Microbiology
Fall 2014
Elephantiasis Disease
Team Captain: _____Caitlin MacRae_______
Team Members: ___ _Giana Sanderson_____
___ _Christina Jackson_____ _____ Melissa Richardson ___
__ Brittany Roy ___ _
_ Morgan Grace _ ____
Class Section: _____ Tuesday/Thursday 1100
General Description
Elephantiasis, also known as Lymphatic Filariasis, is an infectious disease that results in the swelling of a person’s extremities (i.e. arms, legs, etc..). It is caused by three types of worms the most prominent infector is the Filarial Worm. This worm is transmitted from a female mosquito when it bites a person. The mosquito typically acquires the worm when it bites another animal for its meal. It starts off as a small parasite and then grows into an adult worm. The worm settles into the lymphatic system of humans causing the arms and legs to enlarge. When an individual has elephantiasis, their skin and subcutaneous tissue will thicken. This gives rise to the extremely enlarged and swollen limbs, which is what contributes to the name of this disease. Although elephantiasis can be found in humans anywhere, it is most prevalent in India, Africa, South Asia, and the Pacific. This disease is mostly found in tropical regions as well as subtropical regions.
Diagnosis
To have an absolute definitive diagnosis of elephantiasis requires the actual nematode be identified within the body tissue or fluid of an individual experiencing symptoms of the infection. Obtaining this can be difficult, as lymph nodes and blood vessels in which the nematodes have infected swell and are not easily accessible. Often, blood samples can be examined to reveal the presence of microfilariae. Blood samples are taken at night to increase the likelihood of the sample containing the parasite. A newer immunodiagnostic test, based on the detection of antigens of W. bancrogti is not only effective but specific and sensitive. An added benefit of this test is the blood samples do not have to be taken at night.
Treatment
Treatments for elephantiasis vary from general treatments to medicinal treatments. In most situations, medications are found to not be very effective against the adult worms due to new microfilariae being produced, even after months of treatment. Common treatments for elephantiasis involve bed rest, the elevation of affected limbs, and the wrapping of the limbs in compression bandages to help with swelling. With signs of infection, it is important for the skin to be washed cautiously and dried, and for nails to be clipped and maintained to avoid any more injury or infection. Although some medications are found to be ineffective, it is aware there are different treatments for different areas. For example, in the United States, the medication of choice is the drug diethylcarbamazine (DEC), which is known to kill the microfilariae along with some of the adult worms. Although this drug can kill off the microfilariae and adult worms, the brisk destruction of the worms can provoke immunological reactions – fever, sore throat, and muscle pain. Using low dosages of DEC along with steroids, anti-inflammatory agents help to cause the immunological reactions to not occur. For areas outside of the United States, a combination of drugs between albendazole and ivermectin are administered to the patient, and is recommended by the global filariasis elimination program. Although there are alternative ways to manage elephantiasis, one last vital consideration for treatment is the presence of the Wolbachia bacteria, which are known for living in symbiosis with the filarial parasite. With this bacterium present, it allows for the antibiotic to kill the bacterial population, resulting in the death of the worms. With elephantiasis, it is ultimately important to be aware of specific