Monsters Inside Me

HOST VO

A family of killers is breathing inside a man’s lungs.

TONY BRIXEY VO/OC

When I woke up and saw the blood on my pillow, it did scare me.  I wasn’t sure what to think.

HOST VO

A hideous organism makes its nest in a mountain biker’s head.

AARON DALLAS VO/OC

I woke my wife up and I said, “You’ve got to see it.  It’s, it’s making noises and it’s moving.”

HOST VO

And a flesh-eating monster reproduces with furious speed.

DR. STEVE SKODA VO/OC

And the name literally means man eater.

HOST VO

All very different parasites with one thing in common.  They have perfected the art of reproduction.  They are all sex maniacs.

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 just like every other organism on the planet.  Their goal is to reproduce and make more parasites, and they are very good at it.  So good, in fact, that there are more parasites on Earth than any other type of creature.  As a strategy for survival, parasitism is incredibly successful.

DAN RISKIN VO/OC

If you’re a parasite, that means you’re living off of a host.  And your host can provide food.  It can provide shelter.  And that means that parasites are freed up to put all their energy into what really matters, sex and reproduction.

HOST VO

Parasites have evolved countless ways to reproduce.  They are the ultimate sex maniacs.

DAN RISKIN VO/OC

Some parasites have a very simple reproduction strategy.  Make as many offspring as you possibly can, and hope that just a few of them will survive.  Other parasites are much more deliberate.  They choose the timing and the place for reproduction very carefully, thereby maximizing the likelihood of their offspring surviving.

HOST VO

Many parasites cause their host little harm or discomfort which ensures they continue to breed undetected.

HOST VO

Other parasites make their presence savagely felt as a man in Colorado is about to find out.

HOST VO

Aaron Dallas is a ski instructor in Carbondale, Colorado.

AARON DALLAS VO/OC

We’ve lived in Carbondale about four years now.

HOST VO

He lives with his son Bodie, and his wife Midge.

MIDGE DALLAS VO/OC

It’s a great town.  It’s got mountains and skiing, biking.  We love that we can get on our bikes and don’t have to get in our cars for weeks at a time.

AARON DALLAS VO

And the big part of moving here was the community activities and stuff.

HOST VO

The Dallas family is constantly on the go.  But in the Spring of 2007, something stops Aaron in his tracks.

AARON DALLAS OC/VO

It was planting time.  And as I was bending over to shovel, I felt this sharp pain in the back of my head.  As I bent down, it got worse and worse.  So I immediately stood back up and the pain went away.  I thought, “That’s kind of strange.”

HOST VO

The stabbing pain continues intermittently.  But Aaron can’t identify any obvious cause.  A week later, he begins to feel the skin on the back of his head is changing.

AARON DALLAS VO/OC

I started to discover there were some distinct bumps on the back of my head.

HOST VO

Aaron can feel a ring of five individual bumps protruding from the back of his head.  He decides to wait and see if the bumps go away on their own.

MIDGE DALLAS VO/OC

Aaron’s a typical male and it takes a lot for him to go to the doctor.

HOST VO

But then a frightening symptom forces him to seek medical help.

AARON DALLAS VO

Probably in the second week, they started to bleed.  These bumps were bleeding, oozing.  It was fairly continuous.  I was starting to get more and more concerned.

HOST VO

With the back of his head oozing blood and pus, Aaron heads to see his local doctor in Carbondale.  The doctor examines the bumps and tells Aaron they are infected bug bites.  If insect bites are scratched and the skin is broken, infection can easily occur causing a condition called cellulitis or inflammation of the soft tissues underneath the skin.

AARON DALLAS VO/OC

Yeah, that made perfect sense.  And he gave me a topical lotion to put on there that would clear up any infection.  I was pretty convinced that that was going to take care of it.

HOST VO

Back at home, Aaron notices a surprising reaction to the ointment.  

AARON DALLAS VO/OC

Well when I put this lotion on, the bumps reacted.  They would get very irritated in a way that I had never felt irritation before.  It was almost as though I was making the bumps angry.  

HOST VO

The ointment does nothing to reduce the infection.  In fact, after three weeks the bumps have doubled in size.

AARON DALLAS VO/OC

As I’m getting ready to go biking, I get my shorts on and my jersey on and my shoes on.  I grab my helmet and as I put it on my head, I realize my helmet doesn’t fit.  The bumps, by this point, had become so large that the helmet that I had had for three years no longer fit over my head.

HOST VO

Aaron’s swollen head forces him to confront the possibility that something is invading his body.

HOST VO

He makes an appointment with a specialist in Denver.  It’s a three hour journey from Carbondale through several high mountain passes.  On the trip, Aaron notices a curious new sensation.

AARON DALLAS VO/OC

So in the same way my ears are filling up and clearing, the bumps on my head are getting worse.  And as I’m going down, they’re feeling better.

HOST VO

Aaron describes the shooting pain, the bleeding and the pressure changes.  The specialist gives him a diagnosis which explains the strange ring of bumps and the sharp bursts of pain.

AARON DALLAS VO

The doctor thought that it was probably a recurrence of shingles.  I had shingles earlier in the year in February.

