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Re: Re:

ScienceIsCool said:
King Boonen said:
ScienceIsCool said:
- Froome has stated that he has required multiple treatments (praziquantel) because the disease "came back".
- The above is a lie (http://www.path.cam.ac.uk/~schisto/) as the disease does not work this way. He would have to be re-infected back in the dodgy lakes of Kenya each time.
Actually, it's perfectly possible he required multiple treatments. Praziquantel is effective against the larval stage and adult worms, but not very effect against juvenile worms and completely ineffective against eggs. While one treatment is usually fine it is not at all uncommon for someone to receive a longer course of treatment. This longer course of treatment also takes a slightly different format to most long treatments. You would be treated, go away for a couple of weeks or so, be re-examined or return with similar symptoms and treated again. It's perfectly possible that a lay man could interpret this series of events as the disease "coming back".
My understanding was that, as you describe, a second course is required if after a few weeks eggs are being found in the urine or stool. That's really not what Froome described at all. He was talking many months between treatments. Anyways, I'm thinking that further discussion probably belongs in the Badzhilla thread that McLovin is allergic to.

John Swanson
Yes, I believe that's right, although neither of the available drugs are 100% effective all the time so it is possible that a person may require more than 2 treatments. The human host part of the life cycle takes at least a month, so it is possible that he may be treated once, again in a month and again in another month or two, possibly skipping the middle treatment. I don't fully remember the timeline people worked out and trying to find it in the Badzilla thread is probably going to be impossible! I also can't remember if it was claimed it was chronic or acute which would have an impact on the likely success of treatment or what Froome claimed each time his story differed. Just to be clear, I'm not defending him or what he said, I can't remember what it was, but it is possible, although not hugely likely, that his treatment may have taken some months.

Yes, probably better for the Badzilla thread, but that's as much a sprawling mess as any other thread gets in the clinic after a while so probably best to just leave it :)
 
Jul 21, 2012
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Re:

bigcog said:
Didn't realise there were so many qualified doctors on here, with a specialism in tropical medicine lol
it's not quantum mechanics. Anyone with half a brain can read about this stuff and figure out that Dawg is lying.

If you or anyone else think Dawg is telling the truth why don't you try to prove it?
 
Re: Re:

ScienceIsCool said:
Ah. You don't understand the difference between opinion and fact. Let's fix that.

opinion: a view or judgment formed about something, not necessarily based on fact or knowledge. <an example might be that orange is the best color, or Froome is the most obvious doper since Rob Ford>

fact: A fact is something that has really occurred or is actually the case. The usual test for a statement of fact is verifiability, that is, whether it can be demonstrated to correspond to experience. <ex: it's a fact that adult schistomes (Bilharzia worms) do not reproduce inside the host, and it's a fact that qualifications have no bearings on what the facts are>

Experts are needed when you want to hear an informed opinion related to a vast and/or disparate range of facts. Can people survive the trip to Mars? Better to get an opinion from NASA. Did Badzhilla "flare up" in Froome several months after treatment? Nope. Doesn't work like that.

John Swanson
Yes, I see what you mean, as demonstrated by your spurious opinion.
 
Mar 27, 2015
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what seems to be the problem ?
someone has to give Contador, Nibali and Quintana a run for their money

Nibali, COntador are the same thing as Froome. talk big about doping, shaddy connections, etc. Quintana and the colombians another lol group, their local races are a circus.

the only difference is that the "talented" are just dopers from young age, Froome is a late doper.

also, on the badzilla thing, you may want to slow it down, you sciencecools,sniper and whatever , you know *** about diseases, medicine, tratements and stuff.
 
Aug 31, 2012
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Unlike the bots, all of which are lawyers (Froome would never get convicted. There is no evidence, not a single shred), doctors (Badzilla is really bad and Froome definitely had it and there was certainly nothing unusual about his multiple rounds of treatment even though it only takes 1 in the vast majority of cases) and atmospheric computational fluid dynamicists (Froome had Tailwind all the way up Ventaux but no one else did)
 
Jul 21, 2012
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The skythreads will always be an endless cycle of posters laughing at their over the top doping and bots spewing variants of "never tested positive".

