I watched a documentary about Morgellons, and the patients would often seem quite reasonable at first, but the more they spoke, and the more they described their symptoms, the crazier they sounded.
One patient, whose brother, ironically, was a physician (and one skeptical of Morgellons as anything other than delusional parasitosis), seemed earnest, if intense, in describing how Morgellons had destroyed his quality of life... but then he started describing how he felt like he was able to inadvertently affect electronic devices, especially RF-based ones, because the Morgellons "fibers" in his extremities caused some kind of interference. At this point, he sounded squarely cuckoo for Cocoa Puffs.
However, one could very well imagine an infectious disease, with or without a dermatological component, causing delusional parasitosis. Maybe they have some virus or something that makes them think they have these "fibers?" Or a parasite? Toxoplasma gondii is known to affect inhibition. UTIs in the elderly are notorious for making them crazy.
Perhaps a bit tangential to the main topic, but it is of course true that UTIs can adversely affect cognition in the elderly, even precipitate delirium, etc., depending on type and severity of infection. Naturally that also occurs with other sources of infection, and factors including intoxication due to drugs (prescribed or otherwise) and a host of others. Vulnerability to such decompensation is greater among those already functioning marginally. As such accurate diagnosis can be hard to establish particularly when multiple factors are implicated, hardly a rare circumstance. (At least in my physician-practice that's frequently been the case.)
I appreciate your comment pointing to the importance of carefully evaluating individuals manifesting new onset delusional ideation or other "mental" disturbance. It might be associated with an obscure condition, but likely enough it's the result of common maladies. The worst error is thinking one knows what's going on before (or not at all) thoroughly investigating the possibilities.
This disease is different because its main symptom is dementia.
> However, one could very well imagine an infectious disease, with or without a dermatological component, causing delusional parasitosis.
Except what's more likely is that it's just psychological - which doesn't mean it doesn't have physiological treatments, it's just going to be for the psyche issue though.
Put it another way: it's well recognized eating disorders exist. But they're psychological disorders: they respond to psychological interventions and treatments, and are curable, but can also "spread" in viral like ways - i.e. an eating disorder can be induced by environmental (peer group) factors.
We don't generally posit that a virus spreads eating disorders, nor has any evidence of one been identified. And so in the same way, there's no reason to think Morgellons should have any underlying pathological cause that's any different, since none has been identified but we are aware of a number of psychological self-harm disorders (which can be amplified or spread sociologically but also just be unusual presentations of other conditions).
Besides that fact that in this particular case there probably really is 'something' (it would be rare for the brain to spontaneously exhibit CJD symptoms, though it does happen this would most likely not lead to a cluster of cases), you don't need to propose an infectious disease for people that say they have symptoms where there are none, when there is ample proof of people being able to influence each other into believing all kinds of crap to the point that it becomes part of their identity.
I once had a woman and her husband visiting to inquire about buying a house I owned in Northern Groningen, pretty much as far away from anything as you could possibly get in this crowded country. They arrived in a taxi that was blanked for the day (it turned out the man was a cab driver) and after looking the place over and liking it visibly the woman said 'oh, we really like it, but there is one more thing, I am allergic to electromagnetic radiation so let me verify that' (eye roll by the man at this point). She went to the car and came back with a box with a dial on it that she had bought online (a pretty basic field strength meter, set to the most sensitive part of the range) and started walking around muttering to herself and waving the box around like a modern day dowser.
After a while of this she came to me and said she was really sorry but she had to drop her interest because the house was absolutely infested with EM fields. In Amsterdam, where they lived, they had turned their whole apartment into a cage of Faraday with copper mesh nailed against every surface (it turned out they lived right opposite the KPN microwave tower next to the RAI so maybe she even had a point, that thing featured multiple RF links beaming 100's of Watts on tight beam links between other such towers, at some point in the past these carried our long distance phone calls before fiber came along).
I asked if I could see her box for a second and pointed it at the sun: the needle pegged instantly and she was most surprised, so I explained that what she is measuring is real, but so faint that the chances of any kind of interaction with her body are most likely delusional.
Here the conversation abruptly ended...
As for TFA: prions, the agents responsible for CJD are remarkably resilient and annoying and can make it through the foodchain across the digestive barrier and into the brain and even a single one of them can cause CJD.
https://www.nhs.uk/conditions/creutzfeldt-jakob-disease-cjd/