Are non-infectious diseases actually not contagious?

This report is in http://www.youtube.com/channel/UCjgNNygY5v4j_AyYwrOTuvA

R. Zhaxylykova. (2013) PhD. Clinician with 48-years’ experiences.

This is my report about serious discovery in the field of clinical medicine. I devote it to EAACI-WAO Congress 22 – 26 June 2013 in Milan.You have enough time to acquaint with it, discuss it and to take a decision.

The name of my report is

Are non-infectious diseases actually not contagious?

Nowadays the main problem of health of population in the economically developed countries is the so-called non-infectious diseases (NIDs), including the dermatologic, allergic, rheumatic, oncologic, neurologic, cardiovascular, mental and other diseases. The etiology of most of these diseases still remains completely unexplained. At the same time the studying of epidemiology of almost all non-infectious diseases, carried out by scientists from different countries, evidence of the infectious nature of their distribution. What is the real nature of these diseases?

We approached to the answer of this question absolutely accidently. The stated work was carried out in Kazakhstan in the period from 1973 till 2012, first on the basis of the gastroenterology department of the Republican Clinical Hospital (RCH), and then was based on a variety of medical institutions in Almaty, Kentau and Astana.

When a patient with discoid lupus erythematosus arrived in a ward for which I was in charge of and from the lesion on her face excreted a huge amount of Demodexes, I did not agree with dermatologists in her non-infectious for others. By the already-established technique for examination the clinical condition of the skin in the dynamics, I began to observe the skin of open parts of the body of all people contacted with her. For the period from 1974 to 1979, the number of such people was 342. The uniformity of the nature of the detected change on their skin in comparison to changes on the skin of the patient, showed the possible Demodex origin of these changes.

Unintentionally I began to look closely at the skin of open parts of the body of all the people I met. I estimated that the similar changes were observed on the skin of 70-93% in-patients in different Republican Clinical Hospital departments, but there were more people with healthy skin among residents and tourists I met in Almaty. To verify connection of the skin changes with mites, I began to assign patients to additional anti-mite treatment in compliance with all measures required for the treatment of scabies. In the control group the identical patients have not received anti-mite treatment. As a result, from 1975 till 1978 the observation was performed in 137 patients of the main group and 131 patients of the control group. The results of the treatment surprised: the primary improvement (although statistically doubtful) occurred in patients receiving anti-mite treatment as earlier phase of termination of an itch of skin (for 3-17 days compared to 9-18 days in the control group), and a sticking improvement of the skin visual condition. After two months the skin itching was not observed in almost all patients of the main group and only in 30% patients of the control group. The observed positive result of the treatment was in favor of the mite- origin of the skin changes of the patients. The cured patients infected again by their partners who although did not complain but had a change in their skin. It should be emphasized that in that period the number of people with beautiful healthy skin dramatically decreased.

After the completion of the main scientific work in the first half of 1980, I rechecked my observations on other 49 in-patients. Anti-mite treatment clearly gave the elimination of subjective symptoms and clinical improvement of the skin. Thus, the facts indicated the presence of an infectious disease caused by Demodexes with weak itching and insignificant changes in the skin. But it was hard to believe in the existence of clinical infectious disease non-diagnosed and non-recorded by the clinical medicine as the medicine was seemed to be highly advanced and medical technology has reached unprecedented heights. That doubt caused the decision of self-experiment - autoinfection of Demodecosis, carried out on August 10, 1980. As a result my perfectly clean skin changed beyond recognition.

Development of Demodecosis in the clinical experiment left all doubt out: the presence of infectious disease, unconsidered by clinical medicine, caused by Demodexes was undeniable. In January 1981, I notified the management of the Institute of regional pathology where I worked as a senior research fellow. During the years 1981-1982, the studies with the participation of dermatologists and laboratory doctors were conducted in different medical facilities, children and adults groups in Almaty. At the same time the study of the literature on the mites was begun.

