Veteran tests positive for parasite that was fatal to fellow soldiers.
VENICE — Diagnosed for post-traumatic stress disorder, exposed to a chemical defoliant that saddled him with ischemic heart disease and left his oldest son with a birth defect, John Ball at age 73 thought the worst of Vietnam was behind him.
But last year, half a century after completing combat duty in southeast Asia, Ball was rocked by a newsflash — a dangerous tropical parasite is lying dormant in his system.
Furthermore, over the past two months, two of Ball’s fellow Vietnam veterans from Long Island have died of cholangiocarcinoma, a directly related cancer. Their deaths were preceded by this year’s groundbreaking survey of 50 Vietnam survivors who submitted samples to a Department of Veterans Affairs facility in Northport, New York. Fourteen of them, or 20 percent, tested positive for antibodies generated to fight liver flukes, which are alien to American ecosystems.
Ball argues VA bureaucrats are dragging their feet on publishing that data.
“They’re petrified of how many people are going to come up, because it’s not just Vietnam vets,” says Ball, who winters in Venice with his wife, Carol. “The most prominent cancer in South Korea is caused by liver flukes. We have been sending troops to Korea for nearly 70 years; we have 30,000 troops there now, with their dependents, their families. And it’s not just Korea — it’s all over southeast Asia.”
Some two dozen species of the tiny hermaphrodites inhabit riverine systems from Asia to Africa and parts of the Middle East. Ingested largely through the consumption of raw or undercooked fish, flukes have infected some 90 million people worldwide, according to the World Health Organization.
The organisms can be inactive for decades, often residing in bile ducts, and by the time symptoms manifest, the disease is often fatal. The Centers for Disease Control reports that between 5,000 and 10,000 new cases of cholangiocarcinoma are diagnosed each year in the U.S., with highest rates among Asians and Hispanics.
The stage for Ball’s Kafkaesque odyssey into the realm of killer parasites and the VA’s response to it was set 50 years ago, when he was just another anonymous grunt slogging through South Vietnamese rice paddies and rivers with the 1st Battalion 26th Marine Regiment in 1966-67. Although he says he could’ve acquired the worm from multiple sources, Ball chuckles about the time he and colleagues did some “fishing” by dropping concussion grenades into murky water.
“When you’re hungry,” he says, “you’ll eat anything.”
In 2015, Ball and fellow veteran Jerry Wiggins were preparing to yield the leadership of their PTSD Veterans Association of Northport non-profit to younger members. That’s when they got some weird news from fellow Nam vet Jim Delgiorno. Delgiorno told them he’d just tested positive for something neither had heard of — liver flukes.
After asking around at their local VA facility, Ball and Wiggins learned that three veteran employees had died from cholangiocarcinoma. They consulted the VA’s onsite infectious disease specialist, who suggested they submit stool samples to the only lab in the world that tests for liver flukes — in Seoul, South Korea. The results came back in September 2016. Wiggins was clear. Ball wasn’t so lucky.
“Patient returning to ID clinic after serological screening showed evidence for infection with S.Japonicum,” noted VA specialist George Psevdos in identifying the species. “The latter parasite does not exist in US; likely exposure was in SE Asia during the veteran’s service.”
Ball put in for service-connected disability. After all, the VA concedes on its website that the leafy-looking worms could have followed the veterans home from southeast Asia. “However,” it adds, “currently VA is not aware of any studies that show that bile duct cancer occurs more often in U.S. Vietnam War Veterans than in other groups of people.” In September this year, Ball’s claim was denied.
In an email to the Herald-Tribune, VA spokeswoman Tatjana Christian stated: “From 2013 through Nov. 8 of this year, VA received 240 claims for cholangio or intrahepatic conditions. Of those claims, 57 were granted. Without reviewing each individual’s case file, it’s not possible to tell if the Veteran claimed his condition was due to service in Vietnam or possible exposure to Liver Fluke.”
This spring, however, the Long Island VA clinic conducted first-ever testing on 50 New York veterans for liver flukes, with 14 positive returns. Furthermore, according to an Associated Press investigation, “about 700 veterans with cholangiocarcinoma have been seen by the VA in the past 15 years. Less than half of them submitted claims for service-related benefits, mostly because they were not aware of a possible connection to Vietnam.”
The AP also discovered that 80 percent of the claims submitted were rejected because of decisions that “often appeared to be haphazard or contradictory.”
Back in Venice, Ball is already receiving service-connected disability checks for PTSD and heart damage from exposure to the herbicide Agent Orange. In 1996, after mounting evidence led to a new class of injuries linked to dioxin, Ball’s oldest son — whose first surgery to repair the hole in his back occurred when he was less than one day old — began receiving VA health-care benefits for spina bifida.
Ball says the New York VA liver fluke study is still awaiting peer-review for publication. According to the CDC, the water-borne parasites can usually be killed through drugs long before symptoms occur. Delgiorno, the initial bearer of bad news, died on Oct. 3 at age 69. Another buddy, Vietnam-veteran-turned-cholangiocarcinoma-awareness activist Jerry Chiano, succumbed to the disease on Nov. 19.
Ball says veterans — particularly the remainder of the 2.7 million who served in Vietnam — can’t afford to wait.
“How many guys have we had serving in Asia? Plus families and dependents? We need the VA to start testing for liver flukes immediately,” says Ball. “It should be part of routine testing.”