Zoonoses – a load of cock-and-bull?

February 14, 2013

by Joel (Snowathlete)

wordle made up of zoonotic wordsFor millennia man has predicted the end of the world: an asteroid strike, a super-volcano, global warming… but in recent years, we’ve been told that our greatest threat is the microbe. In 2003 it was Bird flu, then in 2009 it was Swine flu, but as we’re still here, perhaps it’s a cock-and-bull story, rather than a bird and pig one?

Either way, we’ve got bigger fish to fry regarding our own disease, but all this talk of animals may not be far from the truth when it comes to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

Zoonoses (Greek: “zoon” = animal, “nosos” = disease) are diseases that are transmitted to humans from other animals, and such diseases are caused by a variety of pathogen types including parasites, bacteria, fungi, and viruses. Such pathogens transmitted to humans from animals are called zoonotics.

Animals are well known for transmitting diseases to humans: H5N1 (birds), H1N1 (swine), Toxoplamosis (cats), Lyme disease (tics), Rabies (dogs), etc. Rabies alone kills more than 50,000 people a year.

How common?

A study from the Royal Society, looking at 1415 pathogens known to infect humans, reported that 61% were zoonotic [1]. Therefore it is more likely than not that our illness – if it is caused by a pathogen – is zoonotic in origin. Additionally, it is thought that many anthroponoses (diseases transmissible between humans) started out as zoonotics, including measles and AIDS (the latter killing more than 25 million people in the last thirty years). 

The current position on zoonotic diseases from the Centres for Disease Control and Prevention (CDC) is that “approximately 75% of recently emerging infectious diseases affecting humans are diseases of animal origin.”

The threat

flea

Picture curtesy of kat m research

Zoonotics have been responsible for a great deal of damage to human civilization over the years. Yersinia pestis, a gram-negative bacterium transmitted by fleas, is responsible for the Bubonic, Pneumonic and Septicemic plagues. In the fourteenth century this zoonotic was the cause of the Black Death – one of the most deadly pandemics in history – killing between 30 and 50 percent of the population of Europe, and it continued terrorizing Europe for hundreds of years.

In the modern era there is a great threat of a global pandemic of zoonotic origin, but predicting the emergence of such a disease has proven difficult. Our monitoring of emerging zoonotics has improved, but our best method so far is to contain such emerging zoonotics swiftly, erradicating them if possible, before the pathogens evolve to become communicable between humans.

A good example is New Variant Creutzfeldt-Jakob disease (nvCJD), the human form of Bovine Spongiform Encephalopathy (BSE). nvCJD is a zoonose that emerged in the 1990s following the outbreak of BSE in British cattle in the late 1980s. 

Measures taken to avoid further infection of humans, such as the slaughter of more than four million cattle and the restriction and banning of certain beef products, meant that only around two hundred people are thought to have died from nvCJD to date, and only three cases of human to human transmission have been reported (all as a result of infected blood transfusion).

Transmission

Zoonotics can be transmitted via infected water or food, via a contaminated environment or indirectly via a vector. A vector is an animal that carries and transmits the zoonotic pathogen to a human. In the case of Lyme disease, for example, the vector is usually a tick, and has itself picked up the zoonotic parasite Borrelia from a reservoir.  A reservoir is the animal that hosts the disease in the first place; in the case of Lyme disease this is often a rodent or bird. Although Lyme disease is understood to sometimes cause a bull’s eye type rash, it often doesn’t (more bull, I’m afraid).

Those who work or live with animals are at a greater risk of catching zoonoses, but although getting rid of the cat might reduce your chances of catching toxoplasmosis, pets have long been associated with health benefits and a study looking at CFS patients that had cats or dogs as pets showed no increased prevalence [2]. Avoiding smaller animals, such as insects, is particularly difficult and the chances are that you wouldn’t even notice being bitten.

Then there are animal viruses accidentally put into vaccines, such as the rotavirus gastroenteritis vaccines which were found to be contaminated with DNA belonging to Circovirus 1 (PCV1) and Circovirus 2 (PCV2) [3]. PCV2  can cause a wasting disease in pigs but is not thought to cause disease in humans. That means that it isn’t yet classified as a zoonotic, but whether it could emerge as a future zoonotic is a matter of continuing debate.

