Could It Be Lymphatic Filariasis?

This article offers information about the disease lymphatic filariasis. Lymphatic filariasis (LF) is, after malaria, the second most common mosquito-borne disease globally. LF is caused by three species of nematode parasites, which can be spread by a wide range of mosquito species. There have been several recent case reports of LF occurring in travelers. LF has a widespread geographic distribution, mainly affecting the tropical regions of the world, particularly the Indian subcontinent, tropical Africa, South and Central America, Southeast Asia and the Pacific Island countries. Routine screening tests, such as a full blood count, may reveal eosinophilia, and, although this may be a useful marker for various helminthic infections, including LF, in the returned traveler, it is nonspecific. Unlike community control programs, where a single annual dose of diethylcarbamazine (DEC) plus albendazole/ivermectin is used for all population members, the treatment of individual patients relies on multiple doses of DEC alone. DEC is the only antifilarial drug that is both microfilaricidal and macrofilaricidal. Recently, there has been some suggestion that doxycycline at a dose of 100 mg daily may be useful in preventing LF. This drug regimen is thought to be sufficient to eradicate endosymbiont Wolbachia, which appears to be present in the LF nematodes. Interestingly, doxycycline is one of the preferred malarial chemoprophylaxis regimens for many travelers to malarial areas, which often are also LF endemic. However, further research is needed.