Comments on: Nodding Disease

Nodding Disease

naturalog — Thu, 22 Mar 2012 09:52:36 -0800

Since 2010, over 3,000 children throughout northern Uganda have come down with nodding disease, a degenerative neurological condition, reports CNN.

The causes of nodding disease, which first emerged in the 1960s in Sudan, remain unclear. Afflicted children suffer from seizures, physical degeneration, and sometimes pyromania. Some treatment clinics have been established, but they remain underfunded and still face the problem of getting care to those in need. Uganda Nedagalalyayo, an association of traditional healers, has asked the government to involve them in investigating treatment options. The Ugandan government has also considered using helicopters to spray affected areas with pesticides, in hopes of curbing the spread. Nodding disease has gained some coverage in the media lately, in part due to criticism of the inadequacy and problematic nature of Kony 2012/Invisible Children.

By: KokuRyu

KokuRyu — Thu, 22 Mar 2012 10:03:01 -0800

It is currently unknown what causes the disease, but it is believed to be connected to infestations of the parasitic worm Onchocerca volvulus, which is prevalent in all outbreak areas.[10] O. volvulus, a nematode, is carried by the black fly and causes river blindness. In 2004, most children suffering from nodding disease lived close to the Yei River, a hotbed for river blindness, and 93,7% of nodding disease sufferers were found to harbor the parasite--a far higher percentage than in children without the disease.

By: infinitywaltz

infinitywaltz — Thu, 22 Mar 2012 10:08:43 -0800

Afflicted children suffer from seizures, physical degeneration, and sometimes pyromania. It causes pyromania? That's possibly even freakier than the idea that toxoplasmosis causes people to love their cats more.

By: Iridic

Iridic — Thu, 22 Mar 2012 10:33:47 -0800

But Onchocerca volvulus is fairly well understood as a disease agent in its own right, and there are plenty of places where the worm runs rampant and Nodding Disease does not. It may be that the cause of Nodding Disease correlates very strongly with Onchocerca distribution; or, and I think more likely, there's at least one other factor - a second parasite, a microbe, an environmental factor - that combines syndemically with Onchocerca to produce seizures, stunted growth, and bizarre cognitive effects. And whatever that co-infection is, it's spreading rapidly.

By: Joakim Ziegler

Joakim Ziegler — Thu, 22 Mar 2012 10:47:15 -0800

naturalog: "Afflicted children suffer from seizures, physical degeneration, and sometimes pyromania." They really need to get this into a House episode before the end of the show. Imagine the hijinks, what with the patient setting fire to House's cane and stubble and whatnot.

By: kaibutsu

kaibutsu — Thu, 22 Mar 2012 10:50:40 -0800

Immediately after telling my mom that I won a grant to go work in Kenya next year, she started telling me about the horrors of nodding disease. Luckily, pointing out that I'm 11 years past the upper bound age for the disease helped calm things down a bit....

By: Maias

Maias — Thu, 22 Mar 2012 11:09:37 -0800

It also seems possible that genetic variation in populations accounts for why it only occurs in some areas where the parasite exists: there's a form of OCD that is related to strep throat infections that basically seems to occur because some genetic variant of the immune system causes it to attack the basal ganglia in the brain when exposed to strep. Thankfully, most people don't have that but one might imagine that there are regions where there's less genetic variance since people have lived in the same place for centuries and so they would have more people susceptible in one place. This sounds truly awful.

By: KokuRyu

KokuRyu — Thu, 22 Mar 2012 11:14:10 -0800

Luckily, pointing out that I'm 11 years past the upper bound age for the disease helped calm things down a bit.... Your mom was on IRC with just now, and wanted you to look up Blackwater Fever, Guinea Worm, and Filariasis.

By: KokuRyu

KokuRyu — Thu, 22 Mar 2012 11:15:15 -0800

Interestingly, Googling "Guinea Worm" brought up this amusing bit of trolling.

By: Renoroc

Renoroc — Thu, 22 Mar 2012 11:30:49 -0800

CARL, GET IN THE HOUSE!

By: KokuRyu

KokuRyu — Thu, 22 Mar 2012 11:47:56 -0800

"The Jungle Rot Kid on the Nod" springs to mind.

By: juliapangolin

juliapangolin — Thu, 22 Mar 2012 11:52:45 -0800

Interesting stuff. My understanding is that mass hysteria/conversion syndrome has not been ruled out.

By: small_ruminant

small_ruminant — Thu, 22 Mar 2012 11:58:37 -0800

Wouldn't it be tricky to permanently stunt every kid's growth via mass hysteria?

By: small_ruminant

small_ruminant — Thu, 22 Mar 2012 12:08:41 -0800

This BBC article suggests the mass hysteria theory has been debunked.

By: StickyCarpet

StickyCarpet — Thu, 22 Mar 2012 12:46:27 -0800

"The Jungle Rot Kid on the Nod" springs to mind. posted by KokuRyu I heard that in William Burroughs' voice even before I googled it.

By: smoke

smoke — Thu, 22 Mar 2012 15:05:08 -0800

My understanding is that mass hysteria/conversion syndrome has not been ruled out. Really? My understanding is that it really really had.

By: ltracey

ltracey — Thu, 22 Mar 2012 18:41:23 -0800

I think Iridic or Maias or both are right. Their conjectures would be the first two things I would look at. It's interesting that they've localized the involvement of the hippocampus, and that familiar, but not unknown, food can start the nodding. Might it be stimulation of the hippocampus by the memory of the food be a trigger? I would be more reluctant to attribute it solely to genetic variance, only because it would seem to have swept through a population so swiftly. But if there were significant population shifts (due to war, famine, etc.) bringing refugees from outer areas where they may have been isolated previously, then I would give a much longer look at this.

By: chairface

chairface — Thu, 22 Mar 2012 21:32:28 -0800

I searched the first two articles and didn't see any mention of pyromania. Searching google for "nodding disease pyromania" returns this post itself as the top hit. Is there some strong evidence for the pyromania claim?

By: naturalog

naturalog — Thu, 22 Mar 2012 23:02:09 -0800

chairface: from the CNN article: "There are other bizarre symptoms. Often the children will wander off by themselves and get lost in the bush. And other children will start fires, according to parents and medics in the field. Others appear confused and traumatized." It's also mentioned in the sidebar of the same article. I seem to recall also reading about that elsewhere when I was finding links for this post, but the history from then is on a different computer, so I can't go back and check.