Zoonotics and ME/CFS

Some zoonotics are routinely found in humans – perhaps more so in ME/CFS patients – but the medical community has a tendency to dismiss such infections as many are thought not to cause disease, or to cause only mild, short-lived symptoms. Only pathogens that have already been proven to be particularly dangerous, like certain strains of E.coli, or Crimean-Congo Viral Hemorrhagic Fever (a tick-borne virus that occurs mainly in Africa and Asia) are treated more seriously when presented, as without treatment they can be fatal.

While some other zoonotics have been well researched and do not cause disease, or are mild and self-limiting, many others have not been well studied so could be significant factors in diseases like ME/CFS. Nevertheless, the general rule seems to be “safe until proven to cause harm”. This leaves a lot of room for a known or unknown zoonotic to be the cause or the trigger of ME/CFS. 

Even if such zoonotics are not the cause of ME/CFS, the immune-dysfunction associated with the illness may leave patients more vulnerable to such pathogens as secondary infections. Such infections are taken very seriously in illnesses, like HIV-AIDS, but the world has a lot of catching up to do before it recognises this threat in the case of ME/CFS.

Studies looking at zoonotics in ME/CFS

Staphylococci adhering to the surface of red blood cells of an CFS/ME patient from the UK (microphotograph copyright, Walter Tarello).

Staphylococci adhering to the surface of red blood cells of an CFS/ME patient from the UK (microphotograph copyright, W. Tarello).

In 2001 Dr. Walter Tarello, a veterinary surgeon from Perugia, Italy, reported the possible existence of CFS in horses infected with micrococci-like organisms, hinting at a zoonotic cause for the illness in humans. The horses were treated with Sodium Thiacetrarsamide, an arsenic based antibacterial, resulting in eradication of the bacteria and complete symptom remission [4]. Similar findings were later found in dogs, cats [5] and birds [6, 7].

The veterinary surgeon and his wife, themselves CFS suffers, then treated themselves with the same drug and made complete recoveries [8]. Indeed Dr Tarello’s recovery has lasted, as shown by his ability to compete in the Dubai Marathon earlier this year, finishing in a very respectable time. Many CFS sufferers can hardly dream of making such a strong recovery, which highlights the need for more research into such treatments.

Dr W. Tarello completing the Dubai Marathon

Image copyright, W. Tarello.

As well as raising the interesting question of whether other ME/CFS sufferers, besides Dr Tarello and his wife, might be infected by the same or similar micrococci-like organisms, what is clearly illustrated is that animal pathogens can be transmitted to humans and cause the same symptoms as ME/CFS. Zoonotics are common, easy to pick up, and are the cause of many different diseases in humans.

If we look at Irritable bowel syndrome (IBS), which often presents as a co-morbid condition with ME/CFS, we see that another zoonotic is implicated. This time it is Giardia lamblia, which was found to be the cause of both persistent IBS and chronic fatigue following an outbreak in Bergen, Norway in the autumn of 2004 [9,10]. Again we can see that a zoonotic is able to infect humans and cause symptoms common in ME/CFS.

Commonly linked with ME/CFS

There are several other zoonotic pathogens that have been proposed to cause ME/CFS, or are often present as co-morbid infections. Some of the most commonly linked are Borrelia, Bartonella (Toxoplasmosis), Babesia, Coxiella burnetii, Rickettsia and Ehrlichia chaffeensis. Several ME/CFS researchers are looking at some of these zoonotics and investigating what role they might play in the pathology of the illness, so we have reason to be bullish about future progress in this area.

I will be reporting on some of these zoonotics in future articles in the series, so look out for the next article: Borrelia – in the Lyme Light.

 

Joel was diagnosed with ME/CFS in 2009 but struggled with the illness for some time prior to this. He loves to write, and hopes to regain enough health to return to the career he loved and have his novels published.

 

REFERENCES

1. Taylor et al. Risk factors for human disease emergence. philosophical transactions of the royal society of biological sciences. 2001.

2. Wells DL. Associations between pet ownership and self-reported health status in people suffering from chronic fatigue syndrome. Journal of Alternative and Complementary Medicine. 2009.

