Monsters Inside Me

MUSIC IN

HOST VO

Deadly organisms lurk all around us.  When one attacks an 11 month old boy, it could be disastrous.

TONY RICHARDSON VO/OC

We were absolutely devastated.  It was the worst day we’d ever had.

HOST VO

A Vietnam Vet survives the ground war.  But can he beat a hidden enemy that’s been living inside him for years?

TIM CARMACK VO/OC

The pain was outrageous.  I wanted to scream.

HOST VO

And a father has no idea a killer is lodged in his brain.

JOHN FIGGE OC

They were like, you know, we need to do brain surgery.  That’s great.  Just make this stop.

HOST VO

Three very different parasites.  Three sleeper cells lying dormant until they’re ready to attack.

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 out bodies, disable our immune systems.  They are parasites.  But to those infected, they are the Monsters Inside Me.

HOST VO

Parasites are the most successful organisms on the planet.  They live in or on other living creatures called hosts.

DAN RISKIN VO/OC

In a parasitic relationship, there have to be two parties.  There’s a host that loses and there’s a parasite that wins.  There are countless organisms that make a living off of us.

HOST VO

We can’t always see them because they’re like sleeper cells, perfectly adapted to live undercover feeding, growing and breathing.  Ticking biological time bombs, they lie dormant until it’s time to strike.

DAN RISKIN VO/OC

For a lot of parasites, an important part of the life history or the lifecycle is to hide and wait.  There’s always some kind of an environmental cue that is going to tell it that now is the time to act.  That it’s going to cause it to spring into action, and that is called a trigger.

HOST VO

They attack when it’s least expected as one family is about to discover.

HOST VO

May, 2002.  Tony and Valerie Richardson are a young couple living with their two sons, four year old Zachary and 11 month old Garrett.  On the surface, their life seems idyllic.

VALERIE RICHARDSON OC

And we felt very lucky to have two great kids.

TONY RICHARDSON VO

One of our favorite things to do is go to out and play on the play equipment.  Garrett likes to slide down slides, and he likes playing in the grass.

HOST VO

But their family is about to be torn apart.

TONY RICHARDSON VO

Garrett’s unusually sleepy.  And he’s, he’s taking extremely long naps.  And we were worried because he had never slept that long before.  It didn’t really seem like he was sick other than he was especially sleepy.

HOST VO

The next day Garrett is worse.  In fact, he hardly wakes up at all.  The Richardsons immediately take him to their doctor.

VALERIE RICHARDSON VO

And we see two pediatricians.  They’re both a little perplexed and worried, so they send us to the hospital to have further tests done.

HOST VO

Garrett is obviously sick but it’s not clear what’s wrong with him.

VALERIE RICHARDSON OC/VO

He had a multitude of tests.  A spinal tap.  A urine analysis.  Lots of blood work.

HOST VO

The test results show that Garrett’s white blood cell count is unusually high.  This indicates that his body is under attack.

TONY RICHARDSON VO

When the doctor tells us about his high white blood cell count, they said that there was no disease that they, that they knew of that was associated with the pattern of symptoms that he was showing.

HOST VO

The following morning, two days after being admitted, Garrett’s condition nosedives.

TONY RICHARDSON OC/VO

We go to the playroom to play with toys.  Garrett’s crawling around and suddenly he falls over.  He just tips over to his right and, and hits the floor.  It wasn’t until the next day when he was consistently falling over that I realized that this is part of something larger.

HOST VO

But Garrett’s loss of balance is only the beginning.

VALERIE RICHARDSON OC/VO

I put together the fact that he’s no longer reaching for crackers and is having a hard time finding his toys.  I call Tony in a panic.

TONY RICHARDSON VO/OC

And she just said, “He can’t see anymore.”  And I thought about it and I said, “You’re right.  He can’t.”

HOST VO

Unable to sit or stand with his eyesight failing, Garrett Richardson’s condition remains a mystery.  But the Richardsons are determined to save their baby.

HOST VO

And leading Parasitologist at the University of Indiana, Dr. Kevin Kazacos, thinks he might have the answer.

DR. KEVIN KAZACOS VO

I specialize in animal parasites that infect people.

HOST VO

Kazacos has just received a sample of Garrett’s blood.  He adds an enzyme to the blood serum.  If the serum changes color, it will indicate that Garrett is being attacked by a deadly parasite.  But the Richardsons will not receive the results for a few more agonizing days.  As a precaution, Garrett is given a course of anti-parasitic drugs.  But it may be too late.

DR. KEVIN KAZACOS VO/OC

When we see a child affected with clinical signs, there’s been significant damage already.

HOST VO

Kazacos shares his suspicions with Garrett’s doctors.  And they order another battery of tests.  One stands out, the MRI of Garrett’s brain.

