Monsters Inside Me

MUSIC IN

HOST VO

A sinister assassin ravages a seven year old girl.  Can her mother and doctors figure out what it is before it’s too late?

LORI ROBERTS VO/OC

I was in shock at that point.  I thought my daughter is gonna die.

HOST VO

A normal day on the factory floor ends with a machinist fighting for his sight.

JOHN MATTHEWS VO/OC

This is freaking me out.  If this goes to my other eye, I’m looking at the possibility of being blind.

HOST VO

And an unknown killer attacks a team of doctors and threatens to leave them for dead.

DR. ROBERT WELTI VO/OC

Something’s going on here; it’s not just me.  We needed help.

HOST VO

Three very sinister parasites that are brilliantly adapted to life inside the human body.  They are vicious, they are wily, they are shape shifters.  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 depend on other living organisms called hosts for their food and survival, and some of the most successful parasites are capable of surviving in a range of different environments: in the air we breathe, the food we eat and in the ground we walk on, and as their environment changes so do the parasites.

DAN RISKIN VO/OC

All parasites need to be able to take advantage of their hosts, but some parasites can’t do that when they’re first ingested.  It’s only after they go through a complete physical transformation that they become a threat.

HOST VO

And when these shape shifters do change form, they can devastate a host from the inside before the host even knows they’re there.

HOST VO

Gainesville, Florida.  In 1997, Lori Roberts is a 42-year-old court reporter living with her daughter Manisha.

LORI ROBERTS VO/OC

We love living in Florida because of the weather.  We don’t like cold weather.  We like to swim, take the dogs for walks.  It’s just a lot of fun.

HOST VO

Adopted as a toddler, Manisha is a bright and healthy seven year old who enjoys school and playing with her friends.

LORI ROBERTS VO/OC

Manisha is very, very sociable.  She loves people; she loves being around people, happy go lucky.

HOST VO

But their luck is about to change. 

HOST VO

One night in April Lori is setting the table for dinner when Manisha says something that worries her.

LORI ROBERTS VO/OC

She said, “Mommy, my head hurts.”  So I said where does your head hurt and she pointed to right here, “It hurts like right here,” and she was very specific about where it hurt.  She was so very insistent; it’s like my heart skipped a beat.  I felt like something might be wrong and I was worried.

HOST VO

Lori takes her daughter to the doctor.  The physician examines Manisha but doesn’t find anything wrong and sends them home, but Lori isn’t convinced.

LORI ROBERTS VO/OC

It was just she was so young.  She was seven years old and I didn’t know of any seven year olds that had headaches, so the fact that she was very insistent about her head hurting caused me concern.

HOST VO

A few weeks later Lori and Manisha are out watching an ice skating show.  20 minutes into the performance Lori notices that something strange is happening to her daughter.

LORI ROBERTS VO/OC

I noticed she was looking over at a corner of the gymnasium and there was nothing there and I thought what is she looking at?   And then I, I noticed beside her there was a, a pool of water or something.  I thought oh she spilled her drink and then I looked again and realized she’d gone to the bathroom.  I kind of tried to shake her and she didn’t move.  

HOST VO

Lori carries her daughter to the lobby where a bystander…

HOST VO

…immediately calls 9-1-1.  Manisha remains totally unresponsive.

LORI ROBERTS VO

She did not move at all; she did not blink and by that point I realized something is really, really wrong.

HOST VO

Ten minutes later the ambulance…

HOST VO

…arrives and rushes Manisha to nearby Shands Hospital.

LORI ROBERTS VO/OC

They started asking me has this ever happened; does she have a medical condition?  And of course all those answers were, were no.  I was just so, I was so scared.  I had no idea what could have caused it.  At that point I thought my daughter is gonna die.

HOST VO

By now Manisha has been unconscious for almost half an hour.

LORI ROBERTS VO/OC

It was the longest 20, 30 minutes of, of my life that had, that I’ve ever lived through.

HOST VO

Pediatric neurologist, Dr. Paul Carney, is called in to examine Manisha.

DR. PAUL CARNEY VO/OC

Manisha was presenting with, with spells or fits and they turned out to be seizures.  She had never had seizures before so this was concerning.

HOST VO

When Manisha finally starts to regain consciousness, Dr. Carney makes a telling observation.

DR. PAUL CARNEY VO/OC

What was actually quite revealing was that her head turned to the left and her eyes turned to the left.  The right brain controls the left body; the left brain controls the right body.  So something was going on in the right frontal brain.  Did she have an infection in the brain?  Did she have something that was being caused by a bacteria or was it a brain tumor?

