"Elephantiasis Nostras Verrucosa or the Elephantiasis Disease" is a wonderful example of a paper on infections. Lymphedema infection, caused by lymphatic filariasis (LF), has emerged as the second-largest cause of human disability in the world. It results in physical disfigurement, and frequently results in rejection of those infected, by friends and relatives. The World Health Organization has categorized this disease as neglected. As much as a third of those with this disease are to be found in the low – lying, coastal and tribal areas of India (Narahari, Aggithaya, Prasanna, & Bose, 2010, p.
145). Lymphatic Filariasis is caused by the parasitic worm Wuchereria bancrofti, which is borne by mosquitos. The most severe complication of this infection is elephantiasis, and this disease continues to pose a grave health problem in the developing world. A measure of hope has been provided by mass drug administration, which seems to have the capacity to completely eradicate this disease (Hotez, 2008, p. 72). Elephantiasis nostras verrucosa has been described as a progressive disease. In its natural course, it produces large scale enlargement and horrific malformation of the affected area.
A large number of patients with this disease exhibit a long-standing history of edema preceding the development of fibrosis, hyperkeratosis, papules, and verrucous lesion. With the progress of this disease, the subcutaneous tissue and dermis undergo increasing fibrosis, the affected area undergoes massive enlargement and the skin becomes noticeably thicker and verrucous (Sisto & Khachemoune, 2008, p. 144). This is accompanied by superficial ulcers and the production of a fetid odor, as the disease progresses. Furthermore, bone deformities and septic arthritis could also develop. As the disease progresses, it could even become inevitable to amputate the affected area.
On occasion, this disease could result in septicemia and death (Sisto & Khachemoune, 2008, p. 144). Elephantiasis results in significant enlargement of a body part, on account of the accumulation of fluid and connective tissue. It is generally observed in the legs, arms, breasts or any other body part. The commencement of this disease is usually with enlargement of a limb accompanied by fever. The initial swelling is soft, but over time connective tissue grows in the area, which makes it hard.
Moreover, the skin acquires the look of the hide of an elephant. This is due to the coarsening and thickening of the skin on account of the swelling and explains the reason for this disease being termed as elephantiasis (Brown, et al. , 2011, p. 953). The obstruction of the lymphatic vessels, in general, produces the syndrome termed elephantiasis. This disease is characterized by the gross swelling of the tissues and skin, chiefly in the lower trunk and body. The principal targets of this disease are the legs and genitals, which result in coarse, thickened, and ulcerated skin.
This disease produces fever and a feeling of cold that is accompanied by shivering. This disease causes considerable distress and is very painful. Moreover, it severely restricts the patient’ s capacity to live normally. One of the cardinal complications of elephantiasis is the reduction in blood supply due to obstruction, which renders the skin infected and gangrenous (Lippincott, 2010, p. 104). In the usual course, the symptoms of elephantiasis do not come to the fore immediately and are discernible only after the passage of a few years.
In some cases, there are no symptoms. Adults depict the worst symptoms of this disease, and it is prevalent to a greater extent among men than women. There is considerable damage to the genital area, with the massive enlargement of the testicular sacs. Moreover, the limbs and breast may swell to several times their usual girth (Ashby & Turkington, 2007, p. 95). It is microfilaria density that constitutes a significant element in the control, epidemiology, and treatment of human filariasis. Some of the common clinical signs and symptoms of this disease are elephantiasis, hydrocele, and periodic fever (Anosike, et al. , 2005, p.
181). The WHO initiated the Global Programme to Eliminate Lymphatic Filariasis, which depicted substantial progress in the year 2008. This disease has been identified as endemic in 81 developing countries. Among these 66 countries completed the task of mapping their endemic foci, 13 countries had exhibited progress in such mapping, while 2 countries had to commence the exercise. Among the endemic nations, mass drug administration (MDA) was seen to be unnecessary in 10 countries. Among the 71 countries that required MDA, 51 countries were provided with this intervention (World Health Organization, 2009, p.
437). The World Health Organisation has recognized the importance of reducing this infection. Several studies have disclosed that just 34 of the endemic countries have successfully implemented the norms for MDA. In the year 2007, more than 56 million people were treated in the South – East Asia region. This increased substantially to 232 million in 2008. The WHO employs therapy for treating the disease, wherein the drugs diethylcarbamazine, albendazole, and ivermectin are administered in combination (World Health Organization, 2009, p.
