Elephantiasis – Filariasis Cause, Symptoms, Treatment, Prevention

Elephantiasis / Filariasis is a disease of the human lymph system. In this article, you will get everything you want to know about Elephantiasis Filariasis.

This article contains Elephantiasis / Filariasis Cause, Causative organisms, Pathophysiology, Symptoms, ACUTE and Cronic MANIFESTATIONS, Grading of Lymphodema of Limbs, Investigations Test and Treatment of Elephantiasis / Filariasis

What is Elephantiasis / Filariasis?

Definition of Elephantiasis / Filariasis, Meaning of Elephantiasis / Filariasis:-

Elephantiasis / Filariasis caused by nematodes that live in the human lymph system is called Lymphatic Filariasis. These parasites are transmitted through vectors. Adult worm of this parasite lives in the lymphatic system, cutaneous tissue, or body cavity. Blocks lymphatic system drainage causing swelling of the leg.

Elephantiasis / Filariasis Causative organisms:-

What is Cause of Elephantiasis / Filariasis:-

• Wucheria Bancrofti;
• Wucheria Malayi;
• Wucheria timori

Wucheria bancrofti is common in Maharashtra & mainland India.
Wucheria bancrofti transmitted by Culex quinquefasciatus, Culex quinquefasciatus is the vector of Wucheria bancrofti.

Pathophysiology of Elephantiasis / Filariasis:-

How Elephantiasis / Filariasis spread in Human Body?

1. Culex quinquefasciatus breeds in association with human habitations. Prefers polluted waters, such as sewage and sullage water collections including cesspools, cesspits, drains and septic tanks, The eggs are laid in rafts containing 150-40 eggs each depending on quality and quantity of blood meal taken.
2. At the optimum temperature of 250C to 300C, the eggs hatch within 24 to 48 hours. The entire cycle from egg to emergence of an adult is completed in 10-14 days.
3. Adult worms live in lymph vessels & LNs by making a nest in the dilated lymphatics. Survival of Adult worm – 5-8 years ( max -15 years).
4. After mating F worm particulates millions of microfilaria in blood circulation.
5. Day – microfilaria lives in lung arterioles, Night – peripheral circulation (Nocturnally periodic) Development of microfilaria in mosquitoes takes 10-14 days to form infective larvae. (L3)
6. Man is the natural host, All ages & genders are susceptible to infection.
7. Youngest age recorded with filarial infection is 6 months. Disease manifestation appears in a small proportion of infected individuals, commonly over 10 years of age.

NATIONAL FILARIASIS CONTROL PROGRAMME (NFCP)

National Filaria Control units: 16 (ADHS(M)7) Night blood surveillance in the jurisdiction, Examination of blood slides, Treatment, Weekly Anti larval
measures, Fogging, Morbidity management, Hydrocelctomy.

Survey Units: 6 (ADHS(M) 1 )
Regional night blood surveillance, Entomological surveillance, Examination of blood slides

ACUTE MANIFESTATIONS of Filariasis:-

ACUTE DERMATO ADENO LYMPHANGITIS (ADLA)-

• Fever with chills
• Usually, extremities are involved
• Extremely painful, tender, swollen, red
• Draining LNs in the axilla, groin – swollen & tender.
• Cellulitis, an abscess.
• The entry of bacteria through lesions of the affected part is the main reason.

Acute Filarial Lymhangitis (AFL)-

Symptoms of Lymphatic Filariasis:-

• At the site of the death of adult worm – small tender nodes are formed. (Scrotum/limbs)
• Inflammed lymphatics stand out as cords underneath the skin.
• No fever, 2-day inf.
• Due to the death of worm by Anti filarial drugs / spontaneously.

Acute Epididymo orchitis & funiculitis-

• Inflammation of structures in the scrotal sac.
• Severe pain, tenderness, swelling of the scrotum with fever with rigor.
• Testes, Epididymis or spermatic cord – swollen & tender.
• Precipitated by secondary infections.

Chronic Manifestations of Filariasis:-

1. Hydrocele – Common in bancroftian filariasis. Accumulation of fluid in tunica vaginalis sac covering the testes. Swelling increases gradually. Long-standing cases – scrotum size – enormous.
2. LYMPH SCROTUM – The skin of scrotum may be covered with vesicles distended with lymph known as – LYMPH SCROTUM
3. Chronic disease limb involvement.

