What is Elephantitis?
The definitive origin of elephantiasis is truly inexplicable, not until in the recent time. It might have been because of its long history and other irrelevant terms have been used to identify such condition. There have been mythological presentations for such disease. It was coined to as “elephantitis”, literally meaning inflammation of the elephant. People in ancient times, compared the symptom of the disease to the elephant’s hide and to the size of the affected body part. The commonly affected populations are the people of Africa and South East Asia. This has been a form of incapacitation to the affected population and a source of disfigurement.
History will take us, that people in the olden times have claimed it to be as an “Iliad of Diseases”, arising as a complication from other conditions. Skiapodes (shadow leg), in Greek times, are people from Ethiopia that are characterized to have great legs. Other myths include the curse of Saint Thomas; legend has it, only occurred to those who lead him to martyrdom. These classical beliefs only prove how this condition surfaced in such an early time that it has caused many people disability.
But as time has progressed and that people have the definitive cause for such condition, it has not been hard to look into the real cause of elephantiasis.
Elephantitis Types
There are two types of elephantiasis:
Lymphatic Filariasis
This is the most common form of elephantiasis, suggesting elephantiasis as a complication. This involves the lymphatic system, that the presence of the parasitic worms can alter its normal function. This is transmitted through mosquitoes and can make the person affected become a host.
Non-filarial elephantiasis
This does not involve any parasitic infestation. This may be due to persistent contact to volcanic ash that another condition called podoconiosis. This is a common disorder to families who are always bare-footed and who live in volcanic zones. This condition presents swelling of the lower part of the body; feet and lower legs.
Elephantitis Symptoms
It would usually take years before this condition can manifest any gross enlargement of a body part. It would take time for the parasites to accumulate in the blood vessels, causing restricted circulation and fluid buildup in the nearby tissues.
Signs of acute infection of elephantiasis are as follows:
- Fever, chills, sweating, headaches, vomiting, and pain –These symptoms indicate the allergic reactions from its source. These are responses from the transmitted parasite from its vector (shall be discussed in the causes).
- Enlarged and abscesses in lymph nodes, swelling of the affected area, skin ulcers, and joint pain can be a sign of continuing growth of the worms.
Signs of chronic infection of elephantiasis are as follows:
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- Gross enlargement of the lymph nodes, scrotum or penis, vulva (female genitalia), breasts, foot, legs and/or arms –These are primarily filled by fluid but eventually will become hard and thick.
- Skin discoloration –Indicates disease complication and infection.
Elephantitis Causes
It took centuries before the main cause of this condition was identified. This is from three parasites from a known vector, mosquitoes. The parasitic worms are the following:
Wuchereria bancroti
This parasite is greatly responsible and a common cause of lymphatic filariasis. 90% of all cases are linked to such worm. This is common in Africa, Turkey, Southeast Asia, Australia, and South America. Humans are the reservoir for this type of worm. It is transferred from one person to another by the female Anopheles, Aedes and Culex specie.
Brugia malayi
The mosquitoes Mansonia, Anopheles and Aedes carrying this parasite has infected 13 million people of most Asian countries such as Philippines, Thailand, Vietnam, Malaysia, China and India. But among the cases of lymphatic filariasis, only 10% of to total affected is caused by this parasite.
Brugia timori
Its primary vector is the Anopheles barbirostris. This parasite has lesser range of affectation compared with the two above. It can also be seen in the islands of the Indonesian archipelago, like Timor.
These parasites are roundworms, which are long and can block the lymphatic system. The lymphatic system is highly responsible for the removal of interstitial fluid from tissues, controls and manufactures lymphocytes (white blood cells), fat absorption, and is responsible for the defense mechanism of the body. Because of the action of these parasites, there would be instability in the growth of lymphocytes, inadequate fluid removal from the interstitial spaces and immunity is hindered for its role. This explains why there is enlargement of the affected region, especially the areas where lymph nodes are mostly situated.
Elephantitis Treatment
A lot of prospects have been presented in eradicating this condition in the world. They aim that by the year 2020, this condition is erased from the face of the earth. But the only way to do that is for proper treatment and prevention. Unfortunately, a vaccine has not been developed in order to avoid such condition. But one way of preventing it is protect oneself. Cleaning and, as much as possible, removing breeding sites of the mosquitoes is one way. Use of long-sleeved shirts/blouses, long pants, and the use of mosquito nets while sleeping a step away in becoming infected. This is recommended to people who live in the areas commonly affected of filariasis. When travelling to countries where filariasis is found, you should not forget to consult your doctor for to acquire preventive measures. The use of footwear is recommended to people living in volcanic areas.
For lymphatic filariasis, it is recommend to be treated with medications. Diethylcarbamazine or DEC is a widely used drug at killing the parasite that is circulating in the bloodstream. It has several actions against the parasite such as killing quickly the microfillariae and reducing the size of the enlarged nodes, thus reducing elephantiasis. The use of antibiotics has shown good results for treating elephantiasis. This drug would include doxycycline, a tetracycline antibiotic. Ivermectin is used to cure parasitic infections such as roundworm infections. But these drugs may have untoward effects such as allergic reactions.
Another treatment would include surgery. This is applicable to cases of excessive enlargement of a body part. This is done to remove the excess fibrous tissue, draining interstitial fluid, and remove worms. But this has been noted as entirely unsuccessful, unless all the parasites have been totally removed and no recurrence shall be expected.
Elephantitis Pictures