TONY RICHARDSON VO/OC

The scan shows that his brain has shrunken, and that he’s sustained severe brain damage.  We were absolutely devastated.  It was, it was the worst day we’d ever had.

HOST VO

When the results of Garrett’s blood tests finally come back, they reveal that the toddler is harboring a parasitic roundworm called Baylisascaris.  His condition is so rare that only 14 cases have ever been recorded in the United States.  There are no known full recoveries.  And at the very least, Garrett risks serious brain damage.

DR. KEVIN KAZACOS OC/VO

We have them here in the bottle.  It’s a very deadly parasite.  The larva forms will infect a wide variety of animals.  It’s killed over 120 species of birds and mammals, including humans.

HOST VO

Roundworm eggs can live outside of a host for years.  They lie dormant in the soil, invisibly waiting for a host to come along.  And in this case roundworm eggs made it into Garrett’s stomach.  There, the acid in his stomach activated the eggs and they hatched.  Larvae two millimeters long emerged and burrowed through the intestinal wall into the blood.  They travel through Garrett’s body bursting out of blood vessels and attacking internal organs.  Only on rare occasions do they make their way to the brain where the larvae break through the brain’s defenses and eat the brain from the inside.  Unfortunately, this is what happened to Garrett.  The larvae then began to digest his visual cortex, the part of the brain controlling sight which is what caused him to go blind.

HOST VO

At the hospital, the doctors break the news to the Richardsons.

VALERIE RICHARDSON VO/OC

I remember it vividly.  It was Garrett’s first birthday, and so people had come to the hospital with gifts and toys and balloons.  And the doctors come in and tell us that the tests are confirmed that Garrett does have the parasite.  And, we were crushed.

HOST VO

Garrett’s life hangs by a thread as the parasitic roundworm threatens to claim another victim.

TONY RICHARDSON VO

I can’t remember the doctors actually ever saying anything positive about how thing were going to turn out.

HOST VO

One year old Garrett Richardson is fighting for his life.  His brain is being eaten by a deadly parasitic roundworm called Baylisascaris.

TONY RICHARDSON VO/OC

He’s getting worse and worse.  He’s losing ability after ability.

HOST VO

The roundworm larvae had eaten so much of his brain that Garrett is unable to sit up, crawl or see.

VALERIE RICHARDSON OC

My worry was that he was going to die.

HOST VO

Garrett is given a powerful anti-parasitic drug called Albendasol that impairs the worms’ intestines and starves them to death.  But the chances of success are slim.

TONY RICHARDSON VO/OC

This parasite was so deadly that there really wasn’t much help.

HOST VO

For more than 20 years, scientists have studied how this parasite spreads.  In a forest in Indiana, Professor Gene Rhodes is going to try and catch the wild animal that carries Baylisascaris.  Finding the animal could shed light on how outbreaks occur.

GENE RHODES OC/VO

Hey, it looks like you got one.  There are a number of animals that could be infected.  But the number one suspect is the raccoon.

HOST VO

Like any wild animal, raccoons must be handled with caution.

GENE RHODES VO

Well the first thing we need to do with a trapped raccoon is to knock it out.

HOST VO

Gene uses Telazol which will gently anesthetize the raccoon while avoiding undue stress on the animal.  If the raccoon is carrying the adult roundworms inside its intestine, there will be eggs in its feces.

GENE RHODES VO

I’m going to turn the animal over, and I’m going to slowly insert my finger into its rectum to get fecal material on my glove.  I’m going to smear it into the test tube.

HOST VO

This procedure might look unpleasant, but the raccoon is not harmed.

HOST VO

Rhodes sends the fecal samples to his colleagues in Chicago.  Dr. Kristin Page analyzes up to 600 raccoon samples a week.

DR. KRISTIN PAGE VO

There’s some eggs.  That confirms it.  This animal was positive.

HOST VO

Dr. Page’s work on the lifecycle of the parasite holds the secret to how Garrett became infected.

HOST VO

The adult worm lays its eggs in the raccoon’s gut.  The eggs are passed out in the raccoon’s feces.  The eggs are eaten by a second or intermediate host and hatched into larvae in the intermediate host’s stomach.  The larvae migrate through the intermediate host’s body, attack its central nervous system and kill it.  The intermediate host is then eaten by the raccoon and the lifecycle is repeated.  The raccoon is immune to the parasite.  It never feels a thing.

HOST VO

Tests show that 80 percent of raccoons in North America are infested with this parasite.  Yet fatal infection in humans is rare.

DAN RISKIN OC

For this parasite to affect humans, they have to be ingested in very large quantities.  And once they’re inside a human, they have to migrate and happen to end up at the brain.

HOST VO

So how did Garrett Richardson get infected?

