Detecting Microbes: Omar Amin, Ph.D.

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Detecting Microbes

Omar Amin, Ph.D.

 

Chapter 15 of Optimal Digestive Health - A Complete Guide, edited by

Trent W. Nichols, MD, and Nancy Faass, MSW, MPH.

Published by Healing Arts Press, Rochester, Vermont

Copyright 1999, 2005 by Nancy Faass and by Trent W. Nichols, M.D.

 

 

Many of us have heard about illnesses caused by Giardia and other

parasites, but we tend to overlook connections between these microbes

and digestive disease. According to the Centers for Disease Control,

microscopic parasites probably cause more than 90 percent of all

parasitic infections in the United States. Many doctors believe we

may be seriously underestimating parasites as contributors to disease.

Worldwide, infections diarrhea due to cholera, amoebas, Giardia, and

Blastocystis, among others, is the second leading cause of death,

fatal to 3 million people a year.

 

JUST A TROPICAL DISEASE?

 

We consider this type of problem an exception in America, a rarity.

Most doctors and patients don't usually think of parasites as a common

cause of illness. We assume we've eradicated these problems with

modern sanitation and water treatment. But research shows that

parasitic infection is common, and the incidence is increasing. In

many cases these infections underlie familiar digestive illness and

other conditions as well.

 

Symptoms of intestinal infection are not isolated or unusual.

Opportunities for exposure to and transmission of parasitic infection

increase as overseas travel and immigration expand. Parasites are

also transmitted in food processed through mass methods of farming,

food manufacturing, and shipping from sources all over the world.

Water treatment in huge urban systems is unable to totally eliminate

contamination and periodically makes it worse.

 

Giardia, for instance, is often waterborne, and these infections are

on the rise. In 1997, The Wall Street Journal reported an average of

2 million cases annually in the United States. Giardia is also a

problem worldwide, even in some modern cities (via the public water

systems).

 

Cyclospora, a parasite in the news, is tracked as a new or emerging

pathogen; sometimes it is transmitted on imported fruit. In 1996 it

was found on Guatemalan strawberries and raspberries. However, it is

also domestic and common in the United States; like all infectious

agents, it can be transferred in stool, on human hands, and as

contaminants in food, especially fresh vegetables and fruit, and water.

 

Cryptosporidium, another waterborne parasite, caused illness in more

than 400,000 people in Milwaukee in 1993. More than 4,000 were

hospitalized, and more than 100 died. Cryptosporidium is found in the

public water systems and reservoirs of many American cities. In some

places, such as the San Francisco Bay Area, it is known to be

transmitted by the runoff from hillsides where cattle graze, upstream

from unprotected reservoirs.

 

A Case of Undetected Infection

 

When he was about 6, Tony started having problems connected with his

digestion. Tests for paratites came out negative. The doctor said it

was ulcerative colitis and put Tony on a variety of medications,

including steroids. However, his condition did not improve; in fact,

it actually worsened. More tests were performed and a stool sample

was sent to a lab specializing in the detection of parasites. An

infection with Entamoeba histolytica, a common but virulent amoeba,

was detected. Based on the information from the test results, another

of Tony's doctors prescribed medication targeted at clearing the

parasite, and his symptoms resolved.

 

It is impossible to determine if the E. histolytica infection caused

the ulcerative symptoms (which it often does) or if an earlier

intestinal condition compromised the integrity of the GI lining,

paving the way for the E. histolytica to become established. It is

clear that the host-parasite relationship was a causal influence,

since the elimination of the parasite was instrumental in resolving

the ulcerative condition. The key component here is the proper

identification of the specific parasite in the test sample

 

What happened in Milwaukee drew the attention of the media and the

public because so many people were affected. But doctors are coming

to believe that all over the country this kind of infection happens

every day. Most of us live crowded together in big cities, many of us

travel overseas, we frequently have contact with people from all over

the world, and we have many opportunities for exposure.

