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14-September-2008 12:50:33 - Filariasis This article may require cleanup to meet 's quality standards. Please improve this article if you can. March 2008 Filariasis Classification and external resources ICD-10 B74. ICD-9 125.0-125.9 MeSH D005368 See special page for Filariasis in domestic animals Lymphatic Filariasis Philariasis is a parasitic and infectious tropical disease, that is caused by thread-like parasitic worms, of the type filarial nematode. Examples are Wuchereria bancrofti, Brugia malayi, and Brugia timori. The parasites are transmitted by insect bites, usually mosquitoes. Lymphatic filariasis is extremely rare in Western countries. Contents 1 Presentation 2 Incidence/prevalence 3 History 4 Diagnosis 5 Treatment 5.1 Antibiotics as a possible treatment 6 Eradication efforts 7 See also 8 References 9 External links Presentation The most spectacular symptom of lymphatic filariasis is elephantiasis-thickening of the skin and underlying tissues-which was the first disease discovered to be transmitted by a mosquito bite. Elephantiasis is caused when the parasites lodge in the lymphatic system. Elephantiasis affects mainly the lower extremities, whereas ears, mucus membranes, and amputation stumps are rarely affected; however, it depends on the species of filaria. W. bancrofti can affect the legs, arms, vulva, breasts, while Brugia timori rarely affects the genitals. Incidence/prevalence Filariasis is endemic in tropical regions of Asia, Africa, Central and South America with more than 120 million people infected and one billion people at risk for infection.1 In communities endemic with lymphatic filariasis, as many as 10 percent of women can be affected with swollen limbs and 50 percent of men can suffer from mutilating genital disease.2 History Lymphatic Filariasis is thought to have affected humans since approximately 1500-4000 years ago. The first clear reference to the disease occurs in ancient Greek literature, where scholars discuss diagnosis of lymphatic filariasis vs. diagnosis of similar symptoms that can result from leprosy. The first documentation of symptoms occurred in the 16th century, when Jan Huygen Linschoten wrote about the disease during the exploration of Goa. Soon after, exploration of other parts of Asia and Africa turned up further reports of disease symptoms. It was not until centuries later than an understanding of the disease began to develop. In 1866, Timothy Lewis, building on the work of Jean-Nicolas Demarquay and Otto Henry Wucherer, made the connection between microfilariae and elephantiasis, establishing the course of research that would ultimately explain the disease. Not long after, in 1876, Joseph Bancroft discovered the adult form of the worm, and finally in 1877 the life cycle involving an arthropod vector was theorized by Patrick Manson, who proceeded to demonstrate the presence of the worms in mosquitoes. Manson incorrectly hypothesized that the disease was transmitted through skin contact with water in which the mosquitoes had laid eggs. In 1900, George Carmichael Low determined the actual transmission method by discovering the presence of the worm in the proboscis of the mosquito vector.3 Diagnosis The diagnosis is made by identifying microfilariae on a Giemsa stained thick blood film. Blood must be drawn at night, since the microfilaria circulate at night, when their vector, the mosquito, is most likely to bite. There are also PCR assays available for making the diagnosis. Treatment The recommended treatment for killing adult filarial worm for patients outside the United States is albendazole a broad spectrum anti-helminthic combined with ivermectin.42 A combination of diethylcarbamazine DEC and albendazole is also effective.2 Antibiotics as a possible treatment In 2003 it was suggested that the common antibiotic doxycycline might be effective in treating elephantiasis.5 The parasites responsible for filariasis have a population of symbiotic bacteria, Wolbachia, that live inside the worm. When the symbiotic bacteria are killed by the antibiotic, the worms themselves also die. Clinical trials in June 2005 by the Liverpool School of Tropical Medicine reported that an 8 week course almost completely eliminated microfilariaemia.67 Eradication efforts In 1993, the International Task Force for Disease Eradication