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Woman’s rare eye infection highlights (low) risk of parasite spread by flies

An Oregon woman is the first known person to become infected with a tiny parasitic worm that lives in the eyes of cattle, according to a case study report published Monday by researchers at the Centers for Disease Control and Prevention (CDC).

Nobody should panic, however. Although common in animals, eye-worm infections in humans are extremely rare. And, if caught and treated early, they don’t cause any permanent damage to the eye.

“This is only the 11th time a person has been infected by eye worms in North America,” lead author Richard Bradbury, who heads the CDC’s Parasite Diagnostics and Biology Laboratory, told CNN. “But what was really exciting it that it is a new species that has never infected people before. It’s a cattle worm that somehow jumped into a human.”

Exciting? I’m not sure that’s the right word, at least from the public’s perspective. But the case is certainly interesting. It also suggests that Americans may be more susceptible than previously thought to certain parasitic infections.

‘I was shocked’

The woman, 28-year-old Abby Beckley, was working on a salmon boat in Alaska two summers ago when her left eye became irritated and inflamed. A week later, when the symptoms didn’t go away, she decided to investigate.

BuzzFeed reporter Nidhi Subbaraman, who interviewed Beckley, describes what happened next:

Standing at the mirror in the galley, [Beckley] plucked at her eyeball, as if extracting a contact lens. 

“I put my fingers in there in kind of a picking motion and I pulled out a worm,” Beckley [said]. “I looked at my finger and it was moving and I was shocked.” 

Beckley said she woke up her bunkmate to show her the worm, a piece of tangled white fluff wriggling at the end of her index finger. “She confirmed I wasn’t crazy,” Beckley said.

Over the course of the next few days she pulled out about a half dozen more worms. “I was living with these things, and I’d just keep pulling them out when I’d feel them,” Beckley said. 

A rare global parasite

Beckley flew home and went to see specialists at the Oregon Science and Health Laboratory in Portland. They extracted two more worms, and sent one to the CDC for analysis. It was identified as being the nematode Thelazia gulosa, which commonly infects the eyes of cattle, but had never been found in humans.

CDC

Two other species of Thelazia — callipaeda and californiensis — were already known to infect humans, but mostly in Europe and Asia and in places with poor living conditions and where people live in close daily contact with animals. They are spread between animals — and sometimes between animals and humans — by flies that feed on the substance that lubricates the eyes.

All 10 previously reported cases of human thelaziasis in the United States (nine in California and one in Utah), which date back to the 1970s, involved Thelazia californienis.

Although it’s not known exactly where Beckley became infected with Thelazia gulosa (she has no recollection of a fly landing on her eye), Bradbury and his colleagues believe it may have been while she was horseback riding in rural south Oregon, an area with a lot of cattle.

Keeping her calm

Meanwhile, back in Oregon, Beckley’s eye doctors told her the best treatment for her eye infection was to inspect her eyes regularly and pull out any worms she found. Eyewashes had failed to flush out the worms, and the doctors didn’t want to give her an anti-parasitic medicine for they worried a dead worm might remain in her eye and cause scarring.

So, over a two-week period in August 2016, Beckley carefully extracted 14 more of the translucent worms from her left eye.

Thelazia gulosa
CDC
Adult Thelazia gulosa removed from the eye of
human on a person’s finger.

How did she keep her calm during that process?

“You can go into ‘Poor me, Oh, my God, I’m going to let this destroy me,’ or you can just think, ‘OK, these are worms, and now I know the life cycle, and I know that they will die, and they are just sharing space,’ ” she told CNN. “Doesn’t mean I wasn’t grossed out! It doesn’t mean I wasn’t angry! But I would try to self-soothe and put it in perspective.”

The infection cleared up and Beckley has had no more symptoms. Nor, fortunately, has she seen any more worms. 

Beckley hopes her going public with her story (she’s described only as “a 26-year-old avid outdoorswoman from Oregon” in the case study) will help anyone else who finds themselves in a similar situation.

“Part of the reason I’m speaking out is that I had wished I could find one article or source that would reassure me this happened to someone else and they are fine,” said Beckley, who is now 28 and a psychology student at Southern Oregon University. “If this does happen again, I’m hoping my story will be out there for the next person to find.”

FMI: The case report was published online in the American Journal of Tropical Medicine and Hygiene, where it can be read in full.

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