Elephantitis

This is a tropical disease caused by a parasitic round worms known as microfilariae that enter the blood. Genus involved include Wolbachia, Wuchereria and Brugia. For humans to get this disease they must usually get bitten by a mosquito, which acts as the host and vector for three species Wuchereria a bancrofti (most common 90%), B timori, and Brugia malayi.

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History This disease has been documented in ancient text by Ancient Greek and Roman scholars. They noted the similarities between the enlarged limbs and cracked skin of infected individuals to that of elephants. Elephantiasis translates to “a disease caused by elephants” which absolutly not the case. Wuchereria bancrofti was named after physician Otto Wucherer and parasitologist Joseph Bancroft who studied filarial infections in the late 1800’s. Bancroft was one of the first to suggest it was transmitted by mosquitoes. Mode of Transmission

Parasites are transmitted through the bite of an infected mosquito and develop into adult worms in the lymphatic vessels of humans. Blockage of lymph nodes inhibits flow of lymph throughout the body which results in chronic edema and can have massive swelling potential mostly in lower extremities. Signs and Symptoms Lymphoedema of the limbs, genital disease, swelling of the scrotum and penis, and fevers are just some of the issues reported by the people infected between 2 weeks and many years after infection. The majority show no symptoms, but most incur lymphatic damage and as many as 40% have kidney problems.

Target Population This opportunistic infection is common in sub-tropical regions and Africa. To date, Africa, India, South East Asia and South America have the majority of infectious cases reported. Children and adults are both equally as likely to become infected. Statistics Lymphatic filariasis is noted as one of the most common causes of disability in the world and affects over 120 million people. Worlldwide, 25 million men suffer from the genital swellings associated with lymphatic filariasis. With no known vaccine there are still about 40 million disfigured or incapacitated by the disease today.

Treatment With no vaccine, the only option is treatment including antibiotics and medications. The recommended treatment is through mass drug administration of a single dose of two medicines given together – albendazole (400 mg) and ivermectin (150-200 mcg/kg). These medicines prove to clear microfilariae from bloodstream. The medications usually have harmful side effects. Treatment and diagnosis in the early stages of infection are preferred and keeps transmission percentages lower. Treatment can prevent or minimize not only the larval stages of the infection but also kill the adult worms in the lymph areas.

Research WHO efforts to eliminate lymphatic filariasis is supposedly on track to be successful by 2020. University of Illinois professors are currently developing a vaccine for the prevention of lymphatic filariasis. It has been shown to produce strong immune responses in test mice. The vaccine proves to be protective against both W. bancrofti and B. malayi infection. Clinical trials in 2005 by the Liverpool School of Tropical Medicine reported an eight-week regimine of doxycycline almost completely eliminated microfilaraemia in blood.

Nocturnal habits of the mosquito vectors have been researched and found to play a role in transmission also. Prevention WHO established the Global Program to Eliminate Lymphatic Filariasis (GPELF) in 2000. An estimated 6. 6 million children have been prevented from being infected according to WHO since GPELF launched. Mosquito control is another measure to thwart transmission, going as far as insecticide-treated nets to protect people in endemic regions. Patients also must maintain rigorous hygiene and take necessary precautions to prevent secondary infections that tend to accompany the disease.

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