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Wednesday, May 27, 2009

What Causes Elephantiasis ?

[Extracted from]

Elephantiasis is a syndrome most often caused by an obstruction of the lymphatic vessels, which results in extreme swelling of the skin and tissues, typically in the lower trunk and body. It primarily affects the legs and genitals, resulting in baggy, thickened and ulcerated skin, along with fever and chills.

Elephantiasis can be very painful and uncomfortable and reduces the sufferer’s ability to lead a normal life. A serious complication of elephantiasis can be obstructed blood vessels, which limit blood supply and cause the skin to become infected and gangrenous.

Elephantiasis has two main forms and several related disorders :

Lymphatic filariasis, which is the most common form of elephantiasis, is caused by a parasitic disease resulting from a bite from an infected mosquito. This form of elephantiasis is caused most commonly by the Wuchereria bancrofti parasite, but also can be caused by Brugia malayi and Brugia timori,. These parasites are all nematodes, or roundworms, that are transmitted by mosquitoes. The parasite inhabits the lymphatic vessels, resulting in their inability to drain the affected extremities.

It is not definitely known if the parasite itself is the sole reason of the swelling, or if the fact that the immune system is working to fight the parasitic infection contributes to it. Lymphatic filariasis affects people primarily in the tropics and is concentrated in Africa. It is estimated that 120 million people spread over 80 countries are affected by elephantiasis. Approximately one-third of these suffer serious cases of the disorder.

Nonfilarial elephantiasis, the second type of elephantiasis, is non-parasitic. This type is more common to Africa’s central mountains. It is caused by repeated contact with volcanic ash in the area. The primarily barefooted population receives chemicals from the soil into their feet, and the chemicals travel to the lymphatic vessels and irritate and block them.

Hereditary lymphedema is a disorder related to elephantiasis. It is a genetic disorder that, either by an underdevelopment of the lymph vessels or other factors, causes an accumulation of fluid in the affected extremities.

Treatment of elephantiasis depends on the type of the disorder the person is afflicted with. Lymphatic filariasis is treated with medication designed to kill the parasite. These medications include Suramin, Diethylcarbamazine, Ivermectin, Metrifonate, Mebendazole and Levamisole. Recent studies of use of the antibiotic doxycycline show promise. Medicines must be taken early after the primary infection, but they can have toxic side effects. The problem with effective treatment of elephantiasis is that it is difficult to diagnose it early enough.

Doctors have found that careful, daily cleaning of the affected areas helps prevent secondary skin infections that may be associated with elephantiasis. Surgical treatments are usually only effective on scrotal elephantiasis, but not on limbs. Unfortunately, there is no vaccine available at this time.

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