Morgellons

Morgellons or Morgellons disease is a controversial name for an alleged polysymptomatic syndrome characterized by patients finding fibers on their skin, which they believe are related to other symptoms, including intense itching, skin lesions, as well as a wide range of other chronic symptoms. These symptoms are occasionally accompanied by the belief in an infestation by some unknown arthropod or parasite. The term Morgellons is not in accepted use by the medical community and the syndrome is widely held by the medical community to be a type of delusional parasitosis. There is no agreed-upon physical cause, etiology, diagnostic criteria or proven treatment. Pressure from patients, including doctors and nurses who claim to have a host of difficult symptoms, resulted in a June 2006 statement from the federal Centers for Disease Control and Prevention that it had begun organizing a committee for the purpose of investigating Morgellons to determine whether it exists.

Origin of name

The name Morgellons was coined in 2002 by Mary Leitao of McMurray, Pennsylvania, while investigating her son's unexplained rash. She named the condition Morgellons (with a hard g), after a condition from the monograph A Letter to a Friend by Sir Thomas Browne, in 1690, wherein he describes several medical conditions in his experience, including that endemial distemper of children in Languedoc, called the morgellons, wherein they critically break out with harsh hairs on their backs. A 1935 paper by British doctor C.E. Kellett identifies the name morgellons with the Provençal term masclous, or "little flies". It is doubtful that the 17th-century disease has anything to do with modern day Morgellons; however, the similarities were such that Leitao elected to use the name as a consistent label when addressing politicians, physicians and health departments.

Morgellons Research Foundation

Leitao, who has a Bachelor of Science degree in Biology from the University of Massachusetts at Boston and has worked as a chemist, formed the Morgellons Research Foundation (MRF) in 2002. The Morgellons Research Foundation website states: "This non-profit foundation is dedicated to finding the cause of an emerging infectious disease, which mimics scabies and lice." The foundation attempts to raise public awareness of Morgellons via web and press campaigns. They are conducting limited research into the cause of the symptoms. They also conduct letter writing campaigns to the U.S. Congress, urging that Morgellons be taken seriously.

In May 2006 the Morgellons Research Foundation was featured in a number of local TV news segments coordinated by the MRF's director of communications. This resulted in a significant rise in the public awareness of the term Morgellons. Earlier, in February 2005, a report on a local Fox affiliate in Duval County, Florida, prompted the Duval County Health Department (DCHD) to investigate. Their report concludes:

[…] it was determined after extensive reviewing of these articles that Morgellons Disease is synonymous with delusional parasitosis (CDC, 1999).

DCHD Epidemiology consulted a pediatric dermatologist within the health department for his professional opinion. It was concluded that this is a psychological condition that has been mentioned in literature for hundreds of years.

The DCHD report notes that there was a significant spike in reported cases after the news report and that "this is attributed to the airing of Fox News’ coverage of the illness and is not a true cluster of disease."

In response to the May 2006 TV coverage, the Los Angeles County Department of Health services issued a statement that

No credible medical or public health association has verified the existence or diagnosis of "Morgellons Disease." The current description of the disease is vague and covers many conditions. Until there is a credible, national standard for the diagnosis of this condition, there is no basis for making it a reportable disease.

MRF troubled by controversy

At least three of the eight members of the organization resigned in August 2006 over disagreements with Leitao over the treatment of charitable contributions to the organization, including Dr. Greg Smith and Randy Wymore.

Dr. Greg Smith, a Gainesville, Ga., pediatrician, had recently posted a donations-soliciting letter for the MRF. He has since posted a retraction and stated: "I cannot in good faith ask anyone to contribute to the foundation."

Randy Wymore, an Oklahoma State University assistant professor of pharmacology and MRF's director of research, has also resigned and distanced himself from the organization. He has stated that "The research I'm doing is not affected by this." [1]

Symptoms

The symptoms are frequently characterized as rashes or non-healing skin lesions, associated with unusual structures on or under the skin that look like granules and filaments, and in particular a burning or itching sensation as if small parasites are crawling on or under the skin.

According to the Morgellons Research Foundation, most sufferers test positive for Lyme disease (borreliosis).

Some sufferers complain of seeing insects flying in and out of their skin (considered by some to be a possible secondary infection in existing lesions of unknown cause), while others say they have filaments or fibers growing out of their skin. Some of these fibers are microscopic, while others are so large that they can be seen growing with the naked eye. The fibers range in color, some being white, blue, black or red, and are often dismissed by doctors as lint. It is also noted that widespread reports of skin fibers only date back to the time they were described at a Morgellons website.

Sufferers often complain of fatigue, depression, and cognitive difficulty that may impair work performance.

The Morgellons Research Foundation states that the "troubling sensations and accompanying physical structures" are the most consistent symptoms.

Differential diagnoses

The symptoms of patients presenting with Morgellons are varied, and may match several other medical conditions. Frequently these symptoms may then be diagnosed as any of a number of conditions including:

• Scabies - an infestation of the mite Sarcoptes scabei.
• Lice - an infestation of parasitic insects.
• Atopic Dermatitis or Eczema - a common skin condition with various causes including stress.
• Neurodermatitis - Eczema or other skin condition exacerbated by scratching
• Tinea - A fungal infection of the skin or hair.
• Folliculitis - An infection of the hair follicles.
• Cellulitis - A skin infection.
• Seborrhea - A condition due to over-active sebaceous glands
• Impetigo - A rash caused by bacterial infection
• Compulsive skin picking - Obsessive picking at ones own skin.
• Drug side effects - from use, overuse, or withdrawal.

