Infectious Diseases: Fighting Filaria in Africa and India

Number 2 Leading Cause of Disability Worldwide

The knowledge of filaria (philaria) came to me as a shock in a high school health class, where my cohort of students at about age 16-17 was presented weekly with a mulitude of shocking conditions asa well as the consequences of high-risk behaviors and the lack of sanitation around the world.

Up until the time of viewing the documentary concerning filaria in Africa, many of us had never imagined the variety of conditions killing people in less developed nations.

The film portrayed children and adults suffering from a chronic elephantiasis, one of the end products of the filariasis that spreads through the operation of the life cycle of worms that are also called nematodes (specifically, often Wuchereria bancrofti and Brugia malayi). These worm parasites breed within mosquitoes trhat are the vectors that pass the worms as larvae from person to person via bites.

A single leg or both legs from the knees, down of these patients grew swollen nearly as large as an elephant's lower limb. An affected human foot looked especially like an elephant's foot. This condition was painful, inhibited mobility, and was fatal.

Happily, a vaccine existed for the condition. We viewed one vaccination. A nude child was placed standing on a board upon which pigeon-toed feet were drawn. As the child matched his feet to the drawing on the board to that his buttocks protruded in oppostie directions, a long, large gauge hypodermic needle was thrown like a dart into one buttock. A large container of serum was screwed into the needle and the serum was injected slowly.

Total Damages

The organization GlobalHealth.org reports that along with physical damage and loss of mobility, lymphatic filaria also results in economic and psychosocial harm and loss. The organization has found that filaria and other "neglected diseases" that have not been targeted for swift elimination in the past, have caused a total of an equivalent of 57,000,000 disability-adjusted life years (DALYs) every year. This is a lot of toal damage that can be eliminated with vaccines. Please see the reference link below.

Neglected Diseases

I heard no more about flaria until I studied preventive medicine, where I was found a more complete story. Filaria is often placed into the category of Neglected Diseases, although, estimates in the 2000s claimed that it could be eradicated globally for $1 USD per at-risk person. In addition to the lymphatic type of the disease that results in elephantaiasis, we have a subcutaneous type in which worms invade fat under the skin and a severe cavity type in which worms invade other body parts -- and a total of 9 varieties of nematodes are at fault.

The diease called Lymphatic Filariasis (LF) can exist undetected the human body for longer than 10 years. In 2010, the disease is thought to put at risk one billion individuals globally, in 80 countries and not only Africa and India. However, 1/3 of the logged cases exist in Africa and 1/3 in India.

The incidence of the disease is increasing as a result of fast city growth without adequate planning in sites located in subtropical and tropical areas of the world, including Central and South America - especially Brazil according to some sources, South and Southeast Asia, Pacific Islands

The disease can progress after 10 years of slience into elephantiasis, also called Malabar Leg. The worms (parasites) interfere with the lymphatric system of humans and results in sweliing called edema. The disease also causes swollen breasts, genital injury (most often to males), and thickly hardened skin. Other symptoms can manifest as well and can vary according to which vareity of nematode is at work.

Elimination of Filaria from 1998 to 2020

The World Health Organization (WHO) created the Global Alliance to Eliminate Lymphatic Filariasis with the mission to eliminate filaria as a health problem by 2020 (see the reference links below). They estimate that 120 million victims exist in 80+ countries and that one billion people, 20% of the global population of 2010, are at risk. The number of patients is growing. However, significant progress has been shown through in 2008 the success of donated vaccines and successful prevention among 6,600,000 children. Medications administered as vaccines are required for 6 years per the WHO and have usually included albendazole in combination with either DEC or Mectizan®.

From the CDC: Worm Life Cycle in Filaria

(public domain)
(public domain)

Life Cycle Summary

FIVE STAGES

  1. Heterosexual worms mate and the female births thousands of live microfilariae (tiny larvae that look like threads).
  2. The mosquito (the vector insect) takes up the tiny creatures in ingested blood at night while biting a human
  3. The microfilariae molt inside the insect and develop into 3rd-stage larvae.
  4. The mosquito ingests blood from a second human and injects the infectious larvae into the dermis of the skin of the human.
  5. One year passes, more or less. The larvae molt into 2 additional stages to become adult worms.

 

For Future Study

Advances in the study of filaria are ongoing. Scientists have completed the full genome for one of the variety of worms responsible for filaria infection and disability, with the information useful for further preventing their infestation of humans and animals. Animals affected have included reported cattle, dogs, and sheep. In addition, at least one form of elephantiasis is thought to be unrelated to worms altogether, but the result of irritants in the local soil.

The swelling in some cases of elephantiasis has been eased by an antibiotic injection, while others have been treated with surgery. Some cases of swollen feet have been treated with consistent wearing of shoes, as in cases of other types of post-surgery foot swelling. It seems that no treatment for any type of the elephantiasis is very effective overall, and that prevention through vaccination and protection against mosquito bites are the preferred actions.

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Comments 19 comments

DiamondRN profile image

DiamondRN 6 years ago from Charlotte, NC USA

Filaria is very similar to the heart worm that occurs in dogs. When an infected dog's heart is dissected, it looks like it is full of spaghetti.


snagerries profile image

snagerries 6 years ago from Singapore

I never heard about this disease Lymphatic Filariasis as you have mentioned. That's a great number.


