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.
Facebook
Twitter
Instagram