New Beginnings: Spring Edition

My life has completely changed since my last post, seven months ago. I wanted to write, in fact, I had a list of topics going for a while, but I just couldn't find a spare hour or two to really iron out the details. In the time since my last post, I got married, traveled to Europe (specifically Paris and London) for my honeymoon, had a birthday, got some new science-specific tattoos, published some papers, was asked to teach a few classes in the fall, took some steps to better myself in my career and my personal life, and got a cat. I have a hard time fitting in time for the gym, or even really breathing!

Here's my husband, on our honeymoon, in a Medical History Museum in Paris (I'll blog about that later). 

I have ideas for new blog posts every day, and I'm going to do my best to start catching up. Be warned, though, my ability to write somewhat blog posts may have decreased, since I've been working on writing three papers simultaneously in the last few months. Maybe you're a distinguished scientist, maybe you're a student, or maybe science is just a hobby to you, but I don't think I need to explain that scientific writing is not the most flavorful of writing styles.

The weather is getting warmer, especially for those of us in California (It was 80 degrees this weekend!). This means gardening, hiking, a general increase in "outdoorsiness". There are two things that I want you to be aware of as you start enjoying the warm weather: Lyme Disease and soil-transmitted parasites! I'll cover soil-transmitted parasites in my next blog post.

One of my dear friends, Kristen, has been trying to dig her heels into some research on Lyme Disease, and I promised I'd post something about it. Since I am stupid, I forgot that I had already written about ticks! Not necessarily Lyme Disease, but a tick-borne virus. Actually, maybe I should try to convince her to write a little guest-blog post for us about what she's learned!? I can imagine myself asking her to do that, and can clearly picture the mixed emotion of extreme excitement and annoyance that would wash over her face. Kristen, if you are reading this, I won't make you do it!

The Tick, via PopGunChaos

Lyme Disease is a bacterial infection that is quite weird, in that you have the ability to be successfully treated with the use of antibiotics within the first few weeks, but it can become chronic if left untreated. Lyme disease has been reported in 80 countries worldwide, and is especially concentrated on the east and west coast of the United states in regions with wooded areas and areas with tall grasses.

Lyme Disease rash variations, via bayarealyme

The bacteria responsible for Lyme Disease is Borrelia burgdorferi, which is a spirochete that has a double membrane, instead of being gram positive or negative. B. burgdorferi is an obligate parasite that uses ticks (Ixodes pacificus) as a vector to infect their mammalian hosts, like rodents, deer and humans. Transmission of B. burgdorferi to smaller mammals doesn't typically result in Lyme Disease (although the rash has been seen in many domesticated dogs that live in rural areas), making that complication specific to human hosts. Ticks transmit B. burgdorferi to humans while taking a blood meal. A simple "bite" doesn't usually do the trick. Transmission is dependent on the length of time the tick has been present on the host (usually 36-48 hours minimum), and on the level of infection within the vector (is the bacteria just in the midgut? or is it present in many different organs, like on the mouth parts and throughout the digestive tract?).

Also, according to samples studied from the Pacific Northwest (California and Oregon), only about 1-1.5% of ticks are infected with B. burgdorferi. With increases in tick populations, the probability of transmission increases. This is one of the reasons warmer seasons lead to more infections.

Ixodes pacificus, via Riekes Nature Blog

Tick size comparison before and after a blood meal, via WA Department of Health

Many studies are trying to determine the proliferation and survival mechanisms of B. burgdorferi because it lacks common pathogenic factors, like lipopolysaccharide, toxins, and specialized secretion systems. Researchers think this may be because B. burgdorferi did not evolve to cause disease in mammals. Not only is there a wide range of variation between bacterial strains of B. burgdorferi, but the analysis of the DNA has shown that it is rapidly evolving.

So why don't you want Lyme Disease? If you are one of the lucky ones that has a resident tick for more than 36 hours, and doesn't identify the symptoms within the first few weeks of infection (meaning you probably wouldn't seek treatment either), then you could experience a wide range of chronic symptoms. Initial symptoms are classic "flu-like" symptoms, such as fever, chills, muscle aches, stiff neck, and just feeling like crap (clinical phrase). To be fair, unless you see a rash with these symptoms, I don't know why you would seek treatment. We've all been sick before, and usually flu-like symptoms aren't severe enough to run to the doctor. A lot of people miss the rash because it's on their scalp/under hair, or somewhere they can't see, like on the back of their neck and trunk areas.