HOST VO

Shingles is caused by a virus that attacks nerve endings, causing shooting pain and pus filled blisters.

AARON DALLAS VO/OC

So what he told me was that it should clear up on its own.  I thought, “Well, that’s different than what it was before.  But because it’s on my head, maybe it manifests itself differently.”

MIDGE DALLAS VO

When he came back from the specialist in Denver, I think we were really defeated, though we didn’t know how long he would be in this pain.

HOST VO

And the pain is becoming hard to withstand.

AARON DALLAS VO/OC

The pain would come as though I had backed myself into a nail on the side of the wall.

HOST VO

Then, for Aaron, the most terrifying moment of all.

AARON DALLAS OC

As I’m lying in bed one night, I can hear noises in the back of my head.  I can hear the bumps making noise.  Just a very faint, scratch, scratch, scratch, scratch.  I woke my wife up and I said, “You got to see it.  It’s, it’s making noises and it’s moving.”

MIDGE DALLAS OC

When he would say they were moving, I didn’t disbelieve him but I didn’t completely believe him because it was hard for me to believe that he would feel like shingles were moving inside of him.

AARON DALLAS VO

I’m telling myself, “Stop imagining it.  It’s just a figment of your imagination.  Don’t let it get to you.  Just concentrate.  Let the pain go away and go back to sleep.”  At this point everything is going through my head.  What, what could it possibly be?  Is it cancer?  Is it, you know, what are, what are all of the things that could cause bumps on the back of your head to get so debilitating?  

HOST VO

Desperate to find an answer, Aaron heads back to his original physician.

AARON DALLAS OC

So I decide that I’m going to make him do something about these bumps, even if we have to cut them off.

HOST VO

This time, before his appointment, Aaron makes a small but important change to his routine.

AARON DALLAS OC

I took a shower right before I went to the doctor.  And went with wet hair to see the doctor.  This time he parts my hair, looks at the bump and pauses.  He goes, “Oh my God.”  “What is it?  What do you see?  What is it?”  And he says, “I don’t know.  All I can see are things moving inside the bumps on the back of your head.  I think they’re botflies.”

HOST VO

The botfly is a hairy insect about twice the size of a housefly.  Its maggot larvae are known to live as parasites in human flesh.

AARON DALLAS OC

I am immensely relieved that I’m not going crazy.  That there really are things moving and making noise on the back of my head.

HOST VO

Aaron’s head has been a nursery to five growing botflies.

DAN RISKIN VO/OC

Botflies only have a few offspring over the course of their lives.  But they’re very careful about where they place them so that those offspring are more likely to survive.

HOST VO

Skin provides food and shelter for baby botflies.  And the botfly larvae are brilliantly adapted to living in the flesh of another organism.  Botflies have special mouth parts that allow them to burrow into their host’s skin.  At the maggot’s rear end is a breathing tube that keeps the larvae supplied with oxygen while it’s in the skin.  The doctor can see the botfly maggots through their breathing tubes which form holes on the top of each bump.

AARON DALLAS VO

And because I had taken a shower right before I went to the doctor, I had washed off all the crusty stuff, all of the things that would block the holes.  And because the holes are now clear, the doctor and the nurse can see things moving in the back of my head.

HOST VO

But how did the larvae get into Aaron’s flesh?

HOST VO

Botflies live in Central and South America, not Colorado.  The doctor asks Aaron if he’s traveled to the tropics recently.  

AARON DALLAS VO/OC

We had been going to Belize for me to do a bike race.  A day in early June the bike team and I traveled to a race in Northern Belize.  They got the basic hotel room.  I opened the window.  I turned the fan on.  And as I open the window, I see that there’s no screen on the window.  And about five minutes of opening the window and turning the fan on, the room is full of mosquitoes.  I pulled the sheet on my bed all the way up to the top of my head and tried to go to sleep, giving the mosquitoes as little room as possible to hassle me.

HOST VO

But what do mosquitoes have to do with the botfly maggots taking root in Aaron’s head?

HOST VO

Aaron Dallas is in a hotel room in Belize surrounded by mosquitoes.  He doesn’t realize these insects are about to deposit a cargo of parasitic eggs onto his head.  The mosquito plays a vital part in the life cycle of an insect called the botfly.

DAN RISKIN VO/OC

To complete its lifecycle, a botfly has to find a way to get its eggs onto the skin of a host.  But the adult botfly has a problem.  It’s too big and conspicuous to drop the eggs off for itself.  So what it does is it uses a mosquito to deliver the eggs for it.

HOST VO

The female botfly ambushes a mosquito in mid-flight.  The botfly lays its eggs and glues them to the underside of the mosquito.  When the mosquito lands on human skin, body heat melts the glue.  The eggs fall off the mosquito and hatch into larvae which burrow into the skin.  If they are undisturbed, they will remain there for six weeks.  Eventually the larvae crawl out through the breathing hole, fall off the skin and burrow into the ground.  Four weeks later, they emerge as adult botflies.

DAN RISKIN OC

Because botflies only make a few offspring,…

MUSIC OUT

…they need those offspring to get where they need to go.

MUSIC IN

And that’s why using a mosquito is such a brilliant strategy.

