Elephantiasis is caused by infection with the filarial worm which is transmitted through the mosquito to humans and lives in the human lymph system.
The disease is typically characterized by the thickened skin and grossly enlarged limbs that the disease deserves its name. The infection is unusual in certain areas of the world, while in others it is endemic. The treatment can take about 8 weeks to eliminate all microfilariae in the blood.
Elephantiasis TreatmentsGeneral treatment measures include bed rest, elevation of affected limbs and wrapping of limbs in compression bandages. This helps to reduce the swelling. If there are signs of an infection, usually the next measure takes care of the skin on the foot and the leg to prevent an infection that can worsen the swelling. The skin should be carefully washed and dried. Nails are cut off and cleaned to prevent injuries and unintentional infections.
As far as the drugs are concerned, the treatment differs as follows:
In the United States is the drug of choice diethylcarbamazine or DEC killing the microfilaria and also some adult worms.
For countries outside the United States, a combination of albendazole and ivermectin is generally used.Another important consideration in the treatment of elephantiasis is the presence of Wolbachia bacteria living in symbiosis with the filaria parasite. If an antibiotic is used to kill the bacterial population, the worms also die.DEC is able to kill microfilaria as well as adult worms. However, rapid elimination of the worms can trigger immunological reactions such as fever, throat pain and muscle pain. A low dose is therefore often used in combination with steroids, anti-inflammatory agents that can combat the initial immunological reactions. One of the regimens recommended by the global filariasis elimination program is one-dose ivermectin with or without albendazole.