If someone is dense enough to actually still think Froome is clean they are beyond help no matter how many arguments one can throw at them so what's the point? Only a positive test can make them think Dawg is doping. Much better to just update the ignore list as martinbickers makes new accounts.
 
Re:

SeriousSam said:
(Badzilla is really bad and Froome definitely had it and there was certainly nothing unusual about his multiple rounds of treatment even though it only takes 1 in the vast majority of cases)
Vast majority?

http://www.ncbi.nlm.nih.gov/pubmed/9692165 - 42.5% cure rate after a single treatment, 76.1% after two.

http://www.ncbi.nlm.nih.gov/pubmed/11123824 - 71.6% cure rate after a single treatment.

http://www.idpjournal.com/content/3/1/47 - 62.6% cure rate in non-HIV infected individuals.

S. mansoni Resistance to praziquantel has been shown:

http://www.ncbi.nlm.nih.gov/pubmed/23052781

http://www.ncbi.nlm.nih.gov/pubmed/12474468

The efficacy of praziquantel is usually dependent on the intensity of infection. If Froome had a fairly intense infection then it is perfectly possible that he required multiple treatments months apart.

I don't believe in Froome being clean, but fact checking is important.
 
Re: Re:

King Boonen said:
SeriousSam said:
(Badzilla is really bad and Froome definitely had it and there was certainly nothing unusual about his multiple rounds of treatment even though it only takes 1 in the vast majority of cases)
Vast majority?



S. mansoni Resistance to praziquantel has been shown:

http://www.ncbi.nlm.nih.gov/pubmed/23052781

http://www.ncbi.nlm.nih.gov/pubmed/12474468

The efficacy of praziquantel is usually dependent on the intensity of infection. If Froome had a fairly intense infection then it is perfectly possible that he required multiple treatments months apart.

I don't believe in Froome being clean, but fact checking is important.
eh....only he never...he didn't even know he had it it the symptoms were so benign...and he was riding in the pro peleton...a feat most 'seriously' healthy people couldn't manage...
 
Re: Re:

gillan1969 said:
eh....only he never...he didn't even know he had it it the symptoms were so benign...and he was riding in the pro peleton...a feat most 'seriously' healthy people couldn't manage...
Disease intensity is measured by number of eggs in the stool, not symptoms, as far as I'm aware. Although there is correlation it is again perfectly possible for someone to be less affected by the infection than someone else who has a milder diagnosis.

Again, I'm not defending Froome or attempting to account for his inconsistencies, merely pointing out that it is not the "vast majority" of cases that are cured with a single treatment.
 
Oct 16, 2010
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Re: Re:

King Boonen said:
Disease intensity is measured by number of eggs in the stool, not symptoms, as far as I'm aware. Although there is correlation it is again perfectly possible for someone to be less affected by the infection than someone else who has a milder diagnosis.

Again, I'm not defending Froome or attempting to account for his inconsistencies, merely pointing out that it is not the "vast majority" of cases that are cured with a single treatment.
good posts, KB.
As for Gillian's legitimate question, what thou thinketh of this (taken from first post in badzilla thread):

"If schistosomasis/bilharzia was diagnosed in 2010, Froome should have been given the one day treatment and it should have no longer been an issue. The only reported occurrences of when the initial treatment does not eradicate the infection is when a heavy worm burden is in the system (i.e. a lot of worms infected Froome.) Even in those cases, treatment does not drag on for 18 months+. A heavy worm burden would also make the symptoms more severe than "I was always getting little colds and coughs, nothing serious"."
viewtopic.php?p=1307593#p1307593
 
King Boonen said:
SeriousSam said:
(Badzilla is really bad and Froome definitely had it and there was certainly nothing unusual about his multiple rounds of treatment even though it only takes 1 in the vast majority of cases)
Vast majority?

http://www.ncbi.nlm.nih.gov/pubmed/9692165 - 42.5% cure rate after a single treatment, 76.1% after two.

http://www.ncbi.nlm.nih.gov/pubmed/11123824 - 71.6% cure rate after a single treatment.

http://www.idpjournal.com/content/3/1/47 - 62.6% cure rate in non-HIV infected individuals.
.
Those are studies taken in areas of endemic bilharzia. One is in Tanzania, one is in Senegal.Of people who live amongst the disease every day. That means a) they are likely to have a higher burden of worms to begin with since they are in constant contact with the water (the first one is fishing villages. A fisherman is going to contact Bilharzia way more than a rich European tourist) and b) they are at constant risk of reinfection throughout treatment. The same day the pzq is taken by them, they could find themselves beginning the process of reinfection by coming into contact with bilharzia in the water. The pzq won't kill the new worms entering the body, it only kills those worms in the system at the time.