HOST VO

Dr. Carney orders a battery of tests including a C-T scan of Manisha’s brain.  The results are not good.

DR. PAUL CARNEY VO/OC

She had a very, very well defined lesion in the right frontal region.  You could sort of see the outline of something that looked very odd.  There appeared to be a very small structure, it almost looked like a head of something.

HOST VO

Something is lurking inside Manisha’s head, the question is what.

LORI ROBERTS VO/OC

And I remember just looking at her laying there and wondering what was going on in her head.  Just that, that tremendous fear knowing that something was wrong.

HOST VO

The scan is so unusual that Dr. Carney seeks a second opinion.  He sends the images to Dr. Margaret Hostetter, a leading infectious disease specialist at Yale University.

DR. MARGARET HOSTETTER VO/OC

We were able to review all of the scans that had been done in Florida.  We could see that it was walled lesion with fluid inside.

HOST VO

The unusual appearance of the lesion gives Dr. Hostetter a clue as to the cause of Manisha’s seizure, but to be certain she needs to perform more comprehensive tests.

LORI ROBERTS VO/OC

I said you know I don’t mind bringing Manisha up there if that would help you and she said that would be wonderful.  We could actually do some very detailed cuts on the M-R-I and so we immediately made our plane tickets to fly up to Yale like with, within a week.  I mean this is my baby.  I was terrified.  I was afraid I was gonna lose her.

HOST VO

Seven year old Manisha Roberts has suffered a massive seizure.  Doctors have no idea why.  Desperate to find out what is wrong with her daughter, Manisha’s mother Lori turns to infectious disease expert Dr. Margaret Hostetter of Yale University.

HOST VO

For the next three days Dr. Hostetter and her team subject Manisha to a battery of tests.  

HOST VO

Finally Dr. Hostetter calls Lori into her office.

LORI ROBERTS VO/OC

I sat down and she looked at me and she said I’ve gone over all the tests.  She said based on my experience, based on my knowledge I feel very, very confident that this is what she has.

DR. MARGARET HOSTETTER VO/OC

Really the presentation is most consistent with neurocysticerocosis.  

HOST VO

Neurocysticerocosis is a life threatening condition caused by the pork tapeworm parasite.  The pork tapeworm has a distinctive head marked by a double ring of sharp hooks.  When it gets into a human it uses these hooks to burrow through tissue.  Once in the bloodstream it can travel to the brain where it forms a protective casing around itself called a cyst, where it can live for several years.  As the cyst grows it puts pressure on the brain, causing seizures.

HOST VO

Left untreated these seizures can result in brain damage, coma or even death.

LORI ROBERTS VO/OC

I was in shock.  I, I just was, I couldn’t talk, I couldn’t think.  I was very, very worried about what was gonna happen.

HOST VO

Manisha’s doctors immediately start her on a course of antiparasitic drugs.  As they wait to see if the drugs are effective they’re left with one unanswered question: 

HOST VO

…how did the parasite end up in Manisha’s brain in the first place?

DAN RISKIN VO/OC

A person can get pork tapeworm two different ways.  If they get it from eating undercooked infected pork they get a worm in their gut, but if they get it from eating soil that’s contaminated with eggs things are much worse.

HOST VO

While the adult worm can feed in the gut, it cannot burrow out.  But if an egg is ingested it can become a larva.  The larva can burrow through tissue and form cysts.

DAN RISKIN VO/OC

And if those cysts occur in the brain that can be deadly.

HOST VO

Because the worm is lodged in Manisha’s brain, the doctors think she became infected through ingesting water or soil contaminated with pork tapeworm eggs or through contact with an infected person.

HOST VO

And when Lori tells the doctors that Manisha was adopted from Nepal at age three, the link to the parasite becomes clear.

DAN RISKIN VO

In parts of the world where sanitation is not very good, up to six percent of the population harbor this parasite.

DR. MARGARET HOSTETTER VO/OC

I think it’s extremely likely that Manisha got this very early in life, perhaps in toddlerhood.

HOST VO 

The parasite has been laying dormant in Manisha’s brain for years.

LORI ROBERTS VO/OC

I just couldn’t imagine that a parasite could be in her brain for four and a half years and not even show any symptoms of it until very recently.