DR. KEVIN KAZACOS VO

The average raccoon sheds about 26,000 eggs per gram of feces.  Okay?  A gram of feces is about the size of your little fingernail.  A gram is not very much.  Can a child get into a raccoon latrine and eat a gram of feces?  What happens if they eat ten times that amount and it has that many eggs?  They’re going to take in a huge number of eggs.

TONY RICHARDSON VO

Our doctors told us that it’s likely that he picked up something off the grass when he was crawling and put it in his mouth that had the parasite on it.

HOST VO

At the hospital, the Richardsons are determined to do everything they can to save their son.  Miraculously, the drug treatment seems to be working.  And after eight days in the hospital, Garrett is sent home to be cared for by his parents.

TONY RICHARDSON VO/OC

We realized that we were his best hope in helping him recover or whatever it would take.

HOST VO

Garrett’s life is still in jeopardy.  One side effect of the treatment is massive inflammation caused by the parasites dying off and releasing toxins in his body.  To combat the inflammation, Garrett is prescribed steroids.

TONY RICHARDSON VO

The steroids made him horribly uncomfortable.  He was crying all day long every day until he slept.  He’d sleep at night.  And when he woke up, he’d start to cry again.

SFX

HOST VO

After three weeks of treatment, the parasites are dead.  Garrett’s life is changed forever.  But three years later, he has recovered far more than his doctors predicted.

TONY RICHARDSON VO

It took him two years to be able to learn to crawl again.  And then he was able to walk at four.  He never gives up.  We’re extremely proud of him.

HOST VO

In addition to his other milestones, Garrett has even regained some of his lost sight.

TONY RICHARDSON VO/OC

He can see toys and he can see faces and recognize people.

HOST VO

While the Richardsons must cope with the effects of the raccoon roundworm, they are grateful to still have their son.

TONY RICHARDSON VO/OC

He’s a very joyful boy, and that, that makes us happy.

VALERIE RICHARDSON VO/OC

We miss the child he would have been but love the child that he is.

HOST VO

Although the consequences of roundworm infection can be severe, cases like Garrett’s are extremely rare.

DAN RISKIN OC

Deadly human parasites like the raccoon roundworm are very, very uncommon.  In the history of the USA, there have been fewer than 20 reported cases of Baylisascaris.

HOST VO

And there are steps people can take to avoid infection.  Keep an eye on small children playing outdoors, especially near wooded areas where raccoons live.

HOST VO

One of the things that makes these tiny sleeper cells so dangerous is that you never know when they will strike.  The raccoon roundworm’s eggs hide in the soil for years.  But once they’re in a host, they attack with voracious speed.  Other parasites use a different strategy.  They invade quickly, but lay undetected for years.

HOST VO

September, 1967.  Tampa, Florida.  Sergeant Tim Carmack has just completed a tour of duty in Vietnam.  He returns home.  But just four days later at MacDill Air Force Base, a life-threatening fever takes hold.

TIM CARMACK VO

It was like I was melting on the bed.  And I went into a coma.  It got so bad that they told my mother and my stepfather that they were making arrangements for my funeral because I would not come out of this.

HOST VO

Doctors diagnose him with malaria, but the fever breaks after five days and Tim emerges from his coma.  He makes a full recovery, except for one lingering issue, recurring asthma-like symptoms.  

TIM CARMACK VO

I couldn’t hardly breathe out of my nose, out of my mouth.

HOST VO

Tim learns to live with the symptoms and gets on with his life.

HOST VO

36 years later in 2003, Tim has a booming business painting houses and marries former nurse Shannon Potter.  They start a family and Tim is working more than ever.

SHANNON CARMACK VO/OC

He worked seven days a week.  I had to drag him home on Sundays.

HOST VO

His family believes all the years of working as a painter are taking their toll.

TIM CARMACK VO/OC

My legs were swelled up.  But they had been doing that, you know, off and on for a few months.

SHANNON CARMACK OC/VO

I thought, you know, he just needed to cut back on being on his feet for so long.

HOST VO

Tim tries to delegate his work and keeps off his feet as much as he can.  But it doesn’t help.  And one morning, he wakes up to a terrifying sight.

TIM CARMACK VO/OC

I seen a liquid coming out of a spot on my leg.  The liquid was thick, goldish.  It’s heavier than like baby oil.

SHANNON CARMACK VO

I got him a paper towel, and we noticed that it came back.  And there wasn’t really a cut there or anything for it to come through.  It was just coming out of the pores.

HOST VO

Tim’s leaking legs are truly disturbing.  But could this be the start of something far more sinister?

TIM CARMACK OC/VO

What really scared me the most was none of us knew where the liquid was coming from or what was causing it.

SHANNON CARMACK VO/OC

I was just thinking something’s got to be done.  There’s something definitely wrong.

HOST VO

The best way to avoid getting a tapeworm is to do which of the following.  A, never drink from a well.  B, thoroughly cook meat before eating.  C, always wear shoes when walking outside.