Very little of that is relevant to froome who fits the second group of people - European travellers back in Europe. Back in Europe there is exactly 0.0 risk of reinfection since the bilharzia isn't there. That means treatment is almost 100%. There are no studies into this group because there is no need. There are no health risks, there is nothing complex a study would help identify. The pzq kills the mansoni. The only time the treatment doesn't work is if there is a heavy worm burden. In that case the dose of pzq may only be sufficient to kill most of the worms. When a scan shows there are still worms in the system, the patient will undergo pzq again and this time it will kill the remaining worms.

The efficacy of praziquantel is usually dependent on the intensity of infection. If Froome had a fairly intense infection then it is perfectly possible that he required multiple treatments months apart
While it's possible froome had a heavy worm burden, it should be pointed out there are reasons to question this. Generally heavy worm burdens are most common in children since having a heavy worm burden is directly proportionate to how much time you spend in the water and children spend a lot of time in the water playing. Next are fishermen who aren't always in the water but are in contact with it, and locals who come into contact with it often. Rich European tourists (even if born in Africa) who are temporarily visiting the country are lowest down on the list. They get Bilharzia from a single instance of contact with the water, they don't generally spend anywhere near enough time in it to get a heavy worm burden.
A more important factor is lack of knowledge of bilharzia. There is an emphasis on education as many locals do not know how Bilharzia enters the system. They don't know that being in the water brings the risk of Bilharzia. Froome does. According to one article him and his brothers had Bilharzia as children.
So it's bizzare to think he would spend all his time on a short vacation to Kenya, swimming in waters he knew were dangerous. As a cyclist no less. Did he want to catch Bilharzia as much as possible deliberately?
Thirdly, as the original poster from the other forum who questioned froome, pointed out, the symptoms he claims to have had for the first year were extremely mild and do not in anyway fit what one expects from a patient with a heavy worm burden. Apparently pro cycling should have been out of the question. Instead Froome claims that for the first year all he had was an occasional cough or something.
Furthermore, last year Froome readjusted (again) his date of infection moving it back to 2006 (I think to explain why his 2007-2010 were so poor as well). That further confuses his story. It's even more bizzare since that means he spent 6 years living with a heavy worm burden while not suffering any of it's symptoms and avoiding any long term organ damage. And considering Bilharzia dies out naturally overtime anyway, what was originally a heavy worm burden should not have been a heavy worm burden 4 5 years later when he was undergoing treatment.

In any case even if he had a sufficiently heavy worm burden to begin with (extremely unlikely for the above reasons) he would have been cured on his second treatment. Standard procedure is that that happens a few weeks after the first. What definitely doesn't happen is that the patient waits 6 months for an unknown reason then returns to try the cure again (then waits another 6 months, and another 6 months). Its even more bizzare for a pro cyclist who needs to be cured of Bilharzia ASAP to continue his job. The idea that Froome would do one treatment than wait 6 months is ***.

What also definitely doesn't happen is that after the 2nd treatment the disease is declared gone, allows the patient to podium a grand tour and then reappears again 2 months later. Pzq kills bilharzia or it doesn't. It doesn't put it to sleep for a month. With his stories of chemotherapy and constant relapses, froome and sky are portraying a disease like cancer which can reattack a patient after being eliminated. Someone in PR screwed up big time.

To sum up: the main confusion stems from the difference between patients in Africa and patients in Europe. Obviously everyone hears Bilharzia and looks at studies into Bilharzia. But there is an important difference stemming from the fact that 1 group is at constant risk of reinfection, while another group is immune to reinfection. 1 group doesn't have the money or medical facilities to fight it and the other does.