HOST VO

In Colorado, Aaron’s doctor is about to interrupt the lifecycle of the botfly maggots in Aaron’s head.

AARON DALLAS VO

At this point, I’m pretty relieved.  Because at this point I finally have a doctor who is going to do something about the bumps on the back of my head.

HOST VO

But extracting botfly larvae can be a dangerous business.

DAN RISKIN VO

Botfly larvae are ringed with little tiny black spines.  And those are there so that if you try to pull it out, it’s going to get lodged into place.  It’s a great way to make sure that it doesn’t get pulled out by the host.

HOST VO

One way to extract a botfly is to cover the air hole, starving the maggot of oxygen.  When the cover is removed, the maggot surfaces and can be extracted safely.  When Aaron took a shower, he removed the scabs that were covering the air holes.  The botflies come to the surface and the doctor prepares to extract them.

AARON DALLAS OC

And the next thing I know, I can feel something being pulled out of my head.  And I can almost hear it go, pop.

MUSIC OUT

I don’t like to use the word maggots because it’s not a very nice word, and it doesn’t make me feel very good that there were maggots in my head.  But what he showed me were maggots.

MUSIC IN

HOST VO

For Aaron, the mystery is finally over.

AARON DALLAS VO

There was kind of a giddiness and a happiness inside me because my entire body knew that it was over.

DAN RISKIN VO/OC

For the parasites, having a mosquito deliver their eggs is a great strategy because they can get into all kinds of different organisms.  But sometimes the mosquito will drop the eggs off on a human.  And humans typically figure out that they have a botfly infection and get rid of it before the botfly has a chance to mature.  So for the botfly, humans are a bit of a dead end.

HOST VO

The encounter with the botflies has not changed the Dallas’ love of outdoor exploration.

MIDGE DALLAS OC/VO

Yeah, this experience has not changed my attitude about Central America or Belize or traveling at all.

AARON DALLAS VO/OC

You can’t walk through Belize trying to be careful.  You walk through Belize trying to take in as much as you can.  And, unfortunately, sometimes that includes some of the local wildlife.

HOST VO

To avoid hosting a botfly, keep away from mosquitoes when in the tropics.  Always use insect repellant and cover up at dusk.

DAN RISKIN VO/OC

To complete its lifecycle, a botfly has to find a way to get its eggs onto the skin of a host.

HOST VO

The botfly’s cunning reproductive strategy ensures more of its young survive.

DAN RISKIN VO/OC

For a botfly larva, skin is a perfect place to live.  It’s warm.  It’s moist.  There’s food.  You’re physically protected.  And, of course, because it’s such a great place to live, they’re not the only parasites that have figured that out.

HOST VO

One parasite uses flesh to produce hundreds of babies at a time, the screwworm.  The screwworm fly lays its eggs in the open wounds of live animals.  The hatching maggots are voracious eaters.  Their curved teeth tear at their host’s flesh causing deadly infections.  Across the Western hemisphere, they massacre livestock and also attack humans.

HOST VO

Dr. Steve Skoda of the US Department of Agriculture is one of the world’s leading experts on this killer pest.

DR. STEVE SKODA OC

The Latin name is Cochliomyia hominivorax and the name literally means man eater.

HOST VO

Dr. Skoda and a team of researchers breed thousands of these parasites and study their reproductive cycle in the hope of stopping them.

DR. STEVE SKODA VO/OC

These are the flesh eaters right here.  This is the parasitic stage.  These are the parasites.

HOST VO

But what makes this flesh eater so successful?  The screwworm is a formidable enemy with a powerful weapon, sex.  

DR. STEVE SKODA VO/OC

Males are promiscuous.  They’ll mate as many times as the females come around with as many females as they can, as many times in one day as they can.

HOST VO

Female screwworm flies, on the other hand, take a different approach to mating.

DAN RISKIN VO/OC

Female screwworm flies have a great trick in terms of their sexual reproduction.  They only have to mate once, and then they’re able to store all the sperm from that mating event for the rest of their lives.  And they never have to go looking for a mate again.  And because the females aren’t wasting all this time on mating, they’re able to spend more time looking for open wounds where they can lay their eggs.

HOST VO

She begins laying up to 300 eggs in the nearest open wound.  Less than 12 hours later, body heat induces the eggs to hatch.  Immediately the maggots begin to feed enlarging the wound minute by minute..  When the maggots reach maturity, they drop from the host and burrow into the ground where the larvae become flies, ready to mate and perpetuate the cycle.  The entire lifecycle of a screwworm takes just 20 days.

DR. STEVE SKODA VO

If you have one breeding male and female and they go unrestricted in their ability, they could make thousands and thousands of flies in just a couple of weeks really.

HOST VO

Screwworms have a simple and efficient lifecycle, allowing them to reproduce with incredible speed.

HOST VO

But other parasites must take several complex steps through many hosts before finally reproducing.

HOST VO

Tulsa, Oklahoma.  Outdoorsman Tony Brixey is the picture of health.  When he’s not home with wife, Misty, he’s hard at work as a chemical applicator for an electrical company.

TONY BRIXEY VO

My job involved actually mixing chemicals, putting those in sprayers.  We were spraying broad leaf plants to keep those from growing into the power lines.

