Elephantitis, Including Details About Recent Medical Advances

¶ … Elephantitis, including details about recent medical advances in the treatment of the disorder and general information about the disorder and the effects it has on the body. Elephantitis is a very serious disease that affects the lymph nodes in the body, and is carried by mosquitoes. Until recently, it has been very difficult to treat, but new treatments have been found that are showing promise in eliminating the disease, which was once thought to be incurable.

Elephantitis, (also called lymphedema filariasis), is a unique disease that is caused by microscopic worms that only live in adult adults' lymph nodes. A researcher writes, "It is a mosquito borne parasitic disease caused by thread like worms that live in the human lymph system. The worms causing this are wuchereria bancrofti, brugia malayi and brugia timori" ("Health Care Magic"). The worms breed in the lymphatic system and obstruct it, which causes the affected limb to swell, often dramatically and grotesquely. The editors continue, "Due to lymphatic obstruction, the back pressure in the lymphatic channels develops leading to dilatation of the superficial vessels, resulting in extreme swelling" ("Health Care Magic"). There is a specific chain of events that allow the worms to mature. Their larvae can only survive in specific types of mosquitoes, while the worms themselves can only survive inside the human body. When a mosquito bites an infected person, the larvae travel into the mosquito through the blood, and live there until the mosquito deposits them in another human when they bite. The larvae then travel to the lymph nodes, mature into adult worms, and start the process all over again. The worms can live anywhere from three years to eight years, but some have been known to live twenty years or more. That is why it is so difficult to treat the disease; the worms are long-lived and consistently reproduce.

The disease can affect different areas of the body, but two of the most common are the legs and arms. It is a rare disease, and usually occurs in the tropics, mainly in South America, the Caribbean, Central Africa, Asia, and the Pacific Islands ("Medical Dictionary"). The mosquito carries the worm, and when it bites a victim, the worm enters the body and settles in the lymph vessels. Surprisingly, the disease seems to currently be spreading, for some reason. A medical dictionary notes, "It is estimated that 120 million people in the world have lymphatic filariasis. The disease appears to be spreading, in spite of decades of research in this area" ("Medical Dictionary"). No one knows why it is spreading. There are a few, very rare, additional causes of Elephantitis, which include a protozoan disease called leishmaniasis, repeated streptococcal infections, removing lymph nodes surgically, or a hereditary birth defect ("Medical Dictionary").

Symptoms of Elephantitis include "Swelling of lymph nodes, lymphedema, swollen arm pit lymph nodes, swollen groin lymph nodes, breast swelling, arm swelling, fever, massive leg swelling, male genital swelling, pain, and thickened skin" ("Health Care Magic"). Because the threadworms that cause the disease can live for many years, symptoms often last for an extremely long time. Another researcher notes, "Due to the long lifespan of the wuchereria worms, therapy lasts several years, during which time the symptoms continue to persist,' said University of Bonn professor Achim Horauf" (Outland). Often, the initial symptoms lead to other symptoms. The Dictionary continues, "The body's allergic reactions may include repeated episodes of fever, shaking chills, sweating, headaches, vomiting, and pain. Enlarged lymph nodes, swelling of the affected area, skin ulcers, bone and joint pain, tiredness, and red streaks along the arm or leg also may occur" ("Medical Dictionary"). Abscesses on the lymph nodes and vessels, and on the skin, are also common. The symptoms come on gradually, and as they occur, the skin thickens and becomes rough, which is one of the reasons for the name of the disease.

To diagnose the disease, physicians use microscopic examination of the blood to look for the parasite. They can also use a lymph node biopsy to diagnose the disease. It can have several complications, including "lymph system damage, kidney damage, pain, disfigurement, sexual disability, and social rejection" ("Health Care Magic"), because the disease is misunderstood, and sufferers are often extremely disfigured. Socially, they suffer a stigma because of the nature of the disease, and in severe cases, it is difficult for them to maintain normal daily activities.

There have been several treatments developed for Elephantitis, but none of them have been completely successful until recently. Physicians have used Diethylcarbamazine (DEC), Antihistamines, and Corticosteriods in the past. These drugs are excellent for killing the larvae, but they have little effect on killing the adult worms, so they have to be taken for long periods of time until all the worms die. This can create problems in patients with severe cases, because they will have to use alternative forms of treatment, as well. In milder cases, treatment like exercise and using pressure bandages can also help.

Physicians have also drained the lymph nodes manually, used pneumatic pumps, and even done surgery to correct the condition. However, recently scientists have had success in treating and eliminating the worms using simple antibiotics. Scientist Outland continues, "Horauf and his colleagues found that adult wuchereria worms can be killed indirectly by killing essential bacteria that live inside the worms. After 14 months of treatment with the antibiotic doxycyclin, only 20% of elephantitis patients still had living adult worms, compared to 89% of a placebo group" (Outland). This is a breakthrough in treatment, and it offers hope for the many people that have been living with the disease with little hope of recovery. The Medical Dictionary notes, "With DEC treatment, the prognosis is good for early and mild cases of lymphatic filariasis. The prognosis is poor, however, for heavy parasitic infestations" ("Medical Dictionary"). The discovery that antibiotics kill the bacteria the worm feeds on is a breakthrough in treatment, and it offers greater hope to those who suffer from heavy infestations. Author Outland states, "Current drugs for Elephantitis can kill the worm larvae, or micro-filariae, but have no affect on the adult worms. In addition, these drugs can have serious side-effects" (Outland). Further studies need to corroborate these findings, however, since there is evidence that the disease is spreading, despite these new discoveries.