Most people who have chronic Lyme Disease and are being actively treated still feel exhausted all the time. But, without treatment, B. burgdorferi can spread to your brain and heart, resulting in major organ damage and failure. The most common and alarming symptoms are numbness, paralysis, and muscle weakness. It's pretty awful, and you don't want it.

My family has many stories that involve ticks. As you probably know, I am a huge hypochondriac. My poor husband, Peter, has to put up with text messages from me saying things like "AM I HAVING A STROKE?" and "MAYBE ITS CANCER". (Whatever, he knew what he was getting himself into...). I'm also pretty outdoorsy. I'm a runner and love to hike. I hike year-round, but that doesn't stop me from asking Peter to check me for ticks every time I come home from a hike.

My first run in with a tick was in elementary school, on a class hike. My mom, a nurse, was one of the chaperones, and saw it crawling on the back of my neck. I don't remember it actually biting me, but every time we bring that story up, she gets very serious. She hates bugs.

After a hike with my mom, I had the fun opportunity of getting a tick to back out of her skin by using a hot matchstick. She thought it was a mole on her back that was being irritated by her running bra. Sorry mom. Luckily we caught it and she escaped sans Lyme Disease.

Another awesome tick story: my sister is an amazing athlete, and signed up to do her first triathlon a few years ago. She felt sluggish and terrible a few weeks before, was diagnosed with early Lyme Disease despite not seeing a rash (there are diagnostic tests that are done, too), and started treatment immediately. She still competed in the triathlon and finished with a great time. See what I have to live up to? Ugh.

Tales of the WebMD's Symptom Checker (and it's blatant inaccuracies)

After a fun weekend spent at the Monterey Bay Aquarium with my family, I woke up this morning feeling terribly ill. I generally consider myself to be in good health; I rarely get sick, and when I do, my symptomatic stage only lasts briefly before recovery. 

With that being said, I am a total hypochondriac. I know far too much about diseases, and I'm constantly driving my friends, coworkers and family members crazy with my static state of worry. Headache? Must be a brain aneurism. Back pain? Herniated disc. Tired? Must be cancer. Botulism. Sun stroke. Gangrene.


 

This kid is the best part of the movie "The Switch".

So, let's back up a bit. On Thursday or Friday, a lady at my place of employment returned from being sick with "a cold". She still sounded awful, but we've all experienced that residual upper respiratory gunk at the end of a sickness. I'm mentioning her because I'm pretty sure she was my introduction, my infector of sorts. Yet, it could have been anyone (...but it was probably her).

Friday, nothing. I felt fine. I finished out a stupid week at work, and went home for date night.

Saturday, great. Went to the aquarium, touched a lot of things. Washed my hands a lot.

Sunday, I woke up feeling a bit off. I had a sore throat, but was it because I had slept with my mouth open? Did my nasal cavities drain into my throat? Eh, I'll walk it off. Went to lunch got my hair done (I know, so glamorous), and felt tired whilst doing so (maybe I was relaxed? I don't know), but no trace of a sore throat. By the time I made it home (eh, 5ish?), I was beat, my throat was sore, and I was developing a headache.

So, I did what any normal person would do. I made some soup. Ate 4 cloves of raw garlic. Made some ginger tea, squeezed an entire lemon into it. Gargled with salt water, repeatedly. Took my vitamins. Stayed hydrated. Peed a billion times. Went to bed (relatively) early.

Usually that regimen works, but this morning, I woke up SICK. Symptoms: mild fever (which is pretty odd for me, as i usually run a bit cooler than the typical body temp), terribly sore throat, and weepy, crusty eye. One of these things is not like the other, one of these things just doesn't belong.

Yea, what? Weepy, crusty eye?

I called out sick to work because I'm not willing to infect anyone else (because that's just rude!), and went back to sleep to try to "sleep it off". If you know me at all, you'll already know that me going back to sleep is quite a feat in itself. I'm a "up at 6" type of person, but I managed to knock myself out until 9:30 AM. Then, I called my partner to drum up some sympathy. This is exactly what he said to me:

"Weepy, gross eye? Uh oh, you know what that sounds like? Pink eye. Do you know how you get pink eye? From going to aquariums, touching all the railings that all the gross little kids touched with their little, fecal contaminated hands and then rubbing your gross hands all over your eyes."

 

I've never had pink eye... but I am a chronic eye-rubber...and I did touch a lot of railings that day.