HOST VO

The hectic work schedule keeps Tony busy and away from his family.

TONY BRIXEY VO/OC

My job required me to travel sometimes up to six days a week.

HOST VO

One winter’s day, Tony notices that he’s developed a persistent cough.

TONY BRIXEY VO/OC

It progressively got worse, coughing deeper, harder.  Hard to catch my breath.

HOST VO

Tony begins to suspect that his cough might be job related.

TONY BRIXEY VO/OC

I just knew it had to be those chemicals.

MISTY BRIXEY VO/OC

Maybe the chemicals were getting into his lungs and maybe that’s why he was coughing.

HOST VO

But Tony isn’t too alarmed and decides to deal with it on his own.

MISTY BRIXEY VO/OC

Tony has never been one to just go to a doctor.  He feels if he ignores something, it’ll will go away.

TONY BRIXEY VO

I just didn’t really think it was that serious.

HOST VO

Two weeks after the cough develops, Tony returns home from a long week at work.

TONY BRIXEY VO

My chest just felt tight and then I couldn’t get enough air.  So I get up out of bed and walk to the bathroom and just cough up a lot of blood.

HOST VO

What could be causing Tony Brixey to cough up so much blood?

HOST VO

The best way to avoid the botfly parasite is to A, stay out of fresh water in Africa or Asia.  B, wash your hands before handling food.  C, avoid mosquitoes in tropical areas.

HOST VO

The best way of avoiding the botfly parasite is to C, avoid mosquitoes in tropical areas.

HOST VO

Oklahoma resident Tony Brixey has been sick for weeks with a persistent cough.  But his condition takes a dramatic turn when he begins coughing up blood.  Tony and his wife Misty start to panic.

MISTY BRIXEY OC/VO

When I saw all of the blood in the toilet I was really scared that something was very wrong with him.

HOST VO

Misty rushes Tony to the family doctor.  She tells him about Tony’s exposure to chemicals at work.  But the doctor dismisses the idea that chemicals are the culprit.  Instead, he suspects bronchitis, an infection of the airways leading to the lungs.  He puts Tony on a two week course of antibiotics.

TONY BRIXEY VO/OC

I finished the antibiotics and I had actually gotten worse.  So, we went back to the doctor.

HOST VO

The doctor didn’t really know what to think.

SFX

HOST VO

He refers Tony to a pulmonologist who takes a closer look at his lungs.  And right away, he sees something shocking.

TONY BRIXEY VO

And they actually did a scope down into my lungs and saw little black specks.

HOST VO

The pulmonologist can’t tell what the little black specks are.  But right away, Misty offers up one possibility.

MISTY BRIXEY VO/OC

I’m not sure when he started, but from early teenage years, he had been chewing tobacco.

HOST VO

The doctor agrees that the specks do look like remnants of chewing tobacco.  If Tony had swallowed some chewing tobacco, particles could have gone down his bronchial tubes and settled in his lungs.

TONY BRIXEY OC/VO

Somehow it had made it into my lungs and that’s what those, the little black specks was caused from.

HOST VO

Since he does not see any signs of infection, the doctor prescribes more antibiotics and tells Tony to stop chewing tobacco.

MISTY BRIXEY VO

I did not like the fact that he chewed tobacco.  I was always trying to get him to quit.

HOST VO

Tony returns home and follows the doctor’s orders.  But three weeks later, he wakes up to a horrific sight.

TONY BRIXEY VO/OC

When I woke up and saw the blood on my pillow, it did scare me.  I, I wasn’t sure what to think.

HOST VO

Alarmed, Tony calls his wife who rushes him to the hospital.  There he is put under the care of an Infectious Disease Specialist, Dr. David Scheck.

DR. DAVID SCHECK VO

In addition to the coughing up of blood-tinged material, he was also having some chest pain.  And there was just concern that maybe there was progression of whatever process was going on in his lung.

HOST VO

Dr. Scheck knows these black specks must be related to Tony’s symptoms, but he has no idea what they are.

DR. DAVID SCHECK VO

We had to, number one, further identify what these objects were and then to figure out a course of action.

HOST VO

Scheck orders a biopsy of the black specks and sends them to a pathologist.

HOST VO

Tony can only return home and wait.  Finally, the results come in.

TONY BRIXEY VO

One of the nurses from Dr. Scheck’s office called and set up an appointment for my wife and I to come to Tulsa to talk about the results of the biopsy.  I was a little worried about why they wouldn’t tell us over the phone what, what the problem was.

HOST VO

Misty fears the worst.

MISTY BRIXEY VO

I thought he was getting cancer.  I thought my husband may be dying.

HOST VO

Two days later, Tony and Misty make the two hour drive to Tulsa.  Tony braces himself for the news.  

DR. DAVID SCHECK VO/OC

What they found was an object or objects that actually looked like eggs.

HOST VO

The black specks in Tony’s lungs aren’t chewing tobacco.  They are eggs.  Dr. Scheck has never seen anything like it.

DR. DAVID SCHECK OC/VO

And it certainly was something that wasn’t very common to see here in Oklahoma.  It looked like a parasite.  What wasn’t known was what type of parasite it was?  Specifically because when you examine these eggs, sometimes they all look very similar.