In reply to my report addressed to the Minister, Academician T. Sh. Sharmanov, in 1981 the Scientific Medical Council (SMC) of the Ministry of Health (MoH) of Kazakhstan sent me to the Republic Institute of Dermatology and Venereology to prove my scientific position – presence of Demodicosis of the dermatological patients. In the presence of the members of the created Committee the laboratory doctors of the Institute identified 100% Demodexes at different stages of development among the specifically indicated by me 42 pathological elements of the skin (feet, legs, hips, back, belly, upper limbs, back of a head) of 37 in-patients and out-patients. Thus, contrary to statement occurring in dermatology about Demodexes creeping out on skin surface to lay eggs, the research proved Demodexes inhabitation on people skin by colonies. Then it was necessary to demonstrate a complete cure of those patients with ethiopathogenetic anti-mite medicines and thus definitively to prove Demodex etiology of the disease in conjunction with examined dermatology patients. However, the Institute management was quick to give an official response to the Scientific Medical Council of the Ministry of Health with the reference to the information from the literature that Demodex is saprophyte and is present of 100% of people.

In 1981, during the working out of the treatment of grafted Demodicosis I had a severe allergic complication. The skin became of the beet color and was swollen. The skin became wet in the bends, covered with bright red papules, already burst and massive bubbles. The condition was serious, so the chief dermatologist of the Republic, Professor Makasheva Raisa Karimovna, who examined me together with ten student doctors, gave the direction to in-patient treatment with a diagnosis of "Erythroderma." That case served for me as an occasion to follow a more thorough study of Demodex and allergies interrelation. Professor Makasheva R. K. did not take seriously the conclusion that I had grafted Demodecosis. To my direct question whether I was infectious to others, she replied negatively. But soon two cats were infected with Demodecosis with the material, excreted from my allergic skin.

The facts obtained leave no doubt about the presence of Demodecosis, so I decided to retrain to a dermatologist and allergist to continue studies in a specialized laboratory. But I was refused not only in the creation of such laboratory but even in getting a job as an ordinary dermatologist in Almaty. So I had to move to Kentau, where I had been promised to work as an allergist and dermatologist. The patients with pollinosis at the exacerbation stage and with other allergy options fully recovered under the Children's Medical Union allergist's office of Kentau town. The patients got rid of eczema, neurodermatitis, dermatitis and other skin problems under the Dermatological office of Kentau dermatological and venerological dispensary. There were some casuistic cases, when the patient, unsuccessfully treated for three and a half months after our three ethiotropic therapy procedures, came to work in the specialty, and the patient who had to change her place of residence because of allergies moved back to Kentau. It seems what else evidences of the correctness of the theory of origin of the diseases should be provided, if ethiopathogenetic treatment leads to the total recovery? I hoped to get understanding and support from the administration of the Ministry of Health of the Republic, so I moved back to the capital. Unfortunately, the administration of the Ministry of Health had been fully replaced, and it was necessary to state the problem from the beginning for the newly appointed persons. Having been tired of fighting with misunderstanding, I got a job as a local doctor of Polyclinic No. 4, where I was working from 1984 till 1990, providing care to the patients primarily of therapeutic profile taking into account the degree of infestation of the skin by Demodexes. After the Soviet Union collapse I began to work as a privately practicing allergist-dermatologist in a small scientific and medical enterprise "Saule" created by me with the attraction to work of the specialist – acarologist and laboratory assistant.

For 39 years I have observed the skin of open parts of the bodies of more than 2 million people, 98% of which were affected by mites (acariasis). Skin covering of 388 780 people was examined, 96% of them had mite affected skin. Moreover, the situation was as follows. Every year the symptoms of affected skin increased: in 1979 were found in 65% , in 1980 –in 79%, in January 1981 - more than in 97%, from August 1981 –in 100% of the patients. Respectively the number of people with healthy skin decreased. Besides, every year there was progression and complication of Acariasis. Thus, 93% of the patients had the initial stage of Acariasis in January 1981, in 1982 - 89%, in 1983 - 78% of the patients. Currently, the initial stage of Acariasis occurs not more than 30% of the patients, even among children. The subjective symptoms of Acariasis were absent at 85% of affected patients in 1991 and only at 27% in 2006. In 1991 it was possible to achieve a complete recovery of the patient with the initial stage of Demodecosis in one month, but in 2006 it was required not less than 6 months. The above facts say about Demodecosis progression.

