Monsters Inside Me

MUSIC IN

HOST VO

A young boy falls prey to a vicious attacker leaving his life hanging by a thread.

STEVE SPEELMAN OC/VO

He told me he couldn't see me and that he was scared.  That's when I got scared.

HOST VO

A loving husband is stuck down by the deadliest parasite on the planet.

MARIA BEALL VO/OC

I'm thinking my husband's dying in front of my eyes.

HOST VO

And a marathon runner picks up a ruthless killer that eats him from the inside.

DR. BRUCE DEZUBE VO/OC

I was very concerned that if we didn't have a diagnosis soon, Nathan would die.

HOST VO

Three very different parasites, all with the same lethal strategy.  They feed off their host, then leave them for dead.  They are everywhere.  They are fatal.  They are Cold Blooded Killers.

MUSIC OUT

MUSIC IN

HOST VO

Worms invisible to the human eye.  Insects thirsty for blood.  Microscopic amoeba.  They might look harmless, but these are some of Nature's deadliest creatures.  They can hijack our bodies, disable our immune systems.  They are parasites.  But to those infected, they are the Monsters Inside Me.

HOST VO

Parasites are organisms that live in or on other living organisms called hosts.

DAN RISKIN OC

Some parasites adopt a relatively benign survival strategy, living off of the host without doing too much damage.  But some parasites take a much more ruthless approach.  They devour their host's resources.  They destroy their bodies and they don't stop until the host is dead.

HOST VO

And when the deadliest parasites strike, the chances of survival are very slim as one family is about to find out.

HOST VO

September, 2008.  Steve and Lori Speelman live in the town of Baldwinsville, New York.

STEVE SPEELMAN VO

I was looking for a great place to raise our kids.  The thing that attracted me to Baldwinsville was it had a great winter.  It was a big hockey community.

HOST VO

Their nine year old son, Chris, lives and breathes ice hockey.

STEVE SPEELMAN VO/OC

Chris started playing ice hockey at four years old.  He had a natural gift for it.  Chris likes the competition, but he's a fun, loving kid.  We always say, "Chris loves being a kid."

HOST VO

One morning in early autumn, the Speelmans take Chris to hockey tryouts.

STEVE SPEELMAN VO

Chris has spent all summer working real hard to pass this travel team tryout.  We go out.  All the kids are lined up waiting to take the ice.

HOST VO

But when his turn comes, Chris isn't his usual competitive self.

STEVE SPEELMAN VO/OC

He was dropping his stick.  He looked like he was struggling.  He was usually one of the fastest skaters, and he was coming in last in some of these drills.

HOST VO

His mom, Lori, also spots Chris' unusual behavior.

LORI SPEELMAN VO/OC

I noticed that a few times he just fell.  And it just seemed very unusual for him.  But I didn't, I just thought he wasn't trying his hardest.

HOST VO

The next day, the team's roster is posted online.

LORI SPEELMAN VO/OC

We went on the website and they listed all the team players, and Chris' name was not on it.  As a parent, I feel so bad.  He just started crying and he said he tried his best.  Chris was extremely upset.

HOST VO

Steve and Lori encourage Chris to put the disappointment behind him.

HOST VO

But a few days later, when Chris comes home from school, Lori notices something strange.

LORI SPEELMAN OC

I was doing homework with him and I noticed that he just would daze off.  And the only way to get his attention was to actually get in front of him and call his name.

STEVE SPEELMAN VO/OC

He's having these moments where he dazes out.  I have to really, really hold his hand through homework assignments.  This is stuff he knows.  This is stuff that he could have done in ten minutes because he'd be so eager to go outside and play.  Now I'm helping him figure out what two times five is.  He's starting to get frustrated, like he just really doesn't know.  A light bulb went off in my mind that maybe something's not right here.

HOST VO

By the end of the week, the Speelmans realize that lack of concentration is the least of Chris' problems.

STEVE SPEELMAN VO/OC

It's Friday night.  It's pizza night.  We're sitting here having dinner as a family.  Everything seems normal.  Chris kind of gets up from the table and says, "I'm not hungry."  Which is odd because he's usually good for three slices of pizza.  He goes onto the couch in front of the TV, and the next thing I know he's sleeping.  I looked at my wife and I said, "He must be sick."  We take his temperature.  It was 103.

LORI SPEELMAN VO

He always tended to get high fevers.  He's also had ear infections.  We were hoping that it would just go away.

HOST VO

But on Wednesday night just before bedtime, there is an alarming development.

LORI SPEELMAN VO/OC

Chris is laying on the couch and it's getting late.  My husband picks Chris up and Chris just started freaking out.

STEVE SPEELMAN VO

He's yelling hysterically for me to put him down.  He does not want to be touched.  He just keeps yelling at me, "Dad, don't touch me.  Don't touch me.  Put me down."  He's got a hockey player mentality.  Nothing hurts him.  I've never been so scared in my life.  It is clear something is wrong.

HOST VO

Startled, Steve races Chris to the emergency room.