 

In a survey of 5,792 samples received at the Parasitology Center,

Inc., in 2000, of 2,896 patients, 916 (32 percent of) patients were

infected with parasites; higher than the previously reported national

average of about 20 percent.

 

A Sample of Intestinal Infections, in the U.S. (2000)

A survey of 5,792 samples from 2,896 patients,

received at the Parasitology Center, Inc., Tempe, Arizona

Pathogen -- Percentage

of Samples Infected

 

Digestive Symptoms

 

General Symptoms

Blastocystis hominis -- 72%

Flatulence, bloating, diarrhea,

cramps, constipation, poor digestion/

poor absorption

 

Fatigue, nervous and skin

disorders, pain, skin conditions,

nausea, allergies, muscle problems

 

Entamoeba histolytica -- 7%

Diarrhea, constipation, cramps,

bloating, flatulence

Fatigue, nausea, allergies, pain,

weight loss, insomnia

 

Entamoeba coli (E. coli) - 5%

Diarrhea, cramps, flatulence,

bloating, constipation, irritable bowel

Fatigue, allergies, headache, nausea,

depression / irritability, joint/back pain,

skin problems

 

Cyclospora - 2%

Sypmtoms that come and go,

bloating, flatulence, diarrhea, cramps

Fatigue, itching, nausea, anemia,

headache, muscle aches,

depression

 

Entamoeba hartmanni - 1%

Diarrhea, bloating, cramps,

flatulence, irritable bowl

 

Nervous system, respiratory, and

skin disorders, allergies, pain, nausea

SOURCE: O.M. Amin, " Seasonal prevalence of intestinal parasites in

the United States during 2000. " American Journal of Tropical Medicine

and Hygiene, vol 66, no. 6 (2002): pp.799-803

 

Among this sampled population, we noticed a number of typical

characteristics.

 

* More than half the people with infections had traveled overseas

in the past five years.

* People traveling to Mexico and Europe had the highest risk of

infection.

* People living in households where someone was infected had twice

the risk of infection.

* Of people who were infected, some had no symptoms.

* This implies that some people unknowingly act as carriers.

Since they have no symptoms, they might be unaware of the problem, go

untreated, and unknowingly pass it on to others.

* People infected by more than one parasite had symptoms similar

to those with single infections.

* Women were twice as likely to be infected as men and to be more

heavily infected.

* The most prevalent pathogen was Blastocystis hominis (72

percent), with Cryptosporidium (13 percent) and Entamoeba species (8

percent) ranking second and third, respectively.

 

Greatest Risk Factors

Primary Factors

 

* Foreign travel

* Having a partner or someone in the household with a parasite problem

* Previous parasitic infection (implying relapse or reinfection)

* Not washing fresh vegetables adequately

 

Other risks

 

* Drinking tap water

* Poor hygiene

* Dining out often

* Frequenting salad bars

* Having pets

* Going camping (or drinking the water from streams or even fountains)

* Working at an infant-care center

* Living in an institutional setting or group home

 

PARASITES AND DAMAGE TO THE BODY

 

Parasitic infection can be damaging to humans by direct injury to the

tissue of the digestive tract or the liver, among other organ systems.

In addition the most destructive effects may not be caused by the

parasite itself, but by its toxic by-products, which are produced

unintentionally as a part of its living process. Parasites can

disrupt digestive activity, can cause malabsorption, and can interfere

with the action of digestive enzymes and nutrients. In addition,

parasites can compromise the human immune system in order to promote

and ensure their own survival.

 

DIFFICULTIES IN DIAGNOSIS

 

Parasitic infection have long been considered diseases of the tropics,

so physicians often don't consider them when diagnosing common

illnesses. Parasitology is seldom discussed in the mainstream medical

journals, and traditionally there has been little reporting of

parasite incidence. For example, Giardia has been widely tracked by

the Centers of Disease Control (CDC) only since 1987. When physicians

received their training, very little information is provided on

parasitology in medical school and in professional journals. Given

the lack of information and minimal clinical exposure, doctors don't

usually consider parasites as a possible cause of illness, especially

when the symptoms aren't confined to the digestive tract.