HOST VO

But the pathology report holds a clue.

DR. DAVID SCHECK VO

It seemed to have a central operculum which is kind of a central spine.  And then it, the way that its attachment features were oriented on the egg itself actually made us start to think what this type of parasite was.

HOST VO

When he realizes which parasite he’s looking at, Dr. Scheck is astounded.  It is a parasitic worm commonly found in Asia and South America called Paragonimus kellicotti or the lung fluke.  It lives and breeds in the lungs causing chronic inflammation.  In serious cases, the lung fluke is deadly.

HOST VO

Once inside the host, the parasite burrows through the body’s tissues in search of its breeding grounds, the lungs.

DAN RISKIN VO

Once the parasite makes its way into the lung, it has everything it needs to reproduce.  It has oxygen.  It has nutrients.  It has a nice warm environment, and it even has a way of getting its eggs out into the environment in an easy way.

HOST VO

The fluke causes inflammation in the host’s lungs making the host cough up blood that is laden with parasitic eggs.  The egg-laden blood is re-swallowed and passed out of the body in the feces.

DAN RISKIN OC

So for these organisms, reproducing in the lung is a brilliant strategy.

HOST VO

But how did this parasite get inside Tony Brixey’s lungs?  The answer lies in the lung fluke’s complex lifecycle.

DAN RISKIN VO/OC

Lung flukes have several intermediate hosts.  And at every stage they’re getting closer to the definitive host where they’re going to be able to sexually reproduce.  And in this case, the definitive host is a human.

HOST VO

First, the lung fluke attacks a fresh water snail.  Once inside the snail, it grows into a tadpole like larvae.  Then the larvae invade a second host, often a crustacean.  If the crustacean is eaten raw, the larvae will enter their new human host.  In about 30 days, the adult lung flukes start to mate in the human lung.  Crustaceans, the parasite’s intermediate host, provide a clue to the source of Tony’s infection.

DR. DAVID SCHECK VO/OC

So that made us go back and talk to the patient about what his potential exposures may have been.  

HOST VO

First, Dr. Scheck asks Tony if he’s been out of the country recently.

TONY BRIXEY VO/OC

I had not been out of the country in my entire life.

HOST VO

Tony’s lack of any travel history puzzles Dr. Scheck.

DR. DAVID SCHECK OC

There were only about four or five conclusive reported cases in North America at the time.

HOST VO

But there has never been a reported case of lung fluke in this particular area.  So how did Tony Brixey come in contact with this rare parasite?

HOST VO

Infectious Disease Expert Dr. David Scheck has just learned what parasite is living in Oklahoma resident Tony Brixey’s lungs.  The parasite that is causing Tony to cough up blood is called a lung fluke.  To pinpoint the source of infection, Dr. Scheck turns to foods Tony may have eaten recently.

TONY BRIXEY OC/VO

He said it’s usually contracted by eating raw fish, shellfish, things along those lines.

HOST VO

Right away, Tony thinks he knows where he picked up the lung fluke.

TONY BRIXEY VO/OC

Approximately seven months prior, some buddies and myself were camping, caught some crawfish.  I picked some up out of the bowl and just ate them raw.

MISTY BRIXEY VO/OC

Why, why would you eat raw crawdads?  Why?  That’s disgusting.

TONY BRIXEY OC/VO

It’s normal practice so I never thought anything about it.

HOST VO

But to the doctors, the raw crawfish are the prime suspects.

DR. DAVID SCHECK OC/VO

He had had some exposure to improperly cooked crawfish which likely was the source of his exposure.

HOST VO

Tony’s infection, though rare, is not impossible to get in his home state.

DR. DAVID SCHECK VO

But we know from some animal studies that Paragonimus parasite is endemic in North America.  There are some of these parasites in Oklahoma.

HOST VO

Dr. Scheck now knows how long the parasites have been ravaging Tony’s lungs.  For Tony, the next steps are crucial.

DAN RISKIN VO/OC

Part of this parasite’s lifecycle involves getting from the gut to the lungs.  If it takes a wrong turn and ends up in the spinal cord, you can get paralyzed.  If it turns and goes into the heart, you can have sudden death.

HOST VO

The parasites have been mating uncontrollably in Tony’s lungs for the last seven months.  If he isn’t treated quickly, he could die.  Dr. Scheck has no time to lose.

DR. DAVID SCHECK OC/VO

The treatment for this particular organism is Praziquantil.

HOST VO

When ingested, Praziquantil paralyzes the lung fluke and dislodges it from the walls of the lungs.  Once dislodged, the lung fluke is then destroyed by the body’s immune system.

TONY BRIXEY VO/OC

So after I took the pill, it was approximately two and a half to three weeks before I started seeing improvement.

DR. DAVID SCHECK VO/OC

In the subsequent office visit, he was already doing very well and he had no further coughing up of the blood.  He has gone on to do real well and is having no further lung symptoms.

HOST VO

And today, Tony is parasite free and lucky to be alive.

MISTY BRIXEY VO/OC

Tony is doing fine today.  After taking the medication, he has not had a single symptom.

HOST VO

Tony is back to his old ways, all except for one.

