Lymphatic Filariasis

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Lymphatic Filariasis
Jack Prior, Ryan M. Murphy, and Aliya Robbins
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What is Lymphatic Filariasis?

• Parasitic disease where worms enter the blood
  stream through numerous mosquito bites over a
  number of years.
• Affects 120 million individuals in over 80
  countries in the tropical regions due to stagnant
  water and poor irrigation systems

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Infected Regions
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History

• Pre-1876
• The only known symptom of this disease was
  elephantiasis because of its outward appearance.
• 600BC
• Ancient Hindu medical workers referred to
  elephantiasis in Sanskrit texts.
• 600- 250BC
• Men affected by elephantiasis were not allowed to
  become Buddhist priests.
• 10th- 13th Centuries
• Persian and European physicians have accurate
  descriptions of elephantiasis.
• 1876
• Joseph Bancroft discovered the parasite that
  causes lymphatic filariasis in an abscess on the
  arm of a butcher.

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Parasites

• White, slender roundworms
• Three types Wuchereria bancrofti, Brugia malayi,
  Brugia timori
• Live for 5-7 years, produce millions of offspring
• Block the lymphatic system
• Network of channels and lymph nodes that help
  maintain fluid levels in the body
• Blockage leads to edema (collection of fluid in
  tissues)

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Process of Infection
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Symptoms

• Fever
• Kidney damage
• Skin abnormalities due to bacterial infection.
• Elephantiasis
• Swelling of limbs and genitalia
• Male Enlargement of scrotum, penis retracted
  under skin, spermatic cords thickened
• Female Long tumorous mass covered by thickened
  ulcerated skin develops on the vulva

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Social Impact of Disease

• Sexual Disability
• Communities frequently shun those disfigured.
• Inability to work
• Women with visible signs may never marry or
  spouses and families will reject them.

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Personal Account

• June/July 1996 29-participant study done by
  Jennine Coreil in Haiti
• Lack of Mobility
• I had a child to be baptized and I had to send
  someone to stand in my place as father
• Embarrassment
• When I went to school I felt very embarrassed. I
  didnt have the desire to go back.
• The hardest part for me is having to get help
  from someone to pee

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Personal Accounts

• Lack of Knowledge
• When I was little I was playing in the street
  and a trucks tire ran over my feet.
• I thought the injury made my foot cold and
  that is what made my foot become big.
• Lack of Trust in Doctors
• When you go to the hungans house, your foot
  gets even bigger.
• Severity
• I ask for death because it makes me very sick. I
  have been suffering with this for 35 years.

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Diagnosis

• Until recently, very difficult to diagnose
• Nocturnal periodicity The worms can only be
  detected in the blood of those infected around
  the hour of midnight.
• New specific card test Detects parasites using
  only finger prick blood tests any time of day.
• Ultrasound can identify rapidly moving adult
  worms.

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Treatment and Management of Elephantiasis

• Prevention
• Mosquito nets, insect repellents
• Voodoo healing techniques
• Elevate and exercise affected body part
• Skin treatment
• Wash area twice daily
• Antibacterial cream
• CDP (Complex decongestive physiotherapy)
• Lymph drainage, massage, compressive bandages

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Management and Treatment of Lymphatic Filariasis

• Currently Used
• Antifilarial drugs (DEC and ivermectin) are
  useful against larval offspring
• Testing
• Doxycycline
• Tested on a Tanzanian village.
• Found to almost completely eliminate adult worms
  14 months after treatment.
• Sustained loss of larval offspring for 8-14
  months after treatment.
• Albendazole and DEC
• Given together once a year
• Found to be 99 effective in removing
  microfilariae from blood for full year after
  treatment

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World Epidemic

• Continuing to grow throughout the global
  community.
• Global Alliance to Eliminate Lymphatic Filariasis
• Strategy stop spread of infection, alleviate
  suffering of infected individuals by using
  albendazole and DEC
• Other plans Papua, New Guinea utilization of
  church eldership

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Work Cited

• http//www.who.int
• www. Wikipedia.com
• http//www.filariasis.org
• http//www.cdc.gov/ncidod/dpd/parasites/lymphaticf
  ilariasis/default.htm
• http//elephantiasis.freeyellow.com/
• http//www.healthatoz.com/healthatoz/Atoz/ency/ele
  phantiasis.jsphttp//
• http//www.medicalnewstoday.com/medicalnews.php?ne
  wsid26197
• http//www.jcu.edu.au/school/sphtm/documents/lfrev
  iew/lfreview.pdf
• http//elephantiasis.freeyellow.com/pictures.html
• http//www.emedicine.com/med/images/2251elephantia
  sis3.jpg
• http//www.liv.ac.uk/images/newsroom/press_release
  s/2005/06/elephantias
• http//www.biosci.ohio-state.edu/parasite/wuchere
  ria.html
• http//www.scienceblog.com/cms/node/8267
• Seppa, Nathan Attack on Elephantiasis, Science
  News 6/25/2005, Vol. 167 Issue 26, p404-405, 2p