A Petition for the Development
of a Reliable Diagnostic Test
and Treatment for the Most Prevalent
Chronic Gastrointestinal Infection
in United States Civilians[20,21] and Veterans[9]

 

Blastocystis is a gastrointestinal protozoan that causes symptoms of abdominal pain, diarrhea, constipation, skin rash, severe fatigue, and headaches [1-4] in many immunocompetent persons [5].  It is spread through contaminated food and water.  Symptoms vary and only about 30% of cases present with diarrhea [7].  For some patients, fatigue is the most severe symptom.  Other patients develop severe skin rashes which do not respond to conventional dermatological treatments [3].

Blastocystis was thought to be harmless in the United States until the 1980's, when case reports began coming from the Middle East concerning the association of Blastocystis with these symptoms and psychiatric co-morbidity [1].  The reports were corroborated in several large studies in the United States and Vancouver [5], and by research from the NIH scientist [6-8].  One report noted that 50% of Persian Gulf War Veterans returned with Blastocystis infection [9].  But other US physicians contested these findings and insisted Blastocystis was harmless [10].  All research in the United States was ended by 1994, and it became a research topic that has been "off-limits" to US researchers: the NIH has funded no research in over 14 years [11]. 

(Added October 2009:  The most current research suggests that expression of symptoms is primarily dependent on host genetics.  However, it is possible that a new type of Blastocystis has entered the country which spreads more efficiently than previous types)

Overseas, research continued and it was determined that many types of Blastocystis can infect humans [12-13], so the type of Blastocystis in the Middle East probably was not the same kind that was found in the United States in the 1980's.  Over 100 studies followed the original report from Saudi Arabia [13a], but remarkably there has been no follow-up to address this infection in veterans or civilians in the United States.

Additional research showed that at least one type of Blastocystis in the Middle East is virulent enough to kill rats [14]; that Blastocystis from the Middle East is resistant to antiprotozoal drugs [15-16]; and that the most common type is not reliably detected using the tests we have in the United States [17-18].  Between 1990 and 2000, the frequency with which Blastocystis infection was found in samples in labs in Western States in the United States rose from 2.6% to 23% [19-21].  It is now the most prevalent gastrointestinal infection in the Western United States, and it has a higher rate of antiprotozoal resistance than any other gastrointestinal protozoan [15].

In the United States, the NIH has not funded clinical research into Blastocystis infection since 1994 [11].  Physicians are left without adequate diagnostics or treatments, and patients are diagnosed with Irritable Bowel Syndrome [22-24].

You may wish to support this petition because:

• You are a health care provider, and you understand the cost of chronic gastrointestinal illness of unknown cause, and you would like to have access to reliable diagnostics and treatments for this infection.
   
• You are a public health official, and understand it is problematic when patients have a gastrointestinal infection which can not be diagnosed, and which is resistant to common antiprotozoals.
   
• You have returned from vacation travel overseas with chronic gastrointestinal illness which can not be diagnosed or treated by physicians in the United States.
   
• You have returned from military deployment in the Middle East with chronic gastrointestinal illness which can not be diagnosed or treated.
   
• You or a family member have developed chronic gastrointestinal illness of unknown cause, and the illness appears to have an infective cause but nothing can be identified by your physician.  For more information, click here to read an article about Blastocystis and Irritable Bowel Syndrome.
   
• You are a Senator or Representative, and you understand the cost of chronic illness to you constituents.

SIGN THE PETITION

Read the long version of the petition.

Your support is important!  Please sign the petition and fax the form back to us.  Select the form that best matches your status:

1. I am a HEALTH CARE PROVIDER or PUBLIC HEALTH OFFICIAL
    
2. I am a SENATOR or REPRESENTATIVE
    
3. I am a VETERAN or CURRENTLY ACTIVE MILITARY
    
4. I am the director of an ORGANIZATION which would like to support the petition
    
5. I am an INDIVIDUAL, or none of the above apply.

SUPPORTERS

The following people support a Funding Opportunity Announcement from the NIH for development of reliable diagnostics and treatments for Blastocystis Infection.

If you would like your name listed differently, just initials listed, or removed contact us.

(Alphabetically)

Dr. Omar Amin, PhD (6/2/2008)
     Professor of Parasitology, University of Wisconsin, - 1992
     Fullbright Scholar
     Founder, The Parasitology Center, Inc.
     Publication list and resume

Joseph Blotnick, Massachusetts, First Congressional District (6/4/2008)
   Returned Peace Corps Volunteer

Kenneth Boorom, Oregon, Fifth Congressional District (5/28/2008)
     BSEE/MSEE Stanford University
     Adjunct Professor, Boise State University, 1997, 1999
     Adjunct Professor, Oregon State University, 2000
     Director, Blastocystis Research Foundation
     Symptomatic since 2003
     Publication List

Liona Boyd LLD CM, Connecticut, Fourth Congressional District (6/4/2008)

Professor/Dr.  Thomas J Borody, MD PhD FRACP FACP FACG AGAF (5/28/2008)
     Director Centre for Digestive Diseases
     Member, American Gastroenterological Association
     Publication List

Laurie Childers, Oregon, Fifth Congressional District

Sgt. Max Claymore, California, 27th District (6/4/2008)
    United States Marine Corps, CH-53 Helo Crewman
    Saigon '75, El Salvador '81 & Grenada '83

SPC Tanya Cummings (5/28/2008)
   72nd MP Company
   Deployed for duty in Persian Gulf for Operation Desert Shield/Desert Storm
      December 1990-July1991.