TONY BRIXEY VO

To this day, I do not eat raw crawfish.  I make sure that they are fully cooked.

HOST VO

And that’s the best way to avoid the lung fluke.  Always fully cook crustaceans before eating them.

DAN RISKIN OC

Lung flukes go through two intermediate hosts before they finally get to the lung.  And once they get to the lung, they can finally have sex.  For lung flukes, sexual reproduction inside the lung tissue is a great strategy.  But other parasites are just as successful when they reproduce outside the body.

HOST VO

For parasites living outside the body, stealth is key.

HOST VO

November, 2008.  Waitress Donna Kaminsky is relaxing at home on the outskirts of New York City when she notices an unusual red spot on her arm.

DONNA KAMINSKY VO

It was actually like a cluster of three tiny marks, and it was just very, very intensely itchy.  And the itchiness would not go away.  It was constant.

HOST VO

As the week goes on, the itching gets worse and starts to spread.

DONNA KAMINSKY VO/OC

It wasn’t like a mosquito bite where you itch it and then if you stop, you’re fine.  It just was intense itching all the time.

HOST VO

Many things can cause itching.  But in this case, Donna thinks she knows what it is.

DONNA KAMINSKY VO

After a while I thought maybe it was a rash because I do have a milk allergy.

HOST VO

Donna eliminates all dairy from her diet.  But it doesn’t help.  After a week, her skin still feels like it’s crawling and menacing red welts are spreading across her entire body.

DONNA KAMINSKY VO/OC

Now I had them on my back.  I had noticed that I had two on my ankle.  I probably had about 12 different marks.

HOST VO

Donna rules out a milk allergy as the cause of her symptoms.  But begins to wonder, could she have contracted a contagious disease at work?

HOST VO

Frightened that she has some unknown disease, Donna schedules an appointment with her family doctor.  What he says surprises her.

DONNA KAMINSKY OC

When he looked at them, he’s, he knew automatically that they were bug bites.

HOST VO

But from the way they looked, any number of insects could have made these bites.  The doctor gives her hydrocortisone cream to relieve the symptoms.  But even with the cream, the itching only gets worse.

DONNA KAMINSKY VO

I just started ripping everything apart.  But I just really didn’t know what I was looking for.

HOST VO

But Donna sees no evidence of an infestation.  If it is an insect, what kind of bug could be so elusive?

HOST VO

She turns to the Internet and finds a likely explanation for the constant itchiness, scabies.  Scabies is caused by a microscopic mite that burrows into the skin laying three to four eggs per day.

DONNA KAMINSKY VO/OC

When I heard scabies I was just scared out of my mind.

HOST VO

But scabies infection involves skin to skin contact, and Donna hasn’t been in touch with anyone who has it.

DONNA KAMINSKY VO/OC

At this point I had no clue what it could be.  I knew that I had these marks.  I knew that they were itching intensely.  I found no evidence of bugs anywhere in my room.  I just didn’t know what to do.  I was so overwhelmed with the whole situation.

HOST VO

So what’s biting Donna?  The answer is a parasite that’s becoming more common by the day.

HOST VO

Waitress Donna Kaminsky is not alone in her apartment.  Something is biting her.

DONNA KAMINSKY VO/OC

And I’m very afraid of bugs.  And, you know, I’m thinking about, you know, what are they releasing into my body?

HOST VO

Donna goes back on the hunt, scouring the Internet for similar cases.  She stumbles upon a photo of a rash just like hers.  It’s clear.  Donna has bedbugs.  

DONNA KAMINSKY VO/OC

And I was absolutely terrified that it was something that was biting me in my sleep.  I mean just the thought of laying in a bed that, that you’re getting bitten by bugs.  And the bugs are sucking your blood is absolutely terrifying to even think about.

HOST VO

Donna is not alone.  Nearly eradicated 60 years ago, bedbug numbers have increased 50 fold in just the last five years.  So what is the secret behind this parasite’s population explosion?

HOST VO

Louis Sorkin is a researcher at the American Museum of Natural History in New York City.  He believes the bedbug’s resurgence is due to its ghastly, but effective, mating ritual.  Most animals, even insects, go through the motions of wooing a mate.  Not bedbugs.

LOUIS SORKIN OC/VO

Bedbug mating is called traumatic insemination.  The male bedbug is actually stabbing the female through her body wall and depositing sperm.

DAN RISKIN VO

Bedbugs have a super weird way of having sex and it’s called traumatic insemination.  Males actually jump on a female and stab them through their backs with their phallic organ.  The more aggressive the male, the more successful it will be in reproducing.

HOST VO

The female soon heals, and 24 hours later she begins to lay her eggs.  She can lay up to 12 eggs a day and up to 500 in her lifetime.  The eggs have a sticky coating which helps them adhere to tiny cracks and crevices.  About ten days after mating, the eggs hatch and tiny millimeter long nymphs emerge ready for their first blood meal.

HOST VO

To demonstrate how the bedbug actually finds its food, Louis conducts a grisly experiment on himself.

LOUIS SORKIN VO

They’re always hungry.  Bedbugs are attracted to us by the carbon dioxide in our breath, and also the heat from our bodies are two very important cues.