Grading of Lymphodema of Limbs:-

• Grade I – Pitting edema, Reversible on elevation
• Grade II – Non –pitting edema, non-reversible on elevation.
• Grade III – Gross increase in volume in Gr II lymphedema with dermatosclerosis & papillomatous lesions.

Advanced Skin thickened & thrown into folds, often with hypertrichosis, black pigmentation, nodules, warty growth & intertrigo in the webs of the toes or chronic non-healing ulcers.

Elephantiasis Filariasis Investigations:-

Smear examination:- Examination of blood slides, Blood smears are collected between 8.30 pm and 12 midnight.

Puerperal Sepsis Causes, Symptoms, Management

Elephantiasis Filariasis Treatment:-

Treatment for Lymphatic Filariasis:-

1. Night Clinics:- Night blood surveillance in the jurisdiction.
2. Tab DEC(100 mg) Dose 6mg/kg/day for 12days no direct action on MF but modifies them in such a way that they are eliminated from the host immune system. Weekly Anti larval measures, Morbidity management.
3. Mass Drug Administration (MDA)- Interruption of transmission of filariasis by Annual MDA for 5 years or more DEC Albendazole, in selected districts.
4. No effect on chronic obstructive disease
5. Dying worms may trigger acute lymphangitis, fever with chills, arthralgia due to release of antigens from dying worms
6. Treatment repeated every 6 months if symptomatic or MF in circulation

Management of Acute Attacks (ADLA) of Filariasis-

1. Relieve pain, Cold compress, Rest (no exercise), Elevate leg, Fluids, Antipyretics
2. Hygiene and care for entry lesions.
3. If you have lymphedema/elephantiasis these are the simple things you should do:
4. Wash your legs and skin folds with soap & water, Dry it with a clean cloth.
5. Put antibacterial or antifungal ointment locally, if required.
6. Keep your leg(s) in a raised position while sitting or sleeping.
7. Exercise anytime, anywhere convenient. Raise your toes up and down, rotate your foot from the ankle clockwise and anticlockwise Walking is good exercise.
8. Please Note: Don‘t do the exercise if you have high fever and acute infection as it will be
9. painful. If you are a heart patient consult your doctor before doing the exercise and elevating your feet

What Is an Outbreak of Filariasis?

The occurrence in the community of cases of an illness clearly in excess of expected numbers. The outbreak is limited to a small focal area.

An epidemic covers large geographic areas & has more than one focal point.
The occurrence of 2/more epidemiologically linked cases of a disease of outbreak potential.
Levels of response to different triggers, Trigger Significance Levels of response

1. Suspected /limited outbreak Local response by a health worker and medical officer2 Outbreak
2. Local and district response by district surveillance
   officer and rapid response team
3. Confirmed outbreak • Local, district and state
4. Widespread epidemic • State-level response
5. Disaster response • Local, district, state, and center

FAQ about Filariasis:-

Q.1) which parasite causes filariasis?

ANS –

• Wucheria Bancrofti;
• Wucheria Malayi;
• Wucheria timori

Q.2) what filariasis disease?

ANS- Elephantiasis / Filariasis is a disease of the human lymph system.

Q.3) Which mosquito causes filariasis?

ANS- Culex quinquefasciatus, Culex quinquefasciatus

Q.4) Which organism causes filariasis?

ANS- Wucheria bancrofti.

Q.5) How does filariasis spread?

ANS- By mosquito bite.

Q.6) Can filariasis be cured?

ANS- Yes, If treated early.

Q.7) Which mosquito spread filariasis?

ANS- Culex quinquefasciatus, Culex quinquefasciatus

Q.8) How filariasis cause edema?

ANS- Adult worm of this parasite lives in the lymphatic system, cutaneous tissue, or body cavity. Blocks lymphatic system drainage causing swelling of the leg.

Q.9) Where is lymphatic filariasis found in the body?

ANS- In the leg, Scrotum.

Q.10) Can filariasis cause itching?

ANS- Yes, It may cause itching.

Q.11) Why filariasis is called elephantiasis?

ANS- In filariasis leg becomes like elephant leg so called as elephantiasis.

Q.12) How can filariasis be prevented?

ANS- 1) By preprophalactic medicine. 2) By avoiding mosquito Bite.

Q.13) Can lymphatic filariasis be prevented?

ANS- Yes

Q.14) Can lymphatic filariasis be prevented?

ANS- Yes

Q.15) Elephantiasis caused by?

ANS- Filariasis caused by nematodes.

Q.16) Is elephantiasis contagious?

ANS- No