I would like to list briefly the most prominent clinical manifestations of Demodecosis: hair loss, dryness, greasiness, porosity, excessive wrinkling, hilly skin surface, the presence of acne, abundance of different spots, atheroma, papillomas, pinkness of different intensity up to brown-red, thick fleshy or

torous nose, red thickened eyelids, greasy or dry dull hair with dandruff, greasy ears turning pink in the sun and in the heat, etc. Among the hardly noticeable manifestations of Demodecosis there is rough dry "goose" skin as if sprinkled with semolina or small beads, colored circles under the eyes, the abundance and depth of mimic wrinkles, narrow wrinkled forehead, greasiness of skin of a back of a nose or all face, dryness of skin of side parts of a face and front part of legs, abundance of “birthmarks”, presence of small convoluted capillaries, cyanotic vessels of a body shown through skin, and etc. If a person unintentionally slightly strokes or scratches this or that part of bogy - undoubtedly it is Demodecosis.

The skin condition is no wonder believed to reflect its owner` s health state. Therefore, we should remember the healthy skin is never dry or oily, and has no rash!

Among 42 980 patients who applied for medical help there were 12567 children under the age of 14. 92% of the patients were previously treated in various hospitals and / or at healers without any results. Before contacting us those patients were diagnosed as the following: 57.7% - allergological, 37.4% - dermatological, 1.4% - ophthalmological, 1.2% - rheumatological, 0.5% - oncological, 0.4% - gynecological, 0.4% - endocrinological, 0.3% - surgical, 0.2% - urological, 0.1% - mental, 0.4% - other diagnoses or applied without diagnoses.

All patients received the common treatment plus an additional external treatment according to their skin infestation degree with the mite with the mandatory rigorous compliance with recommendations for elimination of the nearest environment from dust mite allergens. Thus the full recovery occurred in 70 - 95% of patients consistently implemented the additional recommendations.

The additional recommendations were as follows. To maintain the skin purity, as well as for its mechanical cleansing from mites it was recommended to take hygienic shower with soap and a washcloth regularly (1-2 times a day, morning and evening). It is best to alternate laundry soap with tar soap, with Sulsen soap and with green soap. In the case of dry skin it was recommended to use any soap with glycerin, “Dove”, etc. At the end of the shower, to wipe with a just ironed towel, always to put the clothes ironed from the inside and outside, to change bed clothes at least twice a week, and in the presence of skin or allergic disease - every day, to wash bed linen at the washing machine mode of 85-90 degrees. A blanket, a pillow, a mattress should be made of anti-allergic material. A mattress and a bedside wall should be vacuumed weekly. The bed should be thoroughly cleaned on all sides once a week. It is necessary to perform a thorough cleaning under the bed at least once a week. Top underclothes should be often shaken and processed with anti-mite sprays in compliance with all required safety precautions. It is recommended to make regular thorough cleaning in a room, an apartment and in a house. Do not keep animals in the house. Upholstered furniture should also be regularly cleaned thoroughly. Dust from vacuum cleaner must be removed from a dust collector in due time. It is better to use water vacuum cleaners from which dust in due time is removed on the sewerage. Just use regular detergents to wash the floors and for other household needs. We regularly interested in the correct execution of the above recommendations. When assigning treatment, we interested in the work conditions and we repeated recommendations for the patients so that the patients receiving the treatment will not get infected again at work, at home and at other sites.

Acarological examination (by scraping, the skin inspection in vivo, provocative way to identify mite colonies, enucleating of identified colonies) was held for 17 837 people. In that case, Demodex (in 99.8%) was more often detected. In 1.2% of that cases were identified Dermatophagoideses, in 0.3% of the researches - Sarcopteses. In 0.2% of the researches mites were not found. There were not any mites of 18 persons with healthy skin. The comprehensive examination of the dynamics of the skin as well as of the biotope was conducted for 412 patients with acarologist participation. Then we revealed the following paradox: Demodex was found in the patients` skin and the large amount of Dermatophagoides – on their life subject.