J. Ford, Hawaii, Second Congressional District (6/10/2008)

Representative Sara Gelser
   Oregon State House of Representatives, District 16

Adam Graham, California, 30th Congressional District (6/4/2008)

TH, Oregon, Fifth Congressional District (6/2/2008)

Lynne Hazen, California, 25th Congressional District (5/31/2008)

Jill Higgins, Massachusetts, First Congressional District (6/4/2008)
    Returned Peace Corps Volunteer

William Ittner, Oregon, Fifth Congressional District (6/4/2008)

David M. Jones, Arizona, 8th Congressional District (6/4/2008)
    President, Paradox Inc.

MK, Oregon, Fourth Congressional District (6/4/2008)

Dr. Ahmed Kilani, PhD (5/31/2008)
     President, Clongen Clinical Labs
     PhD, Infectious Diseases, UC/Berkeley '99
     Post-Doc, Medical Microbiology, Stanford University School of Medicine '01
     Publication List

John Koenig, Oregon, Fourth Congressional District (6/4/2008)

LJ, Oregon, Fourth Congressional District (6/2/2008)

Michael Johnson, Washington State, First Congressional District (6/2/2008)
   Central Kitsup School District

KJ, Washington State, First Congressional District (6/2/2008)

SPC Kirt Love (5/28/2008)
    141st Signal Battalion, 1st Armored Division
     Deployed for duty in Desert Shield/Storm from December 20th, 1990 to April 30th 1991.
     Awarded Army Commendation Medal
     Director, Desert Storm Battle Registry
     Member, Gulf War Veterans Advisory Committee

The Honorable Richard Neal (2/29/2008)  Letter
     United States Congressional Representative, Massachusetts, 2nd district.

Staff Sergeant Russel Pollak (5/28/2008)
     3rd Armor Division
     Deployed for duty in Desert Storm January 3, 1991-June 1991
     Egypt MFO February 1983 - August 1983

Jacqueline Rodriguez, Arizona, 8th Congressional District (6/4/2008)

Dr. Dan Sheehan, MD (6/4/2008)
    Author, "Association of Blastocystis hominis with signs and symptoms of human disease"
    Albert Einstein College of Medicine, New York City, NY

John B. Simon, California, 30th Congressional District
   Board of Governors, City of Hope, Los Angeles

S Stuart, New York, 14th Congressional District (6/4/2008)

Carl Studlar, West Virginia, First Congressional District (6/4/2008)

Alana Tarkington, California, 19th Congressional District (6/4/2008)

MZ, Massachusetts, First Congressional District (6/4/2008)
 

CONTACT YOUR REPRESENTATIVE IN CONGRESS

The National Institutes of Health (NIH) has been chartered by Congress as the primary granting organization for biomedical research in the United States.  As part of that charter, they are expected to fund research to provide timely scientific information to researchers concerning infectious diseases.  In 2008, they will receive $29 Billion for this purpose - more than the Gross Domestic Product of many countries.

When your doctor can't diagnose or treat you, it's because the NIH has not funded the research, and you should tell your Representative in Congress what you think about that.  So please contact your Representative to have them support the petition. 

Click here to get contact information for your Congressional Representative.

You may have to contact them several times.  Calling their office may work.  If you do not receive any reply, please contact BRF and we will follow-up with them.

(If you want to learn more about how Blastocystis makes your muscles twitch, and causes widespread pain, read this and this. 
Most of the volume of a vacuolar Blastocystis cell is occupied with protease)
 

Lists and Slides about Blastocystis

• List of studies showing Blastocystis from Middle East and China causes death in animals
   

• List of studies indicating chronic protozoal infections produces psychiatric illness
   

• Map showing US States with largest number of samples positive for Blastocystis.
   

• Graph showing rise in prevalence of Blastocystis in last 10 years
   

• List of over 100 studies identifying Blastocystis as pathogenic (long)
   

• List of over 100 studies  identifying Blastocystis as pathogenic (reduced to fit on fewer pages).
   

• List of studies fulfilling Koch's Postulates (showing Blastocystis causes disease in animals)
   

• Questions and Answers about Blastocystis (under construction)
   

• February 2008 letter to US Representatives with references to peer-reviewed medical studies.

