MAP: Where We’ve Been and Where We’re Going Part 4

Before I continue, I’ll write how proud I am to be an American – born and raised on US soil; it is within these borders, although increasingly limited, that, as citizens, we can voice our opinions without retribution (we hope). Countless brave women and men have given their lives, limbs and cognitive abilities that we may have a voice; that is what democracy is all about. Segueing this into my next post, let’s be thankful that, as patients, we have a voice.

As you’ve read, a hearty, thriving, ubiquitous bacterium known as MAP (mycobacterium avium subsp. Paratuberculosis) is what I believe led to my developing Crohn’s Colitis 8 years ago. Interestingly, 10 years prior to diagnosis, I lived in Europe – unbeknownst to me, in a hotspot of MAP and Crohn’s Colitis development. My insightful friend Anita and I were discussing these events when the good Lord reminded me of two very important facts during my European sabbatical:

-Sudden onset of unexplained diarrhea

-Sudden onset of recurrent strep throat symptoms following diarrhea

Once I arrived back to my lovely States, my Renaissance man dad took me to a physician, who cultured the strep spots; test results were inconclusive yet I was told if the symptoms kept recurring, a tonsillectomy would be required. Following a round of antibiotics, the symptoms eventually dissipated and I settled back into US life. Little did I know that I had probably been infected with a pathogen, stealth and diligent, which incubated and multiplied for 9 years before striking.

Interestingly, MAP likes to bask in lymph nodes, hence the recurrent strep throat symptoms; no wonder the doctor couldn’t confirm strep, it wasn’t strep, it was another bacteria – MAP, making initial contact then bedding down for the long haul.

Additionally, it has been suggested that MAP leads to fissure development and eventually that of fistulae; I cannot describe how upset this makes me. When I first had symptoms of Crohn’s, I developed a fissure – the GI who examined and diagnosed the fissure concluded I had a “virus”, and instructed I return in a month (apparently chronic diarrhea/pain, rapid weight loss and hair falling out in chunks is of no concern). She was gifted.

However, the next GI, aware of the fissure, told me I was “too young” to have GI disease (despite family history and me being aged 35). He flatly refused to perform a colonoscopy; he was a genius as well. If you’ve read previous blogs, you know that I developed 7 fistulae over the following years; imagine where I would be had I known about MAP, then. Imagine where I would be had I stayed under the “care” of the 2 GI’s who dismissed me. 6 feet under.

During research, I read of a teen that presented with swollen, cervical lymph nodes, of which two were removed and found positive for MAP; within 5 years, he developed Crohn’s. My heart goes out to him. [1]

Only a few specific antibiotics kill MAP, yet the type of antibiotic I was prescribed for strep, was not the classification to eradicate this pathogen, which requires anti TB meds. This bacterial family dug their toes into the sands of this new, warm host (me), developing tactical plans of battle and ensuing colonization, amidst clinking cheers of frozen refreshment and Buffet karaoke, heralding my wasting away.

My focus is getting this info to you, to make your own informed decisions; as we champion, ask your own questions, conduct your own research. I cannot emphasize how, now more than ever, is the importance of buying local no matter what part of the world we live. MAP lives in soil, remaining mostly unaffected by fluctuating temperatures; ensure you effectively cleanse your produce!

AU and a few European governments, to name a few, recognize the potential public health crisis from the pathogen MAP, its correlation to Johne’s Disease and thus Crohn’s Colitis, and are paving the way towards containment. AU has enacted programs including: Market Assurance Program (MAP) – (interestingly enough), (J-BAS) Johne’s Beef Assurance Score, and (CHD) Cattle Health Declaration  [2], [3], [4]. Why do other countries, including my beloved USA, continue to negate this looming threat?

  1. Where Are All the Mycobacterium avium Subspecies paratuberculosis in Patients with Crohn’s Disease?
  2. Market Assurance Program
  3. J-BAS
  4. CHD

Photo Courtesy: Kat Yukawa


Judy Wanamaker

You are so brave, Krista. Your putting the word out on MAP is wonderful. We have found that doctors are often quick to recognize every hoofbeat as a horse, and seldom do they look for a zebra. That deficiency can cost a patient her life, as you know. Prayers continue for your cure.


Judy, your words of encouragement and prayers always make this easier. I love your analogy of the horse and zebra, and yes, unfortunately it is true across the spectrum. Thank you for being a continual support system!

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