STEVE SPEELMAN VO/OC

When we're in the emergency room, the doctors are looking at Chris and they go through all the standard testing, blood tests and everything else.  I could see the look on the doctor's face now, and obviously I know something's wrong.

HOST VO

The test on Chris' spinal fluid has come back abnormal indicating that there could be something wrong with Chris' brain.  Chris is put in the care of Pediatric Neurologist Dr. Kevin Ragosta.

DR. KEVIN RAGOSTA OC/VO

His behavior was such that I thought that it could be a virus infection.  If you don't treat them early and aggressively, they can destroy your brain.

HOST VO

Dr. Ragosta prescribes an antiviral medication.

HOST VO

But the mysterious illness only gets worse.

STEVE SPEELMAN VO/OC

As the night goes by and I'm by his side, he starts shaking.  His body starts tremoring, and his eyes are starting to roll in opposite circles from each other.  And they actually start kind of going up in his head.  And he told me he couldn't see me and that he was scared.  And that's when I got scared.

HOST VO

Dr. Ragosta rushes him to the ICU.

DR. KEVIN RAGOSTA VO

He started having seizures and his level of consciousness became clearly compromised.

HOST VO

MRI's reveal that Chris is suffering from encephalitis, a dangerous swelling of the brain often cause by an infection.

DR. KEVIN RAGOSTA OC

His brain was clearly inflamed.

HOST VO

When the body's attacked by a foreign invader, it sends immune cells to the infected area causing inflammation.  Normally, this helps the body heal.  But inflammation in the brain can be fatal.  As the brain tissue swells, it presses against the skull killing the brain's own cells.  If enough cells die, the brain stops functioning and the victim dies.

DR. KEVIN RAGOSTA VO/OC

He was regressing instead of progressing.  And then you reach a point and said, "Okay, he doesn't have something that we can actively treat with antibiotics or anti-viruses."

HOST VO

Chris is getting worse by the hour.

DR. KEVIN RAGOSTA VO/OC

His awareness of the environment just started to become less and less and less.  And the boy that was just talking to you a day or two earlier now doesn't even seem to know your existence.

STEVE SPEELMAN OC

And they said the next day that was going to happen was he wasn't going to be able to breathe on his own.  And they said that to protect his airways, they were going to need to induce him in a coma and intubate him.

LORI SPEELMAN VO/OC

At this point, I don't know what to think.  It's the scariest thing I've ever went through.  My husband and I just, are still hoping everything's just going to turn out okay.

HOST VO

The doctors connect Chris to a ventilator and within minutes, he slips into a coma.

STEVE SPEELMAN OC

I was shocked and scared, and I asked the doctor, "What are the chances of him coming out of this?"  I was given, you know, a variety of it could be a day, it could be weeks or it could be years or it could be never.  My wife's there with me.  Both of us break down crying and we're asking out loud, "Why would this happen to a nine year old boy?"

HOST VO

Chris may never wake up again.

DR. KEVIN RAGOSTA VO/OC

He was just lapsing into a deeper and deeper coma.  That can be a bottomless pit.

HOST VO

Steve and Lori Speelman have spent the last six days in the hospital fighting to save their nine year old son Chris' life.  His brain is so swollen that doctors have put Chris in a temporary coma to protect him.  But Chris is so sick that the doctors are afraid he may never wake up.

DR. KEVIN RAGOSTA VO/OC

He was just lapsing into a deeper and deeper coma.  That can be a bottomless pit.

HOST VO

The doctors still have no idea what is causing Chris' brain to swell.

DR. KEVIN RAGOSTA VO

I didn't know what it was.  We knew Chris was worsening.  The MRI continued to show evidence of brain inflammation.

HOST VO

With Chris' life in the balance, Dr. Ragosta considers one final treatment, steroids.

DR. KEVIN RAGOSTA OC

Steroids is one of those two-edged swords.

HOST VO

Steroids can reduce the inflammation by inhibiting the body's immune response.  But in doing so, they might give whatever's attacking Chris free rein and make the infection even worse.

STEVE SPEELMAN VO/OC

The doctors were very clear that this was experimental.  And that there wasn't enough in the scientific literature to prove that this would work or not work.  And we decided to go for it.

HOST VO

Dr. Ragosta administers the steroids, and he and the Speelmans wait anxiously.

DR. KEVIN RAGOSTA VO/OC

When he was started on the steroids, I started realizing that his response was a little bit better.

STEVE SPEELMAN VO/OC

He was starting to yawn.  And that might seem, you know, very miniscule but I haven't seen his face move in 17 days and now he was yawning.

HOST VO

Encouraged by Chris' responses, Dr. Ragosta decides to test his ability to breathe on his own.

STEVE SPEELMAN OC/VO

They take the ventilator out of Christopher and everything's fine.  He's breathing well on his own.

HOST VO

After a month in a coma, Chris finally wakes up.

LORI SPEELMAN OC/VO

Eventually Chris opens his eyes.  He's not looking at you.  He just kind of is staring into space, but we're becoming a little more hopeful.

