1.230 million people are at risk for elephantiasis (lymphatic filariasis), a syndrome in which a lymphatic system’s blockage enlarges the legs or scrotum by a parasite called filaria.
Elephantiasis is usually regarded as synonymous with lymphatic filariasis. This tropical disease consists of that filarial-type parasite (threadworms), transmitted by some types of mosquitoes, block the circulation of lymph (the fluid that travels through the lymphatic vessels with an important immune and metabolic function), causing swelling of the legs and most often the scrotum.
Secondarily there is a thickening of the skin and soft tissues so that the legs take on the appearance of elephant feet. Hence the name ‘elephantiasis.’ Problems all cause pain to those affected, different degrees of disability, and generally a tremendous social stigma due to their physical appearance.
It is a disease of certain tropical and subtropical areas of Africa, South Asia, the Pacific Islands, South America, and the Caribbean. It affects millions of people worldwide (it is estimated that around 120 million people), causing disability and suffering (it is estimated that there are 40 million disabled or disfigured by this problem). Since mosquitoes transmit it, the most effective way to protect yourself individually is by avoiding the bite of the mosquitoes that transmit it.
The infection is usually contracted in childhood. The diagnosis of elephantiasis is not always easy. It is based on detecting tiny larvae or microfilariae, especially in blood, although sometimes an ultrasound is performed to detect adult worms.
There are many asymptomatic cases and sometimes acute symptoms; these are the ones who benefit the most from treatment with antiparasitic drugs. When the chronic phase has already been reached, drug treatment is not very effective with the onset of lymphedema and skin changes.
Despite being considered a neglected tropical disease, progress is being made in the fight against it. The World Health Organization has a unique program to eradicate programs of the massive use of antiparasitics in all people living in risk areas to break its transmission cycle.
Causes of elephantiasis
Elephantiasis or lymphatic filariasis is a tropical disease unattended. Parasites of the Filarioidea family produce it. They are a type of low worms. Specifically, lymphatic filariasis is caused by Wuchereria bancrofti, Brugia malayi, and Brugia timori. Wuchereria bancrofti produces 90% of cases and affects about 110-120 million people in tropical and subtropical regions of Asia, Pacific Islands, Africa, parts of South America, and the Caribbean. There are another 10 million people infected with Brugia malayi, found in China, India, Indonesia, Korea, Japan, Malaysia, and the Philippines. Brugia timori is only found on the islands of the Indonesian archipelago.
Of those affected, 25 million men suffer from the genital disease hydrocele, which is scrotum’s enlargement. Another 15 million people suffer from lymphedema of the legs.
These filariae are transmitted by different types of mosquitoes, including the Culex (especially in urban and semi-urban areas), Anopheles (rural areas), and Aedes (in the Pacific islands). Mosquitoes become infected with microfilariae (very small 0.15 mm larvae) by sucking blood from an infected human host.
Adult males measure about 40 x 0.1 mm and females 100 x 0.25 mm. They live in the lymphatic system for 6-8 years, and during that time, they produce millions of tiny larvae that circulate in the blood. It is unknown whether the alteration of the lymphatic system is caused by the parasite or by the reaction produced by the immune system itself when trying to fight the parasite; it’s probably for both reasons.
