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Disease and Delusion Spread by the Internet I thought the following might be an interesting experiment: Invent a disease and

a set of vague symptoms. Build a web site and start a tax-exempt charity for the disease. Send out press releases about the newly discovered disease and its disturbing symptoms and provide a link to the web site. Then sit back and see how many people come to the site or call the foundation claiming to have the disease. Such an experiment probably would reveal quite a bit about the powers of suggestion, hypochondria, and the expanding reach of the Internet. Unfortunately, someone has done my experiment. A South Carolina housewife came up with a disease she calls Morgellons and a set up a tax-exempt charity called the Morgellons Research Foundation. Apparently, her son had a rash and, instead of going to the doctor, she started snooping around the Internet for a possible cause. She came across some medical references (from the 17th century!) that may have described something similar to her son’s “condition” and she latched onto the name. She now has about 7,000 fellow Morgellons sufferers. That’s an impressive number of hypochondriacs with online access. In 2006, Hillary Rhodes, a reporter in Ohio did a story on the Morgellons Research Foundation. She wrote, “Don’t visit that [web] site, though. You might get swept up in what some people believe is a case of mass hysteria. If that’s what Morgellons is, it would be the first apparent case to spring from the Internet.” So what exactly is Morgellons disease? From the patient perspective, it’s a bizarre skin condition in which worm-like fibers of various colors emerge from lesions on the skin. “I was

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feeling things moving under my skin,” one patient reported. From the perspective of most physicians, Morgellons is just another form of delusional parasitosis. Delusional parasitosis is a well-known psychiatric condition in which patients believe they are infested by bugs, worms, or parasites crawling on them or under their skin. To be fair, there are a variety of fleas, bedbugs, lice, mites and ticks that bite and feed on skin. They often leave bite marks that swell and itch, and which may become infected if scratched repeatedly. But in the absence of obvious bite marks from insects and arthropods, or allergic reactions, many physicians are forced to consider a psychiatric origin for the patient’s complaints. Last November, University of Pennsylvania professor, Caroline Koblenzer, wrote, “The patient is intensely anxious, is obsessively focused on his or her symptoms, brings “specimens” of the offending agent…and is unshakable in his or her belief as to the cause. Elderly women living alone are the most common demographic. Psychiatric co-morbidity, such as depression, anxiety, or personality disorder, can usually be uncovered during a careful interview.” Interestingly, delusions, like contagious diseases, can be spread from one susceptible person to another susceptible person. This is how the Internet can serve as a “vector” or transmitter of illness. “When a person has something bothering him these days, the first thing he does is go online. You can get reinforcement of your ideas very quickly there,” a Canadian psychiatrist told the New York Times last year. Sociologist Robert Batholomew recently suggested the “World Wide Web has become the incubator for mass delusion and it [Morgellons] seems to be a socially transmitted disease over the Internet.”

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Such beliefs also are reinforced by a handful of doctors who claim Morgellons is real and treat patients with a variety of antibiotics and expensive supplements. (These are the same doctors who treat people for chronic fatigue, chronic Lyme disease, Gulf War Syndrome, Multiple Chemical Sensitivity and other poorly defined syndromes and symptoms.) Connected and contaminated by the Internet, Morgellons patients have spread the effects of their shared delusions at least as far as Capital Hill, where Senator Dianne Feinstein (D-CA) urged the Centers for Disease Control and Prevention (CDC) to investigate the matter, and to the CDC where self-diagnosed Morgellons patients were telephoning twenty times a day demanding help. So now the CDC is investigating Morgellons disease. Last summer, a 12-person task force assembled to review patient data, and develop a case definition for Morgellons disease in order to distinguish its symptoms from those of other well-known diseases. It’s not clear how much time and money will be spent investigating a disease imagined in a South Carolina suburb and propagated through the Web. Last summer, Stephen Stone, president of the American Academy of Dermatology told Nature Medicine magazine, “There really is no scientific basis at this point to believe that this is real. Many patients with symptoms similar to Morgellons respond well to antipsychotics.” Seinfeld character, George Costanza, nicely summed up the problems of dermatology and skin when he declared, “Wash it, dry it, move on!” Today, in the Internet Age, he probably would say, “Wash it, dry it, log off!”

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