HOST VO

But the doctors are cautious.  They still don't know what has brought Chris to the brink of death.

DR. KEVIN RAGOSTA OC

There's always concern when you don't know what's going on that it could flare back up.

HOST VO

Worried that Chris could relapse at any time and still without any idea what has caused the illness, Dr. Ragosta turns to Infectious Disease Expert Dr. Leonard Weiner.  Dr. Weiner and his team pour over Chris' medical records.

DR. LEONARD WEINER VO

It's like a detective story.  In Chris' case, we began to look for more and more unusual causes that might account for his illness such as fungus or bacteria such as tuberculosis.

HOST VO

Then one evening, Chris' mother, Lori, receives an unexpected call.

STEVE SPEELMAN VO/OC

We get a phone call from the hospital and it's the infectious disease doctor.  They tell us, "Hey, we've got some news for you.  A test finally came back positive."  And I'm like, "Okay.  Good, you know, what, what is it?"  And they told us that Chris tested positive for Acanthamoeba.

HOST VO

The Acanthamoeba is a single celled organism that typically feeds on bacteria and yeast.  But if given the opportunity to infect a human host, it becomes a voracious parasite.

DAN RISKIN OC

The Acanthamoeba is normally a free living organism.  That means it can live without a host.  Nevertheless, if it does find its way inside a human host, it will wreak havoc.  And that can be deadly.

HOST VO

The Acanthamoeba enters the body through the skin or up the nose and travels through the Central Nervous System to the brain.  There, it devours brain cells.  After feeding, the parasite divides rapidly causing sudden and massive inflammation.

DR. LEONARD WEINER VO

It creates a very destructive inflammatory response within the brain itself.  And that is almost always fatal.

HOST VO

The doctors don't know how Chris was able to survive or if the parasite is still hiding in his brain.

LORI SPEELMAN VO/OC

The idea of a parasite in him is horrific.  Is he going to get sick again?  I am thinking, "Is this still in him?"

STEVE SPEELMAN OC

The doctors were very upfront and honest.  And, and there was really nothing they could tell us for sure.

HOST VO

Is the parasite that nearly killed Chris Speelman about to launch an even more vicious assault on his brain?

LORI SPEELMAN OC

Honestly, I was, I was fearing the worst.

HOST VO

Nine year old Chris Speelman is a victim of the deadly brain eating parasite Acanthamoeba.  After being treated with steroids, he has made a partial recovery but his parents are terrified that the parasite might still be lurking somewhere in his brain.

STEVE SPEELMAN VO/OC

Now we're looking at Chris and we don't know what the future was going to hold for him.  My wife and I both feared that Chris' recovery maybe wasn't a recovery at all.

DR. LEONARD WEINER VO/OC

There's not a lot of information out there about how survivors do.  Is he going to continue to get better and what's he going to look like a week, a month, from now?  The real way that one knows what's going to happen is to wait.

HOST VO

While the doctors wait to see if the Acanthamoeba returns, they begin to look at how Chris might have contracted such a ruthless parasite.

STEVE SPEELMAN VO

I do know that weeks before Chris' illness we were at a party where there was a pond and Chris and all of his friends were playing by the pond.  And Chris found a hockey puck that he scooped up out of the water.

DAN RISKIN OC

Acanthamoeba are very common in the environment.  They're found in all kinds of places like swimming pools, ponds, inside air conditioning units.  People are exposed to Acanthamoeba all the time.  Normally, that's not a problem because the immune system can stop Acanthamoeba before it takes hold in the body.

HOST VO

But in Chris' case, the parasite somehow sidestepped his immune system and attacked his brain.

HOST VO

Doctors continue to monitor Chris, still fearing that the killer amoeba might still be alive in his system.  But after six weeks of rehab, Chris regains his speech, muscle control and neurological function.

LORI SPEELMAN VO/OC

Chris told me that he wanted to get better because his hockey team had a tournament coming up, and he wanted to make the tournament.

HOST VO

While there is no way for the doctors to prove that the Acanthamoeba is dead, Chris' steady recovery is a sign his immune system has fought off the parasite for good.

DR. LEONARD WEINER OC

So now it's easy to say, you know, Chris' recovery is essentially complete.

STEVE SPEELMAN VO

The doctors assured us that this Acanthamoeba is not going to return.

HOST VO

By January, Chris is not only back on his feet, but back on the ice.  

STEVE SPEELMAN VO

Chris approached everything like the gutsy little kid that he is.

CHRIS SPEELMAN VO

They told me I got better because I was a tough kid.  I am happy that I'm able to play hockey for the stuff I want and play with my friends.  When I grow up, I want to be a professional hockey player.

HOST VO

No one know exactly how Chris beat the parasite.  But they do know that he's lucky to be alive.

DR. KEVIN RAGOSTA VO/OC

If we would have known early on that he had Acanthamoeba, his death sentence might have been written prematurely.

HOST VO

The Acanthamoeba is everywhere, so avoiding exposure to the parasite is nearly impossible.  While the parasite is deadly, cases of Acanthamoeba infection are extremely rare in the United States.

