Cutaneous Leishmaniasis, Lesions, and Sand flies and Morgellons

[tcmgpt13]

This thread is about the topic of leishmaniasis with the exception of the following posts:

32, 33, 34 then all posts between 36-64 are off topic as well and really do not contribute to the discussion of these parasites. The medication used overseas to treat leishmaniasis which is mentioned in posts 65-70 is not available in the US and is best avoided unless under a doctor's close supervision. And even then good outcomes can be tricky.

FIRST POST IN THIS THREAD STARTS HERE:

As everyone here probably knows Leishmanisis parasites can cause skin lesions. The parasite itself normally infects Middle Eastern and in South American populations, but it can sometimes be found in the US as well, at least in its cutaneous form. Currently some veterans from Afghanistan, Iraq, and Kuwait are also showing signs of this parasitic disease:

Update: Cutaneous Leishmaniasis in U.S. Military Personnel --- Southwest/Central Asia, 2002--2004

The CDC site claims these parasitic infections are most often brought into the US by travelers and that no visceral case of it has been acquired within the US itself:

Division of Parasitic Diseases - Leishmania Infection* Fact Sheet

"Is leishmaniasis found in the United States?

Almost all of the people in the United States who have leishmaniasis became infected while traveling or living in other countries.

Occasional cases of cutaneous leishmaniasis which were caught in the US have been reported among residents of Texas and Oklahoma. No cases of visceral leishmaniasis are known to have been acquired in the United States.”

Posted previously by Kritts this article’s opening sentence reveals that “Dermatologists in North Texas were alerted Friday to be on the lookout for a rare skin infection caused by a parasite that may have migrated north from the Mexican border.” :

Rare, non-fatal skin disease found in N. Texans | News for Dallas, Texas | Dallas Morning News | Science and Medicine | Health

It is intriguing to me that the leishmaniasis parasite causes lesions and satellite lesions similar to those some are experiencing with Morgellons. Those physicians treating Cutaneous Leishmaniasis have observed that the lesions are most often round, although sometimes they can also be irregular in shape which seems to be true of many Morgellons lesions as well. They are also non-healing which also parallels Morgellons lesions. This parasite also has a mucosal as well as a visceral form depending on the exact type of leishmania parasite causing the infection. Evidently the mucosal version is harder to cure than the skin lesion type. This next short paragraph includes a mention of the fly vector which causes Cutaneous Leishmaniasis:

"The sandfly vector is a 2-mm long, hairy fly of the genus Phlebotomus in the Old World and Lutzomyia in the New World. These flies are able to pass through the usual netting used for mosquitoes. Sandflies are found around human habitations and breed in specific organic wastes such as feces, manure, rodent burrows, and leaf litter.7" Here is a good drawing one type of sand flies which causes Lesihmaniasis:

Sand flies and Leishmaniasis

A blogger describing his experience with treatment for leishmaniasis (goo is a part of these lesions too):

vagrant Leishmania!

While sand flies may not be the same type of fly forum members with Morgellons are currently describing it is interesting to read about a fly/parasite relationship which is known to cause skin lesions. This proves that at least one type of parasitic skin lesion disease is caused by a fly vector. Why not others?

Yale Professor’s 3 part Video Lecture on Trypanosoma and Leishmania Infections (UPDATED to Provide Current Links to the lecture by Norma Andrews)

Evidently Chagas disease, caused by trypanosoma cruzi along with the trypansoma parasite which causes sleeping sickness in Africa are very closely related to leishmania parasites. This professor mentions that new parasite medications are being developed and tested in third world countries which should give us some renewed hope:

Intracellular Parasitism by Trypanosoma cruzi and Leishmania by Norma Andrews, April 2007 - Part 1: Trypanosoma cruzi and Chagas' Disease (19:23) | SciVee

Intracellular Parasitism by Trypanosoma cruzi and Leishmania: Part 2: Leishmania spp and Leishmaniasis (13:36) | SciVee

Intracellular Parasitism by Trypanosoma cruzi and Leishmania": Part 3: Current Research: Strategies for Cell Invasion and Intracellular Survival (33:43)" | SciVee

This forum thread discusses trypanosoma parasites which cause Chagas disease and sleeping sickness. Lots of links in the posts:

