Desperately seeking
infection
As someone who has multiple allergies and overwhelming food intolerance, as well perennial rhinitis, eczema and allergic asthma, I have been very keen to obtain a hookworm infection since I first heard about the Nottingham project.
I could have travelled to where the worms are endemic and picked up a hookworm infection by walking around barefoot in open air latrines, but the dose is difficult to control when obtained in this way and one could easily pick up something less desirable in the process.
The silver lining to my recent diagnosis of Crohn's disease was that this provided eligibility for inclusion in the current trial of hookworms in patients with this disorder, and I wasted no time in taking advantage of the opportunity.
At my first session at the Wolfson Digestive Diseases Centre at the Queen's Medical Centre in Nottingham, the project was explained in detail by Paul Fortun, the trial team leader, and my suitability for the study was assessed. After this, all of which took place in the 'Bored Room', I was examined in another room designated the 'Hide and Caecum'!
At the next session, a small amount of liquid was dispensed onto a plaster which was then applied to my arm. Contained within the liquid were either ten microscopic worm larvae, or a small quantity of histamine to act as a placebo by imitating the itch caused by the larvae as they make their way through the skin.
Which of these 'treatments' I received was dependent on whether I had been assigned to the active treatment group or the placebo group but, as this is a double-blinded trial, this detail was not revealed to me, nor known by the medical staff involved.
Living with wriggly lodgers
I settled into a routine of diary-keeping and of hospital visits every three weeks for blood tests and the completion of more questionnaires, while waiting for the worms – if these were what I had been given – to take up residence in my gut.
If I had received hookworm larvae, these would travel first, via my blood stream, from their point of entry on my arm to my lungs. They would then hitch a ride on the upward-moving escalator of hairs lining my airways, before being swallowed, passing through my stomach, and finally settling in pairs in the upper reaches of my small intestine. And all without the aid of a sat nav!
As the worms are still minute when they make this epic journey, the host is blissfully unaware of any of their activity. Even when fully grown, this hookworm only reaches approximately 1 cm long and, although it survives by drawing blood, this is also undetectable by the host, and the amount taken is miniscule.
Normal sanitation and hygiene procedures ensure that there is no danger of the worms proliferating in the host, or of infection being passed on to others. The eggs produced by the adult worms only become infectious after they have left the gut of the host and gone through a further stage of growth in soil. In order for a transfer of infection to take place, the next generation of larvae must then be picked up from the ground on bare skin, several days after the eggs were deposited.
The benefits of gut buddies
Quite suddenly, at about the fourth week of the trial, my bowel habits normalised somewhat and abdominal discomfort decreased. Itching at eczema sites eased, sleep improved, my perennial rhinitis dried up completely and a persistent nocturnal throat irritation also improved, completing this impressive list of chronic symptoms which were unexpectedly ameliorated.
What I was hoping for most was to regain some tolerance to normal foods but, eating small amounts of a few common foods (instead of my usual semi-elemental diet) produced only disappointing results initially. However, later in the trial period, several foods which had previously caused a variety of symptoms, including bloating, nausea and abdominal soreness, increased fatigue, headache and inappropriate shivering, began to produce less severe symptoms and, in a few cases, no symptoms at all.
Following eradication treatment at the end of the active phase of the trial, all the positive changes were reversed and I was forced to return to a solely semi-elemental diet, leaving me to ponder whether the benefits had all been due to the placebo effect, or whether I had actually found a remarkably simple solution to many of my health problems.
I am currently negotiating a reinfection with Necator, in order to further assess the possibility that this treatment might be of long-term benefit in my battle with multiple allergy and food intolerance.
Worm therapy opportunities
Many questions remain to be answered about worm therapy, such as what the ideal number of worms might be, and whether it is better to leave the same worms in place for a longer period or to eradicate and replace them every few months.
Further studies will be carried out at Nottingham to try to answer these and other questions, and are likely to involve other diseases as well as Crohn's. A study with asthma patients has already been completed and MS specialists are showing an interest in trialling hookworms with some of their patients.
Would-be worm hosts who are not eligible for a clinical trial could always acquire an infection the natural way, by walking barefoot on faeces-infected ground in a part of the world where hookworms are endemic, as did one adventurous worm hunter who was desperate to cure his asthma. Details of this brave man's exploits can be read in his practical guide to the use of hookworms in the treatment of asthma and hay fever, at http://tinyurl.com/nz46n.
A safer and more convenient, though much more expensive option would be to purchase the eggs of a different gastrointestinal worm – Trichuris suis – from Ovamed, a German pharmaceutical company.
(See http://tinyurl.com/4jhj9c)
Trichuris – a pig whipworm – has been researched at the University of Iowa in the US and found to be a safe and
effective treatment for ulcerative colitis and Crohn's disease in humans. However, as this worm is not naturalised to our species, it does not survive long in the human gut, necessitating repeat infections every three weeks, in the form of a drink laced with the worm's eggs. (See http://tinyurl.com/4wvoxl)
Further information For an overview of the work with hookworms at Nottingham university, see http://tinyurl.com/6rx3zq
For more on specific hookworm studies, including contact details for the researchers involved in the trials, see:
http://tinyurl.com/6cdmyq (for Crohn's disease);
http://tinyurl.com/6zl9bf (for allergy and asthma).
For a fascinating and amusing read on the subject of our complex, and sometimes comical relationship with pathogens and parasites, see Riddled With Life: Friendly Worms, Ladybug Sex and The Parasites That Make Us Who We Are by Marlene Zuk, published by Harcourt.
For a review of this infectious read see http://tinyurl.com/694kct where a link is provided for those who wish to purchase the book.
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