DAN RISKIN OC

The reason Acanthamoeba is such a deadly parasite is that it attacks the brain.

HOST VO

But the deadliest parasite on the planet has a different approach.  It attacks the blood as one computer programmer is about to learn firsthand.

HOST VO

2007.  Software designer Michael Beall and his wife Maria live in the quiet town of Chesterfield, Virginia.

MICHAEL BEALL VO/OC

For fun, we like to travel.  We do physical fitness in sports.

HOST VO

In his free time, Michael is an avid cyclist.

MARIA BEALL VO/OC

He can sometimes go out for 50 mile bike rides.  We both just enjoy taking care of ourselves and feeling great.

HOST VO

But Michael's energetic routine is about to come to a screeching halt.  One evening in June, Michael and Maria go out for a romantic meal.

MICHAEL BEALL VO

We went out to a nice seafood restaurant.  While eating dinner, I started to get an upset stomach and I wasn't sure what was going on.  My head started pounding and I didn't really finish my meal.  I thought maybe it could be food poisoning, maybe some kind of flu.  But I wasn't quite sure.  We leave the restaurant and go home.  The next morning the symptoms continued, you know, headache and stomachache and achiness.  And I didn't seem to improve.

HOST VO

Michael stays home from work hoping the symptoms will go away with some rest.  But after a few days in bed, Michael still has a headache and stomachache.

MARIA BEALL VO

Mike is a very strong kind of guy.  He doesn't give in to colds or flus or anything like that.  But after a few days, he decides that it's time to go to the doctor.

MICHAEL BEALL VO/OC

So I went to a clinic to see if there was anything wrong.  They listened to my breathing, checked for congestion.  They checked my blood pressure, and then give me a simple pain medication and send me on my way.

MARIA BEALL OC

They just confirmed what we thought.  They say that he has a virus.

HOST VO

But whatever is causing Michael's symptoms is much more serious than just a virus.

HOST VO

Michael stays in bed for the rest of the week.  But on Friday, Maria must leave town on important business.

MARIA BEALL VO

I had a lot of traveling that I was doing.  And I'm still trying to keep an eye on Mike just to make sure that he's okay.  But, you know, still we're thinking he just has a virus.

HOST VO

Only a few hours after Maria departs, Michael takes a turn for the worse.

MICHAEL BEALL VO/OC

I wake up and I had a low grade fever.  It just felt like a fluish type of feeling.  The next thing I remember the pounding in my head.

HOST VO

It's the worst headache Michael has ever had.

MICHAEL BEALL VO

It felt like I had a vise on my whole skull and crushing my head in.

HOST VO

With Maria still away on business, Michael calls his mom and tells her about the pounding in his head.

MICHAEL BEALL VO/OC

My mom comes over and realizes that there may be something seriously wrong with me.

HOST VO

Concerned for her son, Michael's mom rushes him to the emergency room.

MICHAEL BEALL VO

I tell the doctor that I had a pounding headache, dizziness, stomachache and that I thought something could really be wrong.  So he did a blood test to determine what was wrong.

HOST VO

Later that night, Maria gets an alarming message.

MARIA BEALL VO/OC

And I get this voicemail that his mom has now taken him to the hospital.

HOST VO

Maria races to the hospital.  When she arrives, she's stunned by what she sees.

MARIA BEALL VO/OC

As I walk into the ER, it's shocking to see my husband laying in the fetal position.  I just remember being really scared.

HOST VO

Finally, the doctor returns with the test results.  Michael has malaria.

MICHAEL BEALL OC

I was very shocked to get the diagnosis of malaria.

MARIA BEALL OC

I'm thinking, "What?  Who gets malaria?"

DAN RISKIN VO/OC

Malaria is the deadliest parasitic disease on the planet.  It causes nearly a million deaths a year.  The disease is called by a single celled parasite called Plasmodium.

HOST VO

The malaria parasite invades the body's red blood cells reproducing inside them until they explode and die.  The dead blood cells then form clumps that block the body's blood vessels, starving its organs and tissues of oxygen, eventually killing them.  But how did the world's deadliest parasite get inside Michael?  The answer lies in its life cycle.  Malaria begins in the gut of a mosquito.  When an infected mosquito bites a host, the parasites travel from the insect's saliva into the host's bloodstream.  The parasites reproduce in the host's blood and internal organs.  When an uninfected mosquito bites an infected host, the life cycle is complete.  Infected mosquitoes thrive in warm, often tropical, locations.  Right away Maria knows where Michael came in contact with the parasite.

MARIA BEALL OC/VO

For our 20th Anniversary, we were at this resort in the Dominican Republic for a week.  They tell us that where we vacationing, it's known for malaria.

HOST VO

Michael was admitted to the ICU where doctors give him an anti-malarial drug to stop the spread of the parasite.  But on the night of July 4th, Michael's condition takes a frightening turn.

