Transcript Lymphatic Filariasis

Lymphatic Filariasis
RANJAN BANERJEE
BIOL 062
N O V E M B E R 2 0 TH 2 0 0 8
What is Lymphatic Filariasis?
 Parasitic disease of lymphatic system
What is Lymphatic Filariasis?
 Parasitic disease of lymphatic system
 Circulates in blood
What is Lymphatic Filariasis?
 Parasitic disease of lymphatic system
 Circulates in blood
 Almost exclusively in humans
What is Lymphatic Filariasis?
 Parasitic disease of lymphatic system
 Circulates in blood
 Almost exclusively in humans
 Among world's leading causes of disability
What is Lymphatic Filariasis?
 Parasitic disease of lymphatic system
 Circulates in blood
 Almost exclusively in humans
 Among world's leading causes of disability
 Increasing due to unchecked urbanization
Prevalence
 Endemic in tropical regions
 Asia, Africa, Central/South America
Prevalence
 >120 million people infected
 1 billion at risk for infection
Cause
 Three worms
 Wuchereria bancrofti - 90% of cases
 Brugia malayi
 Brugia timori
Transmission cycle is complicated
CDC Public Image Library
Risk Group
 People in tropical/subtropical regions
www.groovythemes.com/nature/tropics.shtml
 Repeated mosquito bites over many years
dvice.com/archives/2008/07/sk_telecom_offe.php
Symptoms
 Most due to dysfunctional lymphatic system
The Physiotherapist Pte Ltd.
Symptoms
 Lymphedema
 Gangrene
Symptoms
 Genital damage - hydrocele
 10-50% men
http://img.tfd.com/dorland/hydrocele.jpg
Filarial antigens provoke immune responses
 Increasing levels of IgE and IgG4
Symptoms (cont’d)
 pulmonary tropical eosinophilia syndrome
 Inflammation of the lung
 Cough, shortness of breath
myweb.lsbu.ac.uk/dirt/museum/p6-633.html
Symptoms
 Manifestation may take years
Diagnosis
 Giemsa stain – differential stain
But doing smear is complicated..
 Nocturnally periodic
Nuchprayoon et al. Filaria
Journal 2007 6:6 doi:10.1186/1475-28836-6
Serology is another method
 Immunoglobulin test - antifiliarial IgGs
Treatment
 diethylcarbamazine (DEC)
 Kills microfilarae
 Prevents transmission
 Albendazole
 Kills adults and microfilarae
Slightly different in Africa
 Ivermectin instead of DEC
 Side effects with other diseases
 River blindness
Secondary Treatment
 Good hygiene is important
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Socio-economic Impact
 Disease of the poor
 Incapacitates  cycle
http://www.bbc.co.uk/radio4/today/gallery/media/poverty2.jpg
Social stigma
 “Her husband left her when he realized that her legs
would not shrink, she said. As her new boyfriend, a
handsome out-of-work carpenter, sold goods nearby,
she said, "I don't know if he will leave me, too.”
- Antoinette St. Fab
Efforts
 In 1993 identified as one of six eliminable infectious
diseases
 In 1997, World Health Assembly called for
elimination of LF worldwide
WHO: Global Programme to Eliminate LF
 Goal 1: break cycle of transmission
 MDA
 Combination therapy
 Donated Drugs
WHO: Global Programme to Eliminate LF
 Goal 2: Alleviate suffering in infected persons
 Community education programs
 Community care
© Global Alliance to Eliminate Lymphatic Filariasis
© Global Alliance to Eliminate Lymphatic
Filariasis
Future
 September 20th, 2007 – genome of Brugia malayi
mapped

Vaccine?
http://wishart.biology.ualberta.ca/BacM
ap/cgview_linked_maps/NC_006833/p
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