HOST VO

The adults can be seen with the naked eye, but the nymphs are practically invisible.

LOUIS SORKIN VO

There’s a nymph here, and it’s starting to feed right now.

HOST VO

As the nymphs feed, they turn red with blood.  

LOUIS SORKIN VO

Pretty plump.

HOST VO

But the nymphs are born equipped with a highly specialized weapon, an elongated mouth called a stylet.  It’s shaped like a miniature hypodermic needle.

LOUIS SORKIN OC

Their mouth parts are a very unique tool.  It’s perfectly specialized for feeding on blood.

HOST VO

After finding a capillary, it pierces the skin quickly and efficiently inflicting no pain.  The bedbug’s host never even wakes up.

LOUIS SORKIN VO

They produce saliva which acts as an anesthetic and also as an anticoagulant.  

HOST VO

Using its hollow stylet like a straw, the insect drinks its host’s blood, nearly doubling in size.

HOST VO

After feeding, the engorged bedbug retreats to its hiding place.  In about seven days, it will emerge to feed again.  Bedbugs molt four times before becoming adults that are ready to mate and start the process all over again.

DAN RISKIN VO/OC

For a bedbug, food and sex are intrinsically linked.  There is no way for a bedbug to reproduce sexually unless it’s just had a blood meal.  Blood is the perfect food.  Blood is the way that you deliver all the nutrients to your tissues, so blood has everything in it you need to survive.  For a bedbug, it can get all the nutrients it’s going to need in its entire life just by feeding on blood.

HOST VO

Donna Kaminsky knows she’s hosting these blood suckers in her home.  But she can’t find them or get rid of them.

DONNA KAMINSKY VO

I tried to go to the grocery store about some do-it-yourself spray.  I was spraying everywhere, but it wasn’t helping at all.  I was still getting these bites everywhere.

HOST VO

Constantly battling this night feeder is taking its toll on Donna.

DONNA KAMINSKY VO/OC

Knowing that I may have bedbugs, I couldn’t even sleep.  Because every little tickle or pinch that you felt in your sleep, I thought it was bedbugs.

HOST VO

What will it take to stop these blood-sucking monsters from taking over the country?

HOST VO

In the United States, a blood-sucking parasite is staging a massive comeback.  It’s taking over cities, invading people’s homes and drinking their blood.  It’s the bedbug.  Bedbugs are hard to detect and even tougher to kill.  At the American Museum of Natural History in New York City, Louis Sorkin is an expert in bedbugs.  The city calls Sorkin to inspect infestations around New York on a weekly basis.

LOUIS SORKIN VO/OC

Many of the telltale signs of bedbugs are shed skins, fecal droppings which is digested blood and also dead bedbugs.  Bedbugs, once they’re in your home, they may not just stay in the furniture or in the bed.  They’ll crawl behind pictures.  They’ll go in electric outlets and switches.  In fact, since they’re as thin as paper is thin, they can readily hide in almost any crack or crevice.  If you suspect bedbugs in your home, a good inspection is required.

HOST VO

That’s exactly what Donna Kaminsky decides to get.  She calls a local pest control company, and they immediately send their best search and destroy team.  With a nose 1,000 times more sensitive than a human’s, Roscoe is well equipped to find bedbugs.  If they’re hiding in Donna’s home, Roscoe and his human partner Peter Matisse will find them.  The beagle may be Donna’s best shot at getting her apartment and her life back.

PETER MATISSE VO

Go to work.  Go to work.

HOST VO

Roscoe gets to work right away.

PETER MATISSE VO

Let’s go.  Seek.  Seek.

DONNA KAMINSKY VO/OC

He was very fast and he just sniffed like the whole room.

PETER MATISSE OC

Seek.  Seek.

HOST VO

Finally he gives the sign that he’s located some bedbugs.

SFX

PETER MATISSE VO

Show me.  Show me.  Good.

DONNA KAMINSKY VO/OC

He actually indicated by my suitcase.  That’s when I had an idea of where the bedbugs came from.

HOST VO

With the bedbugs found, Donna retraces her steps.  

DONNA KAMINSKY VO

I had recently been on a trip with my sister to Nashville.  And I was staying at a four star hotel.  And I was just shocked that that was probably the root of where the bedbugs came from.

HOST VO

The bedbugs hitched a ride to New York in Donna’s suitcase.  As she unpacked, they crawled into crevices around her apartment.  A week later, the bedbugs began to search for a blood meal in their new home.

DONNA KAMINSKY OC

It was probably about ten days after I came home from the trip that I started noticing the bites on my arms.

HOST VO

The search and destroy team at Donna’s house has a potent new weapon, Cryonite, a frozen carbon dioxide spray.  At minus 78.5 degrees Fahrenheit, this spray freezes the insects causing their cells to expand and rupture, killing them instantly.

HOST VO

Today, Donna and her apartment are bedbug free.  And though she finally has peace of mind, she’s learned to be vigilant.

DONNA KAMINSKY VO/OC

After this whole experience, I really learned that, you know, when I travel I need to be looking at where I’m sleeping so I wouldn’t have to go through this whole situation again.

