What happened to parasite research?

Do you have knowledge of a patient with any chronic/recurring infection or CFS/ME who was tested?

  • No testing or knowledge thereof

    Votes: 5 100.0%
  • Tested positive (Strongyloidiasis)

    Votes: 0 0.0%
  • Tested negative (Strongyloidiasis)

    Votes: 0 0.0%
  • Tested positive (Cryptostrongylus Pulmoni)

    Votes: 0 0.0%
  • Tested negative (Cryptostrongylus Pulmoni)

    Votes: 0 0.0%

  • Total voters
    5

nerd

Senior Member
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In face of the current Ivermectin discussion, I'd like to reopen an old post in the context of chronic parasite infection.

Firstly, I'd like to cover the nematode Strongyloides Stercoralis. Here is one recent study that shows the prevalence in rural Cambodia and its chronified symptoms (10.1371/journal.pntd.0005685). It involves abdominal pain, nausea, vomiting, diarrhea, urticaria, and cough. Since the chronic type of this parasite infection usually remains unnoticed, it can develop from a chronic to an opportunistic and severe co-infection.

So it's not surprising to find various reports of hyperinfection in COVID-19 patients once given immune suppression.
  • Case Report: Disseminated Strongyloidiasis in a Patient with COVID-19 (10.4269/ajtmh.20-0699)
  • Strongyloides infection manifested during immunosuppressive therapy for SARS-CoV-2 pneumonia (10.1007/s15010-020-01522-4)
  • COVID-19 and Strongyloides (10.2139/ssrn.3766955)
  • Risk of Strongyloides Hyperinfection Syndrome when prescribing dexamethasone in severe COVID-19 (10.1016/j.tmaid.2021.101981)
  • COVID-19 and Dexamethasone - A Potential Strategy to Avoid Steroid-Related Strongyloides Hyperinfection (10.1001/jama.2020.13170)
  • A parasitic infection that can turn fatal with administration of corticosteroids (WHO)
Secondly, there is this single finding of the hidden lungworm Cryptostrongylus Pulmoni in CFS patients (Kaplow, 2001, ISBN:0958186502). I'm so surprised that this has never been followed up or am I mistaken? After 20 years, nothing has happened to verify the work of Kaplow? Do we even know if this lungworm is real and not confused with another parasite? How common is it? Is it really possible that over 50% of CFS patients are infected with this opportunistic parasite? Given Kaplow's data, this parasite could live in symbiosis with pathogens that rely upon and/or induce immune-suppression as part of their pathogenesis. This not only includes herpes viruses but especially SARS viruses which spread in the lungs primarily.

Considering how prevalent these parasites might be, even in developed countries, I wonder how often this is really tested. Not only tested in COVID-19 patients but also "long haulers", patients with other chronic/recurring viral infections, with unspecific chronified symptoms, and with CFS/ME. The only chronic viral infection that has been cross-evaluated with S. Stercoralis is HIV (10.1371/journal.pntd.0001581). Except for this single case report of a triple infection of herpes, with a fungus and the parasite (10.1016/j.rmcr.2020.101330).

Do you know of any guidelines in which either of these parasites have been included as differential or co-diagnosis?
Does anyone know of case reports of people with chronic infections and/or chronic fatigue who were checked for these parasites (either negative or positive)?
Why do you think have these parasites never received a lot of research attention in the pre-COVID-19 era and even now?
 
Last edited:

Hip

Senior Member
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Why do you think have these parasites never received a lot of research attention in the pre-COVID-19 era and even now?
Given that the symptoms of Strongyloides stercoralis don't really match those of ME/CFS, I cannot see any reason to test for this parasite in the context of ME/CFS, unless you are experiencing the symptoms, and have visited an area where this helminth is prevalent. There are thousands of different infections in the world, you cannot routinely test a patient for every one.

More than half of Strongyloides stercoralis cases are asymptomatic, so it often causes no observable issues. I read that over 90% of the population of Gabon are positive for Strongyloides stercoralis.

Like many helminths, Strongyloides stercoralis provides some protection against autoimmune diseases, one study found. It is the high prevalence of intestinal worms in Africa that is thought might explain the lower incidence of of autoimmune diseases on that continent.

A few ME/CFS patients on this forum have made major improvements with helminth therapy, by infecting themselves with the helminth Necator americanus. see here.


Helminth infections are very easy to kill, a single dose of ivermectin is usually enough. Ivermectin is a well-tolerated drug. So if you are concerned about a helminth infection, you can consider taking ivermectin, or an over the counter deworming agent that you can obtain from your local pharmacy.