Georga Public health Morgellons powerpoint presentation
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04/10/23 1
UNIDENTIFIED DERMATOSIS SYNDROME (UDS)
(a.k.a., Morgellons Disease)
SURVEILLANCE DATABASE
04/10/23 2
Jane M. Perry, MPH, DirectorChemical Hazards Program
Environmental Health and Injury Prevention Branch
Georgia Division of Public Health2 Peachtree St., 13th FloorAtlanta, GA 30303-3141
Phone: 404.657.6534Fax: 404.657.6533
e-mail: jmperry@dhr.state.ga.us
04/10/23 3
PRESENTATION FORMAT
• Definitions• Project history• Goals• Hypothesis• Survey• Results• Conclusions• Treatments• Next Steps
04/10/23 4
CHEMICAL HAZARDS PROGRAM
The Chemical Hazards Program was established in 1994 through a cooperative agreement with the Agency for Toxic Substances and Disease Registry (ATSDR)
The mission of the Chemical Hazards Program is to protect the health and promote the quality of life of Georgians through the prevention of exposure to hazardous substances in the environment.
04/10/23 5
“MORGELLONS DISEASE”
Individuals report disturbing symptoms of seeing and feeling crawling, stinging and biting organisms on and in their skin. These organisms are described as fiber-like or black specks, and are accompanied by skin lesions. Sufferers also report chronic joint pain, disabling fatigue, cognitive difficulties, mental confusion, memory loss, behavioral effects, and mood disorders.
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DELUSION OF PARASITOSIS
• An unshakable false belief that live organisms are present in the skin.
--Obermeyer, 1961
• Delusion of parasitosis usually involves young adults who are typically marginal in their socio-economic status where substance abuse is frequently associated, and older adults where drug abuse is usually not associated.
• They will frequently bring in bits of skin, lint, and other “specimens” to try to prove the existence of these alleged parasites. This behavior is so characteristic that it has been referred to as the “matchbox sign”.
• The delusion may be shared by a significant other.
--Koo & Lee, 2001, p, 286
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RULED OUT
• Drug use• Dementia• Professional pest control• Parasites—bed bugs, scabies, fleas, lice,
mites, etc.• History of psychosis
diagnosedundiagnosed
04/10/23 8
HEADLINES
$32 Million Verdict in Mold CaseCourt TV Forensic Files
Morgellons Has Plenty of SkepticsGood Morning America
Disease Baffles Patients and DoctorsPopular Mechanics
04/10/23 9
HEADLINES (cont.)
Doctors Make Progress with Mysterious Disease
Fox TV (San Francisco)
CDC Probes Bizarre Morgellons Condition
The Associated Press
Online Campaign Sparks Interest in New Disease
National Public Radio
04/10/23 10
HEADLINES (cont.)
Itching for Answers to a Mystery Condition
TIME Magazine
Making Your Skin CrawlCBS (Atlanta)
ABC Primetime: Medical MysteriesABC News
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ABC PRIMETIME: Medical Mysteries
August 9, 2006
“Recent research by Randy S. Wymore, Ph.D., assistant professor of pharmacology and physiology, OSU, and a forensic scientist at the Tulsa Police Department has ruled out textile origin of fibers from patients by demonstrating that the fibers do not match any of the 100,000 textile and similar fibers in the FBI database.”
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04/10/23 12
Skin lesions on the legsSource: www.thenmo.org/images.htm
Electron microscope imageSource: www.morgellons.org
Fibers show fluourescenceSource: www.morgellons.org
Typical photo of fibersSource: www.morgellonUSAs.org
04/10/23 13
PROJECT HISTORY
Dawson County case– Bottled water plant– Soil sample results– Saliva test results
Lamar County case– Corporate employed Roofer– Wife has it, too
Spalding County case– Whole family involved– Complaints of fungus– Family moved across the street
04/10/23 14
PROJECT HISTORY (Cont.)
• Delusory Parasitosis article, Epi Rpt. 12/04
• NUSPA survey data
• Morgellons Research Foundation (New Morgellons Order)– Possibly millions of cases worldwide– Over 10,000 registered from all 50 states– About 70 cases registered in GA– GA representative contact interaction
• Am J Clinical Dermatol 2006
• “Unidentified Dermatosis Syndrome”
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GOALS
1. Discourage those with UDS from using toxic chemicals to relieve symptoms.
2. Encourage CDC and other state agencies to investigate these reports.
3. Establish a UDS communication network in Georgia.
4. Identify treatments that offer symptom relief and share this information via the network.
5. Test hypothesis.
04/10/23 16
Abstract
Residents throughout Georgia have reported fiber-like and/or black specks crawling on/in
their skin, and a related set of symptoms including visible sores and disabling fatigue.
In response, CHP developed the Unidentified Dermatosis Syndrome (UDS) Surveillance
Database. It is intended to build and maintain self-reported symptom surveillance capacity.
In addition, data will be analyzed to determine if smptoms may be caused by
exposure to trichothecene (T-2 toxins) in soil.
