Lymphatic filariasis | |
---|---|
Other names | Elephantiasis tropica,[1] elephantiasis arabum[1] |
Elephantiasis of the legs due to filariasis. | |
Specialty | Infectious diseases |
Symptoms | None, severe swelling of the arms, legs, breasts, or genitals[2] |
Causes | Filarial worms spread by mosquitos[3] |
Diagnostic method | Microscopic examination of blood[4] |
Prevention | Bed nets, mass deworming[2] |
Medication | Albendazole with ivermectin or diethylcarbamazine[2] |
Frequency | 40 million (2022)[5] |
Lymphatic filariasis is a human disease caused by parasitic worms known as filarial worms.[2][3] Usually acquired in childhood, it is a leading cause of permanent disability worldwide, impacting over a hundred million people and manifesting itself in a variety of severe clinical pathologies[6][7] While most cases have no symptoms, some people develop a syndrome called elephantiasis, which is marked by severe swelling in the arms, legs, breasts, or genitals. The skin may become thicker as well, and the condition may become painful.[2] Affected people are often unable to work and are often shunned or rejected by others because of their disfigurement and disability.[7]
It is the first of the mosquito-borne diseases to have been identified.[8] The worms are spread by the bites of infected mosquitoes.[2] Three types of worms are known to cause the disease: Wuchereria bancrofti, Brugia malayi, and Brugia timori, with Wuchereria bancrofti being the most common.[2] These worms damage the lymphatic system by nesting within the lymphatic vessels and disrupting the system's normal function. Worms can survive within the human body for up to 8 years, all while reproducing millions of larvae which circulate through the blood.[9] The disease is diagnosed by microscopic examination of blood collected during the night. The blood is typically examined as a smear after being stained with Giemsa stain. Testing the blood for antibodies against the disease may also permit diagnosis.[4] Other roundworms from the same family are responsible for river blindness.[10]
Prevention can be achieved by treating entire groups affected by the disease, known as mass deworming.[2] This is done every year for about six years, in an effort to rid a population of the disease entirely.[2] Medications usually include a combination of two or more anthelmintic agents: albendazole, ivermectin, and diethylcarbamazine.[11] Efforts to prevent mosquito bites are also recommended, including reducing the number of mosquitoes and promoting the use of bed nets.[2]
As of 2022, about 40 million people were infected, and about 863 million people were at risk of the disease in 47 countries.[5] It is most common in tropical Africa and Asia.[2] Lymphatic filariasis is classified as a neglected tropical disease and one of the four main worm infections.[10] The impact of the disease results in economic losses of billions of US dollars a year.[2]