HOST VO

In the war against bedbugs, Peter and Roscoe are formidable opponents.  But bedbugs aren’t just spreading in New York City.  Given their success in the modern world, bedbugs can be hard to avoid.  But you can help yourself by checking the bedding and furniture when you’re staying in a hotel.  And always inspect second hand clothes before bringing them home.

DAN RISKIN VO/OC

One of the reasons that bedbugs are so successful is that they have so many offspring over the course of their lives.  A single bedbug can lay hundreds of eggs in its lifetime.  And even if just a few of those survive, it wins.

HOST VO

Parasites are successful because they are experts at making copies of themselves.  Parasites are in the air, in the soil, in the food we eat and in our beds.  The more we understand about how these sex maniacs reproduce, the more ammunition we have to fight them.  Every parasitic infection is just one battle.  The parasites are winning the war.

HOST VO

For more disgusting parasites and their stomach-churning habits, visit our website, animalplanet.com/monstersinsideme.

HOST VO

The bedbug colony is hungry.

LOUIS SORKIN VO

The way I feed them is invert the jar in my arm, and they can put their mouthpart, their stylets, through the holes.  The holes are a third or a half a millimeter in diameter.  And since the bug, the smallest bug is a millimeter, it doesn’t fit through the hole.  The feeding starts.

HOST VO

The bedbug colony is immediately aware that it’s feeding time.  And they gravitate towards their meal.

LOUIS SORKIN VO

They, they pick up the odor of the arm and some other chemicals that, that are produced.  Bugs that are already on top of the jar have, have started to feed.  Bugs that are not yet there may actually crawl the wrong way and go up toward my hand because of the heat from my fingers.

HOST VO

Bedbugs prefer to feed at night.  And they have a highly developed sense of smell that helps them find their victims.  Bedbugs usually situate themselves ten to 20 feet from a human bed so they can easily locate their prey.  But they can be attracted to a carbon dioxide source from up to 100 feet away.  But once they find their food source, bedbugs are experts at feeding without being detected as Louis Sorkin is finding out firsthand.

LOUIS SORKIN VO/OC

Now I feel the tape on the jar, but I don’t feel any bites.  So there might be 20 to 50 or so bugs, or 100, that have started feeding.  Although it’s a little, possibly I feel some, you know, something going on.

HOST VO

When feeding, it’s vital bedbugs don’t disturb their hosts.  It takes each bug several minutes to fill up, and they can’t risk being caught.  So how do they pierce our skin without waking us?

DAN RISKIN VO/OC

One of the most incredible things about bedbugs is the specialized structure on the front of its face that it uses to drink our blood.  When it bites, the stylet, which is that front part of the face, injects an anticoagulant that keeps the blood from clotting.  And it also injects an anesthetic so that the victim doesn’t feel the bite.

HOST VO

Once they have tapped into the blood supply, bedbugs drink as much as they can.

LOUIS SORKIN VO/OC

The adult bedbug is about five millimeters or a quarter inch long.  And after feeding, it probably increases to about seven millimeters in size.  And not only does it lengthen, but also its volume increases.  So it goes from a flat round shape to a football shape.

HOST VO

After just ten minutes, Sorkin takes the jar off his arm to show what a hundred bedbug bites look like.

LOUIS SORKIN VO

Now it’s forming a mound, raised area around it.

HOST VO

Most people will never be bitten by this many bedbugs at once.  The welt on Louis Sorkin’s arm is caused by the body reacting to the bedbug’s saliva.  It is this reaction that causes itching.

LOUIS SORKIN OC

That’s one of the first ways people realize that they have bedbugs is because of the bites and because of the itching.  In some people, itching is very bad.  And in some people, the welts are very bad.  Some people actually feel not much at all and they don’t even realize they’ve been bitten.  Maybe within that day or up to a few days or nine days later, they might actually get welts.  And the itchiness will occur.  In some people, they feel nothing and they never react to bedbug bites.  Many people who have that problem, well many people who, who don’t feel bedbug bites may have a bad bedbug infestation and just not realize it.

HOST VO

To get a better look at exactly how their special mouth parts work, he takes individual bedbugs out of the colony.

LOUIS SORKIN VO

The tape is left on this jar to keep bedbugs from crawling.  If they were under the metal cover, crawl out on the screw area on the threads.  And here there are bedbugs on the cover.  And you can see there’s plump ones here so they, these are the ones that just fed.  A fully fed adult bedbug can go over a year without feeding as long as it’s kept cool.  That same bedbug, if kept at 80 or 90 degrees and fed and then not given another blood meal will only lasts maybe a month.  

HOST VO

Feeding is integral to the bedbug’s lifecycle.  Bedbugs must feed in order to molt.  Bedbugs molt four separate times.

LOUIS SORKIN VO

In this jar, there’s thousands of bedbugs from first instar bedbugs through adult bedbugs.

HOST VO

Newborn bedbugs are called first instars.

LOUIS SORKIN OC

Instar bedbug hatching from an egg is no longer than a credit card is thick.  So that’s how big a first instar bedbug is, the space between my two fingers.

HOST VO

Every time the bedbug feeds and molts, it goes through another stage.  When they reach fifth instar, the bedbug is an adult.  No matter the stage in their lifecycle, the human is the bedbug’s preferred host.