Patty Inglish, MS profile image

Patty Inglish, MS 6 years ago from North America Author

How horrible! I did not post photos of any cases, because I think they're pretty traumatic looking.

Poor dogs, too. Thanks for sharing your experience.


samsons1 profile image

samsons1 6 years ago from Tennessee

voted up & beautiful! Hoped this disease and others can be eradicated through education of the populous.


ecoggins profile image

ecoggins 6 years ago from Corona, California

Wow. So this is a mosquito born virus. I've heard of malaria and actually had dengue fever, but never heard of mosquitoes picking up larvae and transporting it to others. Does any one know how this type of worm differs from a hook worm?


Patty Inglish, MS profile image

Patty Inglish, MS 6 years ago from North America Author

No virus, just the worms and the 1000s of their tiny larvae. However, sometimes the worms can carry bacteria that cause OTHER infections.


K9keystrokes profile image

K9keystrokes 6 years ago from Northern, California

Yikes! $1 USD per person? Sounds almost too easy. Whata horible condition to have to contend with. Is this something that is monitored by international air agencies? These worms, so it would seem, can travel and make a home with a new person,...are they both transmitted by host or touch? Fantastic hub! Up and awesome Patty.

K9


Hello, hello, profile image

Hello, hello, 6 years ago from London, UK

This is terribleand yet it could be irraticated. That is where the money should be spend. Thank you for the eye opener.


Wendy Krick profile image

Wendy Krick 6 years ago from Maryland

I had never heard of this. Thanks for educating us.


Patty Inglish, MS profile image

Patty Inglish, MS 6 years ago from North America Author

K9 - The WHO and related agencies, with help from drug companies, large private donors, and the military of various nations are monitoring the disease and the vaccinations. An oral medication can be drunk by at-risk people now, so that's easier than injection. However, finding the same people 6 years in a row for each dose can be tough; and some say only 4 years is enough.

The type of filaria I highlighted is tramsmitted to humans by mosquito bite. The microscopics worms are sucked up by the insect from one person and injected into another person when they bite.

Other of the 9 types of worms can be transmitted through contaminated water. I have not read about all of them, but the diseases are ghastly.


SteveoMc profile image

SteveoMc 6 years ago from Pacific NorthWest

Ewwwwwww! Horrible stuff. Well written and captivating information. I am gritting me teeth as I make a mental note, "check the list of diseases before you make vacation plans."


Patty Inglish, MS profile image

Patty Inglish, MS 6 years ago from North America Author

SteveoMc, a very good plan! We can avoid taking disease in and bringing it out as well. Kinda makes one's skin crawl even without the worms.


kaltopsyd profile image

kaltopsyd 6 years ago from Trinidad originally, but now in the USA

Wow, I've never heard of filaria and I wasn't aware of the existence of 'Neglected Diseases.' Thanks for educating me. I'll have to look more into said Neglected Diseases and learn more about filaria too.


Patty Inglish, MS profile image

Patty Inglish, MS 6 years ago from North America Author

Thanks for reading, kaltopsyd. It's a big job to eradicate these things, but progress is being made. I'd forgotten about the disease until I saw the HubPages request. HP comes in very handy.


LeanMan profile image

LeanMan 6 years ago from At the Gemba

This is an awful disease, but like so many it will continue to be spread in Africa and other poor countries due to government priorities being other than their people.


LillyGrillzit profile image

LillyGrillzit 6 years ago from The River Valley, Arkansas

Thank you for sharing. Tweeted.


Nettraveller 6 years ago

When my mother was growing up in Suriname (north coast of South America) filaria was active, and everyone was scared to death of getting it. When she returned after a long absence in the 70's (with my sister and me) there were no new infections, only a few older people (in their 70's and older) with the swollen legs. There was no fear of infection, at least not of filaria. We lived there for three years and there was never a mention of any case of filaria. There was still yellow fever, dengue and malaria, and there were lots of mosquitos, so everybody used mosquito netting over their beds. Apparently it did become possible to stop (but not to reverse) the swelling in the last cases of infection before the disease was conquered. We knew someone there with one partially swollen leg, which had been at that level of swelling for twenty years or more. You could tell that it was swollen and edematous, but nothing like the grossly misshapen limbs of the older patients in whom the disease had fully progressed. Once the tissue has been deformed it cannot go back to its normal shape, even if the infection itself is cured and there are no more filarial worms in the body. Thankfully the disease has been successfully eliminated in Suriname. Please see attached URL. Very good hub!


@samindian... 5 years ago

patty- i am a patient of filaria...it was detected 7 years back and has infected my genital parts...i suffer from high fever an intense pain in my thigh joints and extreme cold...none of the doctors in my area(India) think that it can be cured now...

do you think there is a cure for me...or any medicine that would help me...??? n address of the hospital where i should go...

plz reply soon...n help me out with it...


Patty Inglish, MS profile image

Patty Inglish, MS 5 years ago from North America Author

Call the largest hospital in your state in India and ask the staff your questions. If no success call the World Health Organization. Telephone: + 41 22 791 21 11

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