04/10/23 17
HYPOTHESIS
CHP will examine whether:
1. parasites or other organisms may be causing the symptoms;
2. individuals may share hypersensitivity to mycotoxins (i.e., T-2 toxins) produced by certain fungi/molds present in soil causing specific neurotoxic effects.
04/10/23 18
T-2 TOXIN
Trichothecene (T-2) mycotoxin• Produced by certain fungi and molds• One of the most potent of all naturally occurring toxins• Classified, and has been used as a biological weaponSource Fungi/Mold• Fusarium, Aspergillus, Penicillium, and Stachybotrus• Present in soils throughout Georgia• dependent on substrates, pH, nutrient levels, moisture,
and temperatureSymptoms from Exposure
Skin irritation, severe itching, sores and shedding of the skin, sense distortion, lack of muscle coordination, teratogenic immunosuppressive effects, nose and throat pain, neurological and psychiatric effects…
04/10/23 19
SYMPTOM SURVEY
April 1– October 30, 2006– Administered by phone– Pilot survey (10)– Survey (25)– 54 questions– Recommendations– Referrals– Request for follow up contact
04/10/23 20
CASE DEFINITION
• String-like “parasites” or black specs in the skin, urine, or on the body*
• Crawling sensations in the skin or body*• Sores/itching• Fatigue• Confusion• Memory loss• Hair Loss• Dizziness* If not checked, symptoms do not meet our criteria.
04/10/23 21
CASE RECRUITMENT
Memo– District/county EH program managers– County PH clinics– PH nursing managers– Epi On-call– CDC, other state Health Departments– Morgellons Research Foundation– Georgia Veterinary Medical Association– Activist websites– Others
04/10/23 22
SURVEY QUESTIONS
Demographics Home environment
– Address for GIS mapping– Length of residency– Mold and fungus inside, outside– Flora, soil conditions
Outdoor activities– Gardening– Change in activities
04/10/23 23
SURVEY QUESTIONS (cont.)
Symptoms– When, where began– Onset event– Description– Others in household, pets– Seasonal, other changes– Exacerbation triggers
04/10/23 24
SURVEY QUESTIONS (cont.)
Medical history– Allergies– Lyme disease, ticks– Tests, results– Medications
Doctor visits– Number of visits– Medical specialties
Treatments/symptom relief
04/10/23 25
COMMUNICATION NETWORK
Recommendations (Interviewers Protocol):• DO NOT attempt to treat symptoms with pesticides, household chemicals, or other
products not intended for those uses.• DO try over the counter allergy medicines such as Claritin to relieve your symptoms.
Use only as directed.• DO contact your doctor or veterinarian for prescription strength allergy medicines for
yourself, your loved ones, and your pets.• DO network with other individuals and organizations where members have similar
symptoms.
There are websites where you can contact others who suffer symptoms similar to yours. By listing these websites below, the GDPH is not endorsing any specific organization
or diagnosis or philosophy. For more information about symptoms, visit:
www.morgellons.orgwww.skinparasites.com
www.dpref.comwww.unknownskindisease.com
www.morgellons-research.org/morgellonswww.cherokeechas.com
04/10/23 26
DRAFT RESULTS
Significant majoritymiddle agewhite, non-Hispanic men and womenliving in north half of GAsymptoms < 3 years (but as far back as 20 years)do not report mold in the homediscontinued outdoor activityvisit doctor(s) and/or specialist(s)
Dermatology, Infectious Disease, GI, Internal Medicine, Neurology, Urology,
Ophthalmology, Allergy, Rheumatologyself medicate
bleach, ammonia, inspect spray, dog flea dip, gasoline, kerosene, WD40, Windex, Lysol
04/10/23 27
DRAFT RESULTS (cont.)
Insignificant majority or about equal
females / males
have / don’t have outdoor hobbies
precipitating event
04/10/23 28
DRAFT RESULTS (cont.)
Population
The 10 county Atlanta metropolitan area has 53% of the population of Georgia
North, central, and south Georgia account for the remaining 48%.
North Georgia and the Atlanta area together account for 66% of Georgia’s population
04/10/23 29
04/10/23 30
DRAFT RESULTS (cont.)
04/10/23 31
23%
12%
9%
20%
04/10/23 32
CONCLUSIONS
1. Most of the case reports came from north Georgia and indicate contact with upturned soils.
2. There are associations supporting the hypothesis, but these associations are weak and not significant.
3. While significant trends cannot be defined from this descriptive survey, this survey documents the experiences of those who report these symptoms--including potentially hazardous methods used to alleviate symptoms.
04/10/23 33
EFFECTIVE TREATMENTS
• Add vinegar to shampoo• Complete body shave• Avoid antibacterial soaps• Dry body with paper towels• Encase bedding in vinyl covers• Wash all fabrics with bleach or, for colors, soak
in vinegar.• If no children in household, set hot water heater
to 155 degrees• Replace all carpets with linoleum or tile or
vacuum daily• Keep pets outdoors
04/10/23 34
NEXT STEPS
• Continue analyses• Publish paper• Sampling
– Environmental– Biological– Pets
• CDC investigation
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