declared lymphatic filariaisis one of six potentially eradicable diseases.2 Studies have demonstrated that transmission of the infection can be broken when a single dose of combined oral medicines is consistently maintained annually for approximately seven years.8 With consistent treatment, the reduction of microfilariae means the disease will not be transmitted, the adult worms will die out, and the cycle will be broken.8 The strategy for eliminating transmission of lymphatic filariasis is mass distribution of medicines that kill the microfilariae and stop transmission of the parasite by mosquitoes in endemic communities.8 In sub-Saharan Africa, albendazole donated by GlaxoSmithKline is being used with ivermectin donated by Merck Co. to treat the disease, whereas elsewhere in the world albendazole is used with diethylcarbamazine.2 Using a combination of treatments better reduces the number of microfilariae in blood.8 The use of insecticide-treated mosquito bed nets can also be used to help stop transmission of lymphatic filariasis as well as help control malaria, which is prevalent in many of the same communities in Africa.89 See also Elephantiasis Neglected diseases Eradication of infectious disease References Wikimedia Commons has media related to: Filariasis ^ The Carter Center 2002-10, Summary of the Third Meeting of the International Task Force for Disease Eradication, http://www.cartercenter.org/documents/1181.pdf. Retrieved on 17 July 2008 ^ a b c d e The Carter Center, Lymphatic Filariasis Elimination Program, http://www.cartercenter.org/health/lf/index.html. Retrieved on 17 July 2008 ^ Lymphatic Filariasis Discovery. Retrieved on 2008-01-17. ^ U.S. Centers for Disease Control, Lymphatic Filariasis Treatment, http://www.cdc.gov/ncidod/dpd/parasites/lymphaticfilariasis/treatment_lymphatic_filar.htm. Retrieved on 17 July 2008 ^ Hoerauf A, Mand S, Fischer K, Kruppa T, Marfo-Debrekyei Y, Debrah AY, Pfarr KM, Adjei O, Buttner DW 2003. Doxycycline as a novel strategy against bancroftian filariasis-depletion of Wolbachia endosymbionts from Wuchereria bancrofti and stop of microfilaria production. Med Microbiol Immunol Berl 192 4: 211-6. doi:10.1007/s00430-002-0174-6. PMID 12684759. ^ Taylor MJ, Makunde WH, McGarry HF, Turner JD, Mand S, Hoerauf A 2005. Macrofilaricidal activity after doxycycline treatment of Wuchereria bancrofti: a double-blind, randomised placebo-controlled trial. Lancet 365 9477: 2116-21. doi:10.1016/S0140-67360566591-9. PMID 15964448. ^ Outland, Katrina 2005 Volume 13. New Treatment for Elephantitis: Antibiotics, The Journal of Young Investigators. ^ a b c d e The Carter Center, How is Lymphatic Filariasis Treated?, http://www.cartercenter.org/health/lf/treatment.html. Retrieved on 17 July 2008 ^ U.S. Centers for Disease Control and Prevention, Preventing Two Diseases with One Net, http://www.cdc.gov/malaria/features/nigeria_bednets_program.htm. Retrieved on 17 July 2008 External links Special issue 2005. Indian Journal of Urology 21 1. BBC News article on Lymphatic filariasis Filariasis Research at the University of Tuebingen The Carter Center Lymphatic Filariasis Elimination Program v d e Infectious diseases - Parasitic disease: helminthiases B65-B83, 120-129 Flatworm/ platyhelminth Fluke/ trematode Schistosomiasis Swimmer's itch - Clonorchiasis - Fascioliasis - Paragonimiasis - Fasciolopsiasis Tapeworm/ cestode Echinococcosis - Taeniasis Cysticercosis - Diphyllobothriasis/Sparganosis - Hymenolepiasis Roundworm/ Nematode Secernentea Spirurida Dracunculiasis - Onchocerciasis - Filariasis Loa loa filariasis, Mansonelliasis - Gnathostomiasis Strongylida Hookworm Ancylostomiasis, Necatoriasis, Cutaneous larva migrans Ascaridida Ascariasis - Anisakiasis - Visceral larva migrans/Toxocariasis Rhabditida Strongyloidiasis Oxyurida Enterobiasis - Pinworm Adenophorea Trichinella spiralis Trichinosis - Trichuris trichiura Trichuriasis - Whipworm Retrieved from http://en..org/wiki/Filariasis Categories: Parasitic diseases | Tropical diseases | Neglected diseasesHidden categories: Cleanup from March 2008 | All pages needing cleanup Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages العربية Deutsch Español Français Italiano Bahasa Melayu 日本語 Nederlands Português SlovenÄ?ina Walon This page was last modified on 6 August 2008, at 06:57
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