MARIA BEALL OC

Suddenly, Mike sits up in bed and he starts speaking this computer language.  He's a software developer so I recognize what he's saying is what he writes.  And as he's sitting up in bed and he's speaking this garbly gook, I grab his face and as I look in his eyes, "Mike, do you know who I am?  Do you know where you are?"

HOST VO

Michael seems to have lost control of his mind.  

MARIA BEALL VO/OC

It was one of the scariest things that I had ever witnessed.

HOST VO

And now, Inside The Monster.  Acanthamoeba are commonly found in which of the following environments?  A, swimming pools.  B, air conditioning units.  C, raw sewage.  D, all of the above.

HOST VO

Acanthamoeba are commonly found in D, all of the above.

HOST VO

After a week of crippling symptoms, software designer Michael Beall has been diagnosed with the parasitic disease malaria.  Doctors treat him with anti-malarial drugs but to no avail.  And now there is a bizarre new symptom.  Michael has started speaking in nonsensical computer code.  His wife, Maria, fears her husband may have lost his mind.

MARIA BEALL VO/OC

I have no idea what is going on.  I am extremely scared.  I'm thinking my husband is going to die.

HOST VO

The ICU team calls in Infectious Disease Specialist Dr. Michael Edmond.  When he takes a sample of Michael's blood, he makes a shocking discovery.

DR. MICHAEL EDMOND OC/VO

23 percent of his red blood cells had parasites inside of them.  And that's a very high percentage of red blood cells to be infected.

HOST VO

That's 23 times more than he had only a week earlier.

DR. MICHAEL EDMOND OC

So here we have a smear from Mike's blood.  These little purple dots, every one of those is a malaria parasite.  We can often sit at the microscope for 30 minutes, just to find a single parasite.  This is the most severe case of malaria that I've seen in my career.  If we were to take a teaspoon of his blood, in that teaspoon of blood, would be five billion parasites.

HOST VO

For Michael, the news gets even worse.  His digestive system has been so badly impaired by the parasite, it can't absorb the medication.  With no drugs to stop them, the parasites have spread to the blood vessels that supply the brain.

MARIA BEALL VO/OC

The reason Mike is speaking computer code is because now the malaria has gone to his brain.

HOST VO

To save Michael's life, the doctors must give him huge doses of the medicine intravenously.

MARIA BEALL VO/OC

As this is happening, I have no idea what is going on.  I'm thinking, "My husband's dying in front of my eyes."

MICHAEL BEALL VO

I have three IVs in my arm feeding me intravenously 24 hours a day.

HOST VO

After eight days on the IV drugs, Michael's condition starts to improve.

DR. MICHAEL EDMOND OC/VO

He progressively got better.  As his parasite numbers came down in his blood, his symptoms all started to improve.

MARIA BEALL VO

He is lucid.  He's no longer speaking in computer code.  He is feeling much better.

HOST VO

A few days later, Michael is discharged from the hospital.  But little does he know, his ordeal is far from over.

HOST VO

Two weeks after returning home, Maria has another business trip.  Michael volunteers to drop her off at the airport.

MARIA BEALL OC

We get to the airport and Mike pulls up to where I need to get out.  And he says a very odd sentence to me.  I knew that something wasn't right.  I can't remember the exact words, but the words were out of order.  Suddenly, the hair on the back of my neck stood up.

MICHAEL BEALL OC/VO

At this point, I don't know what to think.  I was told I was cured of malaria.  Now I'm having some other symptoms.

HOST VO

Maria cuts short her business trip, and Michael races back to the hospital.

DR. MICHAEL EDMOND VO/OC

I was called by the emergency room to let me know that Mike had arrived, and he was a very different person than I had seen just the day before in my clinic.  It was very unsettling.

HOST VO

Has the malaria come back or is it something even worse?

HOST VO

Michael Beall is recovering from a near fatal bout of malaria.  His doctors believe they've killed the parasite.  But two weeks after leaving the hospital, Michael is struck by a sudden bout of dizziness and disorientation.

MICHAEL BEALL VO

I'm having more dizziness, trouble with my motor skills.  I can't seem to form a sentence.  Even though in my head, I feel like I can say the words but they're not coming out properly.  That's probably the, the most frightening thing.

MARIA BEALL VO/OC

He seemed to be at the level of about a two or three year old.  I was petrified that this was the new Mike.

DR. MICHAEL EDMOND VO/OC

This is not the normal course of someone who's recovering from malaria.

HOST VO

Dr. Edmond orders a new round of malaria tests, but they all come back negative.

DR. MICHAEL EDMOND OC

There were no parasites in his blood.

HOST VO

Something is still wrong with Michael's brain.  But if it isn't malaria, what could it be?

DR. MICHAEL EDMOND OC/VO

It seemed to me that something else must be going on.

HOST VO

Perplexed, he decides to cross reference Michael's symptoms with a database of malaria research.  What he uncovers is totally unexpected, a rare condition called Post Malarial Neurological Syndrome.

DR. MICHAEL EDMOND VO

What you see is mostly problems with cognition, with thinking and speaking.  The cause of this syndrome remains unknown.  So it's thought to be some type of a immunologic phenomenon that occurs after the infection has cleared.

