Thursday, December 04, 2008

Filariasis*

Filariasis
Filariasis is a helminthic infection found principally in tropical and subtropical areas in Africa, and in the South Pacific regions. The disease is transmitted from man through several genera and species of mosquitoes. The acute disease is manifested by recurrent chills and fever and by visible swelling or nodules of the lymphatics and redness of the overlaying skin due to parasitic involvement.

The illness usually subsides gradually with or without therapy. But in those who have been repeatedly infected and are chronically ill, the inflammatory reaction and scarring of the tissues surrounding the vessels may impede the flow of lymph and blood, and mammoth enlargement (“elephantiasis”) of the arms, legs, scrotum and breasts can occur. During World War II approximately fifteen thousand American military personnel became infected, but prompted withdrawal of these patients from the endemic zones prevented chronic disease and elephantiasis.

Filariasis was the first human disease described in which transmission through the skin was cause by the bites of arthropods. Doctor O. Wucherer (1868) found the embryonic filarial worms in the urine of a patient in Bahia, Brazil. T. R. Lewis (1872), working in India, observed the embryos in the urine and also in the blood, and Joseph Bancroft (1878) in Brisbane, Australia first described the adult worm. The parasite has been designated Wuchereria bancrofti.

The momentous discovery of the role of the mosquito in transmitting the disease was made by the Scotsman Patrick Mansion (1877) while he was practicing medicine in the Far East with the Chinese Imperial Maritime Customs. He became interested in the disease that confronted him, including filariasis. In that disease he recognized the parasites in peripheral blood films and also in postmortems material.

He noted the nocturnal appearance of the parasites in the peripheral blood and postulated that a blood sucking insect might be responsible for transmitting the infection. Manson proved the presence of the microfilaria in the mosquito Culex fatigans, thus supplying the missing link in the life cycle of the disease.
Filariasis

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