HOST VO

Six months later back in Florida Manisha completes her full course of medication and Lori brings her back to Dr. Carney’s office to see if it’s worked.

DR. PAUL CARNEY VO/OC

We were fairly convinced after repeated brain M-R-I’s that the worm was killed.  She’s had no further seizures and she should have an excellent outcome.

HOST VO

Today Manisha is a 19-year-old college student majoring in psychology.  Her childhood bout with a parasite has left no lasting damage.

MANISHA ROBERTS VO/OC

Honestly I never had the thought of how serious the situation was.  I didn’t realize that this worm could actually, could have killed me.

HOST VO

After Manisha’s recovery, Lori adopts her second daughter, Joy, from Vietnam.

LORI ROBERTS VO/OC

The day she was handed to me I took her to the doctor’s office and I said I want her dewormed because the chances are good that we could have avoided all of this had Manisha been dewormed.

HOST VO

In spite of the ordeal the experience has given Manisha a unique perspective on life.

MANISHA ROBERTS VO/OC

If I had not been adopted and I was still in Nepal I would have died from this tapeworm, but the fact that I was brought over here and they caught on to what it was and they were able to get rid of it is an amazing thing.

HOST VO

In the U.S. about 1,000 people each year are found to be harboring the pork tapeworm parasite.  In most of those cases the initial infection occurred overseas.  Travelers to less developed countries should be sure to drink bottled water, eat food that is prepared in sanitary conditions and avoid undercooked pork.

DAN RISKIN OC/VO

The pork tapeworm goes through several different stages in its life cycle.  It lives as an adult worm, as a larva, as an egg and as a cyst, and it’s the fact that it goes through these radical transformations that makes this parasite the ultimate shape shifter.

HOST VO

The pork tapeworm can live inside its host for years without detection, but other parasites make their presence known immediately and when they do the results can be disastrous.  

HOST VO

2009; Cedar Rapids, Iowa.  45-year-old John Matthews and his wife Muna share a love of the outdoors.  John is an avid turkey hunter and expert marksman.

JOHN MATTHEWS VO/OC

I love being out there in the outdoors to see everything I guess wake up in the morning.

MUNA MATTHEWS VO/OC

When he’s not out in the woods hunting he thinks about being out in the woods hunting, so he definitely has turkey on the brain.

JOHN MATTHEWS VO

You’ve got to get out there and try to figure out what the turkeys are doing, trying to fool Mother Nature I guess.

HOST VO

But John has no idea that he is about to become the target of an enemy he can’t see.

HOST VO

One day in early December John is at the manufacturing plant where he works.

JOHN MATTHEWS VO/OC

I noticed all these gray splotches all over my vision.  I thought that I had something maybe on my eye so I started rubbing it and that didn’t take care of it.  It was hard to make out anything in any kind of detail, much like looking through a muddy lens.  It was pretty alarming to me.  I, I’ve never had problems with my, with my eyes.

HOST VO

John calls his optometrist and makes an appointment for the following day.

JOHN MATTHEWS VO/OC

I’m pretty anxious, hoping that she’s gonna be able to figure out what it is and just fix it.

HOST VO

The optometrist performs a series of eye tests.  John’s right eye is perfectly fine, but when she looks into his left eye she sees that the back of his eye is inflamed.

JOHN MATTHEWS VO/OC

She asked me if, if I did any heavy lifting like every day at work and she said well I think maybe you broke a blood vessel.

HOST VO

Broken blood vessels in the eye are not uncommon and usually heal on their own, but to help reduce the inflammation John’s optometrist places him on a course of steroid eye drops.

JOHN MATTHEWS VO/OC

Knowing that it was just inflammation put my mind at ease.  Okay, this is gonna be taken care of; everything’s gonna be just great.

HOST VO

One week later John is in the car with Muna when a new symptom emerges.

JOHN MATTHEWS VO/OC

Muna’s driving and I look a couple blocks ahead of us at the stoplights and I, I said to her, “I see two stoplights.”

MUNA MATTHEWS VO/OC

He goes, “Yeah.”  He goes, “I can see the real one and then I see a, a smaller ghosted image, but I see two distinct images.”

JOHN MATTHEWS VO/OC

The splotches was bad enough but now I’ve got double vision.  All of this from, from a broken blood vessel?  What’s going on here?

HOST VO

45-year-old machinist John Matthews is experiencing blurriness and double vision.  His family eye doctor is stumped and sends John to a specialist,

HOST VO

…Dr. Charles Barnes is an ophthalmologist at the Wolfe Eye Clinic in Iowa City.