HOST VO

There is no treatment for Post Malarial Neurological Syndrome.  The only course of action is to wait for the symptoms to subside on their own.

MARIA BEALL OC

There was really nothing that could be done except to wait.

HOST VO

Within just a few days, Mike undergoes a dramatic transformation.  

DR. MICHAEL EDMOND VO

He started to be able to construct sentences.  And when that happened, I felt like we had probably turned the corner.

HOST VO

By the fifth day, Dr. Edmond is confident his hunch has paid off.

DR. MICHAEL EDMOND OC

I had certainly never heard of the Post Malaria Neurologic Syndrome.  It's not even in any of our textbooks because it's so unusual.  And, in fact, he's the first case ever in the Western Hemisphere.

HOST VO

Today, Michael is fully recovered and back to leading a healthy, active life.

MARIA BEALL VO/OC

Ever since that last hospital stay, things have been great.  I think Mike is healthier now than he's ever been in his entire life.

MICHAEL BEALL VO/OC

I guess I've tried to enjoy life a little more than, than I would have otherwise.  You know, and make the best of it.

HOST VO

Michael Beall beat tremendous odds when he recovered from a parasitic infection that kills millions.

DAN RISKIN VO/OC

If a person's diagnosed in time and receives proper treatment, it's very possible to survive malaria.

HOST VO

It's also preventable.  When traveling in affected areas, taking anti-malarial drugs and sleeping under an insecticide treated net, dramatically reduce the risks of infection.

DAN RISKIN OC

Malaria is deadly because it destroys red blood cells and that prevents the body from getting oxygen to its organs.

HOST VO

But other parasites attack the body's organs directly as one athlete will soon discover.

HOST VO

Fall, 2006.  Dorchester, Massachusetts.  Web analyst Nathan Yang is an avid long distance runner.

NATHAN YANG VO/OC

I started running six or seven years ago.  After a while I was thinking about running a marathon.  The marathon really gives me a goal to shoot for.  It's much easier to actually exercise when you have a goal.

HOST VO

But Nathan is about to encounter a challenge unlike any he's ever faced.

HOST VO

One weekend in October he goes to visit his cousin in New York.

NATHAN YANG OC

We were hanging around in Washington Park.  And then pretty soon after that, I decided to go for one of my training runs.  And afterwards, I remember feeling extremely tired.  A lot more tired than usual.  And at the time, I don't really think anything about it.

HOST VO

At the end of the weekend, Nathan returns home to Boston.

NATHAN YANG OC

Probably the next night, after coming back from New York, I start feeling a little bit of a low fever.  I just thought it was, you know, a little bit of a flu or cold or something.

HOST VO

Nathan assumes the symptoms will go away on their own.

NATHAN YANG OC

I don't really think much about it at the time, so I go back to work.  I resume my usual life.  But the symptoms actually don't go away.  They continue.

HOST VO

Accustomed to being in top physical shape, Nathan is not used to feeling so unwell.

NATHAN YANG VO

I never really had anything wrong with me.  You know, never really had a hospital stay or anything like that.  Never broken a bone.

HOST VO

Concerned that his performance in a marathon might be affected, Nathan makes an appointment to see his doctor.

NATHAN YANG VO

By this time, it's about three weeks before the race so I go see the doctor just to make sure that there's nothing really wrong.  Take my blood pressure.  They examine me.  It's pretty much just a general exam.

HOST VO

After looking Nathan over, the doctor arrives at a diagnosis.

NATHAN YANG VO

So the doctor thinks that it's either a flu virus or some other type of virus that's just taking a little longer to go away.

HOST VO

Nathan decides to take a break from training in order to recover in time for the race.  But late one night he wakes up to a disturbing new symptom.

NATHAN YANG VO/OC

I wake up, you know, in the middle of the night and my clothes are soaked.  I don't think I've ever had night sweats like this.  But it was pretty bad.

HOST VO

Concerned that he might have something more than the flu, Nathan returns to his primary care physician.

NATHAN YANG VO

So the doctor thinks that one of the possibilities for explaining the symptoms was that maybe I had a tick borne illness.

NATHAN YANG OC

At that the time, that actually seemed pretty reasonable.

HOST VO

Ticks are blood sucking arachnids, common in New England.  They can transmit Lyme Disease and a deadly parasitic infection called Babesiosis.  The doctor runs a battery of tests on Nathan's blood.  The results will not be known for several days.

NATHAN YANG VO/OC

And in the meantime, my symptoms just continued to get worse and worse.

HOST VO

In fact, Nathan is so sick he's barely able to get out of bed.

HOST VO

Two weeks after he first became ill, he is forced to make a difficult decision.

NATHAN YANG OC

I had decided that I probably would not run the race.  That's upsetting because I had been training for three months, but it's just a race.

HOST VO

Then, Nathan gets a call from his doctor with some frustrating news.

NATHAN YANG VO/OC

The results from the labs that he had, all the things that he had run were all negative.

