Why bother? - Parasites and the Lack of Attention in the US

I was debating on what topic to choose to write about for this week, and one kept coming to the forefront of my mind. Why parasites? I should have honestly made this the first of my open blog posts even if I vaguely covered the process of settling on parasites as the overarching theme for this blog in the first post. But I digress…

Why parasites? Why go into the deep layers of tissue and skin to rip out the little hookworm nestled in there? Why dive into the warm waters in Florida to search for the microscopic horror of an amoeba lurking there? Why try to cover the topic that would make people cringe and clench their eyes shut when faced with it?

Is it for a shock factor? Perhaps.

What about the clinical significance? Certainly millions of lives have been claimed by malaria. More die from neglected tropical diseases such as onchocerciasis, or River Blindness, and other diseases. This holds a greater weight in my choosing of parasites as my muse.

But there’s something, while gross, intriguing about the creatures that have managed to evolve alongside us rather than being wiped out. They seek to boost their own survival by living off another living being. Some take action right away, infecting just about anywhere in our bodies and waging war against us. Others have evolved to survive, inactive and safe in a cocoon, safe until the time is right.

They lurk in our pets, the soil, fresh water, our food, or even in pests that like to bite us. It seems almost as if there’s no escape from parasites. They continue to thrive and exist in the world with us, and while most parasites don’t aim to end up inside us, inevitably, it does happen. The Toxocara species of roundworm can be found in dogs or cats. Uncooked pork can yield trichinosis. A mosquito bite in Africa can result in malaria.

Parasites seem to remain listed among tropical medicine, even if they exist here in the United States and in Europe. This can result in lack of knowledge among medical practitioners, even infectious disease physicians. If you wanted a Master’s Degree in Parasitology in the US, you’d have to venture over to Texas, Florida, Illinois, Maryland, or New York. Maybe it’s because the US prides itself as being the country with the most and most recent technology in the medical field – even if it helps make our healthcare the most expensive.

With up-to-date and recent healthcare, parasites pose little threat to our health here with few exceptions. The one with the track record of nearly 100% fatal is extremely rare, and you’d probably never see it in your lifetime (unless you went looking for it). So parasites remain forgotten here. Cancer, heart disease, obesity, and other chronic diseases remain much more important on the research list. The creatures that lurk beneath our line of sight in the environment remain in the shadows of more common and pressing health issues.

Ironically, a new theory has risen stating that parasites can be the “norm” and that they are not necessarily harmful. The hygiene hypothesis states that our immune system evolved to combat pathogens, including parasites, and that with the increasing sanitation, our immune systems became hyperactive. What results then are autoimmune and inflammatory diseases such as Crohn’s Disease, allergies, and rheumatoid arthritis. There have also been recent experiments examining the potential therapeutic nature of some parasitic worms.

So why should we care in the US where malaria is a long forgotten disease unless we step foot in Africa or other tropical climates? It’s not just about curbing the pathogens in our environment, but stepping back and searching for the benefits in these parasitic worms that may relieve these chronic conditions. By name, parasitic worms are already labeled as pathogens. They are seen as the enemy, the cause of disease. But like E. coli being used prominently in molecular biological technology as vessels to replicate plasmids, parasites can too be useful beyond their pathogenic nomenclature.

If the hygiene hypothesis is correct, autoimmune and inflammatory conditions were partly because of our transition to sanitation. But all is not lost. These conditions may become a thing of the past if we revisit parasites instead of turning away from them.