Lymphatic Filariasis (Elephantiasis)

Lymphatic Filariasis is an infectious disease caused by microscopic worms that look like threads. The parasites inhabit the human lymph system which combats infection and regulates the fluid balance in our bodies.

There are over 120 million individuals with Lymphatic Filariasis in 80 nations from the tropics and subtropics of South America, the Caribbean, Asia, the Western Pacific, and Africa. Infection is not found in America.

Transmission of the disease can occur when a healthy individual is bitten by a mosquito that has bitten an infected individual. The parasitic worms travel from the mosquito through the skin of the healthy new victim in order to inhabit the lymph vessels. Within the lymph vessels, the parasites mature into adult form and can live for up to seven years as adults. When the adult worms mate, new worms are released into the blood of the human host to continue the cycle of infection.

It takes several mosquito bites over a period of a few months for Lymphatic Filariasis to develop. The population of tropical and subtropical areas are at particular risk, especially if the disease is already prevalent in the area. Visiting tourists are not at great risk and infection can be caught with a blood test.

The symptoms of Lymphatic Filariasis do not manifest until the adult worms die. Until then, Lymphatic Filariasis is asymptomatic. While the disease is usually not fatal, permanent damage to the lymph system or the kidneys can occur. When the lymph system is disturbed, excess fluid can cause swelling of the appendages, a condition known as lymphoedema. Men can experience swelling in the genital region and this is known as hydrocoele. Swelling and a weakened lymph system can make the body vulnerable to other infections. Secondary bacterial infections in the skin are complications of Lymphatic Filariasis. As a result, the skin hardens and thickens, a condition referred to as elephantiasis. 

The major cause of chronic disability over the world, Lymphatic Filariasis causes sexual disability, pain, and disfigurement. In some communities, individuals with Lymphatic Filariasis are social outcasts. People with Lymphatic Filariasis are disowned by their families, lose their jobs, or are unable to find work. The stigma against the disease is devastating.

A lack of good sanitation in tropical and subtropical locations makes areas ideal breeding grounds for mosquitoes, leading to more cases of Lymphatic Filariasis. Prevention of the disease requires medicine for entire communities in order to kill off all the worms and mosquitoes in the area. Prevention against mosquito bites can help prevent the spread of the disease. Mosquitoes are most active during dusk and dawn so staying in air conditioned buildings during those hours can help. Use of mosquito nets and insect repellents are also advised in high risk areas.

People with Lymphatic Filariasis should get an annual dose of medication that kills the parasitic worms in the blood. While adult worms are not killed by the medication, the medication stops the spread of infection. Lymphoedema can occur even after the death of the adult worms. People with lymphoedema should work with a specialist to keep the area clean every day in order to prevent bacterial infections. Exercise and elevation can help with fluid regulation.

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