CDC publishes an in-depth analysis of Mogellons disease

By Dr. Ananya Mandal, MDJan 29 2012

A new study explains the controversial bizarre condition - Morgellons disease that is characterized by crawling sensations in the skin.

In response to increasing reports of Morgellons symptoms, scientists from the U.S. Centers for Disease Control and Prevention analyzed blood and skin samples from 115 patients in Northern California and found no evidence linking Morgellons to an infection or environmental cause. “We saw a growing number of people complaining about these unusual symptoms, and as a public health agency we felt the need to see what was going on,” said CDC spokesman Daniel Rutz. “It was important to rule out an infectious cause because a lot of people were concerned about transmission.” The study was published in the journal PLoS One.

“We believe that the suffering many people associate with this condition is best addressed by a careful objective scientific analysis,” Dr. Michele Pearson, with the CDC, explained during a 2008 conference call to announce the study.

Experts explain that Morgellons is not an official diagnosis but a syndrome of unexplained symptoms including abnormal sensations that sufferers describe as the feeling of insects crawling on the skin. Symptoms also include fatigue. And, perhaps most peculiarly, one symptom is tiny fibers found embedded in waxy scabs on the skin. “They're not alive,” said Rutz, referring to fear that the fibers are insects - or even alien matter. “They're pieces of cotton and other elements of clothing; common debris.” Roughly 40 percent of the skin samples showed signs of chronic irritation.

“These sores appear often to be the result of people picking at themselves, as they would if they had a chronic irritation that couldn't be resolved any other way,” said Rutz, adding that fibers likely slough off clothes and become encrusted in the healing wounds. The study finds that some drugs were detected in hair samples from half of the patients; and more than one-third of patients had a neuropsychiatric condition.

The CDC also found some interesting trends in the 115 patients in the NorCal Kaiser Permanente system who had similar symptoms: they are primarily middle-aged white women, and 60% showed cognitive issues, including memory problems. Two thirds reported chronic fatigue. An earlier study by Mayo Clinic researchers suggested Morgellons was linked to delusional parasitosis. Overall, the study found, Morgellons occurred in about 4 out of every 100,000 people in the Kaiser network, making it a rare condition.

Dr. Anne Louise Oaklander, a neurologist at Massachusetts General Hospital in Boston, said Morgellons might stem from damage to the nerves that transmit the itch sensation. “This causes them to fire without appropriate cause, and it's natural that people interpret this as a sensation of insects crawling on the skin,” she said.

Oaklander said the CDC study ruled out the possibility of insects or infections in Morgellons, opening the door for research into nerve damage and possible treatments. “I think it's wonderful that the syndrome is receiving careful and thoughtful research attention, which has been scarce in the past,” Oaklander said. “And I hope other physicians and researchers are encouraged to take these symptoms seriously, as they're very disabling.”

“It becomes extremely important that everyone approaches this with an open mind; that includes both the patient and the practitioner,” said Rutz. “Don't leave any stone unturned.”