HOST VO

Whatever's making Nathan so sick remains a mystery.

NATHAN YANG VO/OC

So at this point, he decides to refer me to an infectious disease specialist.

HOST VO

That specialist is Dr. Bruce Dezube, a Hematologist at Beth Israel Medical Center.

DR. BRUCE DEZUBE VO/OC

I brought Nathan in and before me was indeed a young man who just looked ill.

HOST VO

Dr. Dezube orders a CAT Scan of Nathan's vital organs.  All appear normal, except for one, the spleen.  One of the spleen's primary functions is to filter and store red and white blood cells.

DR. BRUCE DEZUBE OC

A normal patient's spleen is maybe four to five inches.  His spleen was enormous.  It was the size of a baby.

HOST VO

An enlarged spleen can be life threatening.

DR. BRUCE DEZUBE VO/OC

If the spleen ruptures, the patient could die.  And I was very concerned that that spleen was just going to burst.

HOST VO

Dr. Dezube must find out what is making Nathan's spleen five times its normal size.  He tests Nathan for lymphoma and a variety of other deadly diseases.

DR. BRUCE DEZUBE VO/OC

We ended up sending off 50 blood tests and every one came back negative.  And that's when I said, "Oh my God, we've really got a problem here."  I was very concerned that if we didn't have a diagnosis soon, Nathan would die.

HOST VO

Marathon runner Nathan Yang has been struck down by a mysterious illness.  Plagued by fevers and fatigue, he has gone from being an elite athlete to a frail shell of himself in just a few months.

NATHAN YANG VO/OC

My symptoms just continued to get worse and worse.  It's probably one of the worst things that I've ever had.

HOST VO

Now his doctor has discovered a terrifying new symptom.  His spleen has swollen to five times its normal size.

DR. BRUCE DEZUBE VO/OC

I was very concerned that if we didn't have a diagnosis soon, Nathan would die.

HOST VO

With no idea what is causing Nathan's spleen to swell, Dr. Dezube is left with one final option, remove the spleen altogether.

DR. BRUCE DEZUBE OC/VO

One can live a totally normal life without a spleen.  However, taking the spleen out is often a last resort.

HOST VO

Dr. Dezube schedules Nathan for surgery to have his spleen taken out.  But before the operation can go ahead, the doctors do one final series of blood tests.

NATHAN YANG VO/OC

They take my blood to do all sorts of blood work.  They wanted to make sure that we exhaust all other avenues in infectious disease before actually having my spleen taken out.

HOST VO

48 hours before the operation, the results come back.  

DR. BRUCE DEZUBE VO/OC

I got a call that just totally knocked my socks off.  I got a call that his Leishmaniasis test was positive.

DAN RISKIN OC

Leishmaniasis is a disease caused by the protozoan parasite Leishmania.  When it gets inside the host, it feeds directly on the vital organs.

HOST VO

The Leishmania parasite hijacks the body's immune system by attacking the body's own defense cells.  The parasite devours them from the inside and then uses them to travel through the body.  When the parasite reaches the liver or the spleen where immune cells are made, it gorges itself, paralyzing the body's defenses.

NATHAN YANG VO/OC

It's concerning imagining that there's a parasite inside your body.

HOST VO

The Leishmania parasite is destroying Nathan's spleen.

DR. BRUCE DEZUBE VO/OC

And that parasite takes up residence into the spleen, and it causes the spleen to grow and grow as the parasites grow and grow and grow.

HOST VO

Dr. Dezube must kill the parasites before Nathan's spleen ruptures and kills him.  He floods Nathan's body with heavy doses of powerful antibiotics.

NATHAN YANG VO/OC

I had to be admitted to the hospital for five days and they gave me doses of drug every day.

HOST VO

Dr. Dezube and Nathan can only wait to see if the drugs will work.  But one pressing question still remains.  How did a Leishmania parasite get inside Nathan?

DAN RISKIN OC

The Leishmania parasite is spread by a tiny blood sucking insect about a third the size of a mosquito called the sand fly.

HOST VO

When an infected sand fly bites a human, the parasite enters the new host's blood.  Once in the blood, the parasite feeds on white blood cells reproducing and spreading throughout the body.  When an uninfected sand fly bites an infected human host, the life cycle is complete.

DAN RISKIN OC

The Leishmania parasite is common in places like Asia, Latin America and Southern Europe.  But cases in the US are extremely rare.

HOST VO

The doctors ask Nathan about his recent travels.

NATHAN YANG OC/VO

I was on vacation in Greece with a friend of mine.  We did some hiking in the mountains and in the gorges.  

HOST VO

The doctors think that it was on this trip to Greece that Nathan became infected.  After two days of treatment, Nathan starts to feel an extraordinary change.

NATHAN YANG VO/OC

All of a sudden I could tell that a lot of my symptoms were starting to go away.  I'm feeling really, really relieved.

HOST VO

Finally, by the end of the week, Nathan is parasite free and his spleen has shrunk back to normal size.

