What Is Elephantiasis?

Elephantiasis is a rare, tropical infection by parasitic worms that causes, after the course of a few years, unusual and extreme swelling in the extremities.

A rather uncommon condition to most regions of the world, elephantiasis (medically: lymphatic filariasis) is a chronic parasitic infection that, being spread by mosquitos, is common only to those regions (namely tropical) most afflicted with them--Central America, Africa, and subtropical Asia, for the most part. About one hundred and twenty million are estimated among the afflicted worldwide, though most probably don't know it because the infection is, for a period of seven years or more after contact, asymptomatic, meaning that an individual is likely to walk around for such a period before having any indication of illness that would lead to treatment.

Human parasites Wuchereria bancrofti and Brugia malayi behave identically in the body, and are both spread by mosquito intermediary, meaning that they survive in mosquitos that draw blood from infected persons long enough to be planted in another host. Often, this process is unsuccessful, and worms deposited through that second bite (or subsequent bites) may be rejected by a healthy immune system, and thus not 'take'. The condition is generally called elephantiasis regardless of which worm is responsible, as their effects upon the body are relatively indistinguishable.

Immature worms are actually the ones transmitted from host to host, because the adults are too large to move freely in the bloodstream. These immature worms swim freely through the bloodstream until they are picked up by a mosquito or other blood-sucking parasite. Most of them actually die in the bloodstream, but enough are produced that this is really irrelevant, so long as some small fraction are withdrawn to be passed along to the next individual. The offending mosquito then, with full gut, moves on to a fresh host, where some backflowing blood from its proboscis (needle) gives the worms the necessary route for infection.



Once in the bloodstream, these worms circulate and move toward the lymph nodes of the body, which usually are responsible for the production of some types of immune response. Here the visitors reside permanently, mating and producing new babies with the hope of spreading their genes on to the next host. They cause you essentially no harm until they die--then, clotty masses of dislodged worm tissue begin to clog your lymphatic passageways, which usually are responsible for the transport of non-vascular bodily fluids.

From this result the symptoms. Certain body parts, especially those associated with the lymphatic system, will collect fluid to the point of extreme discomfort. Your arms and legs, especially around the groin and armpits are likely victims, as may be your genitals. The outer labia, in females, and the scrotum, in males, are most likely to show symptoms, and may swell to several times their normal size. Other symptoms usually include bacterial infection of the skin, which may become rough and leathery.

The worm infection is readily treatable, but the symptoms of the disease may only be treated as, well, symptoms--once the worms are dead, there's no removing them from your lymphatic system save by letting the natural course of the condition run through. Management of swelling may be done with anti-inflammatory medications, but control may be difficult to achieve. The main concern of the patient should be to keep the area clean and free of infection. Antibiotics to ward off bacterial infection are likely to be a part of the treatment.

Risk control for lymphatic filariasis is essentially mosquito avoidance, which should be practiced anyway to prevent exposure to any number of parasitic, viral and bacterial conditions. Generally elephantiasis will result only from prolonged exposure to mosquitoes, partly as a result of the relative ease with which the worms may be kept at bay by the immune system in sufficiently small numbers, and partly as a result of the relative rarity of the disease as a whole. Controls on mosquito breeding may be done on a community-wide basis, or may involve ridding your yard of standing water.

The name elephantiasis actually is derived from the case of Joseph Merrick, the so-called Elephant Man, who lived in the late nineteenth century. However, as it turns out, he was misdiagnosed during his lifetime with this condition, and then again in the twentieth century with neurofibromatosis, a wholly different condition. As it turns out, he was probably afflicted with yet another, hereditary condition called Proteus Syndrome, which is in every way unrelated to the disease that still carries his namesake in popular culture. Lymphatic filariasis is rarely called elephantiasis by medical professionals as a result of the title being such a rash misnomer.

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