Causes of Elephantitis

Elephantitis, or Lymphatic filariasis, is a tropical and sub-tropical disease of the lymph system. Usually caused by a microscopic nematode or round worm, the disease results in the swelling and thickening of the skin and underlying tissue of the limbs, genitals and breasts. The disease can be not only disfiguring, but also disabling. While there are treatments, there is to date no cure or vaccine for the disease.

Causes of Elephantitis

• Elephantitis or lymphatic filariasis is a disease of the lymphatic system caused by microscopic round worms. This tropical disease thickens the patient's skin, causing it to look bumpy and wrinkled like the skin of an elephant--hence the name "elephantitis." While different types of the worm can affect different parts of the body, the disease is most known for thickening the skin of the lower limbs and genitals in males and the breasts in females. There is also a non-parasitic form of the disease, caused by contact with soils containing alkali metals and other volcanic by-products.

Symptoms

• The disease causes more cases of disability in the world than any other disease. Skin and the tissue under the skin becomes thick, bumpy, wrinkled and baggy. Some victims are affected only in their upper limbs, while others are plagued with the deformity in the lower limbs and genitals. The disease is also accompanied by fever and pain in the lymph nodes.

Transmission

• Infected tropical mosquitoes bite humans and transfers the larvae of one of eight species of worms which contain specific bacteria. The larvae crawls into the opening in the human's skin and grows into an adult. The adult worms exist only within the human lymph system, the system that controls the body's fluid balance and part of its immune system. The worms grow and eventually block the lymphatic vessels, causing swelling in vessels. It is not clear whether the swelling is caused by the worms or by the body's defensive reaction to the worms. While the adult worms remain in the lymphatic system, their larval offspring make their way into the blood and travel throughout the body via blood and lymph nodes. When another mosquito bites the host, it ingests the larvae, which grows within the mosquito and is later deposited into another host when the mosquito takes a future meal.

Geographic Areas Affected

• While there are no cases of the disease in the U.S., there are many victims of the disease in the tropics and sub-tropics of Asia, Africa, the Middle East, Indonesia, and Central and South America. The non-parasitic type of elephantitis caused by contact with soils containing alkali metals and volcanic by-products is found primarily in Africa, especially in Ethiopia.

Treatment

• Treatments vary depending upon geographic location. In Africa, albendazole, donated by GlaxoSmithKline, is used in conjunction with ivermectin, donated by Merck & Co., while in other areas of the world, albendazole is used with diethylcarbamazine with the hope to eradicate the disease by the year 2020. Rigorous cleansing of the affected body parts has also been shown to be efficacious, leading some to believe that part of the symptoms are caused by skin infections. Surgery is sometimes used in cases of scrotal elephantitis, but it has not proven to be effective on thickened skin of the limbs. Some physicians have tried using pumps to push the fluids out of the affected areas, while others have performed manual lymph drainage. Currently, researchers are trying to find a vaccine for the disease.