Protozoa: Trypanosoma: Sleeping Sickness & Chagas Disease

Something else to think about, as some Morgellons patients do have mucosal symptoms, could this be the reason the parasite form of Morgellons symptoms is hard to control, much less cure? I expect any parasite found in this area of bodily secretions would present a challenge to the current parasitic medications used to treat Morgellons’ patients. It is also true that many parasites have become resistant to the current parasite medications. This next article discusses how Leishmaniasis Cutaneous is treated, rather than focusing on the other two forms of Leishmaniasis infections. It contains a good photo of this type of lesion:

Cutaneous Leishmaniasis: Recognition and Treatment - March 15, 2004 - American Family Physician

A couple older leishmaniasis posts by forum members:

Leishmaniasis or Morgellons in English

Leishmaniasis or Morgellons in English

LC posted last year that Franky had warned members here in an earlier thread that the medication for Leishmaniasis had been trialed on some Morgellons patients, but that these patients died from the medication. I am, however, unable to find Franky’s post on this subject. Here is LC’s post which mentions this:

Leishmaniasis or Morgellons in English

A google search about that problem so far has come up empty as well.

I am not claiming that this parasitic disease is the cause of Morgellons symptoms, however some of the similarities found in Leishmaniasia and Morgellons lesions are fascinating. Could it be a related disease organism? Who knows. The exact cause of Morgellons along with better treatments will hopefully be discovered by parasitiologists and/or other scientists at some future date. as written by tcmgpt13

[niecy]

Hey TC, that is a great post! I just wanted to tell ya that the professor who was looking at my samples listed Leishmaniasis as a possible disease while he was helping me. Hmmm.....he actually found several strange things that weren't supposed to be, hence his fascination with all the samples!!

He said he knew for a fact that our soldiers are bringing it back with them from Iraq.

I found an article somewhere, not sure if it's posted here or not, about a dematologist in Northeast Texas that had confirmed nine cases of Leishmaniasis!!!

You aren't the only person I have met that thinks there could be a connection here....including myself.

Several people that were at the conference in Austin mentioned the possibility of a connection.

[Kritters]

TC...........
I believe that's Jo's fly!!!!!!!!!

[tcmgpt13]

Hi Niecy,

I just found your original discussion about this professor which I did not post on the above thread but will here (the thread title was Colloidal Silver-What's the Real Story, so the first time I researched old posts I did not read it):

Colloidal Silver - What's the Real Story?

It is interesting that someone who is a parasitologist has noticed this connection, but I wonder why he did not suggest you be tested for the antibodies this type of infection causes. It would seem that everyone of us with lesions ought to be tested for antibodies to the infections that are prevalent in South American regions as well as those the soldier can be bringing back here. For one thing Leishmaniasis can be transmitted by blood transfusions. Although soldiers are asked not to donate blood for a year it is always possible they could be bitten by some little fly that then goes on to bite someone else. I do not understand the general lack of concern that a real parasite could be involved with what is happening to many people with Morgellons symptoms. The fact is very few people are checked for any type of parasitic infection at all. No wonder a crawling parasite in the lesions is not found by doing external biopsies, if indeed it is a blood parasite which causes Morgellonslesions. Evidently dogs as well as some other animals also can be carriers during one stage of this parasite.

Hi there Kritts,

The fly does look the same as the fly Jo is reporting she sees involved with her symptoms, but I expect that many small flies could look alike. I am no expert for sure, so I will have to plead ignorance. I think it is also possible that Morgellons is not Leishmaniasis. Morgellons could be an as yet unidentified parasite in the same family which is spread by yet another small fly, especially feasible since the parasites which cause Chagas and African Sleeping Sickness and leishmaniasis are related.

[Jo]

You might be right there Kritts!! I need a close up of the antennae..to see if theyre segmented. I know sandflys can be 'no-see-ums' and old world tiny midges.

Sandfly - Wikipedia, the free encyclopedia

[niecy]

Originally Posted by tcmgpt13

It is interesting that someone who is a parasitologist has noticed this connection, but I wonder why he did not suggest you be tested for the antibodies this type of infection causes.

