I

N FILARIASIS
T ‫۝‬ Human lymphatic filariasis is a chronic
R infestation caused by nematode parasites
O ‫۝‬ Susrutha & Clarke have mentioned.
D ‫۝‬ Named after Wucherer.
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T
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A
U Filaria infesting humans:
Ω Wuchereria bancrofti – Elephantiasis, 90%
S
Ω Brugia malayi – milder form
A
T Ω Onchocerca volvulus – Eye blindness, Africa

I Ω Loa Loa – Loaisis, Africa, repeated swellings.

O Ω Mansonella perstans – Africa, asymptomatic.

N Ω Mansonella Ozzardi
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B • Infected female mosquito, Aedes Poecillus,
N
A • From the entrance
Anopheles, Culex, of the infected larvae to the
Mansonia,
S
T development of the clinical manifestation.
M • Flies
I • Ranges from 8-16 months.
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I More than a billion people in more than 80 countries.
D
E
120 million already affected & 40 million seriously
M incapacitated and disfigured
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O
L
O In endemic communities, 10-50% of men and up to 10% of
women can be affected
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Y
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A
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H
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Y
M
1. Characterized by the presence of
P
microfilariae in the pheriperal blood.
T
2. Others progress from acute to
O chronic stage
M
3. Microfilariae rate increases with
A age and then levels off
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C
A
C
U 1.Lymphadenitis (inflammation of lymph
T nodes)
E 2.Lymphangitis (inflammation of lymph
vessels)
S 3.Fever – rigors, HA, Malaise, lasts 3-7
T days
A 4.In some cases male genitalia is
affected leading to funiculitis,
G epididymitis or orchitis, urticaria,
eosinophilia.
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O 1.Develop 10-15 years from the onset of first
N attack
I 2. In endemic areas, chronic and acute
manifestations of filariasis tend to develop
C more often and sooner in refugees or
S newcomers than in local populations continually
T exposed to infection.
3.Lymphoedema may develop within six months and
A elephantiasis as quickly as a year after arrival.
G
E
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1. Lymphangitis
Y
2. Lymphadenitis
M
3. Lymphadenopathy
P
T 4. Lymphedema (temporary swelling of
lower and upper extremities)
O
5. Hydrocoele (swelling of scrotum)
M
A 6. Elephantiasis (enlargement and
thickening of lower and upper
T extremities, breast, vulva, penis &
O scrotum)
L 7. Chyluria
O
8.Filarial Fever
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S
9.Lymphangiovarix
Y
M 10.Occult Filariasis
P 11.Secondary Bacterial Infection
T 12.Features of immune response
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M
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P Tropical eosinophilic syndrome:
L  Hypersensitive reaction characterized by

I chronic cough, wheezing & persistent

C eosinophilic count
A  ↑ IgE & Meyers-Kouwennar bodies

T  Chest X-ray shows small voluminous lung

I with parenchymal infiltrates
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N
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N
V
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1.DEMONSTRATION OF MICROFILARIA
I 2.IMMUNODIAGNOSIS
G 3.DEMONSTRATION OF PARASITE
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T DIETHYCARBAMAZINE CITRATE
R (HETRAXAN)
E MASS TREATMENT
A SURGICAL TREATMENT
T 1.Elephantiasis and hydrocoele
2.Mild cases lymphedema by
M lymphovenous anastamosis distal to the
E site of lymphatic destruction
N 3.Chyluria by ligation and stripping of the
T lymphatics of the pedicle of the affected
kidney
P
R A.Measures aimed to control the vector:
-environmental sanitation
E -spraying with insecticides
V B.Measures aimed to protect families in endemic
areas:
E -use of mosquito nets
-use of long sleeves, long pants, and socks
N -application of insect repellents
TI -screening of houses
-health education
O
N
 Presented by
Dr. K. John Paul