Monsters Inside Me - Sleeper Cells   View more episodes

Aired at 09:00 AM on Monday, May 31, 2010 (5/31/2010)      View all transcripts from this day

Transcript

00:00:02And that he has sustained severe brain damage.
00:00:07 it was -- it was the worst day we had ever had.
00:00:14Narrator: When the results of garrett's ..
00:00:20...They reveal that the toddler is harboring a parasitic roundworm call baylisascaris.
00:00:27His condition is so rare that only 14 cases have ever been reported in the united states.
00:00:32There are no known full recoveries, and at the very least, garrett risks serious brain damage.
00:00:39 it's a very deadly parasite.
00:00:42The larval forms will infect a wide variety of animals.
00:00:48It's killed over 120 species of birds and mammals, including humans.
00:00:55Narrator: Roundworm eggs can live outside of a host for years.
00:00:58They lie dormant in the soil, invisible, waiting for a host to come along.
00:01:05And in this case, roundworm eggs made it into garrett's stomach.
00:01:09There, the acid in his stomach activated the eggs and they hatched.
00:01:14Larvae two millimeters long emerged and burrowed through the intestinal wall into the blood.
00:01:19They traveled through garrett's body, bursting out of blood vessels and attacking internal organs.
00:01:25Only on rare occasions do they make their way to the brain where the larvae break through the brain's defenses and eat the brain from the inside.
00:01:34Unfortunately, this is what happened to garrett.
00:01:37The larvae then began to digest his visual cortex, the part of the brain controlling sight, which is what caused him to go blind.
00:01:48At the hospital, the doctors break the news to the richardsons.
00:01:53Valerie: I remember it vividly.
00:01:55Um, it was garrett's first birthday, and so people had come to the hospital with gifts and toys and balloons.
00:02:05And the doctors come in and tell us that the tests are confirmed, that garrett does have the parasite.
00:02:12And, uh, we were crushed.
00:02:19Narrator: Garrett's life hangs by a thread as the parasitic roundworm threatens to claim another victim.
00:02:25Tony: I can't remember the doctors actually ever saying anything positive about how things were gonna turn out.
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00:05:38Narrator: One-year-old garrett richardson ighting for his life.
00:05:44His brain is being eaten by a deadly parasitic roundworm called baylisascaris.
00:05:50Tony: He's getting worse and worse.
00:05:52He's losing ability after ability.
00:05:54Narrator: The roundworm larvae have eaten so much of his brain ..
00:06:03Or see.
00:06:04My worry was that he was gonna die.
00:06:06Narrator: Garrett is given a powerful antiparasitic drug called albendezol that impairs the worms' intestines and starves them to death, but the chances of success are slim.
00:06:17This parasite is so deadly thatthere really wasn't much hope.
00:06:22Narrator: For more than 20 years, scientists have studied how this parasite spreads.
00:06:28In a forest in indiana, professor gene rhodes is going to try and catch the wild animal that carries baylisascaris.
00:06:40Finding the animal could shed light on how outbreaks occur.
00:06:45Hey, it looks like we got one.
00:06:46Dr. Rhodes: There are a number of animals that could be infected, but the numb-one suspect is the raccoon.
00:06:53Narrator: Like any wild animal, raccoons must be handled with caution.
00:06:58The first thing we need to do with a trappedaccoon is to knock it out.
00:07:04Narrator: Gene uses telazol, which will gently anesthetize the raccoon while avoiding undue stress on the animal.
00:07:13If the raccoon is carrying the adult roundworms inside its intestine, there will be eggs in its feces.
00:07:20I'm gonna turn the animal over, and I'm going to slowly insert my finger into its rectum to get fecal material on my glove.
00:07:32I'm going to smear it into the test tube.
00:07:36Narrator: This procedure might look unpleasant, but the raccoon is not harmed.
00:07:44Rhodes sends the fecal samples to his colleagues in chicago.
00:07:50 kristin page analyzes up to 600 raccoon samples a week.
00:07:58Dr. Page: There's some eggs.
00:07:59And that confirms it. this animal was positive.
00:08:01Narrator: page's work on the life cycle of the parasite holds the secret to how garrett became infected.
00:08:07The adult worm lays its eggs in the raccoon's gut.