HOST VO

The best way to avoid getting a tapeworm is B, thoroughly cook meat before eating.

HOST VO

62 year old Tim Carmack has just woken up to find his legs oozing out a thick yellow liquid.  Unsure of what’s happening and determined to find the answer to save her husband, his wife, Shannon, hits the Internet.

SHANNON CARMACK VO

There’s heart conditions that can cause you to have problems with swelling, and there’s also diabetes which you know ran through my mind.  You know, maybe he’s diabetic.  He needs to be tested.

HOST VO

As a veteran of the Vietnam War, Tim makes an appointment at a nearby VA Clinic.  When they arrive, the doctor gives him a complete physical examination.

TIM CARMACK VO/OC

I told her my legs was weeping this fluid out.  She looked down and looked at me and says, “There’s nothing we can do for that.”

SHANNON CARMACK VO/OC

I was just thinking, you know, there’s something definitely wrong.  And I was really surprised when they came out and said there’s nothing wrong with him.  Take him home.

HOST VO

But Shannon refuses to give up.  She is determined to get her husband the help he needs.  Over the next year, they see three more doctors.  But each visit brings them no closer to a diagnosis.

HOST VO

Tim is prescribed painkillers for his legs, but they give little relief.

TIM CARMACK VO

I got very weak.  There was times when I was on the job, I would literally have to just sit down and wait for my body to catch up to me.

HOST VO

His condition continues to decline.  Soon, it’s sheer agony even to walk.

TIM CARMACK VO/OC

Man, I hurt.  God, it hurt so bad.  I mean it, it was, it was hard to explain the pain.

HOST VO

After a year of chronic pain and swelling, Tim and Shannon make an appointment at a major hospital in Tampa.  Tim sees a team of experts and gets a thorough workup.  

SHANNON CARMACK VO

Everything just kept coming back negative.  His heart was fine.  He wasn’t diabetic.

TIM CARMACK VO/OC

I felt very disappointed.  All they wanted to do was throw pills at me.  But no one ever addressed what was wrong with me.

HOST VO

Then after two years an even more bizarre and frightening symptom appears.

TIM CARMACK VO/OC

Well the next thing I noticed was getting severe swelling around my scrotum area.  I really didn’t know what was happening with me.

SHANNON CARMACK VO/OC

It gave us a direction when his testicles started swelling that a urologist was our best bet.

HOST VO/OC

And when we first seen him, he kind of acted like the rest of the doctors did.  Well there’s not that much wrong with you, you know.  And he started the same story.  But I finally told him, I said, “Look, there’s got to be something wrong with me somewhere.”

HOST VO

Refusing to take no for an answer, Tim gives the urologist his complete medical history going back 40 years.

TIM CARMACK VO/OC

I told him four days after coming back to the United States, I wound up with what they called full blown malaria.  He says, “You had malaria?”  I said, “Yes, sir.”

HOST VO

Malaria is a deadly disease caused by the parasite plasmodium.  It is transmitted by a mosquito.  And in the jungles of Vietnam where Tim was fighting, mosquitoes were everywhere.  Could a battle with malaria 40 years earlier be the source of Tim’s symptoms today?  Tim’s doctor digs deeper.

TIM CARMACK OC

He said, “What do you mean malaria?”  I said, “That’s what they told me it was.  I had severe breathing problems.  I went into a coma for almost five days.”  And he stopped me and he says, “Mr. Carmack, I’m 90 percent sure of what you’ve got.”

HOST VO

The urologist suspects Tim contracted not one, but two different parasites in Vietnam.  The first, the parasite that causes malaria was successfully treated.  The other went undetected.

TIM CARMACK VO/OC

I said, “What do you mean, a parasite?  How bad are you saying this is?”  And I was devastated.  I didn’t know how long I had to live.

HOST VO

Tim Carmack’s four year struggle to identify what’s been making him ill has finally come to an end.  But the news is not good.  His urologist believes a parasite has been lurking inside his body for the past 40 years.

TIM CARMACK VO/OC

Oh God, I was devastated.  I wanted to know if it could be stopped.

HOST VO

There’s only one way to tell.

TIM CARMACK VO

The urologist ordered me to a primary care doctor and ordered a test for the parasite.

HOST VO

Three days later, the results are back.

TIM CARMACK VO

I went in and he confirmed that I did have the parasite.

HOST VO

The parasite is a thread like worm called W bancrofti.  And the disease it causes is Lymphatic Filariasis.  Although virtually unknown in North America, it is widespread in Southeast Asia where Tim was stationed as a soldier in the Vietnam War.

TIM CARMACK OC/VO

I wanted to know how far this parasite was in my system.  What does it do and what does it cause?