DR. CHARLES BARNES VO/OC

John is referred by his optometrist who had noticed a part of the retina in the back of his eye was a little swollen.  We call this uveitis.  Uveitis is inflammation inside the eye.

HOST VO

Dr. Barnes begins by having John read a simple eye chart.

JOHN MATTHEWS VO/OC

The right eye is still 20-20 and everything looks good in there, but my left eye, I’m looking at the eye chart and all I can see is the bright white light.

MUNA MATTHEWS VO/OC

And I’m thinking I can’t believe you can’t see the one big letter.

JOHN MATTHEWS VO

It was a, a big shock to me.  Both eyes had been 20-20.

HOST VO

But Dr. Barnes has bad news about John’s left eye.

DR. CHARLES BARNES VO/OC

His vision was down to 20-200.  At 20-200 vision you’re legally blind.

HOST VO

When Dr. Barnes looks inside John’s eyes there’s more bad news.

DR. CHARLES BARNES VO/OC

We dilated his eyes and noticed that the retina in his left eye had a very different appearance.  Well, it had kind of a grainy appearance.

HOST VO

The retina is a thin film of nervous tissue that lines the back of the eye and is crucial to central vision.  The grainy appearance suggests that something is destroying John’s retina, but what is it?

JOHN MATTHEWS VO/OC

This is freaking me out.  If this goes to my other eye, looking at the possibility of being blind.

HOST VO

Dr. Barnes is stumped so he puts in an urgent call to a colleague,

HOST VO

…Dr. James Folk, the chair of the department of ophthalmology at the University of Iowa and a leading eye surgeon in the state.

DR. JAMES FOLK VO/OC

Dr. Barnes was worried about a patient because he had had symptoms for just about three weeks and he already was legally blind in this eye.  We were under the gun to try to figure out what was happening because we knew if we didn’t, he was eventually gonna lose vision in that eye.

HOST VO

Dr. Folk takes high resolution photographs of the entire retina.  He searches each image for clues and it’s not long before he finds the culprit.

DR. JAMES FOLK VO/OC

I pulled up this color photo and looked and there, there and behold was a worm.  It was just a shock.

JOHN MATTHEWS OC

A worm?  How, how does this happen?

MUNA MATTHEWS VO/OC

Well you know what, what do you say?  John and I are thinking oh my God it’s eating his eye.  We’re looking at each other in disbelief.  At what point was this going to start to happen with his other eye?

HOST VO

But before Dr. Folk can begin treatment he must identify the worm.

DR. JAMES FOLK VO/OC

You go by the size of the worm and this was about a one point five millimeter worm, so we thought this was the raccoon roundworm.

HOST VO

The raccoon roundworm, also known as baylisascaris, is a parasitic worm that can grow up to 20 centimeters long.  When the eggs of the raccoon roundworm get into the human stomach they start to hatch.  Microscopic larvae emerge and burrow through the intestinal wall and into the blood stream.  The larvae course through the body, looking for food.  If they lodge in the eye they start devouring the eye from the inside out, eventually causing blindness.  And it’s not just John’s vision that’s threatened by the raccoon roundworm.

DAN RISKIN OC/VO

As larvae, raccoon roundworms can travel anywhere in the human body and if they get to the brain, even one or two larvae can be enough to kill.

HOST VO

The worm’s ability to migrate through the body makes it particularly dangerous.

DR. JAMES FOLK VO/OC

These worms, at least these larger worms, can move pretty quickly.

HOST VO

If the worm moves out of sight they’ll lose their chance to kill it.

DR. JAMES FOLK VO/OC

We immediately took John right back to the laser, put a lens on him and started banging away at the worm trying to kill it.

HOST VO

John is awake and can see the worm on a monitor.

JOHN MATTHEWS VO/OC

I can see it wiggling, trying to avoid the laser.  I’m trying to, to will that laser to hit it.  I want this thing dead.

HOST VO

And now, Inside The Monster.  Tapeworms in the brain are the world’s leading cause of which of the following conditions:  A) dyslexia, B) malnutrition, C) epileptic seizures, D) migraines?

MUSIC IN

HOST VO

Tapeworms in the brain are the world’s leading cause of:  C) epileptic seizures.

HOST VO

45-year-old John Matthews has a worm feeding on his eye.  To save his vision doctors must laser the worm before it moves out of range.

