LYMPHATIC FILARIASIS
 
FILARIASIS

Filariasis is caused by several round, coiled and thread-like parasitic worms belonging to the family filaridea.These parasites aftergetting deposited on skin penetrate on their own or through the opening created by mosquito bites to reach the lymphatic system. The disease is caused by the nematode worm, either Wuchereria bancrofti or Brugia malayi and transmitted by ubiquitous mosquito species Culex quinquefasciatus and Mansonia  annulifera/M.uniformis respectively. The disease manifests often in bizarre swelling of legs, and hydrocele and is the cause of a great deal of social stigma. Filariasis is caused by several round, coiled and thread-like parasitic worms belonging to the family filaridea. These parasites after getting deposited on skin penetrate on their own or through the opening created by mosquito bites to reach the lymphatic system.

Brugian filariasis: Lymphadenitis (swollen and painful lymphnode) occurs episodically, most commonly affecting one inguinal lymph node at a time. The infection lasts for several days and usually heals spontaneously. The frequency of episodes may vary from 1-2 attacks per year to several attacks per month. Sometimes lymphadenitis is followed by a characteristic retrograde lymphangitis. The infection may spread to the surrounding tissues, and occasionally involves the whole thigh or entire limb. The infected lymph node may become an abscess, ulcerate, and heal with  fibrotic scarring. The acute clinical course with its complications may last from several weeks to 3 months. Characteristically, elephantiasis involves the leg below the knee but occasionally it affects the arm below the elbow. Genital lesions or chyluria (milky colour urine) do not occur in brugian filariasis.

Bancroftian filariasis: The lymphatic vessels of the male genitalia are most commonly affected in bancroftian filariasis, producing episodic funiculitis (inflammation of the spermatic cord), epididymitis and orchitis. Adenolymphangitis of the extremities is less common. Hydrocele is the most common sign of chronic bancroftian filariasis, followed by lymphoedema, elephantiasis and chyluria. The swelling involves the whole leg, the whole arm, the scrotum, the vulva or the breast. The fluid of hydrocele and chyluric patients may contain microfilariae, even when they are absent from the blood. Chyluria occurs intermittently and is more pronounced after a heavy meal. It is often symptomless, but some patients complain of fatigue and weight loss, resulting from loss of fat and protein.

National Vector Borne Disease Control Programme, 22, Shamnath Marg, Delhi - 110054.