infectious diseases
Bancroftian and Brugian Lymphatic Filariasis
Introduction
Lymphatic filariasis is infection with any of 3 species ofFilarioidea. Acute symptoms include fever, lymphadenitis, lymphangitis, epididymitis, and funiculitis (inflammation of the spermatic cord). Chronic symptoms include abscesses, hyperkeratosis, polyarthritis, hydroceles, lymphedema, and elephantiasis. Tropical pulmonary eosinophilia with bronchospasm, fever, and pulmonary infiltrates is another manifestation of infection. Diagnosis is by detection of microfilariae in blood or lymphatic tissue biopsy specimens, ultrasound visualization of adult worms in lymphatics, or serologic testing. Treatment is with diethylcarbamazine; antibiotics are used for complicating bacterial cellulitis. (See also Approach to Parasitic Infections and Bancroftian filariasis is present in tropical and subtropical areas of Africa, Asia, the Pacific, and the Americas, including Haiti. Brugian filariasis is endemic in South and Southeast Asia. About 51 million people were infected as of 2018, and 40 million have been disfigured by the disease. In 2000 the World Health Organization launched itsGlobal Program to Eliminate Lymphatic Filariasis. As a result, substantial progress has been made in stopping the spread of infection through large-scale, annual treatment of eligible people in areas where infection is present. In 2020, more than 860 million people lived in areas where enough infection was present to require such annual treatment. Lymphatic filariasis is caused byWuchereria bancrofti(about 90% of cases),Brugia malayi, orB. timori. Transmission is by mosquitoes. Infective larvae from the mosquito migrate to the lymphatics, where they develop into threadlike adult worms within 6 to 12 months. Females are 80 to 100 mm long; males are about 40 mm long. Gravid adult females produce microfilariae that circulate in blood. 