Hi TC,

Actually he did. The last time I saw him, when he gave me the sample, he thought as I did that I was about to go to NIH. He told me to be tested for antibodies. Of course I didn't get to go. But I did ask an endocrinologist, who is from the Philippines originally, and who said it was ludicrous to have been diagnosed with DOP, to run the antibody tests. He said it looked to him like a parasitical infection, and he had seen many of them. He also said that he would have to know which tests to run, because there is literally thousands of them.

Tell you what, if you guys will come up with a probable lists of infections, I will go back to him and ask him to run the tests. I firmly believe he will do them.

I have been to many many doctors as most of you have. I have talked with every single one of them since the DOP diagnosis. The really remarkable thing is that not ONE of the specialists, leaving out derms, even knew what DOP was!!! The have LAUGHED at the stupidity of the diagnosis.

That being said, they have tested me for many parasites, but only domestic ones. It is very hard to get insurance to pay for tests on tropical parasites when you have never been out of the country. The closest I had been when this happened was Destin, Florida. But my daughter's then boyfriend had just gotten off of a plane from Cancun. He came directly to our home and sat on our furniture. One thing I did get out of the people at NIH was that MOST infectious parasitical infections are indeed infectious, from one person to another.....it was like pulling teeth, but they did finally admit that during a phone conversation.

I would even be willing to pay out of pocket for the tests.

Niecy

[Robin]

Hello all!
hey Tc,neicey, i've been ridding my face of alot of worms recently its still unbelievable to the abundance of this crap! but anyways i have some interesting articles on parasitic infections that really make sense of why we are so sick this article even says we could be infected for up to 20 yrs and not know it(sound familiar?) please read thru these there most interesting!
Parasitic Flatworms
Human Intestinal Parasites Worms
PLATYHELMINTHES
hi jo, now that i've rid myself of the majority of this i know longer see the flying things!
hope you all are feeling good!
Happy Turkey Day everyone!
Robin

[tcmgpt13]

Since interest has been raised again about about cutaneous leishmaniais in Morgan’s recent thread about a new treatment she is trialing for morgellons lesions I thought I would post this Stanford University discussion about treatments for leishmaniasis. The drug Morgan is experimenting with is sometimes used to treat leishmaniasis (terbinafine hydrochloride, commonly known as lamisil):

treatment

"Promising New Therapies

Miltefosine

Miltefosine (hexadecylphosphocholine) is the first oral drug to treat leishmaniasis. Miltefosine works by inhibiting choline transport to promastigotes; it’s a phosphocholine analog, a new class of inhibitors that may be used in the treatment of leishmania. The drug seems quite promising against visceral leishmaniasis, giving a 97% cure rate (100 mg/day for 28 days) in largest of four studies that took place in the past five years. Miltefosine is a result of collaboration between the government of India, the German biopharmaceutical company Zentaris and Tropical Disease Research (TDR), a program sponsored by the WHO,UNDP, and World Bank. The drug has been approved for use in India to treat visceral leishmaniasis. Although half of all cases of visceral leishmaniasis occur in India, with this new treatment the Indian government has set goal of elimination by 2010.

Side effects for Miltefosine do not seem to be as harsh as those of the standard treatments. 38% of people being treated reported vomiting and 20% reported diarrhea. These gastrointestinal side lasted 1-2 days in _ of patients. Side effects for liposomal amphotericin B were also minimal but its high cost does not make it a good candidate for treatment in endemic areas. Miltefosine is likely to cost less than current therapies and, as an oral drug, it is much easier to administer.

Azithromycin

A recent study in Brazil has demonstrated that Azithromycin, a macrolide derivative structurally similar to erythromycin, may be a good treatment option for cutaneous leishmaniasis caused by L. braziliensis. Azithromycin is an oral medication that can concentrate itself in various organs and tissues; its found in especially high concentrations in phagocytes (leishmania promastigotes taken up by macrophages). Treatments were administered orally according to schedules of 500 mg per day for 3,5, and 10 days and of 1000 mg for 2 days. The study concluded with an 85% cure rate.