All studies into bilharzia are studies into the first group - poor rural Africans. There it is a major world health problem, since there is a lack of medical facilities and education to combat it. This group represents 99.999% of all bilharzia patients. There are several hundred million of them.
On the other hand, in the whole of Europe put together there are every year something like 2 or 3 thousand people who get treated for bilharzia. They represent 0.0001% of the total world bilharzia population, and have easy access to treatment -pzq which is essentially a panacea. So there are no studies into this group, and there is no need. But froome belongs in this group, so any conclusions from studies taken in Africa do not apply to him.

Ironically this was the mistake froome and sky originally made since Wikipedia said that bilharzia needs to be treated every 6 months and sky came up with the story that froome needs to be treated with pzq every 6 months. What they didn't realize was that that conclusion came from a report by the carter foundation into fighting bilharzia in rural Africa that explicitly said that it's cheaper and more efficient to assume everyone in a village has bilharzia and give everyone pzq every 6 months, than to test everyone all the time, since the risk of reinfection is so high.
Froome's village - Monaco does not have an endemic Bilharzia problem and Froome himself has access to world class healthcare. No doctor, not even the one in Maseratis avatar, would ever suggest taking pzq once every 6 months as a treatment for an individual patient in Monaco.

But froome or whoever was in charge of selling the bilharzia story to the press in Sep 2011 never read the source behind the quote and created the story of froome having to get treated for schisto every 6 months for the rest of his life. From this original mistake every subsequent mistake they have made stems.
 
Re: Re:

King Boonen said:
ScienceIsCool said:
- Froome has stated that he has required multiple treatments (praziquantel) because the disease "came back".
- The above is a lie (http://www.path.cam.ac.uk/~schisto/) as the disease does not work this way. He would have to be re-infected back in the dodgy lakes of Kenya each time.
Actually, it's perfectly possible he required multiple treatments. Praziquantel is effective against the larval stage and adult worms, but not very effect against juvenile worms and completely ineffective against eggs. While one treatment is usually fine it is not at all uncommon for someone to receive a longer course of treatment. This longer course of treatment also takes a slightly different format to most long treatments. You would be treated, go away for a couple of weeks or so, be re-examined or return with similar symptoms and treated again. It's perfectly possible that a lay man could interpret this series of events as the disease "coming back".
Weeks being the operative word.

The doctor from Berlin said that a few weeks is possible, but he never heard it go on longer than that.

Froome on the other hand had something like 7 treatments over the course of 3 years averaging out at one treatment per half year.

But that's just the tip of the rainbow. Throughout this time Froome and Sky claimed it was impossible to cure Bilharzia and that Froome was only taking treatment to temporarily remove it from his system.
Going into the 2013 Tour de France Sky even said their biggest fear was that it would return during the TDF.:eek:
The one that didn't even leave France yet alone Europe. Sky were worried Froome would get Bilharzia in France.

There are no words to describe the ignorance.
 
Re:

bigcog said:
Didn't realise there were so many qualified doctors on here, with a specialism in tropical medicine lol
Well if that's your logic, you may want to question Froome's story too, considering according to the story, it was Froome's trainer and former doping cheat Bobby Jullich who discovered Froome's Bilharzia in the first place.

Forget discussing Bilharzia and medical papers on an internet forum. Bobby Jullich is a qualified doctor who diangoses things the real doctors miss :eek:
 
Sep 29, 2012
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it's itchy, apparently, as the worms burrow into your fricken skin.
if he had itas a kid he sure as sht knew when he got it as an adult.
 
The Hitch said:
Those are studies taken in areas of endemic bilharzia. One is in Tanzania, one is in Senegal.Of people who live amongst the disease every day. That means a) they are likely to have a higher burden of worms to begin with since they are in constant contact with the water (the first one is fishing villages. A fisherman is going to contact Bilharzia way more than a rich European tourist) and b) they are at constant risk of reinfection throughout treatment. The same day the pzq is taken by them, they could find themselves beginning the process of reinfection by coming into contact with bilharzia in the water. The pzq won't kill the new worms entering the body, it only kills those worms in the system at the time.
Of course they are, it's the only location that can provide enough regular cases to support a study, but they are still relevant because reinfection does not account for every case of requiring multiple treatments. Praziquantel is only effective against the worms in particular growth stages, it is perfectly possible for worms of differing growth stages to be present in the body, hence the need for multiple treatments.