Difficulties in Detection

Parasites have complex life cycles and are often not shed at regular

intervals. In fact, three of the major parasites in the United States

and worldwide (amoebas, Giardia, and Cyclospora) tend to be shed at

irregular intervals. This means that the parasite may be present in

the stool for two, three, or four days a week, but not the rest of the

week. Entamoeba histolytica is active for one or two days, and then

is not typically active or detectable the next day or two. When E.

histolytica migrates to the liver it disappears from the gut and

becomes undetectable in fecal specimens. If the stool sample is

collected from a patient with one of these cyclical parasites on a day

when the pathogen is not active, it won't be in the stool and

obviously won't be detected by testing. However this doesn't mean

that there's no infection present. At the current time this is a

limitation for which no modern technology can compensate.

Consequently repeated samples are very important. Generally, to make

testing practical, we recommend at least two or three samples be taken

on different days.

 

Emerging Pathogens

 

Another problem we encounter in detection is the fact that there are

so many emerging pathogens. These are new parasites, which remain

insufficiently studied. For example, Cyclospora was formally

classified as a human parasite for the first time just a few years

ago. Before that the labs were probably seeing it, but didn't know

what it was because it hadn't been described as such. Other pathogens

are reclassified as they become better understood or as their

virulence is observed to change. Only in the 1990s has Dientamoeba

fragilis come to be considered capable of causing disease

(pathogenic). In addition there are some life forms in nature that

make detection extremely difficult. Bacteria have been identified

that can exist without a cell wall and therefore can take on many

shapes. These elusive pathogens make diagnosis extremely difficult.

 

OPTIMAL DETECTION

 

The, most effective method of detecting parasites continues to be

stool sampling. The optimal approach involves taking samples every

other day, a minium of 48 hours apart, collecting at least two or

three samples.

 

Although some microbes such as E. histolytica reside in the large

intestine, many are harbored in the small intestine. Pathogens such

as Giardia reside primarily in the small intestine, where they

strongly adhere to the intestinal lining and therefore cannot usually

be detected in samples from stool further down the digestive tract.

For this reason the test must include matter from the small intestine

in order to test as accurately as possible. The best specimen is a

sample of soft stool taken during the occurrence of a diarrheal

episode, because it usually contains material from the small

intestine. In the patient who has constipation, the purge test is

most optimal.

Other Methods of Testing

 

* Elevated white blood count (eosinophil level) may be used as a

screening tool to indicate the need for further testing.

* Antibody testing is also available. Antibody levels of

immonoglobulin (IgG) can indicate infection, but not whether the

infection is current or previous. Repeated testing for IgM levels

will show if the infection is currently active.

* Samples of blood serum can be evaluated to detect parasites

found in the blood. However, this method is useful only for parasites

of the circulatory system, not those most typically found in the GI tract.

* Tissue samples from biopsies of the colon or duodenum can be

tested for parasitic infection, as well as tumors or pathology.

 

Testing for Yeast

A correlation exists between the presence of parasites and the

presence of Candida (and other forms of fungus as well). In addition

when there is excessive Candida present, the levels of beneficial

bacteria tend to be lower. If there are factors present such as

parasites that promote the growth of Candida, it consumes the

resources and the space that would have originally been allotted to

the beneficial microflora (the Lactobacillus and Bifidus). Yeast

overgrowth is also documented as a significant factor in some cases of

attention deficit disorder and autism (based on the work of Dr.

William Shaw and others).