00:08:12The eggs are passed out in the raccoon's feces.
00:08:17The eggs are eaten by a second, or intermediate, host and hatch into larvae in the intermediate host's stomach.
00:08:24The larvae migrate through the intermediate host's body, attack its central nervous system, and kill it.
00:08:30The intermediate host is then eaten by the raccoon and the life cycle is repeated.
00:08:35The raccoon is immune to the parasite.
00:08:38It never feels a thing.
00:08:40Tests show that 80% of raccoons in north america are infested with this parasite, yet fatal infection in humans is rare.
00:08:49For this parasiteto affect humans, they have to be ingestedin very large quantities.
00:08:54And once they're inside a human, they have to migrate andhappen to end up at the brain.
00:08:58Narrator: So, how didgarrett richardson get infected?
00:09:03Dr. Kazacos:THE AVERAGE RACCOON Sheds about 26,000 eggsper gram of feces, okay?
00:09:11A gram of feces is about the sizeof your little fingernail.
00:09:16Am is not very much.
00:09:17Can a child get into a raccoon latrine and eat a gram of feces?
00:09:22What happens if they eat 10 times that amount and it has that many eggs?
00:09:26They're gonna take in a huge number of eggs.
00:09:29Tony: Our doctors told us that it's likely that he picked up something off the grass when he was crawling and put it in his mouth that had the parasite on it.
00:09:40Narrator: At the hospital, the richardsons are determ to save their son.
00:09:45Miraculously, the drug treatment seems to be working, and after eight days in the hospital, garrett is sent home to be cared for by his parents.
00:09:56Tony: We realized that we were his best hope -- helping him recover, whatever it would ta Narrator: Garrett's life is still in jeopardy.
00:10:04One side effect of the treatment is massive inflammation caused by the parasites dying off and releasing toxins in his body.
00:10:12To combat the inflammation, garrett is prescribed steroids.
00:10:17Tony: The steroids made him feel horribly uncomfortable.
00:10:20He was crying all day long, every day, until he slept.
00:10:26He'd sleep at night, and when he woke up, he'd start to cry again.
00:10:30[ Crying ] Narrator: After three weeks of treatment, the parasites are dead.
00:10:36Garrett's life is changed forever, but three years later, he has recovered far more than his doctors predicted.
00:10:45Took him two years to be able earn to crawl again, and then he was able to walk at 4.
00:10:52 we're extremely proud of him.
00:11:00Narrator: In addition to his other milestones, garrett has even regained some of his lost sight.
00:11:06Tony: He can see toys, and he can see faces and recognize people.
00:11:10Narrator: While the richardsons must cope with the effects of the raccoon roundworm, they are grateful to still have their son.
00:11:17TonyHE'S A VERY JOYFUL BOY, AND THAT -- That makes us happy.
00:11:23Valerie: We miss the child he would've been but love the child that he is.
00:11:26Narrator: Although the consequences of roundworm infection can be severe, cases like garrett's are extremely rare.
00:11:35Deadly human parasites, like the raccoon roundworm, are very, very uncommon.
00:11:40, there have been fewer than 20 reported cases of baylisascaris.
00:11:45Narrator: And there are steps people can take to avoid infection.
00:11:49Keep an eye on small children playing outdoors, especially near wooded areas where raccoons live.
00:11:57One of the things that makes these tiny sleeper cells so dangerous is that you never know when they will strike.
00:12:04The raccoon roundworm's eggs hide in the soil for years, but once they're in a host, they attack with ferocious speed.
00:12:13Other parasites use a different strategy.
00:12:16They invade quickly but lay undetected for years.
00:12:23September 1967.
00:12:26Tampa, florida.
00:12:27Sergeant tim carmack has just completed a tour of duty in vietnam.
00:12:32He returns home.
00:12:34BUT JUST FOUR DAYS LATER, at MacDill air force base, a life-threatening fever takes hold.
00:12:41Tim: It was like I was melting on the bed.
00:12:46And I went into a coma.
00:12:49It got so bad that they told my mother and my stepfather that they were making arrangements for my funeral because I would not come out of this.
00:13:01Narrator: Ors diagnose him with malaria, but the fever breaks after five days and tim emerges from his coma.
00:13:08He makes a full recovery except for one lingering ..
