The Shifting Ethics of Mite Fighting

People with parasitic mites all need help in some form or other, and it is difficult to get help without putting others at risk. You escape to a hotel for a night: how do you know your sheets will be thoroughly washed? You throw something out: how do you know no one else will scavenge and use it? You sell your house: even if you disclose, how do you know how the buyers will be affected?

I am convinced we are living at the end of the dark age of mite infestation. Already there are researchers using direct DNA detection on non-parasitic face mites like Demodex folluculorum, who have found ten times the incidence previously believed. Other entomologists are starting to write about the medical impact of parasitic mites like Dermanyssus gallinae. It’s only a matter of time until the two research streams come together and we get to a parasitic mite DNA detection kit for use on humans.

At the same time, other biologists are using the DNA fish leave behind as they swim in rivers (called eDNA, for environmental DNA) to tell which species have swum by. It turns out every organism leaves trace nucleic acids in the environment as it passes. Once that technique is applied to locating parasitic mites in the home, the era of relying on ineffective glue traps will be over.

These developments will be wonderful in several ways. They will end the scourge of misdiagnosis with delusional parasitosis, which has been fueled by lack of real data. Accurate medical and environmental measurements of parasitic mite infestations will enable people with mites to advocate for more research funding, and to take better advantage of the limited treatments that currently exist.

But on the flip side, it may be tough to persuade others to help when the risks are well defined. The therapist who thought you were imagining things may suddenly start worrying you will infest the upholstery in her office. The contractor who comes to haul away your carpeting may turn down the work.

It is incredibly frustrating not to be believed. Real data will usher in a new era. But in the first stages, when the reality of parasitic mites is better understood and before there are better treatments, people with mites will not be able to hide behind the ignorance of others. It will be a far better problem than the ones they face today.

False Diagnosis of Delusional Parasitosis

Below is a link to an article comparing false negative rates using various methods of testing for mites. I believe the PCR method was first used in studies of Demodex and showed much higher rates than with old methods. The interesting thing is, if you read articles in the psychotherapy literature about delusional parasitosis, the authors uniformly assume the validity of old methods like tape testing. So the false negatives with tape testing turn into false positives for delusional parasitosis. Coming soon: a full article on the etiology and sequelae of false diagnoses of delusional parasitosis.