Australia: Live worm detected in woman’s brain

Dr. Sanjaya Senanayake, who is an infectious diseases physician at the Canberra hospital, was having a fairly normal day on the ward when a neurosurgeon colleague called him and said, “Oh my God, you wouldn’t believe what I just found in this lady’s brain – and it’s alive and wriggling.”

The neurosurgeon, Dr. Hari Priya Bandi, had removed a parasitic round worm that was 8 centimeters in length from her patient, which prompted her to consult with Senanayake and her other medical colleagues on the next course of action to take.

After experiencing three weeks of gastrointestinal pain and diarrhoea, followed by a continuous dry cough, fever, and night sweats, the patient, a 64-year-old lady from south-eastern New South Wales, was initially taken to her local hospital in late January 2021. The patient was a native of the region.

By the year 2022, she was also experiencing bouts of sadness and forgetfulness, which led to her being referred to a hospital in Canberra. Her brain was scanned with MRI equipment, which revealed several anomalies that needed to be operated on.

Senanayake stated that they were under the impression that the neurosurgeon would not go into the space expecting to encounter a wiggling worm. “Neurosurgeons deal with infections in the brain on a regular basis; however, this was a once-in-a-career finding.” Nobody was anticipating coming across that”.

The unexpected finding caused a group of people working at the hospital to rapidly gather together in order to determine what kind of roundworm the patient had and, more critically, to make a decision regarding any additional treatment the patient could need.

According to Senanayake, “we just went for the textbooks, and we looked up all of the various types of round worm that could cause neurological invasion and disease.” Their investigation produced no results, so they decided to seek assistance from professionals from other fields.

“Canberra is a small place, so we sent the worm, which was still alive, straight to the laboratory of a CSIRO scientist who is very experienced with parasites,” Senanayake said. “Canberra is the capital of Australia.” After taking a quick glance at it, he exclaimed, “Oh my goodness, this is Ophidascaris robertsi.”

The roundworm known as Ophidascaris robertsi is most commonly found in pythons. The patient at the Canberra hospital is the first known instance of the parasite being identified in a human anywhere in the globe.

The patient lives in close proximity to a lake region that is frequented by carpet pythons. According to Senanayake, although not having any direct encounters with snakes, she frequently gathered wild grasses, particularly warrigal greens, from the area around the lake to use in her cooking.

It has been hypothesized by the medical professionals and researchers who have been working on her case that a python may have deposited the parasite into the grass through its waste. They believe that the patient was most likely infected with the parasite either by direct contact with the local grass or through the consumption of the local greens.

According to Senanayake, the woman required treatment for other larvae that may have invaded other regions of her body, such as the liver. However, due to the fact that no patient had ever been treated for the parasite in the past, caution was used. Certain drugs, for instance, could set off an inflammatory response just as the larvae are dying off. They also required to administer medications to combat any potentially detrimental side effects, as an inflammation can be harmful to organs such as the brain, and because of this, they had to administer medications.

“That poor patient, she was so courageous and wonderful,” Senanayake added. “I feel terrible for her.” “You don’t want to be the first patient in the world with a round worm found in pythons, and we really take our hats off to her for overcoming this challenge,” the doctor warned. It’s been a pleasure to work with her.”

According to Senanayake, the patient is doing well and is still being closely examined. Researchers are investigating if a prior medical problem that caused the patient to have a damaged immune system could have been the source of the larvae taking hold of the host. The findings of the investigation were published in the month of September’s issue of the journal Emerging Infectious Diseases.

The Centers for Disease Control and Prevention in the United States reports that three-quarters of newly discovered or newly developing infectious diseases in people originate in animals.

According to Senanayake, the fact that this was a world-first occurrence emphasized how dangerous it is for diseases and viruses to move from animals to humans, particularly when people and animals start to live more closely together and their ecosystems start to overlap more.

He stated that in the past thirty years there have been approximately thirty new cases of infection all over the world.

“Roughly seventy-five percent of newly emerging infectious diseases around the world are zoonotic, which means that they have spread from the animal kingdom to the human kingdom. Coronaviruses are included in this category.

Because the Ophidascaris infection does not spread from person to person, the case of this patient will not result in a pandemic similar to that of Covid-19 or Ebola. On the other hand, both the snake and the parasite can be found in different regions of the world, which means that it is quite likely that further cases will be identified in the years to come in other nations.

Professor Peter Collignon, who is a specialist in infectious diseases who was not involved in the patient’s case, stated that some cases of zoonotic infections may never be discovered because of their rarity and the fact that clinicians do not know what to look for in these circumstances.

“Sometimes people pass away, and the cause of death is never determined,” he stated.

“It’s worth taking care when encountering animals and the environment, by washing foods thoroughly and cooking food properly, and wearing protection like long sleeves so that you don’t get bitten,” he said. “This includes washing foods properly and cooking food properly.”

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