3. Gilliland SM et al. Investigation of porcine circovirus contamination in human vaccines.  July 2012.

4. TARELLO W. Chronic Fatigue Syndrome in horses: diagnosis and treatment of cases. Comparative immunology microbiology and infectious diseases. 2001.

5. TARELLO W. Chronic Fatigue Syndrome (CFS) in 15 dogs and cats with specific biochemical and microbiological anomalies. Comparative immunology microbiology and infectious diseases. 2001.

6. TARELLO W. Chronic Fatigue and Immune Dysfunction Syndrome associated with Staphylococcus spp. bacteremia responsive to thiacetarsamide sodium in eight birds of prey. Journal of Veterinary Medicine B. 2001.

7. TARELLO W. Etiologic Agents and Diseases Found Associated with Clinical Aspergillosis in Falcons. International Journal of Microbiology. 2011.

8. TARELLO W. Chronic fatigue syndrome (CFS) associated with Staphylococcus  spp. bacteremia, responsive to potassium arsenite 0.5% in a veterinary surgeon and his coworking wife, handling with CFS animal cases.  2001.

9. Wood NJ. Infection: Giardia lamblia is associated with an increased risk of both IBS and chronic fatigue that persists for at least 3 years.  2011.

10. Wensaas KA et al. Irritable bowel syndrome and chronic fatigue 3 years after acute giardiasis: historic cohort study.  2012.

 

Suggested reading

  1. Zdenek Hubálek: Anthroponoses, Zoonoses, and Sapronoses. Journal: Emerging Human Infectious Diseases.

  2. Zoonoses – World Health Organisation

  3. CDC – National Center for Emerging and Zoonotic Infectious Diseases

  4. Clinical Knowledge Summaries: Tick-borne diseases (NICE – NHS)

  5. Table of Zoonotic Diseases and Organisms (UK Health Protection Agency)

 

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25 comments

{ 25 comments… read them below or add one }

peggy-sue February 14, 2013 at 1:49 pm

Interesting and forward looking – to an important area. After all, bacteria and viruses can go through several generations rapidly – they are the most adaptable living things on the planet.

I feel though, that when discussing transmissable spongiform encephalopathies, there should have been some mention of Kuru – the transmissable CJD passed on in a tribe in Papua New Guinea for years and years – long before BSE – with devastating consequences for them all, because of their funeral custom of eating the brains of their dead to honour them. What I don't know is whether or not this was nvCJD being passed on, or CJD itself.

maryb February 14, 2013 at 1:52 pm

I was tested for most of the 'usual suspects' by KdM around 12 of them including Borelia – been around dogs and horses all my life, all came back negative – it'd be practically impossible to test for every single bacteria.
One thing I probably did pick up from the dogs was parvovirus.

Nielk February 14, 2013 at 2:28 pm

I enjoyed reading this article, Joel. Thank you. I'm looking forward for more.

Victronix February 14, 2013 at 2:34 pm

Fascinating.

I wish the mainstream media would cover more of this information, that I have never heard of or see much about. Dr. Walter Tarello should have at least a wikipedia page, if the story is true that he cured himself and his wife. But I see none. I've created them pages for people in the past, but it takes time and energy.

Sushi February 14, 2013 at 2:42 pm

snowathlete

Great article–thanks!

Sushi

Sea February 14, 2013 at 2:55 pm


maryb

One thing I probably did pick up from the dogs was parvovirus.

Actually Mary parvovirus in dogs is a quite different virus
http://www.petmd.com/dog/wellness/evr_dg_parvovirus_across_species#.UR1NkhEaySM

I looked into it when I had parvovirus last year followed by a severe case of the viral arthritis that sometimes happens in adults

maryb February 14, 2013 at 3:13 pm


Sea

Actually Mary parvovirus in dogs is a quite different virus
http://www.petmd.com/dog/wellness/evr_dg_parvovirus_across_species#.UR1NkhEaySM

I looked into it when I had parvovirus last year followed by a severe case of the viral arthritis that sometimes happens in adults