00:13:16...Recurring asthma-like symptoms.
00:13:18Tim: I couldn't hardly breathe out of my nose, out of my mouth.
00:13:22Narrator: Tim learns to live with the symptoms and gets on with his life.
00:13:3036 Years later, in 2003, tim has a booming business painting houses and marries former nurse shannon potter.
00:13:39They start a family, and tim is working more than ever.
00:13:43Shannon: He worked seven days a week.
00:13:45I had to drag him homeon sundays.
00:13:46Narrator: His family believes all the years of working as a painter are taking their toll.
00:13:54Tim: My legs were swelled up, but they had been doing that off and on for a few months.
00:14:01I thought, you know, he just needed to cut back on being on his feet for so long.
00:14:06Narrator: Tim tries to delegate his work and keeps off his feet as much as he can, but it doesn't help.
00:14:12And one morning, he wakes up to a terrifying sight.
00:14:17I seen a liquid coming out of a spot on my leg.
00:14:21The liquid was thick, goldish.
00:14:26It was heavier than, like, baby oil.
00:14:29Shannon: I got him a paper towel, and we noticed that it came back, and there wasn't really a cut there or anything for it to come through.
00:14:37Out of the pores.
00:14:38Narrator: Tim's leaking legs are truly disturbing.
00:14:43But could this be the start of something far more sinister?
00:14:49What really scared me the most was none of us knew where the liquid was coming from or what I was just thinking, "something's got to be done.
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00:19:12Narrator: 62-Year-old tim carmack has just woken up to find his legs oozing out a thick, yellow liquid.
00:19:19Unsure of what's happening and determined to find the answer to save her husband, his wife, shannon, hits the internet.
00:19:26Shannon: There's heart conditions that can cause youto have problems with swelling, and there's also diabetes, which, you know, ran through my mind -- " Narrator: As a veteran of the vietnam war, tim makes an appointment at a nearby v.a.
00:19:41Clinic.
00:19:44When they arrive, the doctor gives him a complete physical examination.
00:19:50I told her my legs was weeping this fluid out.
00:19:55She looked down and looked at me and says, " Shannon: I was just thinking, you know, "there's something definitely wrong," and I was really surprised when they came out and said, "there's nothing wrong with him.
00:20:11" Narrator: But shannon refuses to give up.
00:20:16She is determined to get her husband the help he needs.
00:20:19Over the next year, they see three more doctors, but each visit brings them no closer to a diagnosis.
00:20:28Tim is prescribed painkillers for his legs.
00:20:33But they give little relief.
00:20:35Tim: I got very weak.
00:20:39There was times when I was on the job -- I would literally have to just sit down and wait for my body to catch up to me.
00:20:49Narrator: His condition continues to decline.
00:20:52Soon, it's sheer agony even to walk.
00:21:01Tim: And it hurt. god, it hurt so bad.
00:21:05I mean, it -- it was hard to explain the pain.
00:21:12Narrator: After a year of chronic pain and swelling, tim and shannon make an appointment at a major hospital in tampa.
00:21:19Tim sees a team of experts and gets a thorough work-up.
00:21:23Shannon: Everything just kept coming back negative.
00:21:26His heart was fine. he wasn't diabetic.
00:21:29Tim: I felt very disappointed.
00:21:32All they wanted to do was throw pills at me, but no one ever addressed what was wrong with me.
00:21:47Narrator: Then, after two years, an even more bizarre and frightening symptom appears.
00:21:52Tim: Well, the next thing I noticed was getting severe swelling around my scrotum area.
00:22:02I really didn't know what was happening with me.
00:22:06Shannon: It gave us a direction, when his testicles started swelling, that a urologist was our best bet.
00:22:15Tim: When we first seen him, he kind of acted like the rest of the doctors did -- "well, there's not that much wrong with you," you know, and he started the same story.
00:22:29..
00:22:32There's got to be something wrong with me " Narrator: Refusing to take no for an answer, tim gives the urologist his complete medical history, going back 40 years.
00:22:45Tim: I told him, "four days after coming back to the united states, I wound up with what they call full-blown " " " Narrator: Malaria is a deadly disease called by the parasite plasmodium.
00:23:03Um it is transmitted by a mosquito.
