China isn’t (mostly) tropical. But we suspect maybe one kid picked up a so-called ‘tropical’ disease there.
Today we left before dawn to see Kevin M. Cahill, M.D., author of Tropical Medicine, a textbook now in its 8th edition from Oxford University Press. One kid’s gut problems have lasted 7 months (since visiting the Tibetan yak herders in W. Sichuan), plus, lately, terrible headaches and dizziness. All the pediatricians, gastroenterologists, lab tests (soon he’s also to see a pediatric neurologist) said head and stomach pains were UNrelated. That seems odd. And they said no, it wasn’t infectious, from China.That also seemed, maybe…wrong.
Food- and water-borne diseases are bad in China, still, including in cities. The other child got giardia (a parasite) there, with timing suggesting he picked it up in Beijing. Docs told us they see it constantly. (Along with the better-known Traveler’s Diarrhea, a bacteria.) Parasites are, for one, in the water. No one drinks the water, & we brushed our teeth with bottled water. Still, water comes into contact with things you eat.
Dr. Cahill is the U.N.’s chief advisor on medicine in humanitarian crises, and has written or edited about 10 books on tropical medicine. He is renowned for his parasite knowledge. He’s said to shun commercial labs and to examine specimens under his own microscope. One reference he showed us notes that a study (NYC, 2010) found 70% of parasite and amoeba test results at commercial labs were faulty.
Why were our docs so sure, why didn’t they suggest seeing a tropical medicine specialist (I note with gratitude that my friend Aviva did)? Dr. Cahill said medical schools here spend no time on tropical diseases. Well, why? Unlike the U.K., he said, this country never occupied conquered colonies. Aside from the odd adventure traveler, Peace Corps volunteer, or U.N. official, there’s no call for tropical medicine in the U.S. — among the elite. And there just isn’t much concern for the (mostly poor) immigrants who suffer from these things.
When budget cuts come to NYC hospitals, as he put it, “what gets cut are the things the Dominicans get.”
He also told us (before doing a sigmoidoscopy, sampling the intestinal wall) the stool tests our doctors rely on won’t show parasites or amoebas because the creatures live inside the intestine walls — not in stool.
Dr. Cahill thought a parasite might be the cause of things. We’ll find out tomorrow for sure. I desperately hope so, because this child is suffering.
Heartfelt thanks to friend Eric Pearl, & Cousin Liz, who recommended Dr. Cahill.
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Post Script: The great Dr. Cahill found an amoeba, E.Histolytica, the thing that causes amoebic dysentery (among other symptoms). The illness is called amebiasis and is said to affect 50 millionin the world, especially where it’s poor, crowded and hygiene is not good. With 2 meds and some time to heal, we believe he’ll be on the mend. And I’d like to take this opportunity to again “thank” the pediatric G.I. we saw repeatedly who insisted there was no reason to believe the cause of this kid’s suffering was tropical or infectious.