Remember when I tweeted about not allowing pants in my bed? Yea...

Long story short, it's not pink eye. That conversation happened 5 hours ago, and everything is already feeling better (because my immune system is AWESOME).

But, for fun, I decided to check WebMD's symptom checker. I did this a few months ago when I had an odd kidney pain (which ended up being just muscle soreness, but thanks for asking), and my results were either a bruise...or kidney failure.

So, of course, conjunctivitis (or pink eye) was on the list of possible illnesses, but so was blindness. It's best to be thorough?

But then I thought, why aren't there any parasites on that list? So I checked all the symptoms. I said my eyes were bleeding, yellow, pink, red, itchy, droopy, etc. For all they know, my eyes were falling out of their sockets. Even after I checked some severe symptoms, the website didn't tell me to contact a doctor or to call emergency medical services. What a horrible website!

There are many parasites that can affect your eye tissues and sight. Some are caused by nematodes, others are caused by single-cell parasites. The range of symptoms these parasites can cause are incredible! Best of all, we do have (most of) them in the United States!

get it out, get it out, get it out! (Parasitic roundworm)

The parasite in the following video is called Acanthamoeba keratitis.



Cases of this particular parasitic infection are often seen in people who wear contact lenses and mix their own contact solution. A. keratitis has to be introduced directly to your cornea for infection to occur, which is easy to do if you are mixing your own contact solution with tap water that contains the trophozoite phase of A. keratitis.

Of course, since its relatively easy to become infected with A. keratitis, it's relatively difficult to treat. Medical treatment with medicated eye drops and antiparasitic medications usually fail, which leaves surgical treatment. So, maybe just go head and spend that extra $4 to buy packaged contact solution?

Moral of this story? My local UPS guy could probably diagnose anyone better than the WebMD Symptom Checker.

What a fluke.

It's embarrassing to think that I haven't written in over two months! While I could write about everything that's been keeping me from detailing the grossest of the gross on here, that isn't the intent of this blog. So we'll skip all that and jump right into the realities of life...

Sometimes, people make choices that they probably shouldn't. Maybe its wearing a particularly ugly sweater (story of my life), or getting a bit-too-risky haircut that you immediately regret (story of my life up until I found my current hair stylist who is my personal deity). Maybe its agreeing to go on a date with someone with whom you know you aren't compatible (story of my college life). Maybe its deciding to eat that fourth (or sixth?) piece of cake. Maybe its eating that raw crab.

Wait...what?

First of all, ew! Secondly, let's get on to the point, shall we?

In the late 1800s, two tigers housed in the same European zoo died mysteriously. Weird... tigers are supposed to live forever, right? Well, researchers were baffled. What could kill a tiger, let alone two?? Upon performing autopsies on the majestic beings, researchers discovered a mass in the tigers' lungs. Was it cancer? Was it a booger? (I can just see the headlines: TIGER KILLED BY GIANT BOOGER). A few years later, people in Taiwan started to show similar lung booger infections, and that's when things started to get weird.

Paragonimus westermani, a lung fluke, is still rampantly infecting humans and animals alike to this day. These infections primarily occur in Asia, also recently in the United States, and are often linked to humans consuming raw seafood (particularly crustaceans).

Ok, so I exaggerated a little bit. P. westermani adults are typically the size of a jelly bean or a coffee bean, but they are hermaphroditic in the adult stage of the life cycle. Typically, you become infected with multiple metacerciaria (I like to call this the "teen" stage) which means you could develop a few ounces of jelly beans in your lungs! Fun!

Why is this a big deal? Well, these living boogers can kill you. P. westermani is a selfish parasite, that is basically just using your natural immune response to "spread it's seeds", so to speak. Once you've consumed that raw crab delicacy (say, Chinese Drunken Crab? or Eriocheir?), the intermediate stage of the lifecycle, or the metacerciaria penetrate through your diaphragm and into your lung tissue.

This is your lung with a friend.

There have been documented cases of P. westermani "getting lost" in the sea of your organs, and taking a wrong turn. Patients have been paralyzed by the flukes accidentally burrowing into their spinal cord. Other cases show that flukes can overshoot their target, and burrow their way into your heart, creating a decent sized fissure which can lead to heart failure or sudden death.