00:23:08And in the jungles of vietnam where tim was fighting, mosquitoes were everywhere.
00:23:15Could a battle with malaria 40 years earlier be the source of tim's symptoms today?
00:23:23Tim's doctor digs deeper.
00:23:24" I said, "that's what they told me it was.
00:23:31"I had severe breathing problems.
00:23:33" and he stopped me, and he says, carmack, I'm 90% sure of what you've " Narrator: The urologist suspects tim contracted not one but two different the first, the parasite that causes malaria, was successfully treated.
00:23:58The other went undetected.
00:24:00Tim: I said, "what do you mean, a parasite?
00:24:03" and I was devastated.
00:24:08I didn't know how long I had to live.
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00:26:58Narrator: Tim carmack's four-year struggle to identify what's been making him ill has finally come to an end.
00:27:05But the news is not good.
00:27:08His urologist believes a parasite has been lurking inside his body for the past 40 years.
00:27:14Tim: Oh, god, I was devastate I wanted to know if it could be stopped.
00:27:19There's only one way to tell.
00:27:23Tim: The urologist ordered me and ordered the test for the parasite.
00:27:33Narrator: Three days later, the results are back.
00:27:39Tim: I went in, ..
00:27:43That I did have the parasite.
00:27:50Narrator: The parasite is a threadlike worm bancrofti, and the disease it causes is lymphatic filariasis.
00:27:58Although virtually unknown in north america, it is widespread in southeast asia, where tim was stationed as a soldier in the vietnam war.
00:28:10..
00:28:12How far this parasite was in my system.
00:28:18What does it do? and what does it cause?
00:28:22Narrator: robert hartzell is tim's primary care physician.
00:28:27Dr. Hartzell: Filariasis has an insidious onset.
00:28:30It can affect the lungs.
00:28:33Just causes massive swelling, and the worst-case scenario -- you know, I'm sure everybody's heard of elephantiasis.
00:28:39Narrator: Elephantiasis is an extreme thickening of the skin and underlying tissue.
00:28:46That's probably the worst-case scenario.
00:28:48Narrator: But how did tim's doctors overlook the disease 40 years earlier?
00:28:53The key lies in the parasite's ability to hide.
00:29:00Its life cycle begins inside a mosquito.
00:29:05When the mosquito bites a human, hundreds of tiny larvae swarm into the bloodstream.
00:29:11Next, they travel to the lymphatic system, a crucial network in the human body.
00:29:19Dr. Riskin: The lymphatic system is a series of tubes that drain fluid out of your tissues, so if you ever have swelling in your fingers or in your hands, the way that that fluid gets back out into the bloodstream is by the lymphatic system.
00:29:32Narrator: Undetected in the lymphatic system, they grow into adult worms three to four inches long.
00:29:39The adult worms mate and produce even more larvae.
00:29:40An these microscopic larvae leave the safety of the lymph vessels and nodes to invade other parts of the body.
00:29:50During the day, they lie low in the lungs, causing respiratory symptoms.
00:29:56[ Coughing ] it explained where my breathing problems were coming from.
00:30:01I knew that this was not the way my body acted.
00:30:08Narrator: But at night, the drop in our body temperature triggers the larvae to move out of the lungs to their next destination.
00:30:15Dr. Riskin: For the life cycle to be completed, the larvae have to be picked up by a mosquito, so what the parasite does is move close to the lungs during the day and then migrate out towards the skin at night where they'll get picked up by a mosquito, and that daily migration is timed by the natural sleep rhythms of the host.
00:30:34Narrator: The unsuspecting mosquito transports the larvae to a new host, and the life cycle repeats itself.
00:30:43Tim's most severe symptoms began after tangled bits of dead worms plugged up his lymphatic system.
00:30:50Lymph fluid built up in his legs and testicles and leaked out of his pores.
00:30:58Filariasis is treatable with antiparasitic medication caught early, but for tim, the diagnosis comes too late.
00:31:06His filariasis has caused damage to his lymph system, and he's gonna have that for the rest of his life.
00:31:14Narrator: Though tim's life will never be the same, he's learned to manage his affliction through daily exercise and massage.
00:31:22Oh!
00:31:23Here it comes!
00:31:25One, two, three!
00:31:27Shannon: Tim's days are spent with his legs up.