The discovery of mites in large amount in the dust of any staying of people wonders no one today. And, while as pathogens are recognized only Dermatophagoides, bodies remains and excreta which are allegedly inhaled with household or bed dust caused respiratory allergies of humans. But the pioneers and we have found that Dermatophagoides penetrate into the human internal organs and tissues, causing dermatophagoidoz in the form of its clinical masks as bronchial asthma, allergic rhinitis, allergic conjunctivitis, pollinosis, and others.

The axiom is well-known: any part of a mite is allergenic to human body. The anti-bodies to allergens are always formed in immune-competent body. A long time ago scientists proved the presence of anti-bodies to components of Sarcopteses of the patients with classic scabies, to components of Demodex – of the patients with demodectic blefaroconjunctivitis, to Dermatophagoideses’ components - of the patients with atopic bronchial asthma. Therefore, any disease caused by mites always has allergic basis.

There is no so contradictory information about any other mite in medical science as one about Demodex mite. Over 170 years, it is found in the skin of all the humans. The literature describes many cases of Demodexes detection in human body secretions (saliva, tears, sputum, bile, feces, etc.). They have been found in the course of glandular tissue lining the bed of nerve fibers, in soft tissue of the nose alae, in lymphatic vessels and nodes, spleen, and liver. The Krulikovsky balls formed by Demodexes in subcutaneous fat tissue of humans are described. Although it is credited with the role of the human skin symbiont, but by now it is firmly stated in medicine that Demodex causes discoid lupus erythematosus, demodectic blepharoconjunctivitis and red acne. In fact, these diseases are distinct clinical masks of one disease called as Demodecosis.

In animals Demodexes are clearly recognized as pathogens that live in the glandular tissue in colonies. According to our data the structure of Demodexes colonies in humans is identical to the structure of the Demodexes colonies in animals. In the center of the colonies is caseous substance, consisting of decomposed remains of bodies of naturally dead mites and their excreta, remains of pitted tissues of the host. Next to the periphery of it there are immobile stages of Demodexes: 1-nymphs, larvae, and eggs. Close to the wall of the colony the movable stages of the mite live: 2-nymphs and imago. In the end the contents of the colonies increasing due to the life activity of mites leads to stretching of the gland capsule, which from the skin surface looks like a sebaceous cyst, lipoma, etc. But why, you ask, the examination of such masses does not detect mites? Because the examination is carried out incorrectly: only the median caseous contents are examined, which primarily comes from the lesion during the taking of the material, and the parietal area, where the mites actually live, is not extirpated and not examined.

Our data do not agree with the existing medical opinion that Demodexes feed on shed epithelium of the skin glands lumina. In this case, they should be considered to be first-aiders of skin pores, cleansing their lumina from the old wasted material, and this, in turn, should cause improvement of the skin condition. However, in case of Demodexes colonization we see the deterioration of the human skin. Demodexes have a powerful stabbing, cutting, suction and biting mouth parts, and with such a device they are hardly satisfied with dead material. Also it is found out that Demodexes on the surface and inside of their body carry other microorganisms being smaller than themselves, that means that the diseases they cause will always associative. For this reason and according to our observations, we believe development of severe systemic destruction of the human body to be frequent, therefore the case of “demodecosis-gravis”, as described in the literature, is not occasional. Based on our own observations, we also stand in solidarity with the opinion referred to in the literature about the involvement of Demodexes in development of almost all skin diseases in humans. Despite the information stated long ago and being far incomplete, some researchers still do not want to admit the fact of demodecosis under the influence of Demodexes.

Our data refute the information in the literature about the “favorite” habitat of Demodexes in the skin affected by them. This view is contrary to the general biological laws: any insects, while multipling, colonize and occupy any vacant ecological niches due to their inherent adaptability. It is well known: the mites, including Demodexes, have inherent tremendous adaptability.