Once in your lungs, your body reacts. It says "I'd rather not breathe living boogers", and proceeds to try and flush out the invader with the initial immune response. Your lungs start to fill with fluids, and in severe cases of infection, this reaction can cause the lungs to collapse. Meanwhile, the P. westermani have been getting busy, creating eggs that irritate your lung tissues even further, causing you to cough severely. One of the first symptoms that people usually experience is violently coughing up blood.

While you are coughing up these eggs, you swallow to regain your composure...and now the eggs have traveled up your airway, and down into your GI tract. Here, they will be passed out with the rest of your waste, and move on to infect others (specifically if sanitation and plumbing are not state-of-the-art). Once the eggs hit a water source, they implant themselves in their vector, aquatic snails. After maturing, they then travel to inhabit crustaceans, and the cycle continues.

If you're a visual learner, here is an Animal Planet video from "Monsters Inside Me" that shows exactly what I just explained, but with poor computer graphics and a mildly attractive, yet nondescript  "biologist":




The onset of symptoms occurs approximately 30 days after ingesting the infected meat. If you think you are infected with a colony of lung flukes, the smart thing to do would be to see a doctor...or ask the internet (OMG am I dying!?!?). If not treated, P. westermani can live inside your lungs for up to 20 years! So, if you're having trouble finding a significant other to fill that void in your heart, maybe you should settle for a long term parasitic fluke infection.



I desperately wanted to show my true geek roots and call this post "Fluke, I am your father", but was advised against it. This is me, kicking a proverbial can down an empty street.

M is for March, and Maggots

I'm sure I don't need to start this by saying I haven't been purposefully neglecting this blog, I really am rather busy. Truly, honestly. But, since I feel so badly about not writing as regularly as I had hoped 3 months ago, I'll make it up by writing about one of my favorite subjects to talk about on a first (and usually last) date.

When you say "fly" to the average person, they usually think about the common house fly, or possibly a unicorn soaring elegantly over a pastel rainbow. Yet, when I think of flies, the first thing that pops into my head is the Botfly. Why? Because its disgusting and amazing.

Botflies are particularly special, because their larvae live as parasites during their development and maturation process. Why would you want to mature in the vast world of exposed nature when you have the opportunity to embed in the flesh of another living species?

Let's break down the amazing lifecycle of the botfly, because its rather unheard of for flies to deposit their eggs anywhere other than...well, you generally only hear of maggots and fly eggs/larvae around garbage cans and dead things, right? These flies are bold, and think that their larvae deserve a better environment than a trashcan. The female botfly, a large and dominating specimen, carries the eggs. She waits until she sees a suitable intermediate vector flying around a suitable host, such as a tick near a grazing animal or a mosquito that is preparing to feast on a human. Once the female botfly has chosen her target, she tackles the insect mid-flight. They begin to fall and roll, and as this happens, the female botfly deposits her eggs onto the intermediate vector and flies away.

I know, this sounds weird, and it definitely is, but the botfly species is smart for doing this. Most species recognize the large botfly as a threat, and will avoid any contact. Yet, if the eggs are disguised on another, much smaller species, then everyone wins!

So now, we've got the intermediate vector covered in eggs. It regains flight and goes after its bloodmeal (although, not all intermediate vectors for the botfly consume blood). When the intermediate vector lands on the mammalian host, the eggs are attracted to the heat, causing them to drop and land on the flesh of their new host. The intermediate vector takes a meal close to the location of the eggs, and they burrow towards the new opening in the flesh.

Once inside, they make their way to a comfortable area under the skin and develop for approximately 8 weeks. They survive subcutaneously by breathing through small tubes in their butt that open at the surface of the skin. These are visible, and will bubble if held underwater.

When the larvae is ready to emerge as a pupae and continue developing in the wild, it will burst from the flesh of it's host. If you can stomach it, here is a video:



Botfly larvae have a distinct "hook" mechanism that allows them to attach to the layers of the skin and avoid being pulled out. If you have a botfly infestation, they must be removed with minor surgery or suffocated before removal. You can see the hooks in these photos, they are clearly visible as the darker spots that form rings around the body.

And here is an awesome photo of a dead (suffocated) botfly larvae being removed from someone's head:

Botflies can be a large issue for small farms raising animals, and for stables holding horses. Also, if the wound is licked, possibly by the animal itself (we've all seen dogs lick their wounds), then the larvae can burrow in the intestinal tract and cause severe infections.

There are many different species of botflies, and they are found all over the world, including in the United States. Now that the weather is going to start warming, you can think of this every time you leave the house!

Happy Spring!