00:31:32We normally do an hour of massage in the morning, and we get him up to try to do a little bit of walking, to do a little bit of exercise, and it's, you know -- figure it out as long as you go, the process.
00:31:47This was a real eye-opener.
00:31:48I didn't know that something so little could be so devastating.
00:31:54Narrator: The carmacks have discovered just how much harm a tiny creaturcan cause, especially if it's able to hide in the body without giving any major warning signs.
00:32:03This is the exact strategy of the filariasis parasite.
00:32:07The reasons that so many parasites can be undted for so long is that that's what they've evolved to do -- to hide and do their job very quietly without setting off any alarms in the body.
00:32:18Narrator: This hide-and-wait strategy is devastatingly successful.
00:32:23Filariasis affects 120 million people worldwide, mostly in the tropics.
00:32:28If you're traveling to a region where filariasis is common, a little bit of prevention can go a long way.
00:32:34Use insect repellant and mosquito netting at night.
00:32:41Like tiny undercover agents, parasites are ever- in the food we eat, the water drink, even on the ground we walk on, lying dormant, waiting to strike.
00:32:572003.
00:32:5834-Year-old john figge and his wife, lisa, wi are settling their two sons ng into a new neighborhood in philadelphia, pennsylvania.
00:33:06John: We spend most of our weekends shuttling our kids around to basketball games and soccer games, that type of thing.
00:33:14Narrator: But their normal routine is interrupted when john begins to experience bouts of dizziness.
00:33:23John: I noticed it, first, probably just driving to work.
00:33:28I really couldn't focus on the road.
00:33:30It was kind of like my head was out of whack there for a second, and then it was fine, and I thought, "hmm.
00:33:36I don't know what that was, but I'm sure " Narrator: But the dizziness doesn't go away.
00:33:42In fact, after a few days, it gets worse.
00:33:46John: I really had trouble keeping my balance.
00:33:50Ned it to being seasick on land.
00:33:53Had to hold on to things a lot to steady myself.
00:33:56Narrator: Together, the dizziness and loss of balance create a new symptom -- constant nausea.
00:34:03However, john and his wife write it off as a simple stomach bug.
00:34:08When your husband complainsto you about not feeling well, you think, "well, he's probablygetting a little bit sick," and I really didn't think much of it at all.
00:34:18Narrator: John takes over-the-counter drugs to cope with the symptoms, but after a few days, it's clear that this is no simple flu.
00:34:26His nausea becomes severely debilitating.
00:34:31He basically said he couldn't stand up, the nausea was so bad, like he needed to see a doctor.
00:34:41Narrator: The couple head to their local emergency room to see if they canet a quick diagnosis.
00:34:46The doctor on call examines john and concludes that his symptoms are most likely caused by an inner-ear infection.
00:34:55John: at least we know what it is.
00:34:59" "it goes away over time.
00:35:02"You're probably just gonna "have to hang out in bed for a few days, " Narrator: But after several days of bed rest, john doesn't improve.
00:35:11In fact, the symptoms worsen.
00:35:13John: It got to the point where even sitting down, it wasn't really helping anymore.
00:35:18It was getting worse and worse.
00:35:22It was really bad.
00:35:23Narrator: After a week of unrelenting dizziness and nausea, the figges realize that something needs to be done fast.
00:35:31This time, they head to a bigger hospital in search of answers and are referred to the neurology department.
00:35:38Dr. Kremens: When john presented to our hospital, first thing I noticed is that he just looked sick.
00:35:43He was retching.he looked very uncomfortable.
00:35:46Narrator: scott kremens is a neurologist at the university of pennsylvania.
00:35:51As the attending physician on call, he is assigned john's case.
00:35:56Loss of balance and dizziness ten indicate neurological problems, so he begins testing john's neurological functions.
00:36:04So, when we had john do tests like touching his nose and then touching my finger, he had a lot of trouble doing that.
00:36:09His hand would shake when he did it, and it was uncoordinated.
00:36:12Narrator: All the signs point to a problem with john's cerebellum.
00:36:16Located at the back of the brain, the cerebellum is the part of the brain that regulates muscle control, coordination, and balance.
00:36:24To find out what could be affecting john's cerebellum, dr. kremens orders a cat scan of john's brain.
