallowed into the gut, where it breeds indefinitely.
One Australian study tracked returned prisoners of war, and found they were still carrying strongyloides 35 years later.
Medical texts list symptoms from rashes to abdominal pain or breathing difficulties, and say if people with strongyloides are given immuno suppressive drugs, it can be fatal.
West Australian pathologist Miles Beaman has seen cases of grey nomads bringing strongyloides back from their travels in the territory and it going undiagnosed.
"Some of those patients have even seen gastrointestinal specialists and still the diagnosis hadn't been made," he said.
The manual the territory government gives doctors spells out the hope that strongyloides will die out "with improving socioeconomic status, as the environmental reservoir diminishes and the infected population ages and dies".

Coordinated campaign

Other doctors suggest that is not going to happen anytime soon, and that a coordinated campaign would be needed to rid the communities of the parasite.
Health Minister Kon Vatskalis believes a special education campaign is not needed because general hygiene campaigns should get the necessary message across.
"We continue to run campaigns about hygiene, washing hands, washing vegetables, don't let dogs come into the houses," he said.
The Government wants to take part in a trial in conjunction with the Menzies School of Health Research that would do mass screening and treatment at one community on Elcho Island.
It has applied for but is yet to secure federal funding.
Mr Vatskalis says if the funding application is not successful, he will consider helping pay from it from territory funds.
But sufferers like Djiniyini Gondarra say the disease needs to be made notifiable and routinely tested for.
"Strongyloides is serious," he said. "And it's not been thought about, not been seriously taken."

Fellow sufferer Nancy Bukalatjpi puts it in just three words: "Help us, please."

Quoted direct from ABC Website: http://www.abc.net.au/news/stories/2009/10/10/2710313.htm