JOHN MATTHEWS VO/OC

I’m trying to, to will that laser to hit it.

HOST VO

After 20 minutes the worm finally stops moving.

JOHN MATTHEWS VO/OC

They tell me the worm is dead.  It was the greatest relief.  It’s dead, wow.  Okay, how soon do I get my vision back?

HOST VO

While John waits for his prognosis, the doctors ponder another mystery.  How did this parasite end up in John’s eye?  Baylisascaris worms live in the gut of a raccoon.  The female worm produces millions of eggs a day which are passed out in the raccoon’s feces.  The eggs are eaten by another animal, usually another small mammal, and enter its gut.  It’s here when the parasite changes it’s shape that baylisascaris becomes deadly.  When an egg hatches and transforms into a larva the larva migrates through the mammal’s body, attacks its central nervous system and kills it.  When its carcass is eaten by an uninfected raccoon the cycle of parasitic infection is complete.  Inside the raccoon the parasite goes undetected and the host never feels a thing.

HOST VO

Dr. Folk finds a clue in John’s lifestyle that links him to the parasite.

DR. JAMES FOLK VO/OC

He likes turkey hunting, you know, he’s out in the woods a lot.  He’s around wild animals a lot.  Maybe he got a little bit on his glove, took his glove off with his mouth or something and we think that’s how he got it.

HOST VO

Finally the doctors arrive to give John his prognosis.

DR. JAMES FOLK VO/OC

You can’t really regenerate the retina.  Once parts of the retina are gone, they’re gone.

JOHN MATTHEWS VO/OC

As far as my vision coming back; that’s not gonna happen.  I’m told that there is too much damage, that what I’ve got is all I’ll have.

HOST VO

Five months later John is back at work and adapting to his partial blindness.  John can still see out of his left eye but the blotches and double vision remain, rendering him legally blind in that eye.

JOHN MATTHEWS VO/OC

I’m still out hunting wild turkey.  I’m not about to give that up.  It’s such a rare thing to happen to anyone.  I’ve got a better chance of being struck by lightning twice than to have this happen again.  I’m not gonna stop living.

DAN RISKIN VO/OC

It’s estimated that 70 percent of the raccoons in North America are infested with this parasite, which suggests that people come into contact with it all the time.

HOST VO

However cases of infection in humans are extremely rare.  To avoid getting this parasite people who work or play in areas populated by raccoons should wash their hands thoroughly after spending time outdoors.

DAN RISKIN VO/OC

At different stages of its life cycle the raccoon roundworm faces very different challenges.  As an egg it has to survive dormant in a very harsh environment for long periods of time and as a larva it migrates to the tissues of an animal, and it’s the ability to do both of these successfully that makes this parasite the ultimate shape shifter.

HOST VO

The raccoon roundworm is extremely common in North America.  Other parasites are less common, but when they do find their way here they can be just as deadly.

HOST VO

California, 1997.  Robert Welti is a 41-year-old anesthesiologist with a love of travel and a commitment to charitable work.

DR. ROBERT WELTI VO/OC

I traveled extensively, one or two trips a year, a group performing reconstructive surgery on children with cleft lips and burns all around the world: Southeast Asia, Vietnam, Asia as well as in South America.

HOST VO

When he’s not traveling, Robert works at Cottage Hospital in idyllic Santa Barbara.  He has no idea that a vicious enemy is lurking, waiting to attack.

HOST VO

It’s late April and Robert is getting up to go to work.

DR. ROBERT WELTI VO/OC

I was about five in the morning.  I had to be in the operating room by seven o’clock.  In anesthesia if you don’t show up the whole machine stops.

HOST VO

But before he can even get out of bed, Robert is hit with a pain in his stomach.

DR. ROBERT WELTI VO/OC

I woke up with explosive diarrhea, cramping, bloating.  I didn’t know how I was gonna get to work, but had to try and push through and do it.

HOST VO

After the first surgery Robert is too sick to continue and heads back home.

DR. ROBERT WELTI VO/OC

I crawled into bed and I wanted to climb under a rock.  All of a sudden now I was having just extreme fatigue like where you can barely raise a limb.  I was feeling bloated and just counting off minutes until I would run back to the bathroom.  Like most physicians I made the error of trying to self-treat.

HOST VO

Robert treats himself with antibiotics and anti-diarrheal medicine for relief.

DR. ROBERT WELTI VO/OC

I immediately pop some Cipro, thinking I had some sort of simple traveler’s diarrhea and started taking Imodium to slow the bowels.