Very little of that is relevant to froome who fits the second group of people - European travellers back in Europe. Back in Europe there is exactly 0.0 risk of reinfection since the bilharzia isn't there. That means treatment is almost 100%.
It is very relevant as it is the only data that exists and it also covers people who are not reinfected. If you think it is almost 100% you have no idea how the treatment actually works, these papers clearly show it is not 100%. It is also possible for travellers to receive multiple infections while in Africa which can again lead to a need for multiple treatments.

There are no studies into this group because there is no need. There are no health risks, there is nothing complex a study would help identify. The pzq kills the mansoni. The only time the treatment doesn't work is if there is a heavy worm burden. In that case the dose of pzq may only be sufficient to kill most of the worms. When a scan shows there are still worms in the system, the patient will undergo pzq again and this time it will kill the remaining worms.
This continues to show your ignorance. There are no studies because it would be impossible to gather enough participants to carry out a meaningful study, it would require mass participation of almost every health service within Europe to record case, treatment, re-emmergence and outcome and would only be funded for a major clinical trial if deemed necessary. Any numbers for Europe would rely on a meta-analysis of medical records and this is woefully inadequate to draw the conclusion that treatment is 100% effective. It isn't. Oh, no-one would refer to them as mansoni, they're schistosomes, the same way you don't refer to the major cause of malaria as falciparum, they're plasmodium, Toxoplasmosis is caused by Toxoplasma, not Gondii, Leishmaniasis is caused by leishmania, not major, mexicana, infantum or donovani.

The efficacy of praziquantel is usually dependent on the intensity of infection. If Froome had a fairly intense infection then it is perfectly possible that he required multiple treatments months apart
Deleted as not relevant to my posts... I'm not defending or discussing Froomes' particular case.
To sum up: the main confusion stems from the difference between patients in Africa and patients in Europe. Obviously everyone hears Bilharzia and looks at studies into Bilharzia. But there is an important difference stemming from the fact that 1 group is at constant risk of reinfection, while another group is immune to reinfection. 1 group doesn't have the money or medical facilities to fight it and the other does.
I'm afraid this is not my confusion. I'm perfectly clear and I also know that not every case of multiple treatment is due to reinfection. Money doesn't really come into it, praziquantel is on the WHO essential drug list and is readily available for treatment of Schistosome infection in Africa, education and diagnosis is the main issue.

All studies into bilharzia are studies into the first group - poor rural Africans. There it is a major world health problem, since there is a lack of medical facilities and education to combat it. This group represents 99.999% of all bilharzia patients. There are several hundred million of them.
On the other hand, in the whole of Europe put together there are every year something like 2 or 3 thousand people who get treated for bilharzia. They represent 0.0001% of the total world bilharzia population, and have easy access to treatment -pzq which is essentially a panacea. So there are no studies into this group, and there is no need. But froome belongs in this group, so any conclusions from studies taken in Africa do not apply to him.
Addressed previously, there are no studies because it is impossible to organise and would never be funded.

But, there are no studies yet you can state that praziquantel is a "panacea" with absolutely nothing to back it up? Utter rubbish and completely illogical.

deleted as not relevant to what I was discussing.
 
Re: Re:

sniper said:
King Boonen said:
Disease intensity is measured by number of eggs in the stool, not symptoms, as far as I'm aware. Although there is correlation it is again perfectly possible for someone to be less affected by the infection than someone else who has a milder diagnosis.