Thats good to know so can't blame the dogs for anything then, always kept good hygiene with my animals, I really worked hard at that. thanks for the info Sea. Good article explains it very well, don't like the bit about foxes can pass the virus on to dogs – we have a lot of foxes around here, sorry not to offend anyone but I really don't like them,always worried about my dogs over the years, now only have an oldie and wouldn't like her to catch anything…. I'm rambling on a bit!

lansbergen February 14, 2013 at 4:46 pm


peggy-sue

I feel though, that when discussing transmissable spongiform encephalopathies, there should have been some mention of Kuru – the transmissable CJD passed on in a tribe in Papua New Guinea for years and years – long before BSE – with devastating consequences for them all, because of their funeral custom of eating the brains of their dead to honour them. What I don't know is whether or not this was nvCJD being passed on, or CJD itself.

There are many TSE strains and the disease this one caused was called Kuru. The laughing death.

Wayne February 14, 2013 at 6:27 pm

Hi Snowathlete, thanks for the informative article.

Some of what you wrote reminds me of a story I once heard about a president of a major medical school giving a commencement address in which he stated that probably half of what the graduates just learned in medical school would end up being proven to be wrong within 5 years. He added that unfortunately, nobody knew what half it was.

I also once watched a PBS program where they speculated how far we have come in understanding the mysteries of many areas of inquiry, including physics, astronomy, medicine, etc. He gave a figure of 4% of what we have truly come to understand reasonably well.

So whenever I see articles referring to the lack of knowledge by "authorities" in their field, it reminds me of the above. I also often think of this when observing some of the arrogance of modern medicine and health practitioners who act as if they know it all, and if they can't explain something by their own yardsticks, then it must be psychological. It feels like Humility 101 should be a prerequisite for anybody working in the health field.

Hmmm, I think I just went on a rant! :rolleyes:o_O

Iquitos February 15, 2013 at 9:37 am

Check out the symptoms of brucellosis in humans:

http://www.vetmed.wisc.edu/pbs/zoonoses/brucellosis/brucellosishuman.html

The incubation period is generally 1-2 months, after which the onset of illness may be acute or insidious. Thereafter, symptoms may include:

an intermittent, "undulating" fever
headaches, chills, depression, profound weakness
arthralgia, myalgia
weight loss
orchitis/epididymitis in men and spontaneous abortion in pregnant woman
Brucellosis lasts for days to months, and can be quite debilitating, although the case fatality rate is very low (except in cases of B. melitensis endocarditis).
Chronic sequelae may include sacroiliitis, hepatic disease, endocarditis, colitis and meningitis.

snowathlete February 15, 2013 at 11:21 am

For those that are interested in the Giardia outbreak in Bergen, Norway, that resulted in patients getting IBS and fatigue symptoms, there is a follow-up paper that was published a couple of days ago (a couple of days after I wrote the above article :rolleyes:) and there is a topic on the forum about it:
http://forums.phoenixrising.me/inde…ristics-and-natural-course.21844/#post-334233

Valentijn February 15, 2013 at 1:33 pm


snowathlete

For those that are interested in the Giardia outbreak in Bergen, Norway, that resulted in patients getting IBS and fatigue symptoms, there is a follow-up paper that was published a couple of days ago (a couple of days after I wrote the above article :rolleyes:) and there is a topic on the forum about it:
http://forums.phoenixrising.me/inde…ristics-and-natural-course.21844/#post-334233

Typical on the timing :p

Giardia is one thing I've wanted to get tested – immediately after moving to the Netherlands, a dog who I had been living with back in Seattle was diagnosed with Giardia. No idea how long she'd had it, but she was constantly trying to slip me some tongue (and occasionally succeeding), so I wouldn't be too surprised if I picked it up from her.

snowathlete February 15, 2013 at 2:52 pm


Valentijn

Giardia is one thing I've wanted to get tested – immediately after moving to the Netherlands, a dog who I had been living with back in Seattle was diagnosed with Giardia. No idea how long she'd had it, but she was constantly trying to slip me some tongue (and occasionally succeeding), so I wouldn't be too surprised if I picked it up from her.

Interesting. Do you get IBS symptoms? Worth testing either way perhaps, as you know it's been an exposure for you.
Anyone know which ME/CFS doctors test for it?