HOST VO

But Robert isn’t the only one who’s ill.

DR. ROBERT WELTI VO/OC

My fiancé called me and she thought she was coming down with something too and we kept obsessing over what had we had in the last day or two and couldn’t come up with anything.

HOST VO

Robert spends the next two days in bed hoping that his symptoms will improve.  Then almost three days after he first got sick he gets an unexpected phone call from his coworker Ruth.

DR. ROBERT WELTI VO/OC

So Sunday night I got a call from Ruth Keyes , who’s a nurse, and she had know I went home Friday and she called to tell me that her husband, who is also an anesthesiologist, had fallen ill with, with G-I symptoms.  Now this was interesting because Ruth’s husband was an anesthesiologist in another group at another hospital.  We had no common contact on a daily basis.

HOST VO

Ruth isn’t the only one to report that people in the medical community are getting sick.  On Monday morning news comes in from a colleague in neighboring Ventura County.

DR. ROBERT WELTI VO/OC

And he revealed the shocking fact to me that there were a, a significant number of anesthesiologists in Ventura County who were also ill with gastrointestinal disease.

HOST VO

Robert’s colleagues are now calling out sick in droves.  Over 15 anesthesiologists in two different counties are mysteriously ill and no one knows why.  The local hospitals are forced to cancel surgeries.  Meanwhile Robert is getting sicker by the hour.

DR. ROBERT WELTI VO/OC

We needed help.

HOST VO

But what could be making the anesthesiologists so sick?

HOST VO

Anesthesiologist Robert Welti is suffering from crippling stomach pains and diarrhea and he’s not alone.  Over 15 anesthesiologists in two different counties are also mysteriously ill, and no one knows why.

DR. ROBERT WELTI VO/OC

We needed help.

HOST VO

Desperate to find out what is making his coworkers so sick, Robert reaches out to a trusted colleague.

DR. ROBERT WELTI VO/OC

I called Dr. Stephen Hosea.  He’s an infection disease expert, well known in the community.  I told him, “Steve, something’s going on here.  It’s not just me and it’s not just the guys in my group it’s, it’s 16, 17, 20 anesthesiologists from two different counties.

HOST VO

Dr. Hosea is shocked at how sick Robert and the other anesthesiologists have become.

DR STEPHEN HOSEA VO/OC

I can remember one physician ended up in the emergency room and this person had to receive intravenous fluids in order to maintain their blood volume and maintain their blood pressure, and certainly people die of these sorts of illnesses because of profound dehydration.

HOST VO

By the end of the week 29 anesthesiologists across three counties have fallen ill with the same symptoms.

HOST VO

Dr. Hosea immediately requests stool samples from all the sick anesthesiologists, but a complete analysis could take up to a week.

DR STEPHEN HOSEA VO/OC

We were pretty desperate to figure out what it was so we could abort this epidemic as soon as possible.

HOST VO

One by one the lab tests come back but they are all negative.  So Dr. Hosea and the pathologists continue to search for the culprit.  Meanwhile the sick anesthesiologists are only getting worse.

DR. ROBERT WELTI VO/OC

My life was reduced to a, the size of my bed.  I lived under the covers with no energy, no will to get up and do anything.

HOST VO

Enter Marian Jean, the lab manager at Cottage Hospital.  She too is baffled by the lab results.

MARIAN JEAN VO/OC

Everything was negative.  The parasite studies were negative, the giardia and cryptosporidium were negative.  Viral cultures were negative.  Things weren’t making sense.

HOST VO

Marian remembers an article that she once read in a medical journal.

MARIAN JEAN VO/OC

The article that I had actually read was dealing with emerging parasitic diseases and I tend to get excited with, with new organisms and emerging pathogens.

HOST VO

She suspects that one of these lesser known organisms might be the culprit.  However the one that interests her is so rare in the U.S. that no test for it has been developed yet, so she develops one herself.

MARIAN JEAN VO/OC

Within the first ten slides we found our first organism and we were quite excited and yelled out eureka and called Dr. Steve Hosea down to look at it with us.

DR STEPHEN HOSEA VO/OC

And we looked under the microscope and could see this for the first time; I mean it was dramatic to have an answer to the question of what was causing this.

MARIAN JEAN VO/OC 

This was the cyclospora organism.

