All About Lymphatic Filariasis (Elephantiasis): Symptoms, Diagnosis, and Management

Lymphatic Filariasis, or Elephantiasis, is an infectious disease caused by parasitic or filarial worms and spread by mosquito bites. These worms affect the lymphatic system and block the lymphatic capillaries, accumulating lymph fluid. Fever, swelling, and inflammation are some of the symptoms of Elephantiasis.  

How does Elephantiasis occur  

Countries with tropical climates commonly have Filariasis. Certain areas do not have infectious organisms, so it does not occur when an individual travels to low-risk areas. However, if one travels to high-risk areas, one can acquire it even for a short travel duration.  

Roundworms, tiny, invisible, thread-like organisms, cause Lymphatic Filariasis. Wuchereria bancrofti, Brugia malayi, and Brugia timori are some of the most common roundworms.  

Tiny thread-like roundworms enter the mosquito's blood when a mosquito bites an infected person. When the same mosquito bites a healthy person, the worm gets transferred from the mosquito to the healthy person's blood. However, this does not occur with a single mosquito bite. It takes multiple bites for the infection to develop.  

After entering the bloodstream, the worm multiplies and develops, affecting the immune system. Male and female filarial worms form nests in the infected individual's immune system, leading to various filarial symptoms.  

What does Elephantiasis look like:  

Filariasis can affect any body part, such as arms, legs, breasts, scrotum, penis, vulva, and face. Most of them can be asymptomatic but can develop underlying damage to the lymphatic system. The weakening of the immune system is one of the significant drawbacks of Filariasis, and it causes various symptoms. Filariasis symptoms look like the following:

• Inflammation  
• Fluid buildup called lymphedema  
• Scrotal swelling leading to hydrocele
• Fluid buildup in the body is called edema  
• Inability to be socially active due to swelling and fluid buildup
• Disfiguration of the affected body parts

Complications of Filariasis:

Lymphatic Filariasis can lead to multiple complications due to a lowered immune response. These include recurrent bacterial infections, swollen and enlarged body parts due to fluid accumulation, thickening of the skin, and tropical eosinophilia syndrome, which causes respiratory difficulties. Kidney damage, proteins in urine, and blood in urine also occur in some individuals. Filariasis in childhood can lead to temporary or permanent disability in adult life.  

Detection of Elephantiasis:

Blood tests are major tests that diagnose lymphatic Filariasis. These include:

• Microscopic analysis detects the worms called microfilariae under a microscope. The worms are active at night, so the blood sample is mainly taken during the night to detect the microorganisms.  
• Antibody tests are also blood tests that help diagnose infection. Antibodies form as a response to infection. Antibody tests are done during the daytime.  

How is Elephantiasis managed:

• Filariasis treatment depends on its symptoms. There is no permanent cure for this infection.  
• Medications target the adult worms, preventing their multiplication and spreading infection. These include drugs such as ivermectin and albendazole, which are taken once a year for a few weeks to manage Elephantiasis.  
• Surgery helps relieve symptoms like fluid buildup, controls hydrocele, and removes dead worms from the body.    
• Elevation and compression garments are tied to the organs to relieve fluid accumulation in the body. 

How to prevent from getting Elephantiasis:

• Filariasis prevention targets affected individuals to interrupt filariasis transmission.  
• Avoid mosquito bites if one is traveling to endemic areas
• Using mosquito nets, insect repellants, and covering the body with long-sleeved clothes
• Preventive chemotherapy medications or a specific annual dose of chemotherapy medications as prescribed by the World Health Organization are some ways to prevent the infection.  
• Community-level mass drug administration is one of the best prevention strategies for Filariasis.

Conclusion:

Elephantiasis or lymphatic Filariasis is an infectious condition caused by roundworms spread by mosquito bites. It significantly affects the lives of many individuals globally. Organisms invisible to the naked eye cause these. The adult worm nests in the body's lymphatic system, affecting the individual's immunity. Blood tests establish diagnosis, which is the key to identification. Filariasis treatment includes prevention, which is paramount for its management. As a permanent cure is elusive, medication helps control microfilariae development.  

Fortis Hospital has a multidisciplinary team of experienced doctors and specialists who can use advanced diagnostic aids to detect microscopic organisms. They can effectively manage the condition using standard protocols to improve patient outcomes.