This Giardia outbreak in the water in Bergen made me wonder about the Incline Village/Lake Tahoe outbreak in the 80s – was it Giardia in the water there as well?

caledonia February 16, 2013 at 12:34 am

Thanks for your article. I thought it was well written. I had forgotten about the Tarello case.

Valentijn February 16, 2013 at 2:18 am


snowathlete

Interesting. Do you get IBS symptoms? Worth testing either way perhaps, as you know it's been an exposure for you.
Anyone know which ME/CFS doctors test for it?

This Giardia outbreak in the water in Bergen made me wonder about the Incline Village/Lake Tahoe outbreak in the 80s – was it Giardia in the water there as well?

I have chronic constipation if I don't take magnesium, but it sounds like after getting diarrhea with the acute infection, constipation is pretty common. And lots of tummy problems, including pain and intermittent diarrhea. But no weight loss. So maybe, maybe not.

It sounds like it would be a common part of a feces parasite screen, and I see a lot of references to it as part of a Triple Feces Test (TFT). A local Dutch lab runs a parasite screen and a TFT (http://www.europeanlaboratory.nl/ , can select "english" in upper right box) but doesn't specify if giardia is included in those tests (it's not included in the basic feces screen based on the Dutch info sheet). I need to ask them to clarify an ANA result anyhow, so might try to ask them about their parasitology screen and TFT at the same time :p

lansbergen February 16, 2013 at 2:39 am


Valentijn

Typical on the timing :p

Giardia is one thing I've wanted to get tested – immediately after moving to the Netherlands, a dog who I had been living with back in Seattle was diagnosed with Giardia.

The RIVM tested me decades ago. I was negative.

Banksy February 16, 2013 at 4:47 am

check this out…im not conspiracy fan, but…u never know. http://www.youtube.com/watch?feature=player_embedded&v=-aHRMjVHggI

snowathlete February 16, 2013 at 6:58 am


caledonia

Thanks for your article. I thought it was well written. I had forgotten about the Tarello case.

Thank you calendonia, nice of you to say.

I can't see that anyone has followed up Dr Tarello's work; tried replicating his findings, done a proper trial of the drug, etc. which is a shame because it looks so promising. His first paper on the subject was in 2001 so perhaps it didn't get the attention that it would today…On the subject of Dr Tarello he is now living and working in Dubai, here is his website. I dont know if anyone knows any experienced veterinarians, but they have an opening for one. An interesting guy to work with, I'd have thought. Given that zoonotics are a major cause of human disease, it's a surprise that we dont see more overlap like this.

Now that it looks like the FDA are engaged and serious about finding a drug for the illness, I wonder if they might look at these arsenic based drugs as possible candidates for some proper trials.

PNR2008 February 16, 2013 at 12:19 pm

Reminds me of Dr Glass that did research on pets that got sick with CFS symtoms after their owners were diagnosed and visa versa in the late 80's.

Sushi February 16, 2013 at 12:44 pm


lansbergen

The RIVM tested me decades ago. I was negative.

I have had a lot of experience with parasites and testing (unfortunately) and a parasitologist explained to me that, as parasites live attached to the bowel wall, the chances of missing them in any one feces sample is high. He preferred to take as scraping from the wall of the rectum and also to do blood tests which would indicate a parasite infection.

Sushi

Sing February 16, 2013 at 8:07 pm

I think you've written an interesting article and don't question that bugs or illnesses which animals have can cross over to us, as we are animals too. If we caught it from another human being, we caught it from an animal. However, I am definitely troubled by the intellectually or scientifically loose aspects of this article–or any other articles here.

First of all, when people, or animals, are said to have CFS-like symptoms, what does this mean? Just fatigue, the number one symptom across all kinds of illnesses? What is the definition of CFS being associated to? Also, when there is only a very small study with no replication, and the rigor of that study is unknown, the conclusions don't seem to amount to much more than anecdotal evidence.

The reason I am being critical is I feel it will end up being harder on patients if we start chasing after every possible cause and association out there. It reminds me of the problem with claims for alternative medicine, nutritional supplements, etc. There are thousands of potential causes and treatments, but which ones are actually valid for ME/CFS with a Canadian or International Case Definition?