What has happened? Why Demodexes began to dominate after the elimination of pandemic classic scabies, which has been raging on the planet for 19.5 centuries? This fact is quite understandable in the existing literature according to the following information. At all times all three genera of mites have been detected in the skin glands of patients with classic scabies: Sarcoptes, Demodex, Dermatophagoides. It is known that Sarcopteses pierce moves in the surface layers of the skin, Demodexes live in the glands of the skin, and Dermatophagoideses affect deep-lying tissue. As a result of specific local treatment of Sarcoptes scabiei a patient with scabies was quickly sanitized due to sufficient availability of Sarcopteses to anti-scabiei drugs. But Demodexes remained in a complex and deep-lying glands of the skin with tortuous excretory ducts. There also remained sporadic Sarcopteses, which were subsequently the cause of the so-called acarine disease carriage (acarotregerstvo). Dermatophagoideses were even more inaccessible to anti-mite drugs due to laying in deep layers of human tissues. The foregoing explains persistence of acarophobic or post-scabies itching of the skin after undergoing scabies. The complete absence of natural antagonists of the microcosm (Sarkopteses, lices, etc.) and control on the part of the host allowed Demodexes to flood all the ecological niches in the skin and the body of the human, and dermatophagoideses - in the human’s immediate environment (bedding, clothes, home, and so on), which we and other researchers detect presently. Thus, a pandemic era of sarcoptic mange was replaced by Demodecosis pandemic. Demodecosis was gradually gaining rates. In the 1970s we recorded an avalanche spread of demodecosis throughout the population. The consequence of the described fact, in our opinion, was a three-fold doubling of the incidence of the earliest and most frequent clinical mask of demodecosis that is allergy, which is fixed by allergists for three decades of the late last century.

Our data indicate not just the ability of Demodexes to cause the disease, but also about their high contagiousness. And this in turn means that if a family or a team has one patient with demodecosis (blepharoconjunctivitis or red acne, atopic dermatitis, etc.), all its members in this outbreak are infected with demodecosis. That's why in medicine blepharoconjunctivitis, discoid lupus erythematosus, or any other disease in which demodecosis is a leading or concomitant disease are not cured practically. For the same reason when treating the face skin diseases, the problems with the eyes are arising and this is proved by ophthalmologists. If Demodex affected facial or eyelids skin or any other area of ​​the body, then Demodexes is everywhere in this man from the head to the finger-ends on the feet and hands. And demodexes in the body of affected people live in colonies, which are easily detected by our developed provocative method of detection of colonies (Zhaksylykova R.D., Malikov A.M., 1982). The denser the skin is populated with mites, the more pronounced changes are in it.

At heat rash, facial wrinkles, the punctate moles, large white or colored spots, loose skin syndrome, psoriasis, neurodermatitis, eczema, melanoma, atopic dermatitis, and other pathological conditions of the skin, potential candidates for anaphylactic shock or Lyell's syndrome after provocation have Demodexes colonies visible in the form of papular elements, being small as millet grain or larger, and with punctate excretory opening. Subsequent enucleating of parietal areas of these masses allows finding in them Demodexes at different stages of development. Colonies of mites are arranged according to the specific structure of the skin glands of the affected patient.

As you understand, we first carried out the mechanical cleaning of the skin of the patients affected by mites. You may ask: why not to immediately release the body from mites? First, we had to strictly comply with existing legislation in the field of medicine and only use approved tools and methods of treatment. Second, any drug, physical or biological agent could cause massive loss of mites in their places of residence in the body affected by them, and thus trigger the development of violent allergic reaction to Lyell's syndrome or anaphylactic shock. On the other hand, the remains of the bodies of massively dead mites, while decaying, could cause intoxication of the human body. To prevent these terrible complications we firstly had to clean mechanically the largest organ (the skin) of the human body from mites, and then with less risk to the patient's life to start cleaning his/her body of unwanted aliens – the mites. We recommend to follow this methodology till the legislative development of radical ways to treat demodecosis and any other acariasis.

The skin is most frequently affected at demodecosis. And this is not surprising, since the inoculation of Demodexes into the human body comes through the skin and mucous membranes communicating with the outside. Cutaneous manifestations and complications of demodecosis are detailed in the book we wrote in 1999, “Allergy as a cause of growth of human diseases to the beginning of the third millennium. Allergy = Acariasis”.

