Hydatid disease is caused by larva of the dog tapeworm, Echinococcus granulosis, with man acting as an accidental intermediate host.
If a person swallows the tapeworm eggs the critters hatch and migrate out of the stomach looking for a place to continue growing.
Here, many organisms have made this person's liver their home.
The worm has settled inside this person's lungs similar to Ahiga's infection in Chapter 12 of The Butterfly Boy.
“I thought echinococcosis was only found in Australia and New Zealand.”
“No. Reports of tapeworm sacs growing in people filtered into hospitals in the Central California Valley in the mid-1960s. By the late 1960s, the disease was reported in Utah and Dinétah.”
“So how did you become involved in this?”
“I found myself in the center of a Dinétah outbreak, and…”
“You were in the center of the outbreak?”
“Yes, it was on the reservation. Dr. Thompson, the federal veterinarian, was called in to help with the problem.”
“I thought Navajo territory was sovereign. How can the federal government exert any influence there?”
“For the most part, Dinétah is self-governing. Tribal law is separate from federal or state governments, but U.S. laws are still selectively applied. The legal power of Indian tribes is not delegated by congressional acts, and for the most part, Congress has about the same power over Indian lands as it has over individual states.
Dr. Thompson helped us eradicate brucellosis from the rez. The USDA’s help allowed the Diné to move their livestock outside the reservation for sale and slaughter. He was called in again to work with Dr. Colgrave on the hydatid problem.”
Rory tapped the brakes and moved to an empty lane. “Why were they called out? Were your sheep symptomatic?”
“No, we discovered it when Ahiga, my cousin, was taken to the hospital because of chest pains. Bidzil grabbed him and threw him on the ground in horseplay. It hurt him so badly he collapsed, and couldn’t get back up. As it turns out, a hydatid cyst ruptured inside his chest, and he was dying from it. They drove to Tséhootsoo’i Medical Center, in Fort Defiance, a few miles away from the high school. Chest x-rays showed a cyst the size of a grapefruit in the right side of his chest. Emergency procedures were required.”
“Oh, wow, that’s bad.”
“It was horrible. They transferred him to the hospital in Gallup. As soon as his parents learned the news, Aunt Heather called out the hatałii …”
“But he wasn’t stable, was he?”
“Sort of, I guess enough to wait, but he needed to go to Gallup. We followed the traditional way first. Aunt Heather called a hatałii to deal with the illness. He was also needed to protect everyone from chʼį́įdii, you know, Navajo ghosts. This was a hospital, a place where many people have died.”
“But you came into the hospital to help me?”
“The older generation will usually only walk through the doors if they feel they have substantial hatałii protection, but I don’t have such strict beliefs.”
“So, what happened to Ahiga?”
“They pulled fluid from the cyst, and microscopic exam revealed the fluid contained a significant amount of debris from an unknown organism. The people at Gallup didn’t know what to make of the cyst either, so they sent Ahiga to surgery. The cyst was from a tapeworm, Echinococcus. The stuff inside the cyst is called hydatid sand, and the sand particles are individual scolices or head parts of new tapeworm larvae. It was creepy.
It took a while for him to get well. He’d had the cyst for a long time. Anyway, they found other people on the rez with the same problem, plus our sheep were infected. Because I was in on it at the beginning, I was involved in collecting data. As a result, I was one of the lesser contributors when the article published, but it opened a lot of doors for me.”