HOST VO

Dr. Robert Hartzell is Tim’s Primary Care Physician.

DR. ROBERT HARTZELL VO/OC

Filariasis has an insidious onset.  It can affect the lungs.  It just causes massive swelling.  And the worst case scenario, you know, I’m sure everybody’s heard of Elephantiasis.  

HOST VO

Elephantiasis is an extreme thickening of the skin and underlying tissue.

DR. ROBERT HARTZELL VO/OC

That’s probably the worst case scenario.

HOST VO

But how did Tim’s doctors overlook the disease 40 years earlier?  The key lies in the parasite’s ability to hide.  Its lifecycle begins inside a mosquito.  When the mosquito bites a human, hundreds of tiny larvae swarm into the bloodstream.  Next they travel to the lymphatic system, a crucial network in the human body.

DAN RISKIN VO/OC

The lymphatic system is a series of tubes that drain fluid out of your tissues.  So if you ever have swelling in your fingers or in your hands, the way that that fluid gets back out into the blood stream is by the lymphatic system.

HOST VO

Undetected in the lymphatic system, they grow into adult worms three to four inches long.  The adult worms mate and produce even more larvae.  These microscopic larvae leave the safety of the lymph vessels and nodes to invade other parts of the body.  During the day they lie low in the lungs causing respiratory symptoms.

TIM CARMACK VO/OC

It explained where my breathing problems were coming from.  I knew that this was not the way my body acted.

HOST VO

But at night the drop in our body temperature triggers the larvae to move out of the lungs to their next destination.

DAN RISKIN VO/OC

For the lifecycle to be completed, the larvae have to be picked up by a mosquito.  So what the parasite does is move close to the lungs during the day, and then migrate out towards the skin at night where they’ll get picked up by a mosquito.  And that daily migration is timed by the natural sleep rhythms of the host.

HOST VO

The unsuspecting mosquito transports the larvae to a new host and the lifecycle repeats itself.  Tim’s most severe symptoms begin after tangled bits of dead worms plugged up his lymphatic system.  Lymph fluid built up in his legs and testicles and leaked out of his pores.

HOST VO

Filariasis is treatable with anti-parasitic medication if it’s caught early.  But for Tim, the diagnosis comes too late.

DR. ROBERT HARTZELL OC

His filariasis has caused damage to his lymph system, and, and he’s going to have that for the rest of his life.

HOST VO

Though Tim’s life will never be the same, he’s learned to manage his affliction through daily exercise and massage.

TIM CARMACK OC

Oh, here it comes.  One, two, three.  Oh.

SHANNON CARMACK VO/OC

Tim’s days are spent with his .  We normally do an hour of massage in the morning, and we get him up to try to do a little bit of walking, to do a little bit of exercise.  And it’s, you know, a figure out as long as you go process.  This, this is a real eye opener.  I didn’t know that something so little could be so devastating.

HOST VO

The Carmacks have discovered just how much harm a tiny creature can cause, especially if it’s able to hide in the body without giving any major warning signs.  This is the exact strategy of the filariasis parasite.

DAN RISKIN OC/VO

The reason that so many parasites can be undetected for so long is that that’s what they’ve evolved to do.  To hide and do their job very quietly without setting off any alarms in the body.

HOST VO

This hide and wait strategy is devastatingly successful.  Filariasis affects 120 million people worldwide, mostly in the tropics.  If you’re traveling to a region where filariasis is common, a little bit of prevention can go a long way.  Use insect repellant and mosquito netting at night.

HOST VO

Like tiny undercover agents, parasites are everywhere.  In the food we eat, the water we drink, even on the ground we walk on lying dormant waiting to strike.

HOST VO

2003.  34 year old John Figge and his wife, Lisa, are settling their two sons into a new neighborhood in Philadelphia, Pennsylvania.

JOHN FIGGE VO/OC

We spend most of our weekends shuttling our kids around to basketball games and soccer games, that type of thing.

HOST VO

But their normal routine is interrupted when John begins to experience bouts of dizziness.

JOHN FIGGE VO

I noticed it first probably just driving to work.  I really couldn’t focus on the road.  It was kind of like my head was out of whack there for a second.  And then it was fine.  And I thought, “Hmm, I don’t know what that was but I’m sure it will go away.”

HOST VO

But the dizziness doesn’t go away.  In fact, after a few days, it gets worse.

JOHN FIGGE VO

I really had trouble keeping my balance.  I likened it to being seasick on land.  I had to hold onto things a lot to steady myself.

HOST VO

Together the dizziness and loss of balance create a new symptom, constant nausea.  However, John and his wife write it off as a simple stomach bug.

LISA FIGGE OC

When your husband complains to you about not feeling well, you think, “Well, you know, he’s probably getting a little bit sick.”  And, and I really didn’t think much of it at all.