Fluconazole

Fluconazole is a triazole antifungal agent that can be administered orally or parenterally. Oral Fluconazole given at a dose of 200 mg per day for six weeks was evaluated as a treatment for cutaneous leishmaniasis caused by L. major. A study that took place in Saudi Arabia found that Fluconazole was useful and well tolerated. It significantly improved chances that lesions would heal more rapidly. Rate of complete healing was 1.76 times higher in Fluconazole group as in placebo and 2.33 times as high at 6 weeks and 3 months, respectively. Fluconazole appears to be a safe and effective treatment for cutaneous leishmaniasis caused by L. major.

Photodynamic Therapy

Photodynamic therapy involves irradiating lesions in order to induce healing. A photosensitizing compound must be applied and selectively accumulate in the lesion and then the lesion is irradiated with visible light. A recent study suggests Photodynamic therapy could be a promising treatment for L. major. Aminolevulinic acid (ALA) was used as the photosensitizing compound. This is the first time that photodynamic techniques have been applied to a cutaneous parasitic infection. Photodynamic therapy as a treatment for leishmaniasis is exciting because resistance seems quite unlikely and amastigotes are eradicated from local site rapidly. There was a significant reduction in lesion size just one week after treatment. Further randomized, controlled studies will need to be done before photodynamic therapy could take a place among other leishmaniasis treatments.

PX 6518

A natural compound, PX 6518, extracted from leaves of the Maesa balansae plant shows promise as an anti-leishmanial agent. The leaves are picked by villagers by hand and sent to the Chemical Institute at the National Center for Natural Science and Technology (NCNST) in Hanoi, Vietnam where the leaves are dried, crushed to extract partially purified PX 6518. The partially purified powder is sent to a company in Belgium, Tibotec. Tibotec is working in collaboration with the NCNST and TDR (Tropical Disease Research) on this potential treatment. PX 6518 has shown good anti-leishmanial activity after a single injection in animal models. The compound is being analyzed in further studies and may be an important treatment in the near future. PX 6518, if successful, would significantly shorten the duration of treatment.”

There is a lot more information to be found on this page. I especially found this paragraph interesting. It could equallly apply to the study of Morgellons. As we already know it is all about the money:

“Leishmaniasis is a generally neglected disease, particularly in terms of new drug development for which there is little potential for financial return. Although there have been significant advances in treatment for leishmaniasis in the past decade, these developments cannot match the scale of more profitable drugs.The real challenge now will be proper translation, distribution and expansion of the advances made; it is essential that the new treatment options become truly accessible, not simply available, in endemic areas so that they may promote healing and save lives."

Linking this thread to Morgan’s thread to keep the information about leishmaniasis loosely together:

Positive overnight results

[niecy]

TC,
I know this probably isn't the exact place to post these links, but I thought of you as I was reading about it. I am in a bad funk right now and couldn't put two and two together if I wanted to, so I thought I would just put it here and let folks if they want to read it and see what they can make of it.

The second is just an excerpt, it was too long to post.

Niecy

Daily Scan: The Amazing Giardiasis Dreamcoat
The Amazing Giardiasis Dreamcoat

Read Comments (0) Some 280 million cases of giardiasis occur in the world each year and its infectivity is due to its "genomic wardrobe," according to this New York Times story. Biologists led by Hugo Luján at the Catholic University of Córdoba in Argentina have discovered that the parasite uses RNAi to silence expression of all but one of its 190 coat proteins to confer resistance to immunity. By blocking expression of the RNA-dependent RNA polymerase and Dicer, researchers created a bug that expressed all 190 coat proteins. While it might not be able to be used to make a vaccine for giardiasis, it "may be conceptually applicable to malaria," says Kirk Deitsch at Weill Cornell Medical College.




A Coat of Many Proteins May Be This Parasite’s Downfall

By NICHOLAS WADE







Published: December 15, 2008
If you return from a trip abroad to find you have projectile vomiting, roaring flatulence, sulfurous belching and explosive diarrhea, the bad news is that you won’t die; you just have an attack of giardiasis, a form of purgatory devised by the single-celled parasite known as giardia.
Skip to next paragraph Enlarge This Image
P. M. Motta and F. M. Magliocca/Photo Researchers
SHIFTY When giardia must wear all its 190 coat proteins at once instead of selecting one and changing it often, it cannot hide from the immune system.