NATHAN YANG VO

Most of my symptoms were either gone or so minor now that they weren't really noticeable.

HOST VO

Within a few weeks of being released from the hospital, Nathan is able to return to his old routine.

NATHAN YANG VO/OC

And I started exercising again and resuming all the things that I had been doing before I started getting sick.

HOST VO

Today, Nathan is fully recovered.  But without treatment, victims of Leishmaniasis have little chance of survival.

DAN RISKIN VO/OC

Leishmaniasis doesn't stop with the spleen.  It will spread to new organs until it finally kills its host.  If this disease isn't treated, the death rate is nearly 100 percent.

HOST VO

There are no vaccines that protect against the Leishmania parasite.  Travelers to affected areas should guard against being bitten by sand flies by using insect repellant and keeping the skin covered whenever possible.

DAN RISKIN OC

Because parasites live inside or on their hosts, it might seem counterproductive for them to kill their source of food and shelter.  But the fact is, once a parasite completes it life cycle, the host becomes irrelevant.  Some parasites leave their hosts relatively unscathed and others are cold blooded killers.

HOST VO

For more disgusting parasites and tips on how to avoid them, visit our website animalplanet.com/monstersinsideme.

HOST VO

But Chris continues to run a high fever through the weekend.

STEVE SPEELMAN OC

Monday morning, it's obvious Chris can't go to school.  He's still sick with 104 fever.  He's got no energy.  He, he hasn't eaten now in two days.  Barely drinking fluids.  It's time to take him to the pediatrician.

LORI SPEELMAN VO

They examined him, and they don't see anything.  So, at this point, they're telling me it's just viral and has to run its course.

HOST VO

Little can be done to combat a virus.  So Chris' pediatrician prescribes antibiotics just in case Chris has a bacterial infection.

STEVE SPEELMAN VO

We follow the doctor's orders.  We continue to give him medicine.  We continue to give him fluids.

HOST VO

But Chris' condition fails to improve.

LORI SPEELMAN VO/OC

My husband and I are very worried at this point.

HOST VO

Michael drags himself back to the doctor.

MICHAEL BEALL VO/OC

I go to the clinic the second time.  At that point, I was emphatic with the doctor saying, "Something's wrong with me."  And the doctor checks me out, and really doesn't have any conclusive evidence of anything wrong with me.

HOST VO

Frustrated, Michael heads for home.  But before he can leave the parking lot, he's hit with a terrifying new symptom.

MICHAEL BEALL OC/VO

I was feeling very dizzy and couldn't drive home.  I don't think I've ever had the feeling of being too sick to drive before.  You know, this worried me a bit.

HOST VO

Michael calls a friend to drive him home and goes straight to bed.

HOST VO

Nathan's hiking trip in Greece was a year before his first symptom.  So how did the parasite survive undetected for over a year in Nathan's body?  One man in Washington thinks he has the answer.  Dr. David Sacks is a Cellular Biologist studying the Leishmania parasite at the National Institute of Allergy and Infectious Disease.  In this experiment, David will infect a test mouse with a Leishmania parasite and observe its progression.  

DR. DAVID SACKS OC/VO

So we're trying to understand why these are such successful parasites.  The work we're doing is to try and explain how these different parasites interact with immune cells in the host that might account for these different clinical outcomes.

DR. NATHAN PETERS VO/OC

And so what we've done is the mouse that was bitten by the sand flies earlier have now been put onto the two-photon microscope.  And what the technology has allowed us to do is a real intimate look at the skin to directly visualize in real time on a, in a live mouse where the parasites end up.

HOST VO

As soon as the mouse is bitten, its immune system comes to the rescue.  The first responders are immune cells called neutrophils.  

DR. NATHAN PETERS VO

The bright green cells here are actually the neutrophils.

DR. DAVID SACKS VO/OC

Neutrophils come in as a very important immune cell in response to any wound whether it's a needle or whether it's a mosquito bite or a sand fly bite.  

DR. NATHAN PETERS VO

So the neutrophils are here shown in green.  And basically what's happening is when the sand fly bites the skin the neutrophils leave the blood and come into the tissue to take out the parasite or attempting to prevent the parasite from establishing infection.

HOST VO

Normally, neutrophils will instantly kill any foreign invaders on the spot.

DR. DAVID SACKS VO

But these parasites have developed very clever strategies to evade elimination by the host's immune system.

HOST VO

The neutrophil ingest the parasite.  But instead of killing it, the parasite overpowers the neutrophil and takes control.

DR. DAVID SACKS VO/OC

So these parasites are extremely successful parasites.  They produce chronic infection.  So by definition, the immune system doesn't deal that well with these parasites.  Even the infections that aren't so severe clinically, they still last a long time.  These parasites have learned to live in a very cell type which should contribute to their elimination.  In fact, it uses the neutrophils to its own advantage.  These parasites have learned how to survive and grow inside of these immune cells and, and are to eat and kill other microbes.

HOST VO

By using Nathan's spleen as their shelter, the Leishmania parasites have been able to survive and thrive for over a year.