00:36:31Dr. Kremens: John's cat scan showed that he had a large mass in the back part of the brain about the size of a large walnut.
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00:39:39I DON'T JUST WEAR THE SHIRT.I LIVE I:tv][C483] Narrator: 34-Year-old john figgeand his wife, lisa, are about to receivevery bad news.
00:41:14John's doctors believehe has a brain tumor.
00:41:18Lisa: I don't thinkanyonecould tell you that your husbandhas a brain tumor, and you don't, you know --you get really scared.
00:41:25Narrator: To confirm the diagnosis, kremens orders a biopsy of the mysterious mass.
00:41:31This means cutting open john's skull and taking tissue directly from his brain.
00:41:38They're like, you know, "we need to do brain " sign me up.
00:41:44" Narrator: The next day, john's surgical team makes an incision into his skull and extracts a sample of the strange mass proliferating in his brain.
00:41:57Downstairs at the pathology lab, technicians examine the sample under a microscope and make an absolutely astounding discovery.
00:42:07Dr. Kremens: I get a page, and I call the , " it's ova and " I was shocked.
00:42:19That meant that he had eggs and worms in his brain.
00:42:23Narrator: In recovery, john is stunned by the n that a colony of parasitic worms has invaded his brain.
00:42:30John: When I heard that it was a parasite and not a tumor, it was a little shocking.
00:42:38I had to keep asking them, 'cause I didn't really understand, how I had these things in my head.
00:42:42Narrator: Her did dr. kremens.
00:42:45Dr. Kremens: I had never seen a parasitic infection in the brain that presented like this, looking like a tumor.
00:42:53Out what kind of parasite is eating john's brain so he can kill it before it's too late.
00:42:59The lab could take hours or even days to identify it, but time is running out.
00:43:05John is at immediate risk of seizures, spinal-cord inflammation, even death.
00:43:10Without a second to lose, dr. kremens interviews lisa again.
00:43:13Dr. Kremens: We were trying to figure o get this?
00:43:16Had he traveled somewhere unusual?
00:43:18We traveled pretty locally around the united states but certainly nowhere exotic.
00:43:25Narrator: kremens considers food as a possible source of the infection.
00:43:31There's an infection called listeria, which people can get sometimes from eating cheeses, and weo like to eat out, so we were thinking maybe this was some sort of Lisa: We had been to some tasting menus where you don't always know what young, and, you know, we were scratching our heads trying to figure out if we'd eaten something strange, but we really didn't remember anything specific.
00:43:55Dr. Kr That we'd seen in the united states, and it didn't look like any parasite that I had ever seen associated with some foodborne illness, so at that point, I realized I just had to ask them more questions.
00:44:06Narrator: kremens returns to the topic of travel.
00:44:10Had they done any exotic traveling in the past five years, or even further back?
00:44:16Lisa's answer could help dr. kremens identify john's parasite.
00:44:22Well, we did go to africa a number of years ago.
00:44:25Narrator: Six years ago, to be exact.
00:44:27Lisa can't imagine that a trip taken years earlier could be the source of the infection, kremens, it's the answer he's been looking for.
00:44:35Well, as soon as I heard that they had gone to I was pretty confident that that was the source of the infection.
00:44:43Narrator: In 1998, john and lisa joined their extended family on a trip to kenya in east africa.
00:44:51The family booked a week-long stay at a vacation resort on the banks of lake victoria, a 300-mile-long freshwater lake located in the heart of kenya.
00:45:01Then he wanted to know had we been swimming in any water.
00:45:06And we, in fact, had.
00:45:08John: They had boats and a little beach, and everyone just hung out on the beach, going swimming, going boating.
00:45:16We were never awe that there was anything we should be concerned about in the water.
00:45:22Narrator: But the water was exactly where john picked up his deadly travel companions.
00:45:28 kremens needs to identify john's parasite.
00:45:33Dr. Kremens: We took pictures of it and sent it down to the center for disease surveillance in atlanta, georgia.
00:45:40And r a few hours, one of our pathologists found a picture, and we looked at that, we looked at john's slide, and we knew that we had de the diagnosis.
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00:48:57Narrator: John figge's doctorsntified the parasite that is growing inside his brainand threatening to kill him.