Related

Health Guide: Giardiasis





Giardia infections can linger for months because the parasite plays a cunning defense against the body’s immune system. In its genomic wardrobe, it has 190 coats to choose from. As soon as the immune system has generated antibodies against one coat, giardia switches to another. Because of the parasite’s persistence and infectivity, some 280 million cases of giardiasis occur in the world each year, the World Health Organization estimates, though most of these are in developing countries where people are more inured to the disease.
Giardia’s offensive game could have a fatal weakness, however. Biologists led by Hugo D. Luján at the Catholic University of Córdoba in Argentina have gained a striking insight into its coat-shuffling stratagem.
With this knowledge, they have accomplished a cunning counterploy: they have forced the parasite to make and wear all its coat proteins at the same time. This altered parasite, they hope, should serve as the perfect vaccine, because it immunizes the body to the full repertoire of giardia’s coat proteins all at once. The idea has worked well in animal tests, Dr. Luján said.
He thinks the same general approach — forcing expression of all coat proteins simultaneously — might help produce vaccines against the other protozoan parasites that rely on coat switching to dodge the immune system. These include malaria and the trypanosomes that cause sleeping sickness and Leishmaniasis.


Antigenic variation in : Giardia lamblia: is regulated by RNA interference : Abstract : Nature

[tcmgpt13]

Uh, oh, I think this could be more bad news for us considering that the war in Afganistan is still ongoing. How many of our military personnel are being infected now by these sand flies? Are adequate precautions being taken as far as their future health (bed nets for one)? I still feel that those of us who have lesions should be tested for leishmaniasis as their is ample opportunity to be exposed to this within US borders. The version in Afganistan will be the old World type (the variety found in the new World is slightly different due to difference insect vector, see first post on this thread for some discussion of this):

Disfiguring tropical disease surges in Afghanistan
AP – In this photo taken in April, 2010, and released by the World Health Organization Friday, Oct. 15, 2010, …

In this photo taken in April, 2010, and released by the World Health Organization Friday, Oct. 15, 2010, a victim suffering from cutaneous leishmanisis AP
By ROBERT KENNEDY, Associated Press Writer Robert Kennedy, Associated Press Writer – 25 mins ago

KABUL, Afghanistan – An outbreak of a tropical disease caused by sand fly bites that leaves disfiguring skin sores has hit Afghanistan, with tens of thousands of people infected, health officials said Friday.

Cutaneous leishmanisis is a parasitic disease transmitted by the female phlebotomine sand fly — an insect only 2-3 millimeters long that requires the blood of humans or animals so its eggs can develop. Treatable with medication and not life-threatening, cutaneous leishmanisis can leave severe scars on the bodies of victims.

The disease threatens 13 million people in Afghanistan, the World Health Organization said, and many impoverished Afghan victims can't afford the medication to treat it.

In Kabul — described by the WHO as "the world capital of cutaneous leishmaniasis" — the number of cases jumped from an estimated 17,000 a year in the early 2000s to 65,000 in 2009, WHO said.

Most victims are women and children. WHO said women and children are more vulnerable because they mostly live indoors at night, where the sand flies prefer to bite, and are therefore more susceptible than men who are generally outside the home.

Peter Graaff, WHO representative to Afghanistan, told The Associated Press on Friday that the stigma and shame attached to the disfiguring disease results in underreporting, and the number of infected people is likely much higher.

"This number is likely to be the tip of the iceberg as cases are grossly underreported," said Graaff.

An outbreak has occurred in a small village in western Herat province's Kohsan district with 63 people infected since August, Graaff said.

The cause of the outbreak was unknown and a WHO team has been dispatched to investigate, he said.

The sand flies proliferate from June to September. They thrive in unsanitary conditions such as piles of garbage and debris, though bed nets offer protection from their bites. As the disfiguring sores grow larger, many suffer social stigmatization.

"The high cost of treatment makes it difficult to integrate anti-Leishmaniasis drugs," said Dr. Suraya Dalil, acting minister of public health. "I urge donors to take this cause seriously, as it causes unnecessary suffering amongst a large number of Afghans."

Disfiguring tropical disease surges in Afghanistan - Yahoo! News

Possibly found in blood supply here and may also be transmitted by transfusions:

Leishmania: risk to the blood supply. [Transfusion. 2006] - PubMed result