Our friend the hookworm

Bill the Mathematician—yes, that’s Bill of the unaccountably broken back—is not always fully recognized as the trendsetter he really is. Right now he’s in Phnom Penh, on his way to the Pasteur Institute to ask for a dose of hookworm larvae. “I thought I’d found a source yesterday,” he tells me, “as PP now has a National Parasitological Center. But somehow they can’t help because ‘it’s time for exams.’ But they did suggest I try L’Institut Pasteur, so I’ll go there this afternoon.”

Cambodia is just one among several countries where Bill has gone looking for the Man, someone who’ll deal him the larvae he needs.

I first learned of his quest some months ago, when Bill told me he’d been diagnosed as having a parasite, but the local tropical medicine specialists in attendance weren’t able to identify it.

“I’d been hoping for hookworm, but they said it was something else.”

That’s right. He’d been hoping for hookworm.  The thing was, Bill had sarcoidosis, an autoimmune system disorder they’d diagnosed back in 2001, that had resisted all other therapies and, from things Bill had heard,  playing host to hookworms could be just what the doctor ordered. And since he was already there in hospital surrounded by parisitologists, he asked  if they could deliberately infect him with hookworm. Alas, they said no.

Bill is as sane as you or me. Possibly saner, often. What I learned in talking to him: Something like 80 percent of Thailand’s population (mostly people upcountry) are infected with hookworm; at the same time, there’s a really low incidence of such ailments as rheumatoid arthritis and asthma. This holds true for other developing countries with large rural populations. First World countries such as Singapore, on the other hand, have low incidences of hookworm and correspondingly high rates of rheumatoid arthritis and asthma.

Interestingly, you can’t acquire immunity to hookworm; scientists believe the creature may have found a way to mitigate the human immune-system response. Sounds to me (the expert, eh?) like an instance of human-hookworm co-evolution, which sounds more interesting, at least, though I guess the “hygiene hypothesis is more likely.”

Anyway, skating over the details, as one must in a blog, there’s reason to believe hookworms, unable to reproduce in the human body, can reduce certain kinds of inflammation and, having provided such services for 2-3 years, they die with no lasting adverse effects.

So why is Bill visiting the Pasteur Institute and so on, when all he has to do is hang around barefoot in some likely toilets? He says it’s more decorous to instead tape the larvae to the skin, like a nicotine patch but different. Other reasons include the fact that while standing near, much less in, toilets there’s no way to control the number of worms you contract, besides which this practice makes a great way to contract strongyloides, a much worse infestation that’s harder to get rid of.

Whatever. Therapeutic hookworms will no doubt catch on. Expect to see otherwise healthy and what passes in California for sane people adopting these and other parasites only because it’s, like, cool, eh? They don’t cause side effects like some medical drugs (read some stories at http://sideeffectsofxarelto.org/current-xarelto-lawsuits/) And hookworms could well be the next big thing in Asian medical tourism. I mean, cosmetic surgery and joint replacements are so last season. And genuine adventure tourists can always go the standing-around-in-toilets route. An excellent fallback for after we’ve crapped up all the beaches and forests,eh?

Here’s just one related article among many, and a website dedicated to asthma and hookworm.

“Parasites rool, OK!” as Carl Zimmer might have it, in his fine book, Parasite Rex.