A Scientific Challenge
“It's hard to say yet which pattern the Morgellons phenomenon will follow. Will it be the next Lyme disease, validated by the medical community? Or will its victims reside in diagnostic purgatory forevermore? Medicine is full of phenomena that sounded like psychological ailments when first proposed but are now linked to invasive pathogens.”
--Elizabeth DeVita-Raeburn, “The Morgellons Mystery”
Upon examining the evidence relating to the debate surrounding Morgellons, the authors hesitate to come to a judgment regarding whether or not Morgellons is a real parasitic disease: we believe that more scientific investigation needs to be conducted to determine conclusively if the symptoms of Morgellons are caused by a parasitic infection. This being said, we can look towards the future and offer our ideas about what would need to be shown if Morgellons will be one day established as a parasitic disease and what implications would arise.
If Morgellons will ever be accepted as a disease caused by an infective microorganism, some of Koch’s postulates will have to be invoked and shown as satisfied in replicable studies presented in a peer-reviewed journal to persuade the medical and academic communities. Currently, Dr. Randy Wymore and his colleagues are using gas chromatography to study the composition of clinical samples of fibers removed from Morgellons patients , with the hopes that analysis of the fiber’s makeup will lead to investigation of plausible infectious agents. While this certainly signifies progress in the scientific investigation, future research will be vital to demonstrate the nature of the Morgellons fibers and to satisfy Koch’s postulates. Robert Koch, a famous German physician and 1905 Nobel Prize winner in Medicine, developed a framework for establishing the presence of a disease-causing agent used in his celebrated investigation of anthrax and tuberculosis. These guidelines, today known as “Koch’s Postulates” are still used in general by microbiologists and parasitologists to aid in experimentally defining the agent of any infectious disease.
According to the postulates:
In many cases, it is impossible to fulfill all of Koch’s postulates for a single pathogen. Koch himself abandoned the first postulate after investigating cholera, which presents asymptotically in some carriers. Further, some viruses only infect humans and for ethical reasons scientists cannot establish disease in a healthy organism without a sufficient animal experimental model. Finally, some pathogens (leprosy, syphilis) are very difficult to grow in culture in vitro and as such cannot be easily isolated and grown in pure culture. Despite these difficulties, if there is indeed a microorganism behind the pathology associated with Morgellons, then some or all of Koch’s postulates will have to be utilized to demonstrate scientifically that an infectious agent is causing Morgellons disease.
Implications of A “Disease”
If Morgellons were eventually accepted by the American medical establishment as a true, independent infectious disease, there would be several certain implications and some possible ramifications. Clearly a case definition would be published and national diagnostic criteria described, and a standard treatment therapy would have to be developed. Medical textbooks and academic literature on parasitology would need to be updated to reflect the discovery of a new parasitic disease cause by an invasive pathogen whose symptoms mimic a well-documented and previously established psychiatric disorder.
There are other possible implications of such a status elevation. Dr. John Dyer, a Professor at the University of Minnesota who specializes in the history of medicine, astutely observed that a collection of symptoms becomes a disease not only because of the scientists and physicians identifying a clear cause, but also due to society’s acceptance of the disease [X]. Societal repercussions may include resistance from health-paying organizations such as HMOs and insurance companies who may have to cope with the disease status from a fiscal perspective. In the past, advocates controversial diseases like Morgellons such as Fibromylagia, Lyme disease, and Gulf War Syndrome have met similar challenges from health-paying organizations.
Funding a Resolution
Whether or not Morgellons is caused by an infectious agent, it is apparent that there is a rising incidence of patients presenting to physicians with Morgellons symptoms and registering online as suffering from Morgellons. Whether or not there is an infective agent causing their symptoms or if the underlying cause is psychosomatic in nature, there is no doubt that many Americans are experiencing true pain and suffering of an unknown source. This fact can be seen as evidence for a potential public risk, and clearly more investigation is warranted— and the organization most equipped to launch and encourage scientific investigation to rule out a public health risk associated with Morgellons is the federal government.
The clustering of cases is particularly noteworthy in California, where according to the MRF database, about 13 percent of the US population lives, while 26 percent of Morgellons cases are located here.  Therefore, something special may be happening in this area to cause increased infections of the disease. The high number of Morgellons patients in California has caused a response by leaders such as U.S. Sen. Dianne Feinstein who has repeatedly communicated to the CDC task force that their investigation is urgent and necessary.  In total, there have been at least 37 letters from US Senators and Congressmen (including at least 7 letters from US Senator Barbara Boxer this year alone) calling for an investigation of this illness. 
However, it is also noteworthy that there are relatively few cases reported in Mexico.  While it is not known why there are so few cases in this bordering country, there are a few possible explanations. First, this could be due to lower availability of overall health services, and thus a lower reporting of the condition. Secondly, Morgellons patients have typically used the Internet as a large source of information and support, and the resources for this communication are likely not as available across the border. Lastly, there is a possible language barrier, in that the MRF website and many of the other main Morgellons resources are published only in English.