HOST VO

John takes over the counter drugs to cope with the symptoms.  But after a few days, it’s clear that this is no simple flu.  His nausea becomes severely debilitating.  

LISA FIGGE OC

He basically said he couldn’t stand up.  The nausea was so bad.  So I decided that it really seemed like he needed to see a doctor.

HOST VO

The couple head to their local emergency room to see if they can get a quick diagnosis.  The doctor on call examines John and concludes that his symptoms are most likely caused by an inner ear infection.

JOHN FIGGE VO/OC

And I thought, “Hey, that’s great.  At least we know what it is.  We have something to go with.”  It goes away overtime.  You know, you’re probably just going to have to hang out in bed for a few days and it will correct itself.

HOST VO

But after several days of bed rest, John doesn’t improve.  In fact, the symptoms worsen.

JOHN FIGGE VO

It got to the point where even sitting down, it, it wasn’t really helping anymore.  It, it was getting worse and worse.  It was really bad.

HOST VO

After a week of unrelenting dizziness and nausea, the Figges realized that something needs to be done fast.  This time they head to a bigger hospital in search of answers, and are referred to the neurology department.

DR. DANIEL  KREMENS VO/OC

When John presented to our hospital, the first thing I noticed is that he just looked sick.  He was retching.  He looked very uncomfortable.

HOST VO

Dr. Daniel  Kremens is a Neurologist at the University of Pennsylvania.  As the attending physician on call, he is assigned John’s case.  Loss of balance and dizziness can often indicate neurological problems, so he begins testing John’s neurological functions.

DR. DANIEL  KREMENS OC/VO

So when we had John do tests like touching his nose and then touching my finger, he had a lot of trouble doing that.  His hand would shake when he did it and it was uncoordinated.

HOST VO

All the signs point to a problem with John’s cerebellum.  Located at the back of the brain, the cerebellum is the part of the brain that regulates muscle control, coordination and balance.  To find out what could be affecting John’s cerebellum, Dr. Kremens orders a CAT Scan of John’s brain.

DR. DANIEL  KREMENS VO/OC

John’s CAT Scan showed that he had a large mass in the back part of the brain about the size of a large walnut.  I was really very, very worried.  I thought I was going to have to be telling his wife that her husband had a brain tumor.

HOST VO

34 year old John Figge and his wife, Lisa, are about to receive very bad news.  John’s doctors believe he has a brain tumor.

LISA FIGGE VO/OC

I don’t think anyone could tell you that your husband has a brain tumor and you don’t, you know, you get really scared.

HOST VO

To confirm the diagnosis, Dr. Kremens orders a biopsy of the mysterious mass.  This means cutting open John’s skull and taking tissue directly from his brain.

JOHN FIGGE VO

They’re like, “You know, we need to do brain surgery.”  And I was like, “That’s great.  Sign me up.  Just make this stop.”

HOST VO

The next day, John’s surgical team makes an incision into his skull and extracts a sample of the strange mass proliferating in his brain.

HOST VO

Downstairs at the pathology lab, technicians examine the sample under a microscope and make an absolutely astounding discovery.

DR. DANIEL  KREMENS VO/OC

I get a page and I call the OR and I say, “What kind of tumor is it?”  And he says, “It’s not a tumor.  It’s  ova and parasites.”  I was shocked.  That meant that he had eggs and worms in his brain.

HOST VO

In recovery,…

MUSIC OUT

…John is stunned by the news that a colony of parasitic worms has invaded his brain.

JOHN FIGGE VO/OC

When I heard that it was a parasite and not a tumor, it was a little shocking.  And I had to keep asking them because I didn’t really understand how I had these things in my head.

MUSIC IN

HOST VO

Neither did Dr. Kremens.

DR. DANIEL  KREMENS VO/OC

I had never seen a parasitic infection in the brain that presented like this, looking like a tumor.

HOST VO

Dr. Kremens must figure out what kind of parasite is eating John’s brain so he can kill it before it’s too late.  The lab could take hours or even days to identify it.  But time is running out.  John is at immediate risk of seizures, spinal cord inflammation, even death.  Without a second to lose, Dr. Kremens interviews Lisa again.

DR. DANIEL  KREMENS VO

We were trying to figure out how did John get this?  Had he traveled somewhere unusual?

LISA FIGGE OC

We’d traveled pretty locally around the United States, but certainly nowhere exotic.

HOST VO

Next, Dr. Kremens considers food as a possible source of the infection.  

DR. DANIEL  KREMENS VO

There’s an infection called Listeria which people can get sometimes from eating cheeses.  And we knew that John and Lisa used to like to eat out.  So we were thinking maybe this was some sort of unusual Listeria infection.

LISA FIGGE VO/OC

We had been to some tasting menus where you don’t always know what you’re eating.  And, you know, we were scratching our heads trying to figure out if we had eaten something strange.  But we really didn’t, didn’t remember anything specific.