437). However, it is quite difficult to arrive at a conclusive diagnosis of filarial disease, which entails the identification of the actual nematode within the body fluid or tissue of a suspected patient. The difficulty arises due to the enormous effort required to access the lymph nodes and vessels, wherein these parasites are lodged. On occasion, blood samples disclose the presence of the parasite (Lerner & Lerner, 2008). Potent medication has to be administered to the patient, as these nematodes release chemicals that cause allergic-type reactions in the patient, at the time of their death.
Although permanent tissue damage is caused, the extreme swelling can be mitigated to some extent by surgical means or application of stockings or elastic bandages (Lerner & Lerner, 2008). Filariasis has proved amenable to treatment with drugs like diethylcarbamazine, albendazole, and ivermectin. Lymphatic filariasis has been addressed by the global program to eliminate it, via the use of a combination of the aforementioned drugs. With regard to onchocerciasis, ivermectin has emerged as the only drug employed by control programs. A recent development has been the advent of doxycycline, which specifically destroys the Wolbachia bacterial endosymbionts.
This effectively provides long term sterility and macrofilaricidal activity (Taylor, Hoerauf, & Bockarie, 2010, p. 1178). Elephantiasis can be prevented and even eradicated by administering the relevant drugs, at least on an annual basis to individuals who are susceptible to this disease. Among this group of people, as much as 80% have to be provided with medication for at least 5 years on a yearly basis if transmission of the disease is to be prevented (EurekAlert, 2010). Elephantiasis is more or less restricted to the disfavored semi-urban and urban areas and the remote rural areas of a country.
This renders it a disease that principally affects the poor. There has been, in recent times, an unprecedented increase in the slum areas of Africa and the Indian subcontinent. This indicates significant growth in poverty. Individuals afflicted with elephantiasis, in general, suffer from physical incapacitation, with the outcome that they cannot lead a normal working life. The consequence is a tremendous escalation in poverty. Thus, by eradicating this disease, there is also a substantial reduction in poverty levels among the affected populace.
The WHO has provided effective drugs to combat this disease, and if its programs are implemented conscientiously, then there is every possibility of totally eradicating this debilitating disease.
Anosike, J. C., Nwoke, B. E., Ajayi, E. G., Onwuliri, C. O., Okoro, O. U., Asor, J. E., . . . Meribe, C. O. (2005). Lymphatic filariasis among the Ezza people of Ebonyi State, eastern Nigeria. Annals of Agricultural and Environmental Medicine , 12(2), 181 – 186.
Ashby, B., & Turkington, C. (2007). The Encyclopedia of Infectious Diseases. Infobase Publishing.
Brown, B. P., Hawley, H. B., Hessen, M. T., Kaplan, C., Moglia, P., & Mouchawar, J. (2011). Magill's Medical Guide. Pasadena, CA: Salem Press.
EurekAlert. (2010, June 29). Community-based education strengthens campaign for elimination of lymphatic filariasis. Retrieved from Bioscience Technology: http://www.biosciencetechnology.com/News/Feeds/2010/06/disease-research-community-based-education-strengthens-campaign-for/
Hotez, P. J. (2008). Forgotten People, Forgotten Diseases : The Neglected Tropical Diseases and Their Impact on Global Health and Development. Washington, DC: ASM Press.
Lerner, K. L., & Lerner, B. W. (2008). Elephantiasis. The Gale Encoclopedia of Science, 2, 1544 – 1546.
Lippincott. (2010). Lippincott's Guide to Infectious Diseases. Lippincott Williams & Wilkins.
Narahari, S. R., Aggithaya, M. G., Prasanna, K. S., & Bose, K. S. (2010). An Integrative Treatment for Lower Limb Lymphedema (Elephantiasis). The Journal of Alternative and Complementary Medicine, 16(2), 145 – 149.
Sisto , K., & Khachemoune , A. (2008). Elephantiasis nostras verrucosa: a review. American Journal of Clinical Dermatology, 9(3), 141 – 146.
Taylor, M. J., Hoerauf, A., & Bockarie, M. (2010). Lymphatic filariasis and onchocerciasis. The Lancet, 376(9747), 1175 – 1185.
World Health Organization. (2009). Global programme to eliminate lymphatic filariasis. Weekly epidemiological record, 84(42), 437 – 444.