Jack Prior, Ryan M. Murphy, and Aliya Robbins

What is Lymphatic Filariasis?What is Lymphatic Filariasis?

Parasitic disease where Parasitic disease where worms enter the blood worms enter the blood stream through numerous stream through numerous mosquito bites over a mosquito bites over a number of years.number of years.

Affects 120 million Affects 120 million individuals in over 80 individuals in over 80 countries in the tropical countries in the tropical regions due to stagnant regions due to stagnant water and poor irrigation water and poor irrigation systemssystems

Infected RegionsInfected Regions

HistoryHistory Pre-1876 Pre-1876

The only known symptom of this disease was elephantiasis because of The only known symptom of this disease was elephantiasis because of its outward appearance.its outward appearance.

600BC600BC Ancient Hindu medical workers referred to elephantiasis in Sanskrit Ancient Hindu medical workers referred to elephantiasis in Sanskrit

texts.texts. 600- 250BC600- 250BC

Men affected by elephantiasis were not allowed to become Buddhist Men affected by elephantiasis were not allowed to become Buddhist priests. priests.

1010thth- 13- 13thth Centuries Centuries Persian and European physicians have accurate descriptions of Persian and European physicians have accurate descriptions of

elephantiasis.elephantiasis. 1876 1876

Joseph Bancroft discovered the parasite that causes lymphatic filariasis Joseph Bancroft discovered the parasite that causes lymphatic filariasis in an abscess on the arm of a butcher. in an abscess on the arm of a butcher.

ParasitesParasites

White, slender roundwormsWhite, slender roundworms Three types: Wuchereria Three types: Wuchereria

bancrofti, Brugia malayi, Brugia bancrofti, Brugia malayi, Brugia timoritimori

Live for 5-7 years, produce Live for 5-7 years, produce millions of offspringmillions of offspring

Block the lymphatic systemBlock the lymphatic system Network of channels and lymph Network of channels and lymph

nodes that help maintain fluid nodes that help maintain fluid levels in the bodylevels in the body

Blockage leads to edema Blockage leads to edema (collection of fluid in tissues)(collection of fluid in tissues)

Process of InfectionProcess of Infection

SymptomsSymptoms FeverFever Kidney damageKidney damage Skin abnormalities due to Skin abnormalities due to

bacterial infection.bacterial infection. ElephantiasisElephantiasis

Swelling of limbs and genitaliaSwelling of limbs and genitalia Male: Enlargement of scrotum, Male: Enlargement of scrotum,

penis retracted under skin, penis retracted under skin, spermatic cords thickenedspermatic cords thickened

Female: Long tumorous mass Female: Long tumorous mass covered by thickened covered by thickened ulcerated skin develops on the ulcerated skin develops on the vulvavulva

Social Impact of DiseaseSocial Impact of Disease

Sexual DisabilitySexual Disability Communities frequently Communities frequently

shun those disfigured.shun those disfigured. Inability to workInability to work Women with visible signs Women with visible signs

may never marry or may never marry or spouses and families will spouses and families will reject them.reject them.

Personal AccountPersonal Account

June/July 1996: 29-participant study done by June/July 1996: 29-participant study done by Jennine Coreil in HaitiJennine Coreil in Haiti

Lack of Mobility:Lack of Mobility: ““I had a child to be baptized and I had to send I had a child to be baptized and I had to send

someone to stand in my place as father”someone to stand in my place as father” Embarrassment: Embarrassment:

““When I went to school I felt very embarrassed. I When I went to school I felt very embarrassed. I didn’t have the desire to go back.” didn’t have the desire to go back.”

““The hardest part for me is having to get help from The hardest part for me is having to get help from someone to pee”someone to pee”

Personal AccountsPersonal Accounts

Lack of Knowledge: Lack of Knowledge: ““When I was little I was playing in the street and a When I was little I was playing in the street and a

truck’s tire ran over my feet.” truck’s tire ran over my feet.” ““I thought the injury made my foot ‘cold’ and that is I thought the injury made my foot ‘cold’ and that is

what made my foot become big.”what made my foot become big.” Lack of Trust in Doctors: Lack of Trust in Doctors:

““When you go to the hungan’s house, your foot gets When you go to the hungan’s house, your foot gets even bigger.”even bigger.”

Severity: Severity: ““I ask for death because it makes me very sick. I have I ask for death because it makes me very sick. I have

been suffering with this for 35 years.”been suffering with this for 35 years.”