References

1. Qadri SM, al-Okaili GA, al-Dayel F. Clinical significance of Blastocystis hominis. J Clin Microbiol. 1989 Nov;27(11):2407-9.
PMID: 2808664

2. Sheehan DJ, Raucher BG, McKitrick JC. Association of Blastocystis hominis with signs and symptoms of human disease.
J Clin Microbiol. 1986 Oct;24(4):548-50. PMID: 3771743

3. Katsarou-Katsari A, Vassalos CM, Tzanetou K, Spanakos G, Papadopoulou C, Vakalis N. Acute urticaria associated with amoeboid forms of Blastocystis sp. subtype 3. Acta Derm Venereol. 2008;88(1):80-1. PMID: 18176765

4. Gupta R, Parsi K. Chronic urticaria due to Blastocystis hominis. Australas J Dermatol. 2006 May;47(2):117-9.PMID: 16637808

5. Doyle PW, Helgason MM, Mathias RG, Proctor EM. Epidemiology and pathogenicity of Blastocystis hominis. J Clin Microbiol. 1990 Jan;28(1):116-21. PMID: 2298869

6. Zierdt CH, Tan HK. Ultrastructure and light microscope appearance of Blastocystis hominis in a patient with enteric disease. Z Parasitenkd. 1976 Oct 12;50(3):277-83. PMID: 997721

7. Zierdt CH. Blastocystis hominis--past and future. Clin Microbiol Rev. 1991 Jan;4(1):61-79. Review. PMID: 2004348

8. Zierdt CH. Blastocystis hominis, a long-misunderstood intestinal parasite. Parasitol Today. 1988 Jan;4(1):15-7. PMID: 15462991

9. Hogue, Theresa. What You Can't See Can Hurt You. Corvallis Gazette Times, January 14, 2007

10. Rosenblatt JE. Blastocystis hominis. J Clin Microbiol. 1990 Oct;28(10):2379-80. PMID: 2101593

11. CRISP search of NIH database for term Blastocystis

12. Noël C, Dufernez F, Gerbod D, Edgcomb VP, Delgado-Viscogliosi P, Ho LC, Singh M, Wintjens R, Sogin ML, Capron M, Pierce R, Zenner L, Viscogliosi E.  Molecular phylogenies of Blastocystis isolates from different hosts: implications for genetic diversity, identification of species, and zoonosis. J Clin Microbiol. 2005 Jan;43(1):348-55. PMID: 15634993

13. Stensvold CR, Arendrup MC, Jespersgaard C, Mølbak K, Nielsen HV. Detecting Blastocystis using parasitologic and DNA-based methods: a comparative study. Diagn Microbiol Infect Dis. 2007 Nov;59(3):303-7. PMID: 17913433

14. Hussein EM, Hussein AM, Eida MM, Atwa MM. Pathophysiological variability of different genotypes of human Blastocystis hominis Egyptian isolates in experimentally infected rats. Parasitol Res. 2008 Apr;102(5):853-60. PMID: 18193282

15. Yakoob J, Jafri W, Jafri N, Islam M, Asim Beg M. In vitro susceptibility of Blastocystis hominis isolated from patients with irritable bowel syndrome. Br J Biomed Sci. 2004;61(2):75-7. PMID: 15250669

16. Haresh K, Suresh K, Khairul Anus A, Saminathan S. Isolate resistance of Blastocystis hominis to metronidazole. Trop Med Int Health. 1999 Apr;4(4):274-7. PMID: 10357863

17. Termmathurapoj S, Leelayoova S, Aimpun P, Thathaisong U, Nimmanon T, Taamasri P, Mungthin M. The usefulness of short-term in vitro cultivation for the detection and molecular study of Blastocystis hominis in stool specimens. Parasitol Res. 2004 Aug;93(6):445-7. Epub 2004 Jul 9. PMID: 15243800

18. Suresh K, Smith H. Comparison of methods for detecting Blastocystis hominis. Eur J Clin Microbiol Infect Dis. 2004 Jun;23(6):509-11. Epub 2004 May 28. PMID: 15168139

19. Kappus KK, Juranek DD, Roberts JM. Results of testing for intestinal parasites by state diagnostic laboratories, United States, 1987.
MMWR CDC Surveill Summ. 1991 Dec;40(4):25-45. PMID: 1779956

20. Amin OM. Seasonal prevalence of intestinal parasites in the United States during 2000. Am J Trop Med Hyg. 2002 Jun;66(6):799-803.
PMID: 12224595

21. Amin, Omar M. The Epidemiology of Blastocystis. hominis in the United States. Research Journal of. Parasitology 1 (1) 1-10, 2006

22.Yakoob J, Jafri W, Jafri N, Khan R, Islam M, Beg MA, Zaman V. Irritable bowel syndrome: in search of an etiology: role of Blastocystis hominis. Am J Trop Med Hyg. 2004 Apr;70(4):383-5.  PMID: 15100450

23.Hussain R, Jaferi W, Zuberi S, Baqai R, Abrar N, Ahmed A, Zaman V. Significantly increased IgG2 subclass antibody levels to Blastocystis hominis in patients with irritable bowel syndrome. Am J Trop Med Hyg. 1997 Mar;56(3):301-6. PMID: 9129532

24.Giacometti A, Cirioni O, Fiorentini A, Fortuna M, Scalise G. Irritable bowel syndrome in patients with Blastocystis hominis infection.
Eur J Clin Microbiol Infect Dis. 1999 Jun;18(6):436-9. PMID: 10442423