The second most frequent clinical masks of demodecosis are allergic manifestations. And it is also not surprising, since any component of any mites bodies are allergenic for the human body. In the presence of demodecosis any trigger that can cause massive death of mites in their habitats, will provoke the allergic reaction. Based on the above, we can safely say that it is because of demodecosis almost all allergists previously stated the development of allergies first of all from the skin and mucous membranes. According to our data, the presence of allergy of internal organs means their affection by mites. Additional proof of this fact is, in our opinion, Demodexes transition to anaerobic type of respiration that was described by some researchers

Knowledge of demodecosis clinical symptoms allows hypothetically assume that all people of the world have the original white color of the skin. In the tropics and subtropics acarofauna is richer than in other regions. Therefore, the skin of the baby with light skin born from the dark-skinned mother is quickly gaining the appropriate color of his race. Unfortunately, at the present time Demodectic acariasis is so deserted that we already begin to observe the cases of intrauterine infection with it, as it can be judged based on the cases of newborns examination in the hospital of Kentau, as well as some of the newborns skin descriptions in the literature. Change in living conditions and contamination of household items and skin with mites have changed the color of white race people's skin, who currently have no absolutely white and clear skin!

Complete recovery of 70-95% of patients as a result of the additional antimite treatment with thorough elimination of habitat from the mite allergens states on the leading role of mites in the etiology of their diseases. Therefore, currently demodecosis is present in all the people as primary or concomitant disease. It means that due to the lack of proper control demodecosis currently present in a variety of clinical masks. In such a situation, the use of anti-allergic drugs is justified pathogenetically and the use of antimite drugs and activities is etiotropic. It is not for nothing that in clinical medicine allergy is a uniting point, and the use of antihistamines is a pathogenetic principle that unites all the sections of clinical medicine. With no causal treatment and proper control demodecosis will progress further, causing an even greater increase of well-known and occurrence of new NID - new clinical masks of demodecosis, that has already taken place in some sectors of clinical medicine (eg, in rheumatology). Just as each of you sees five fingers at each of those around you, so could be seen clearly the objective manifestations of demodecosis in the skin of all the people I met in all the countries where I had been in the past seven years.

Thus, these facts suggest that the Demodex mites are definitely pathogenic to humans and cause a self-titled acariasis, clinical masks of which in the form of the NID are now widely distributed in the population. Consequently, the NID is a slow infection, inoculated through the skin and mucous membranes communicating with the outside with an associative complex of pathogens led by mites. At the beginning of the third millennium, demodecosis is relevant to all the people as a concomitant disease or leading pathology because demodexes affected all the people of the world and it is the official medical data. Wherever foot may tread, there are dust mites - and this is also the data of official medicine. So demodecosis cannot be treated without the participation of clinicians-acarologists and allergists-immunologists. To eliminate demodecosis and its clinical masks it is necessary to consolidate the forces of the population and the medical professionals who need to know the disease clinical findings. In the course of demodecosis liquidation recovery will come from atypical and latent types of Sarcoptic acariasis. However, for the complete elimination of Dermatophagoidic acariasis, which share in the structure of acariasis morbidity is still insignificant, it is required to develop and implement additional treatment.

A few words about the reasons why demodecosis problem has not been taken up by clinical medicine for over 32 years? First, no one clinician with whom I discussed the problem was not aware of clinical acarology issues. Second, most health officials and scientists did not realize that demodecosis as an advanced infection, is able to give a variety of clinical masks. That is, they did not know the axiom: any advanced infection if it is not cured properly, is able to give a variety of manifestations and complications. Third, the most important thing: in due time, I did not enter any of the existing medical mafia groups. I think for the same reason in April 1981, having listened to me, the director of the USSR Institute of Dermatovenerology Professor Yu.K. Skripkin agreed to joint studies, but later he refused in his letter.

I am grateful to colleagues, friends and acquaintances for the feasible help in enormous work had been done. Therefore I express huge gratitude to engineers and the staff of scientific research institute of the Regional Pathology, working in 1981-1983, to stuff and nurses of gastroenterology department of the Republic clinical hospital, working in 1973-1980, also to native, relatives and all my friends. With feeling of profound gratitude I list by name those who assisted in performance of this work in acknowledgments.