DiagnosisDiagnosis

Until recently, very difficult to Until recently, very difficult to diagnosediagnose Nocturnal periodicity: The Nocturnal periodicity: The

worms can only be detected in worms can only be detected in the blood of those infected the blood of those infected around the hour of midnight.around the hour of midnight.

New specific card test: New specific card test: Detects parasites using only Detects parasites using only finger prick blood tests any finger prick blood tests any time of day. time of day.

Ultrasound can identify Ultrasound can identify rapidly moving adult worms. rapidly moving adult worms.

Treatment and Management of Treatment and Management of ElephantiasisElephantiasis

Prevention Prevention Mosquito nets, insect repellentsMosquito nets, insect repellents

Voodoo healing techniquesVoodoo healing techniques Elevate and exercise affected body partElevate and exercise affected body part Skin treatment Skin treatment

Wash area twice dailyWash area twice daily Antibacterial creamAntibacterial cream

CDP (Complex decongestive CDP (Complex decongestive physiotherapy)physiotherapy) Lymph drainage, massage, compressive Lymph drainage, massage, compressive

bandagesbandages

Management and Treatment of Management and Treatment of Lymphatic FilariasisLymphatic Filariasis

Currently Used:Currently Used: Antifilarial drugs (DEC and ivermectin) are Antifilarial drugs (DEC and ivermectin) are

useful against larval offspringuseful against larval offspring Testing: Testing:

DoxycyclineDoxycycline• Tested on a Tanzanian village. Tested on a Tanzanian village. • Found to almost completely eliminate adult Found to almost completely eliminate adult

worms 14 months after treatment. worms 14 months after treatment. • Sustained loss of larval offspring for 8-14 Sustained loss of larval offspring for 8-14

months after treatment.months after treatment. Albendazole and DEC Albendazole and DEC

• Given together once a yearGiven together once a year• Found to be 99% effective in removing Found to be 99% effective in removing

microfilariae from blood for full year after microfilariae from blood for full year after treatmenttreatment

World EpidemicWorld Epidemic

Continuing to grow throughout the global Continuing to grow throughout the global community.community.

Global Alliance to Eliminate Lymphatic FilariasisGlobal Alliance to Eliminate Lymphatic Filariasis Strategy: stop spread of infection, alleviate suffering Strategy: stop spread of infection, alleviate suffering

of infected individuals by using albendazole and DECof infected individuals by using albendazole and DEC

Other plans: Papua, New Guinea: utilization of Other plans: Papua, New Guinea: utilization of church eldershipchurch eldership

Work CitedWork Cited

http://www.who.int www. Wikipedia.comwww. Wikipedia.com http://www.filariasis.org http://www.cdc.gov/ncidod/dpd/parasites/lymphaticfilariasis/http://www.cdc.gov/ncidod/dpd/parasites/lymphaticfilariasis/

default.htmdefault.htm http://elephantiasis.freeyellow.com/http://elephantiasis.freeyellow.com/ http://www.healthatoz.com/healthatoz/Atoz/ency/elephantiasis.jsphtthttp://www.healthatoz.com/healthatoz/Atoz/ency/elephantiasis.jsphtt

p://p:// http://www.medicalnewstoday.com/medicalnews.php?newsid=26197http://www.medicalnewstoday.com/medicalnews.php?newsid=26197 http://www.jcu.edu.au/school/sphtm/documents/lfreview/lfreview.pdfhttp://www.jcu.edu.au/school/sphtm/documents/lfreview/lfreview.pdf http://elephantiasis.freeyellow.com/pictures.htmlhttp://elephantiasis.freeyellow.com/pictures.html http://www.emedicine.com/med/images/2251elephantiasis3.jpghttp://www.emedicine.com/med/images/2251elephantiasis3.jpg http://www.liv.ac.uk/images/newsroom/press_releases/2005/06/http://www.liv.ac.uk/images/newsroom/press_releases/2005/06/

elephantiaselephantias http://www.biosci.ohio-state.edu/~parasite/wuchereria.htmlhttp://www.biosci.ohio-state.edu/~parasite/wuchereria.html http://www.scienceblog.com/cms/node/8267http://www.scienceblog.com/cms/node/8267 Seppa, Nathan Attack on Elephantiasis, Seppa, Nathan Attack on Elephantiasis, Science News; 6/25/2005, Science News; 6/25/2005,

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