HOST VO

Cyclospora cayetanensis is a single celled parasite that ravages the human gut.  The parasite attaches to the lining of the small intestine.  There it forms a protective membrane around itself, preventing the host from absorbing nutrients.  The immune system tries to elinimate the parasite, causing severe diarrhea and vomiting.

DAN RISKIN VO/OC

Left untreated that ongoing diarrhea can cause severe dehydration and that places stress on the circulatory system and the heart that ultimately can be fatal.

HOST VO

Robert has been experiencing constant diarrhea for over a week and there is no end in sight.

DR. ROBERT WELTI VO/OC

Cyclospora wasn’t on my radar.  I don’t think I had heard about that since medical school, but we learned a lot about it and it all fit the picture perfectly.

HOST VO

Dr. Hosea prescribes Robert an antibiotic called Bactrim to kill the parasite, but a crucial question remains.  How did Robert and 28 other anesthesiologists get infected?  Will they be able to find the source of infection before this little known killer goes on an even bigger rampage?

HOST VO

Dr. Robert Welti and 28 other anesthesiologists in a Santa Barbara area have been infected by the little known parasite cyclospora, but how did they get this killer parasite?  Robert is determined to track down the source of the outbreak.  His investigation starts with the parasite itself.

HOST VO

Cyclospora begins as a free living cyst in water or soil.  When the cyst is eaten by a human it travels to the intestine.  In the gut the cyst breaks open releasing two single celled parasites.  The microscopic parasites attach to the lining of the gut where they grow and multiply, forming new cysts.  The new cysts are passed back into the environment with human feces.  There the parasite lies in wait, ready to infect another victim.  The most common way for the parasite to infect a human is through food contaminated with infected feces.

HOST VO

But how did two dozen anesthesiologists who live in three different counties become infected?

DR. ROBERT WELTI VO/OC

We had had a banquet, a pharmacy sponsored banquet, at which three counties worth of anesthesiologists had gathered.

HOST VO

The banquet had taken place eight days before the very first symptoms appeared.

DR. ROBERT WELTI VO/OC

It was held at a great hotel, a great restaurant, well known, everybody loves it.  It was a banquet to establish rapport between anesthesiologists.  We had about 34 people there including spouses and we had a great time.

HOST VO

Thinking that the sick anesthesiologists may have all eaten the same infected menu item, Robert asks the restaurant to provide a copy of the menu from that evening.

DR. ROBERT WELTI VO/OC

It was the usual banquet menu.  There were choices for steak, fish, chicken, that sort of stuff, so I got that menu and distributed it to every anesthesiologist I could and I asked them to circle what they had.  So as those menus came back it became obvious that the common ground that we all shared including the spouses was the dessert, a dessert containing raspberries and a raspberry sauce.

HOST VO

Robert discovers that the restaurant had imported the raspberries from Guatemala.  In Guatemala there is a common phenomena called mal de Mayo, or sickness in May that is found in the country’s human population.

HOST VO

It occurs when heavy spring rains wash human waste over crops.  If the feces is contaminated with cyclospora and the crops aren’t washed, infection can occur.

DAN RISKIN VO/OC

Cyclospora is endemic in less developed parts of the world but outbreaks do occur in the United States, and when they do it’s because people eat infected…

DAN RISKIN VO

…produce that’s been imported like lettuce, basil and raspberries.

MARIAN JEAN VO/OC

Most people who buy raspberries at that time were not washing raspberries, including restaurants because raspberries are very fragile and if you wash raspberries they tend to fall apart.

HOST VO

After one week on the medication the anesthesiologists begin to recover.

DR. ROBERT WELTI VO/OC

I wasn’t back to my normal energetic self but it took a good week to simmer this down and to start to feel normal again.  

HOST VO

By the following week Robert is completely cured.  Today Robert is philosophical about his ordeal.

DR. ROBERT WELTI VO/OC

You know living in this town you just never, never in your foggiest ideas would ever think you’d get a parasite like this.  It just shows the interconnection of, of the whole world now with jet travel and, and the shipping of food.  You can be anywhere and this can track you down.

DAN RISKIN VO/OC

Cyclospora is successful because it’s a shape shifter.  When it enters the body it’s inside a cyst that lets it get past the digestive juices of the stomach, and once it’s past there the cyst opens, releasing the parasites to wreak havoc on the intestines.

HOST VO

In the U.S., public health code now requires all…

HOST VO

…restaurants to wash their produce.  At home the best way to avoid contracting this parasite is to thoroughly wash fresh produce.