If a specific complaint is not identified, the doctor could diagnose a medically unexplained physical symptoms (MUPS) syndrome, such as fibromyalgia or chronic fatigue syndrome. Diagnosis of MUPS is seldom a satisfactory situation for the patient, as many patients feel this implies it is "all in their head." This can lead to an adversarial doctor-patient relationship, which can develop into an iatrogenic neurosis, thus complicating the situation.

Doctors do not offer a diagnosis of Morgellons. While sufferers often initially present with a self-diagnosis, they also continue to self-diagnose after conventional treatments for the medical diagnosis seem not to be working, or after they refuse to accept the conventional diagnosis. At this point the patient is sometimes diagnosed with delusional parasitosis.

Delusional parasitosis

Presentations of Morgellons are frequently diagnosed as delusional parasitosis. The symptoms of delusional parasitosis are very similar to those presented by a Morgellons sufferer who rejects conventional diagnosis of their symptoms, or who presents a belief in the existence of an organism that cannot be observed except by the patient. There is no agreed upon differential diagnosis since Morgellons is not an accepted medical condition.

In her article Delusory Parasitosis, Nancy C. Hinkle outlines thirteen indications attributed to delusional parasitosis, many of which are shared by patients claiming to have Morgellons. These indications include:

• The presentation of physical evidence such as skin scrapings and debris
• Obsessive cleaning and use of disinfectants and insecticides
• Rejection of the possibility of psychological or other explanations
• Emotional trauma, desperation, social isolation
• Having seen numerous physicians, to no avail

The belief that fibers are emerging from their skin is still present in these patients. This belief is generally regarded by doctors as either delusional or a result of simply mistaking fibers from clothing (lint) as fibers emerging from the body. One doctor, declining to be named for a news article, indicated that he treats patients simply by placing a cast over the affected area of skin, protecting it from the patent's scratching, which results in healing in a matter of weeks. This lends weight to the theory that perceived skin abnormalities interpreted as the manifestation of Morgellons are a side-effect of habitual scratching.

Morgellons theories and research

No clinical studies have yet been done into Morgellons. Only one paper mentioning Morgellons has been published in a medical journal; the paper was co-authored by the founder of the Morgellons Research Foundation and other MRF members.

William Harvey of Houston, Texas, chairman of the MRF, champions the disease as real, probably related to Lyme disease, and claims success in treating it with antibiotics.

George Schwartz of Santa Fe, New Mexico believes the cause may be the bacterium Stenotrophomonas maltophilia, and has claimed success in treating patients with antibiotics that target this waterborne bacterium. In his booklet "Lisa's Disease, A Fiber Disease", he describes four stages to this condition. Stage four places body organs in jeopardy. Schwartz also treated patients with anti-worm medication and diatomaceous earth.

Randy S. Wymore of the Oklahoma State University Center for Health Sciences in Tulsa, Oklahoma is conducting research into Morgellons. He has examined the fibers, scabs and other samples from Morgellons patients. To date, Wymore's preliminary research has no conclusive results.

Wymore believes that in 2006 formal studies with Morgellons patients will begin. The Morgellons Research Foundation has recently published a Case Definition for physicians.

A station KENS 5 Eyewitness News report published on the web on July 25, 2006 cites an anecdotal report that certain 'fibers' extracted from under a patient's skin moved and 'intertwined' of their own volition.

New CDC Investigation

The Centers for Disease Control and Prevention are launching a study of Morgellons disease: "We're going into this with an open mind," said Dan Rutz, spokesman for the CDC Morgellons task force that first met in June 2006.

"The 12-person CDC task force includes two pathologists, a toxicologist, an ethicist, a mental health expert and specialists in infectious, parasitic, environmental and chronic disease. The group is developing a case definition of Morgellons."

See also

• Medically Unexplained Physical Symptoms

External links

• The New Morgellons Order
• Morgellons Research Foundation
• Morgellons-Message-Board Morgellons-Message-Board
• Morgellons Disease: Symptoms, Causes and Treatment
• Gallery of images taken by a Morgellons disease sufferer
• High magnification images of fibers taken from a Morgellons disease sufferer at 700x to 5600x
• MorgellonsUSA.com Many typical photos of fibers.
• Research at Oklahoma State University
• Morgellons Watch Skeptical website.

In the news

• "Doctors puzzled over bizarre infection surfacing in South Texas", My San Antonio, 15 May 2006.
• "Parasitic Infection Flummoxes Victims and Doctors", Slashdot, 19 May 2006.
• "Frightening Skin Disease Invades L.A., CBS News, 20 May 2006.
• "The Plague", Dallas Observer, 20 July 2006.
• "Mysterious Skin Disease Causes Itching, Loose Fibers", ABC News, 28 July 2006.
• "CDC Probes Bizarre Morgellons Condition", WREX-TV Channel 13, Rockford, IL August 10, 2006.