Many of us have already exhausted our time, energy, money and hope chasing after special treatments and doctors/practitioners, but what percentage of us defined by the Canadian or International Criteria have recovered? Very few, from my information. I hope our best doctors and researchers do study this illness and look into different treatments in particular (though I consider looking for THE CAUSE a waste of time) but I don't want to get emotionally involved with, or chase after, every possibility before they do.

Even when high-profile people do get involved, we can still be fooled. Witness XMRV. I am as keen for answers and help as anyone, but I can't afford the disappointment that can follow too much speculation, or thinking that we might have our hands on a cause, when all we have is an association, maybe not even a proven association, and if proven, may not even linked to the strictly defined form of ME/CFS–or ME.

I objected to some other specific points. There are people who believe that all CFS, or ME/CFS is Lyme Disease. The "all CFS =Lyme" has been shown to be false, by the spinal fluid study, our failure to respond to antibiotics, etc. The clinical picture may be overlapping, just as it is with Gulf War Syndrome, thought by Dr. Klimas to be caused by pesticide exposure, but the causes, illnesses and treatments are different.

Then about Giardia–it does cause diarrhea, nausea, fatigue, etc. as a result of how the protozoan knocks out the small intestine. It does not attack the large bowel. Most IBS, I think, comes from large intestine problems instead. Giardia symptoms are closer to those of gluten intolerance, which also disables the small intestine, not the large bowel. The types of diarrheas, and malabsorption are different. A sign of a small intestine problem is the lack of fat absorption. It is important for all of us to try to be very careful about our data and claims.

GcMAF Australia February 16, 2013 at 11:12 pm


snowathlete

For those that are interested in the Giardia outbreak in Bergen, Norway, that resulted in patients getting IBS and fatigue symptoms, there is a follow-up paper that was published a couple of days ago (a couple of days after I wrote the above article :rolleyes:) and there is a topic on the forum about it:
http://forums.phoenixrising.me/inde…ristics-and-natural-course.21844/#post-334233

Yes
that is because they wanted to see what you had to say about it before they published ;)

lansbergen February 17, 2013 at 5:22 am


Sushi

I have had a lot of experience with parasites and testing (unfortunately) and a parasitologist explained to me that, as parasites live attached to the bowel wall, the chances of missing them in any one feces sample is high. He preferred to take as scraping from the wall of the rectum and also to do blood tests which would indicate a parasite infection.

Sushi

If you want it to be a parasite Toxocara would be a better candidate.

snowathlete February 17, 2013 at 8:47 am


Sing

I think you've written an interesting article and don't question that bugs or illnesses which animals have can cross over to us, as we are animals too. If we caught it from another human being, we caught it from an animal. However, I am definitely troubled by the intellectually or scientifically loose aspects of this article–or any other articles here.

First of all, when people, or animals, are said to have CFS-like symptoms, what does this mean? Just fatigue, the number one symptom across all kinds of illnesses? What is the definition of CFS being associated to? Also, when there is only a very small study with no replication, and the rigor of that study is unknown, the conclusions don't seem to amount to much more than anecdotal evidence.

Hi Sing,
Thanks for your comments. I'm glad you asked some of these question as it allows me to ellaborate on particular areas in a way that I couldnt really within the limits of the article itself.

With regards to the animals Dr Tarello mentions in his papers, they were diagnosed with CFS-like illness based on the CDC's 1994 criteria (sometimes refered to as Fukuda criteria). Reasonable, given that these studies were carried out before Candian or International criteria were published (2003 and 2011 respectively). I myself was diagnosed originally by the Fukuda criteria, as most still are (at least in the UK) but susequently met the Candian and International criteria.

Dr Tarello and his wife were diagnosed in a way that many of us can relate to: after many tests to rule out other causes, finally being diagnosed with CFS based on the Fukuda criteria. Serum creatine kinase (CK) were also found to be high at rest and CD4/CD8 ratio was found to be low.

At that time, chronic mononucleosis was thought by some to be the cause of CFS and so their IgG EBV titers were also taken (1/160 patient 1 and 1/640 patient 2). So they were given magnesium, selenium and carnitine supplementation, but this had no benefits.