DAN RISKIN VO/OC

Many parasites have an ability we could only dream of.  They can radically change the shape of their bodies to suit their needs.  As a result these shape shifters can take exactly what they need and as their hosts there’s nothing we can do about it.

HOST VO

For more disgusting parasites and tips on how to avoid them, visit our website: Animal Planet dot com slash Monsters Inside Me.

MUSIC IN

HOST VO

One day in the spring Lori receives a disturbing call from Manisha’s school.

LORI ROBERTS VO/OC

Her teacher felt like she had a hard time focusing.  She felt like she was having a hard time learning.

HOST VO

Lori learns that her daughter has recently started testing well below her grade level.

LORI ROBERTS VO/OC

First grade is the first year here in Florida that they do any kind of formal testing and so that was my first indication that something wasn’t right and I immediately contacted her teacher and told her I was very concerned about her test scores, and they were also wanting her to either repeat first grade or go to summer school.  So I was very, very concerned about what was going on.  Her teacher didn’t seem to be as concerned as I was.  She just felt like well, you know, she just needs a little extra help.  She did say she was very, very kind of hyperactive, that she had a hard time focusing, that she would not always want to sit in her chair and pay attention.  Maybe she just needs more one on one to help her focus and settle down and I will make it work.  I will figure out how to do this because it was important to me.

HOST VO

Lori begins to give Manisha extra lessons at home, but no matter how hard she tries Manisha’s school work doesn’t improve.

LORI ROBERTS VO/OC

One of the things that kind of concerned me a little bit was we would go over stuff and then the next day she wouldn’t remember it.  She couldn’t remember her addition and subtraction tables after going over them a lot.  She couldn’t remember sight words, simple sight words, and I felt like she should remember this.

MUSIC IN

LORI ROBERTS VO/OC

There was something that was like a round shape and it was obviously, it didn’t belong there and I about fainted.  I knew that, I thought, I thought she’s got a brain tumor, you know she’s, she’s got a brain tumor.

HOST VO

But Dr. Carney isn’t convinced it’s a tumor and when he takes a closer look at the scans he sees something else.

MUSIC IN

HOST VO

But John’s relief is short lived.  Later that week Muna notices that her husband is behaving strangely.

MUNA MATTHEWS VO/OC

I see him reach for his glass and he kind of misses his glass.  You can tell he couldn’t quite tell where it was and that’s when we really noticed, for me that I noticed his depth perception was way off.

HOST VO

But John, who has yet to finish his full course of medication, is not concerned. 

JOHN MATTHEWS VO/OC

I’m going under the assumption that I’ve broken a blood vessel and maybe this is just a, a natural change, just hoping that things are gonna clear up.  It’s just a waiting game at this point.

MUNA MATTHEWS VO/OC

At that point we were just like okay, obviously something isn’t working because he’s not, definitely not getting better and that was def, you know, most definitely getting worse in that case.  So it was more of a thing like well, okay, let’s play it out, you know.  You have to take these drops and, and continue.  So it was more of a thing where we’re kind of okay, well we’ll follow the schedule for now but there’s something that’s just not right.

MUSIC IN

HOST VO

But shooting a laser into John’s eye could also destroy what’s left of his sight.

JOHN MATTHEWS VO/OC

They tell me that to minimize future damage they’re going to have the laser at, at a lower power to minimize scar tissue but at the same time be able to kill the worm.  While they were lasering, it, it was a number of shots with the laser and I at one point asked if the worm was curling up and moving away and the doctor said, “Yes it is.”  And I said, “I can see it.”  It was the first time that I had seen the worm.  There’s a bright light being shone into my eye and I can see it reflecting into the split lens, just almost floating seemingly inches from my face and I can see it wiggling, trying to avoid the laser.  It appears that the worm was about a millimeter long.  They’re looking at it curled up a little bit.  It’s, it’s not in a nice straight line.  They guess it to be about a millimeter long.

MUSIC IN

JOHN MATTHEWS VO/OC

Muna asks, “So now what happens to the worm?  Does it decompose?  Does John’s body overtake it?  You’re not gonna go in and get it, are you?”

MUNA MATTHEWS VO/OC

They were explaining that after the laser procedure was done, that was one of our questions.  Is okay so how do we get it out of there?  Well the answer was you don’t.  Really, as long as they’ve killed it with the laser there, there’s nothing further that they need to do.  They just leave it in there.  It would probably cause more harm to go in and try to take it out.