 

Dental Toxicities

 

Digestive health starts in the mouth: For many patients, dental and

digestive health seem to go hand in hand. Currently there are a

multitiude of procedures and materials that have been developed by the

dental industry to promote dental health, not to mention to ward off

infections and improve oral hygiene. Manufacturers of dental

materials spare no effort to provide dentists with the widest array of

amalgams, composites, sealants, varnishes, cements, adhesives, pastes,

etc. We all know about mercury and heavy metal toxicity; see for

example, Ziff (2002). What we did not know about is the involvement

of dental sealants (liners in the causation of a newly discovered

disorder called neurocutaneous syndrom (NCS) (Amin, 2003, 2004).

 

NCS is a disorder that degrades the skin (cutaneous tissue) and

neurological system of patients who have been treated with sealants

during filling or root canal procedures. Patients sensitive to sulfa

are especially susceptible to experiencing the neurological and

dermatological toxicity symptoms of NCS. Neurological symptoms

include but are not limitited to pinprick and/or creeping, painful,

and irritating movement sensations, often interpreted as loss of

memory, and light sensitivity may also be experienced. The cutaneous

aspects include the development of small itchy sores or inflamed,

elevated, pimples that may eventually evolve into painful open lesions

with a tendency to spread. General symptoms include compromised

immune system, fatigue, and psychological trauma.

 

A complete description of NCS symptoms, the syndrome, compounding

factors, and the toxic sealants, with case histories and treatment

protocols, is given by Amin (2003, 2004) Dental practitioners should

be aware of the adverse effects of using sealants, and employ this

knowledge to safeguard the well being of their patiesnt.

 

SOURCES:

 

Amin, O.M. " On the diagnosis and management of Neurocutaneous

Syndrome (NCS), a toxicity disorder from dental sealants. " Explore,

vol., 13, no. 1 (2003): pp 21-25.

 

Amin, O.M. " Dental sealant toxicity: Neurocutaneous Syndrome (NCS), a

dermatological and neurological disorder. " Holistic Dental

Association Journal, no. 1 (2004): pp. 1-15

 

Ziff, S. Silver Dental Fillings: The Toxic Time Bomb. Santa Fe,

Aurora Press, 2002.

 

A NOTE FROM THE LAB

 

It has been our experience that some people with symptoms of digestive

disease may also have an underlying parasitic infection.

 

Detecting and treating parasitic infections can be a complex process.

For example, some organisms are classified as commensals,

microorganisms that are present but don't actually cause disease

(nonpathogenic). In the past, parasites thought to be harmless have

included H. pylori, Blastocystis hominis, Dientamoeba fragilis and

even Giardia lamblia. In the past ten years they have been

reclassified, because we now recognize that these organisms and

numerous others can cause serious infections. In fact, some can

contribute to illness that can linger for years if untreated. Once

the infection is found and treated, patients often improve quite rapidly.

 

We've also noticed that parasitic GI infections don't cause symptoms

in the digestive tract alone. The effects of many pathogens are

experienced throughout the body, in any of the major organ systems.

Associated illnesses can include fatigue, difficulties with mental

concentration, depression, and neurological symptoms, as well as

allergies, asthma, arthritis, skin disorders, and other chronic health

problems.

 

Omar Amin, Ph.D., is founder of the Parasitology Center, Inc., in

Tempe, Arizona. He is a professor of parasitology and a Ph.D graduate

of Arizona State University, where he relocated after teaching at the

university of Wisconsin for twenty years. He is an internationally

recognized authority, with more than 145 major publications, extensive

worldwide field research, and international teaching experience. He

has been a Fulbright scholar and has received numerous research grants

for his work. Dr. Amin is available for professional consultations

with health care practitioners and will also answer patients'

questions directly.

 

The Parasitology Center, Inc., offers laboratory testing for the

detection of human parasitic infections and toxicities from

neurocutaneous syndrome; practitioners and patients can contact the

lab at 903 South Rural Road., No. 101-318, Tempe, Arizona, 85281;

phone (480) 767-2522; fax (480) 767-5855;

email OmarAmin

 

Web address: www.parasitetesting.com