Interesting to note as well that this Arsenic derived treatment was not their first choice. They tried antibiotics and anti-malarial drugs first without benefit.

I agree that it would be nice to have the findings replicated and more research into this area. I think I said that in my article.

At the end of the day people have to make their own decision about which avenues to pursue (if any) based upon the limited research that the illness gets, but I agree with being sceptical and cautious. XMRV is a good example. Personally, I thought it was to early to have an XMRV test or to take treatments to tackle it, but other people decided to go ahead and do that. Probablity favours the skeptic in such cases as until a finding has been reliably replicated, its just a possible finding. It may not stand up, and often doesnt.

Sing

The reason I am being critical is I feel it will end up being harder on patients if we start chasing after every possible cause and association out there. It reminds me of the problem with claims for alternative medicine, nutritional supplements, etc. There are thousands of potential causes and treatments, but which ones are actually valid for ME/CFS with a Canadian or International Case Definition?

Many of us have already exhausted our time, energy, money and hope chasing after special treatments and doctors/practitioners, but what percentage of us defined by the Canadian or International Criteria have recovered? Very few, from my information. I hope our best doctors and researchers do study this illness and look into different treatments in particular (though I consider looking for THE CAUSE a waste of time) but I don't want to get emotionally involved with, or chase after, every possibility before they do.

Even when high-profile people do get involved, we can still be fooled. Witness XMRV. I am as keen for answers and help as anyone, but I can't afford the disappointment that can follow too much speculation, or thinking that we might have our hands on a cause, when all we have is an association, maybe not even a proven association, and if proven, may not even linked to the strictly defined form of ME/CFS–or ME.

I objected to some other specific points. There are people who believe that all CFS, or ME/CFS is Lyme Disease. The "all CFS =Lyme" has been shown to be false, by the spinal fluid study, our failure to respond to antibiotics, etc. The clinical picture may be overlapping, just as it is with Gulf War Syndrome, thought by Dr. Klimas to be caused by pesticide exposure, but the causes, illnesses and treatments are different.

I'm glad you brought Borrelia up – not all Lyme is the same and some Borelia species cause illness but not Lyme disease. The overlap in symptomology does mean that it should be ruled out before a diagnosis of ME/CFS is made, and there is also no rule that says someone cant have both Lyme and ME/CFS. Borelia is very interesting indeed. My next article in this zoonotics series will be about Borrelia and Lyme. I look forward to your thoughts and comments once its published.

Sing

Then about Giardia–it does cause diarrhea, nausea, fatigue, etc. as a result of how the protozoan knocks out the small intestine. It does not attack the large bowel. Most IBS, I think, comes from large intestine problems instead. Giardia symptoms are closer to those of gluten intolerance, which also disables the small intestine, not the large bowel. The types of diarrheas, and malabsorption are different. A sign of a small intestine problem is the lack of fat absorption. It is important for all of us to try to be very careful about our data and claims.

I was careful to describe the Giardia findings in Bergen as Chronic Fatigue not Chronic Fatigue Syndrome, because the paper doesnt say that and it doesnt explain how the chronic fatigue they described was evaluated. Nevertheless, the finding demonstrates that a zoonotic can cause symptoms reported as IBS or fatigue, and thats what I am highlighting in this article.

Whether Giardia is a likely cause for CFS/ME or not, I dont know – its not something I have looked into. I may cover it in this series, but I dont plan to cover every zoonotic ever linked with ME/CFS, so I may well not cover it. It depends on whether other studies have looked at it, and also how much interest people show in it as a topic. Some other zoonotics may be more interesting to explore. Thanks for your interest though.

peggy-sue February 17, 2013 at 8:58 am

I used to wonder if my cat had ME. She never moved or wasted a single joule of energy she didn't have to.
It turned out, when she was given painkillers for an injury, that she could move just fine. She's had arthritis all her life.
Now she gets painkillers every day and can move and wash properly. But she's still pretty lazy.

It's very difficicult to make a diagnosis of a creature who can't speak and tell you what hurts or doesn't feel right.

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