00:49:06Dr. Kremens: In john's brain, called schistosomiasis, and it's specifically somethingcalled schistosomiasis mansoni.
00:49:13Narrator: Schistosomes live in freshwater lakes their eggs are released into the environment by the feces of infected people.
00:49:24Schistosome eggs hatch ntact with fresh water.
00:49:28At that point, they will seek out a snail and penetrate the snail's foot.
00:49:32Inside the snail, they transform into tiny worm larvae.
00:49:36These larvae emerge daily from the snail host.
00:49:40Humans entering the water trigger the movement of larvae toward the surface.
00:49:45Attracted to the fatty acids emitted by human skin, larvae swim toward their new host using microscopic tails.
00:49:52The minute larvae penetrate our skin in three short stages.
00:49:57First, they attach to the skin.
00:49:59Then the larvae search the skin for a penetration site -- often at a hair follicle.
00:50:05After finding a penetration site the larvae then emit a chemical which dissolves human skin, producing a tiny hole they can swim through.
00:50:16In the human body, the larvae transform into adult worms and migrate to the blood vessels near the liver.
00:50:23But how did these parasites get john's brain?
00:50:27The answer lies in john's blood.
00:50:32Dr. Kremens: What happens is, the adult worms mature inside the liver, and then they go out of the liver to mate, and then they lay eggs inside these blood vessels around the intestines.
00:50:45And what normally happens is that these eggs go into the intestines, and they're excreted in feces.
00:50:51What happened in john's case -- two worms mated and swam against the tide into john's brain and laid this large group of eggs that grew in his brain.
00:51:04Dr. Riskin: A schistosome can sit undetected in the human body for 20 years, and becauseit can last such a long time, it produces millions of eggsover the course of its lifetime.
00:51:16Narrator: With the diagnosis in hand, kremens immediately gets to work saving john's life.
00:51:20Dr. Kremens: When you treat a parasitic infection, what happens is, the parasites die, but when they die, they release toxins into the brain which can cause swelling, and that in and of itself is very dangerous.
00:51:32Narrator: Until doctors relieve the pressure on his brain, john could still have a life-threatening seizure or go into a coma.
00:51:40Lisa: The doctors couldn't predict you know, how much his recovery was gonna progress.
00:51:46 they really never knew.
00:51:49Dr. Kremens: We actually had to put a tube into john's brain to help relieve the pressure that he was experiencing.
00:51:57Narrator: Two weeks after surgery, john is discharged from the hospital.
00:52:01He's still weak, but he knows that the worst is behind him.
00:52:05Dr. Kremens: When we looked at john's sample under the microscope, he had more eggs and parasites than we could count, so if john didn't have brain surgery, he probably would've died.
00:52:17Lisa: In my wildest dreams, I would never predict that a parasite could cause all these things to happen.
00:52:25It was kind of a one-in-a-billion type of thing, but when you put it all together, you think, "well, I'm glad we caught it when we did, " Narrator: For john figge, the parasite living insi didn't cause a devastating illness for a full six years.
00:52:42Only after it made a wrong turn in john's body and ended up in his brain were doctors able to discover it.
00:52:50Like so many other parasites, living under the radar in the host's body is the key to the schistosome's success.
00:52:57There are a lot of different kinds of parasites in the world, and there are a lot of different strategies that parasites use to complete their life cycles.
00:53:05Some of themuse a boomer-body strategy where they producemillions and million over a short period of time.
00:53:11Others producesmall numbers of eggs but spread it outover a longer span of time.
00:53:17These have in common is that they hidewithout detection at some pointin their life cycle.
00:53:21NaETHER THEY LURK FORYEARS OR STRIKE IMMEDIATELY, Cells liewaiting for their next victim.
00:53:30..
00:53:34But when?
00:53:53[ Coughing ] Narrator: A family of killers is breeding inside a man's lungs.
00:53:57Tony: When I woke up and saw the blood on my pillow, it did scare me.
00:54:01I wasn't sure what to think.
00:54:02Narrator: A hideous organism makes its nest in a mountain biker's head.
00:54:06I woke my wife up, and I said, "you've got to see it.
00:54:10" Narrator: And a flesh-eating monster reproduces with furious speed.
00:54:18" Narrator: All very different parasites with one thing in common -- they have perfected the art of reproduction.
