I hardly ever write reviews on shows, but after watching this episode recently, I felt compelled to review it. Rarely have I seen an episode of any Star Trek series that I felt was a complete waste of my time, but this one's it. When the episode ended, I literally said to myself, "That's the worst Star Trek episode I have ever seen." Apparently from reading about it afterward, most of the ST community agrees with that assessment.
The only redeeming quality of this episode is that the makeup artists did a great job making Tom Paris as disgusting as possible after his transformation. Unfortunately, beyond that there is nothing good to report.
The episode does nothing to expand upon character development or the plot of the show that isn't done in a much better fashion in a different episode. The plot makes very little sense and, in fact, introduces many elements that are flat-out contradictions to accepted aspects of the ST universe.
The acting is flat (probably reflecting the cast's level of excitement after reading the script), the dialogue is poor, and the conclusion of the episode is quick, ridiculous, and unsatisfying... Although, you might get a kick out of the inference that the next step in human evolution is to become a giant salamander. (Wouldn't that be more like a step back a few million years?)
Anyway, suspending your disbelief won't be enough to swallow this pill. There are alot of great Voyager episodes, but this isn't one of them. If you're new to the show, don't judge the body of work on this mistake.