DR. DANIEL  KREMENS VO/OC

We knew this wasn’t any sort of parasite that we’d seen in the United States, and it didn’t look like any parasite that I’d ever seen associated with some food borne illness.  So, at that point, I realized I just had to ask them more questions.

HOST VO

Dr. Kremens returns to the topic of travel.  Had they done any exotic traveling in the past five years or even further back?  Lisa’s answer could help Dr. Kremens identify John’s parasite.

LISA FIGGE OC

Wow, we did, we did go to Africa a number of years ago.

HOST VO

Six years ago, to be exact.  Lisa can’t imagine that a trip taken years earlier could be the source of the infection.  But to Dr. Kremens, it’s the answer he’s been looking for.

DR. DANIEL  KREMENS VO

Well as soon as I heard that they had gone to Africa, I was pretty confident that that was the source of the infection.

HOST VO

In 1998, John and Lisa joined their extended family on a trip to Kenya in East Africa.  The family booked a week long stay at a vacation resort on the banks of Lake Victoria, a 300 mile long fresh water lake located in the heart of Kenya.

LISA FIGGE VO

And then he wanted to know had we been swimming in any, in any water.  And we, in fact, had.

JOHN FIGGE VO

They had boats and, and a little beach.  And everyone just hung out on the beach, going swimming, going boating.  We were never aware that there was anything we should be concerned about in the water.

HOST VO

But the water was exactly…

MUSIC OUT

…where John picked up his deadly travel companions.

MUSIC IN

HOST VO

And it’s the clue Dr. Kremens needs to identify John’s parasite.  

DR. DANIEL  KREMENS VO/OC

We took pictures of it and sent it down to the Center For Disease Surveillance in Atlanta, Georgia.  And after a few hours, one of our pathologists found a picture and we looked at that.  We looked at John’s slide.  And we knew that we had made the diagnosis.

HOST VO

John Figge’s doctors have identified the parasite that is growing inside his brain and threatening to kill him.

DR. DANIEL  KREMENS VO/OC

In John’s brain he had something called Schistosomiasis and it’s specifically something called Schistosomiasis mansoni.

HOST VO

Schistosomes live in fresh water lakes in Asia, South America and Africa.  Their eggs are released into the environment by the feces of infected people.  Schistosome eggs hatch once they come into contact with fresh water.  At that point, they will seek out a snail and penetrate the snail’s foot.  Inside the snail they transform into tiny worm larvae.  These larvae emerge daily from the snail host.  Humans entering the water trigger the movement of larvae toward the surface.  Attracted to the fatty acids emitted by human skin, larvae swim toward their new host using microscopic tails.  The minute larvae penetrate our skin in three short stages.  First, they attach to the skin.  Then the larvae search the skin for a penetration site, often at a hair follicle.  After finding a penetration site, the larvae then emit a chemical which dissolves human skin, producing a tiny hole they can swim through.  In the human body, the larvae transform into adult worms and migrate to the blood vessels near the liver.  But how did these parasites get into John’s brain?  The answer lies in John’s blood.

DR. DANIEL  KREMENS VO/OC

What happens is the adult worms mature inside the liver, and then they go out of the liver to mate.  And then they lay eggs inside these blood vessels around the intestines.  And what normally happens is that these eggs go into the intestines and they’re excreted in feces.  What happened in John’s case, two worms mated and swam against the tide into John’s brain and laid this large group of eggs that grew in his brain.

DAN RISKIN VO/OC

A schistosome can sit undetected in the human body for 20 years.  And because it can last such a long time, it produces millions of eggs over the course of its lifetime.

HOST VO

With the diagnosis in hand, Dr. Kremens immediately gets to work saving John’s life.

DR. DANIEL  KREMENS VO/OC

When you treat a parasitic infection, what happens is the parasites die but when they die they release toxins into the brain which can cause swelling.  And that in and of itself is very dangerous.

HOST VO

Until doctors relieve the pressure on his brain, John could still have a life threatening seizure or go into a coma.

LISA FIGGE VO

The doctors couldn’t predict you know how much his recovery was going to progress.  Would he ever be back to normal?  They really never knew.

DR. DANIEL  KREMENS VO

We actually had to put a tube into John’s brain to help relieve the pressure that he was experiencing.

HOST VO

Two weeks after surgery, John is discharged from the hospital.  He’s still weak, but he knows that the worst is behind him.

DR. DANIEL  KREMENS VO/OC

When we looked at John’s sample under the microscope, he had more eggs and parasites than, than we could count.  So if John didn’t have brain surgery, he probably would have died.

LISA FIGGE VO/OC

In my wildest dreams, I would never predict that a parasite could cause all these, all these things to happen.