Again, I'm not defending Froome or attempting to account for his inconsistencies, merely pointing out that it is not the "vast majority" of cases that are cured with a single treatment.
good posts, KB.
As for Gillian's legitimate question, what thou thinketh of this (taken from first post in badzilla thread):

"If schistosomasis/bilharzia was diagnosed in 2010, Froome should have been given the one day treatment and it should have no longer been an issue. The only reported occurrences of when the initial treatment does not eradicate the infection is when a heavy worm burden is in the system (i.e. a lot of worms infected Froome.) Even in those cases, treatment does not drag on for 18 months+. A heavy worm burden would also make the symptoms more severe than "I was always getting little colds and coughs, nothing serious"."
viewtopic.php?p=1307593#p1307593
Past my knowledge really, I believe however if it was diagnosed in 2010 then at worst you would expect treatment to take maybe 4 months. It's possible that not all worms are eradicated due to a heavy worm burden AND differing life cycle stages which MAY prolong treatment, especially if treated by a doctor unfamiliar with Schistosomiasis (maybe why they stopped saying it was discovered by a South African doctor? Or did that come first?). 18+ months treatment doesn't make sense at all unless there was a massive burden, multiple infections etc. and even then it sounds a massive stretch. 18+ months for diagnosis in a traveller who shows no symptoms and progresses to chronic infection due to mis-diagnosis by doctors unfamiliar with Schistosomiasis? Very, very, very slightly possible, but I don't think that progression or treatment matches up at all with what Froome/Sky said.


Like I said, I'm not defending Froome or Sky, I think they were lying or at best massively confused about what was going on with his treatment and a lot of it was monitoring, but that's being really, really generous.
 
Re: Re:

The Hitch said:
King Boonen said:
ScienceIsCool said:
- Froome has stated that he has required multiple treatments (praziquantel) because the disease "came back".
- The above is a lie (http://www.path.cam.ac.uk/~schisto/) as the disease does not work this way. He would have to be re-infected back in the dodgy lakes of Kenya each time.
Actually, it's perfectly possible he required multiple treatments. Praziquantel is effective against the larval stage and adult worms, but not very effect against juvenile worms and completely ineffective against eggs. While one treatment is usually fine it is not at all uncommon for someone to receive a longer course of treatment. This longer course of treatment also takes a slightly different format to most long treatments. You would be treated, go away for a couple of weeks or so, be re-examined or return with similar symptoms and treated again. It's perfectly possible that a lay man could interpret this series of events as the disease "coming back".
Weeks being the operative word.

The doctor from Berlin said that a few weeks is possible, but he never heard it go on longer than that.

Froome on the other hand had something like 7 treatments over the course of 3 years averaging out at one treatment per half year.

But that's just the tip of the rainbow. Throughout this time Froome and Sky claimed it was impossible to cure Bilharzia and that Froome was only taking treatment to temporarily remove it from his system.
Going into the 2013 Tour de France Sky even said their biggest fear was that it would return during the TDF.:eek:
The one that didn't even leave France yet alone Europe. Sky were worried Froome would get Bilharzia in France.

There are no words to describe the ignorance.
Again, I'm not defending Froome. I cannot remember the timeline but I know it's massively dubious and does not at all reflect any likely treatment. I'm merely pointing out that fallacy that a single treatment is pretty much guaranteed to get rid of the infection. I would think for anyone in Europe 2 treatments at most would be required, possibly 2-3 months apart to both facilitate diagnosis and stop future, multiple treatments.


The returning stuff is obvious bollocks.
 
Jul 5, 2009
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The parasites take 6-8 weeks to reach maturity (multiple sources). So the longest course of Praziquantel would be two months, unless you get re-infected. So there would be ZERO reason for Froome to take multiple treatments past two months regardless of "worm burden".

John Swanson
 
Re:

ScienceIsCool said:
The parasites take 6-8 weeks to reach maturity (multiple sources). So the longest course of Praziquantel would be two months, unless you get re-infected. So there would be ZERO reason for Froome to take multiple treatments past two months regardless of "worm burden".

John Swanson
A high infection intensity could facilitate 3 treatments tops I would think, but that's very unlikely.

As I said to Sniper, it's maybe 4 months tops for a traveller and that's only really in the worst cases.
 
Of course they are, it's the only location that can provide enough regular cases to support a study, but they are still relevant because reinfection does not account for every case of requiring multiple treatments. Praziquantel is only effective against the worms in particular growth stages, it is perfectly possible for worms of differing growth stages to be present in the body, hence the need for multiple treatments.
Particular growth stages. Isn't the particular growth stage - adults? Maybe I am wrong but that is what I was told.
If that is true- its effective against adult worms, then, considering the worms take a few weeks to grow into adults, by the time any European is back in Europe the worms have grown into adults and therefore PZQ is effective against them.

