Lymphatic Filariasis- Causes, Symptoms and Treatment, Transmission & More

Lymphatic filariasis, commonly referred to as elephantiasis, stands as a neglected tropical disease. Transmission of filarial parasites through mosquitoes leads to infection, often acquired during childhood, causing concealed damage to the lymphatic system. The visible and painful manifestations such as lymphoedema, elephantiasis, and scrotal swelling emerge later in life, resulting in permanent disability. Those affected not only experience physical impairment but also endure mental, social, and financial setbacks, contributing to stigma and poverty. As of 2021, 882.5 million individuals in 44 countries lived in regions requiring preventive chemotherapy to halt the infection's spread.

Disease and its causes form one of the major sections of the UPSC examination in General Science of Paper III as well as the current affairs section of the Paper Prelims. We will read about all the static facts related to the topic along with recent news in this article.

Recent News Related to Lymphatic Filariasis

• India’s National Health Policy 2002 set a goal to eliminate Lymphatic Filariasis by 2015, later extended to 2017. The goal set by the Global Program to Eliminate Lymphatic Filariasis was to eliminate LF by 2020. It was later revised to eliminate LF by 2030. National goals across endemic countries have aligned to meet that target.

What is Lymphatic Filariasis?

Lymphatic Filariasis is a neglected tropical disease that occurs when a mosquito transmits a filarial parasite. It is acquired mostly in childhood and causes damage to the lymphatic system. Visible symptoms of this disease are lymphedema, elephantiasis and scrotal swelling later. Globally, it is estimated that 25 million men suffer from hydrocele, and over 15 million people experience lymphoedema due to lymphatic filariasis. At present, at least 36 million individuals continue to grapple with these persistent manifestations of the disease. The eradication of lymphatic filariasis holds the potential to prevent unnecessary suffering and play a role in diminishing poverty.

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Causes of Lymphatic Filariasis

The parasite causing this disease is classified as Nematodes of the family Filarioidea, which is caused by an infected mosquito. There are three types of these filarial worms

• Wuchereria bancrofti
• Brugia malayi
• Brugia timori

Lymphatic Filariasis Life Cycle

The life cycle of lymphatic Filariasis is completed in 8 stages, which are mentioned below.

Source: CDC

Symptoms of Lymphatic Filariasis

Symptoms are mostly asymptotic, acute and chronic. However, the asymptotic conditions still can damage lymphatic systems, and kidneys and alter the body’s immune system. It leads to

• Lymphedema – Tissue Swelling
• Elephantiasis- Skin/Tissue Thickening
• Hydrocele- Scrotal Swelling
• Local inflammation of the skin, lymph nodes and lymphatic vessels often accompany chronic lymphoedema or elephantiasis

Source: WHO

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Treatment of Lymphatic Filariasis

• Persons infected with the Parasite
  • Diethylcarbamazine (DEC) is the drug of choice. The drug kills the microfilariae and some adult worms. Physicians suggest 1 to 12-day medications of DEC.
• Patients with clinical symptoms
  • DEC medications can not cure infected people with Lymphedema or elephantiasis. Hydroceles can be cured by surgery. Lymphedema can be prevented from getting worse by referring to a Lymphedemial therapist.

Transmission of Lymphatic Filariasis

Lymphatic Filariasis is transmitted from an infected person to another healthy person through mosquito bites. When a mosquito bites a person having lymphatic filariasis microscopic worms infect the mosquito. When this infected mosquito bites another person, microscopic worms transfer through the skin and travel through lymph vessels. These worms grow into an adult in the lymph vessel, which mates and releases millions of microfilariae.

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Lymphatic Filariasis in India: Status and Measures

• Around 40% of worldwide cases of Lymphatic Filariasis are found in India
• As per an estimation, around 650 million Indians across 21 states and UT are at risk of Filariasis
• The state of Bihar has the highest endemicity, followed by Kerala and UP. Goa has the least endemicity, followed by Lakshadweep, MP and Assam.
• The flare control program was launched in India in 1955 after a pilot was undertaken in Orissa from 1949-1954.
• An accelerated plan for the elimination of Lymphatic Filariasis was launched by the government in 2018 and rolled out IDA, I.e. ivermectin, diethylcarbamazine citrate and albendazole in a phased manner.
• In 2019, Union Minister of State Dr Harsh Vardhan said India’s current plan is to eliminate lymphatic Filariasis by 2021.

WHOs Response to Lymphatic Filariasis

• To eradicate 20 tropical diseases by 2030, WHO has set up a guideline from 2020-2030
• The WHO Global Program to Eliminate Lymphatic Filariasis has two key components
  • Large scale annual treatment of all eligible people in an area will reduce the spread of infection
  • Providing essential care kits in order to alleviate the suffering
• In 2000, the WHO set up a Global Program to Eliminate Lymphatic Filariasis to stop transmission with the Mass Drug Administration.
• WHO recommends Preventive Chemotherapy by Mass Drug Administration (MDA). Under this, an annual dose of medications is administered to the entire population at risk.
• Mosquito control is a strategy supported by the WHO
• Morbidity management and disability prevention are also considered vital for improving public health. Essential services should be provided by healthcare system such as surgery in case of Hydrocele

Conclusion

With over 41% of global Lymphatic Filariasis cases, India has a major threat towards lymphatic Filariasis. Success in the elimination of Filaria will be achieved in 2030 only when guidelines of WHO like;

• treatment for adenolymphangitis (ADL)
• applying simple measures to manage lymphoedema to prevent the progression of the disease and inflammatory episodes of ADL;
• surgery for hydrocele;
• treatment for infection

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