JOHN FIGGE OC

It was kind of a one in a billion type of thing.  But when you put it all together, you think, “Well, I’m glad we caught it when we did.”  And I’m glad I’m, I’m fine now.

HOST VO

For John Figge, the parasite living inside him didn’t cause a devastating illness for a full six years.  Only after it made a wrong turn in John’s body and ended up in his brain were doctors able to discover it.  Like so many other parasites living under the radar in the host’s body is the key to the Schistosome’s success.

DAN RISKIN OC

There are a lot of different kinds of parasites in the world and there are a lot of different strategies that parasites use to complete their lifecycles.  Some of them use a boom or bust strategy where they produce millions and millions of eggs over a short period of time.  Others produce small numbers of eggs, but spread it out over a longer span of time.  What these have in common is that they hide without detection at some point in their lifecycle.

HOST VO

Whether they lurk for years or strike immediately, these sleeper cells lie waiting for their next victim.  It’s not a question of how or why, but when.

HOST VO

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

DR. KRISTIN PAGE VO

One way to find out if a given raccoon fecal sample is positive would be to bring it back to the lab and do a flotation where we can look for the eggs in the poop sample.  So we have this big bag of raccoon feces.  We take the fecal sample and add it to a sugar solution and mix it up very well.

HOST VO

The eggs are separated from the feces in a centrifuge.

DR. KRISTIN PAGE VO

And spin it for two minutes.

HOST VO

The samples are then placed on a slide to be examined under a microscope.

DR. KEVIN KAZACOS OC/VO

Those few larvae that go to the brain affect the behavior of that intermediate host making that host more easily captured by the raccoon.  And therefore completely the lifecycle.  So if you really want to look at this parasite in evolutionary terms, it has evolved in order to complete its lifecycle.

HOST VO

The warning to other parents is clear.

DR. KRISTIN PAGE VO

Raccoons leave their scat in accumulations on horizontal surfaces like fallen logs or at the bases of very large trees.  And sometimes if these are very close to where children play, it puts children at great risk.

HOST VO

Dr. Page is spearheading a cleanup operation to eradicate the killer parasite that lurks in people’s backyards.

DR. KRISTIN PAGE VO/OC

So this house obviously has children living here.  It’s very close to the forested area.  They have bird feeders which will attract raccoons.  And we found a latrine very close to where the children are playing.

HOST VO

To make the area safe, all traces of raccoon feces must be removed.  The eggs can stay alive in the soil for years, so Page and her team are taking no chances.

DR. KRISTIN PAGE OC

We want to clean, kill the parasite with a handheld propane torch.  And then we can take the top layer of soil away and throw it in the garbage.

TONY RICHARDSON VO/OC

He’s been steadily progressing.  He loves to play music, listen to music.  He loves playing with his computer, going for walks.  And he goes swimming twice a week.  That said, his challenges in the future are, are numerous.  He’s always going to need somebody to dress him, to help him go to the bathroom, to feed him, to brush his teeth.  Pretty much every major activity throughout his life, he will need assistance.

TIM CARMACK VO/OC

It took my life away from me.  I can’t do the things that I want to do.  Everything has been thrown on my wife now.  She doctors me.  She cares for me.  I think she knows more about this parasite now than most doctors do.

HOST VO

But John isn’t Dr. Kremens only concern.  With the source of the parasite revealed, another question arises.  Could John be just one victim in an epidemic?

DR. DANIEL  KREMENS OC/VO

Once we realized that this is what John had, that’s when we said, “Could anybody else in the family have it?”  That’s when it made us decide to test everybody.

LISA FIGGE VO

I think it was always in the back of our minds that we might have it, too.

HOST VO

The test results are staggering.

DR. DANIEL  KREMENS VO

26 members went to Africa.  23 members actually walked in Lake Victoria, and 18 tested positive for Schistosomiasis mansoni.

HOST VO

Including John’s wife, Lisa.  She had also been infected with Schistosomiasis six years earlier.

LISA FIGGE VO/OC

The idea of something inside of you, it was definitely a creepy feeling.

HOST VO

Luckily, all of the party members were symptom free.  Their parasites had either stayed near the intestines or had already been flushed out.  They were tested and treated with medication before the parasitic infection could advance to the extreme degree of John’s illness.

DAN RISKIN VO/OC

Organisms all over this planet are being infected by parasites every day, and humans are no exception.

TONY RICHARDSON VO/OC

Since climbing on things is one of his favorite things to do.

TONY RICHARDSON VO

But it was unusual enough that we decided we should have him checked out.

VALERIE RICHARDSON OC/VO

And he just wants to be left alone.  He wants to be able to lay on his stomach and sleep.  And that was the main reason the doctor was worried.  Garrett isn’t scared.  He just wants to lay down and sleep and have everybody leave him alone.