In which case
reinfection does not account for every case of requiring multiple treatments
The 3 reasons for which multiple treatments are required would be
a) - Heavy worm burden
b) Reinfection
c) Worms not mature

Of those 3, Europeans are immune from b and highly highly less likely to suffer from a or c.

So a study which says that 30% of people in Senegal still had Bilharzia 4 weeks after a dose of PZQ is in my opinion worth little when determining its effectiveness on Europeans in Europe, don't you agree. All 3 major variables are changed drastically.

And as a quick side point Froome was (allegedly) riddled with Bilharzia for a full year before treatment so the worms were definitely adults by that stage.
these papers clearly show it is not 100%
I didn't say it was 100%. I said almost.

And again the papers show the case for rural Africa, under different circumstances.

This continues to show your ignorance. There are no studies because it would be impossible to gather enough participants to carry out a meaningful study, it would require mass participation of almost every health service within Europe to record case, treatment, re-emmergence and outcome and would only be funded for a major clinical trial if deemed necessary.
Well, that's what I said- its not neccesary. There isn't the motivation to devote funding to studies into how to tackle Bilharzia in Europe. Because PZQ has proved efficient. If not the first time then the second time.

Any numbers for Europe would rely on a meta-analysis of medical records and this is woefully inadequate to draw the conclusion that treatment is 100% effective. It isn't. Oh, no-one would refer to them as mansoni, they're schistosomes, the same way you don't refer to the major cause of malaria as falciparum, they're plasmodium, Toxoplasmosis is caused by Toxoplasma, not Gondii, Leishmaniasis is caused by leishmania, not major, mexicana, infantum or donovani.
I'm not going to pretend to have a fraction of the medical knowledge that you do. I don't. And I'm glad to see you have entered the discussion. There have been a few tropical disease experts I have discussed this with and asked questions off, and I have had a lot of pms with Mercxk Index who has a science background as well, but for the most part most people that post on the subject for either side haven't even googled Bilharzia yet alone researched it. Its good to have people in here who can approach the subject with a higher base level of knowledge.

That said, while I can't contribute anything valuable myself, I have discussed this with tropical disease experts and what I am saying comes from my conversations with them. Not in the same words, and I can't claim to speak for them, but I wouldn't offer conclusions or theories on this subject if I hadn't discussed it with someone vastly more qualified.

Its from the people I have spoken to that I got the impression that PZQ is simple. Not in the same words I used, but it was made clear to me that there is nothing for Europeans to worry about, that it is very rare for a PZQ treatment to not work (especially if 2 doses are used during the day). There was also a study (In Africa of course) that said that even when PZQ doesn't kill all the worms, it reduces the intensity of the disease by 90%

And btw I never said that PZQ is 100% effective nor that it is a panacea. I used the qualifiers "almost" and "essentially". That may have been an unscientific way for me to talk, but nonetheless in neither case was I claiming absolutes.
For the first one, I don't know what the cure rate is exactly, but I was told by others that it is very high. And studies in Africa have concluded 65-90% cure rates there, so considering the significantly more favourable conditions in Europe I do not think it would be false to assume its in the high 90's.

As for the second one, what I meant by "essentially panacea" is that ultimately it always cures the patient, and only reinfection could bring it back. At worst it may take a few treatments, but ultimately it always cures, does it not? Absolutely everything I heard is that the patient is always cured, and according to some, always within a few weeks.
 
Sep 29, 2012
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worm stages? pretty sure they penetrate skin at stage x which is when they can be killed. end of. eggs are excreted.
 
Sep 29, 2012
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Re: Re:

The Hitch said:
Dear Wiggo said:
worm stages? pretty sure they penetrate skin at stage x which is when they can be killed. end of. eggs are excreted.
What?
KB seemed to be implying the treatment might be ineffective due to multiple differing worm life cycle stages. hence froome's need for 3+ treatments. I'm simply expressing my doubt that that life cycle stage has any effect based on my readings, and no admonition for people to "wait for a few weeks till worms are all at the same stage for the treatment to work in one go".
 

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