Elephantiasis disease, also known clinically as lymphatic Filariasis, is a vector-borne illness which causes profuse swelling of the legs of an afflicted individual. It is a rare ailment, and is mostly observed in parts of Africa, Asia and in the Middle-East.
Elephantiasis is caused by mosquito bites. Three specific mosquito species are largely responsible for its spread: Culex, Aedes, and Anopheles.
Of these, Anopheles mosquitoes also spread malaria.
This disease has been classified as a “Neglected Tropical Disease” by the World Health Organisation. This means that there are still millions of people who are falling prey to Filariasis; still, scientists are no longer looking for a vaccine.
Elephantiasis causes pain and suffering to those afflicted, not to mention ridicule and social neglect. Often, the afflicted have to stay confined to a room all their lives.
What causes Elephantiasis?
Once any of the pests mentioned above bites a human being, ringworm-like parasites enter the bloodstream. These parasites belong to the family Filariodidea.
Three types of parasites cause this ailment. They are:
Wuchereria bancrofti –
Responsible for the largest number of infections. Around 90% of all cases worldwide are caused by Wuchereria.
Brugia timori –
Was previously thought to cause a different type of Filariasis- Timorian disease. Now, it is thought to cause more than 5% of all cases globally.
Brugia malayi –
Known for causing Elephantiasis disease in countries which are neither tropical nor sub-tropical.
DIY task: Identify all the regions globally on a map where this ailment is rampant. Try and estimate whether there is a relationship between the spread of Elephantiasis and these regions’ socio-economic conditions.
You will be surprised to know the results!
Elephantiasis Symptoms
Initial symptoms are vague including high-fever, rashes and chills. At first, most of those afflicted believe they have caught the Flu. Gradually, the lower torso- legs, sex organs, abdomen- start to swell out of control. This swelling is so severe that most physicians have a tough time controlling it.
The skin around these swollen parts starts to itch and pain, besides becoming rough. Lumpy outgrowth on the skin on these parts is also common.
Since the Filariodidea parasites affect the lymphatic system first, there may also be gradual swelling of lymph nodes of an affected individual’s body. On occasions, secondary bacterial infections have been noted on these regions of our bodies.
Elephantiasis is determined when blood samples are tested under high-powered microscopes. The last stage- chronic lymphoedema- is usually when the disease starts to develop rapidly.
Elephantiasis Treatment
Since there is no vaccine to prevent Elephantiasis disease, a combination of various drugs has to be taken. Patients are usually given albendazole, a potent anti-parasite medication. This drug is also used to treat pinworm illness. Sub-Saharan Africa, one of the most affected areas in the world, has seen good effects thanks to albendazole use.
To complement this medication, Diethylcarbamazine or DEC is also used. In some severe cases, ivermectin may also have many advantages.
All of these medications are administered orally.
For advanced students: There is currently a vaccine in development in the United States. It has shown great results in mice. Find out more information on the official website of College of Medicine, Illinois University.
Also, you can research on how Doxycycline, an antibiotic, is helping fight this ailment.
Elephantiasis Prevention
Till such time as a vaccine emerges, vulnerable populations have to be aware of the vectors which carry these parasites. Experts recommend a three-pronged approach to prevent Elephantiasis disease:
Using a mosquito net every time when going to sleep.
Mass delousing and mass deworming yield positive results in locations where Elephantiasis is rampant.
Sustained efforts to reduce mosquito population.
Public health specialists also advise government and private enterprises to join hands and raise awareness about Elephantiasis disease.
Major drug manufacturers are racing to work on a single medication which will work effectively. It will eliminate the 3-drug IDA (ivermectin, DEC and albendazole) regime.
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FAQs on Elephantiasis Filariasis
1. What is Elephantiasis or Filariasis?
Filariasis, also known as Lymphatic Filariasis, is a parasitic disease caused by infection with thread-like worms called filarial worms. The term Elephantiasis refers to the late, chronic stage of the disease, which is characterised by severe swelling and thickening of the skin and tissues, particularly in the limbs and genitals, making them appear elephant-like.
2. What is the main difference between the terms Elephantiasis and Lymphatic Filariasis?
The terms are related but not identical. Lymphatic Filariasis is the name of the disease itself, caused by the parasitic worm infection in the lymphatic system. Elephantiasis is a major, visible, and severe symptom of chronic Lymphatic Filariasis, representing the physical deformity that results from long-term lymphatic damage and fluid buildup.
3. What are the main parasites responsible for causing Filariasis in humans?
Filariasis is primarily caused by three species of filarial worms (nematodes). The most common one, responsible for about 90% of cases, is Wuchereria bancrofti. The other two species are Brugia malayi and Brugia timori. These parasites are the causative agents that lead to the disease.
4. How is Filariasis transmitted from one person to another?
Filariasis is a vector-borne disease and is not transmitted directly between humans. It spreads through the bite of infected mosquitoes, primarily from the Culex, Anopheles, and Aedes genera. When a mosquito bites an infected person, it ingests the parasite's larvae (microfilariae). These larvae develop inside the mosquito and are then passed on to a healthy person during a subsequent bite.
5. Why does a Filariasis infection cause the extreme swelling seen in Elephantiasis?
The extreme swelling, or lymphedema, occurs because the adult filarial worms live and reproduce in the human lymphatic system. Their presence causes chronic inflammation and blockage of the lymphatic vessels. This blockage obstructs the normal flow of lymph fluid, causing it to accumulate in the surrounding tissues. Over many years, this leads to the characteristic massive swelling and hardening of the skin.
6. What are the common symptoms of Filariasis?
Many infected people show no immediate symptoms. However, the disease can manifest in two main ways:
- Acute Episodes: These involve fever, chills, and painful inflammation of the lymph nodes (lymphadenitis) and lymphatic vessels (lymphangitis).
- Chronic Conditions: This develops over years and includes severe lymphedema (tissue swelling), hydrocele (swelling of the scrotum in males), and the hardening and thickening of the skin, leading to Elephantiasis.
7. Is Elephantiasis fatal, and can the damage be completely cured?
Elephantiasis is generally not fatal, but it is a profoundly disabling and disfiguring condition that can cause immense social and psychological distress. The parasitic infection can be treated with anti-filarial drugs like Diethylcarbamazine (DEC) to kill the worms and prevent further transmission. However, the chronic lymphedema (swelling) that has already developed is often irreversible. Management focuses on alleviating pain, preventing the condition from worsening, and managing secondary bacterial infections.
8. How can the spread of Elephantiasis be controlled in a community?
Controlling the spread of Elephantiasis requires a two-pronged public health strategy:
- Vector Control: Reducing the mosquito population by eliminating breeding sites (like stagnant water) and using insecticides is crucial to stop transmission.
- Mass Drug Administration (MDA): This involves administering preventive anti-filarial drugs to the entire at-risk population once a year. This helps kill the microfilariae in infected individuals, thereby breaking the chain of transmission from humans to mosquitoes.
9. If a mosquito bites a person with Filariasis, can it immediately infect another person?
No, transmission is not immediate. After a mosquito ingests microfilariae from an infected person's blood, the parasites require a development period inside the mosquito. They must mature into the infective 'L3 larvae' stage, a process that typically takes about 10-14 days. Only after this incubation period can the mosquito transmit the infection to another human when it bites again.
