I have 4 of them in my tank, clams (unless caught at your local lake) don't generally carry parasites but if they spawn their young are often parasitic to the fish. That being said, I've had mine about 2 months now and no problems yet. It may just depend on the type of clams. They are serios filter feeders and do a fairly good job filtering out nitrates, though not good enough to reduce water changes. When I clean my tank they open up like they were starved people at a buffet line. More often than not you do not see them, just their syphin when they are eating, or sometimes if you are lucky enough to see them move about, usually after dark. Or, if your sand substrate is very shallow (under .5 inch). I enjoy mine despite not seeing them very often.
\Dan