00:54:30They are all sex maniacs.
00:54:36Worms invisible to the human eye.
00:54:40Insects thirsty for blood.
00:54:45Microscopic amoeba.
00:54:47They mightlookharmless, but these are some of nature's deadliest creatures.
00:54:52They can hijack our bodies, disable our immune systems.
00:54:58They are parasites.
00:55:00But to those infected, they are the monsters inside me.
00:55:06Parasites are just like every other orgastsm on the planet.
00:55:10Their goal is to reproduce and make more parasites, and they are very good at it.
00:55:15So good, in fact, that there are more parasites on earth than any other type of creature.
00:55:22As a strategy for survival, parasitism is incredibly successful.
00:55:26If you're a parasite, that means you're living off of a host.
00:55:29 it can can provide shelter.
00:55:32And that meansthat parasites are freed up to put all of their energyinto what really matters -- sex and reproduction.
00:55:38Narrator: Parasites have evolved countless ways to reproduce.
00:55:45They are the ultimate sex maniacs.
00:55:48Some parasites have a very simple reproduction strategy -- make as many offspring as you possibly can and hope that just a few of them will survive.
00:55:56Other parasites are much more deliberate.
00:55:59They choose the timing and the place for reprtion very carefully, thereby maximizing likelihood of their offspring surviving.
00:56:06Narrator: Many parasites cause their hosts little harm or discomfort, which ensures they continue to breed undetected.
00:56:14Other parasites make their presence savagely felt, as a man in colorado is about to find out.
00:56:23Aaron dallas is a ski instructor in carbondale, colorado.
00:56:29We've lived in carbondaleabout four years now.
00:56:32NaHE LIVES WITH HIS SON,BODIE, AND HIS WIFE, Midge.
00:56:36Midge:IT'S A GREAT TOWN.
00:56:37It's got mountainsand skiing, biking.
00:56:39We love that wecan get on our bikes and don't have to get inour cars for weeks at a time.
00:56:44Aaron: And the big part of moving here was the community activities and stuff.
00:56:50Narrator: The dallas family constantly on the go, but in the spring of 2007, something stops aaron in his tracks.
00:57:00It was planting time, and as I was bending over to shovel, y head.
00:57:07As I bent down, it got worse and worse, so I immediately stood back up, and the pain went away.
00:57:13" Narrator: The stabbing pain continues intermittently, any obvious cause.
00:57:22A week later, he begins to feel the skin on the back of his head is changing.
00:57:27I started to discover there were some distinct bumps on the back of my head.
00:57:35Narrator: Aaron can feel a ring of five individu protruding from the back of his head.
00:57:41He decides to wait and see if the bumps go aw aaron's a typical male.
00:57:48It takes a lot for him to go to the doctor.
00:57:51Narrator: But then a frightening symptom forces him to seek medical help.
00:57:56Probably in the second week, they started to bleed.
00:57:59These bumps were bleeding, oozing.
00:58:05I was starting to get more and more concerned.
00:58:06Narrator: With the back of his head oozing blood and pus, aaron heads to see his local doctor in carbondale.
00:58:14The doctor examines the bumps and tells aaron th are infected bug bites.
00:58:20If insect bites are scratched and the skin is broken, infection can easily occur, causing a conditioncalled cellulitis, or inflammation of the soft tissues underneath the skin.
00:58:31Aaron: Yeah, that made perfect sense.
00:58:34And he gave me a topical lotion to put on there that would clear up any infection.
00:58:40I was pretty convinced that that was gonna take care of it.
00:58:43Narrator: Back at home, aaron notices a surprising reaction to the ointment.
00:58:47Well, when I put this lotion on, the bumps reacted.
00:58:53They would get very irritated, in a way that I had never felt irritation before.
00:59:00It was almost as though I was making the bumps angry.
00:59:02Narrator: The ointment does nothing to reduce the infection.
00:59:06In fact, after three weeks, the bumps have doubled in size.
00:59:11As I'm getting ready to go biking, I get my shorts on and my jersey on and my shoes on.
00:59:16I grabbed my helmet, and as I put it on my head, I realized my helmet doesn't fit.
00:59:20The bumps, by this point, had become so large that the helmet that I had had for three years no longer fit over my head.

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