FILARIA

Dela Rosa, Jessica

called helminthiases.
Culiseta longiareolata
Eight known filarial nematodes
use humans as their definitive
hosts.
Divided into three groups
according to the niche they
occupy in the body:
Lymphatic filariasis
• Wuchereria bancrofti
• Brugia malayi
Subcutaneous filariasis
• Loa loa
• Onchocerca volvulus
Lymphatic filariasis, also
known as elephantiasis
Human disease caused
by parasitic worms known
as filarial worms.
Most cases of the disease have
no symptoms.
Marked by severe swelling in
the arms, legs, breasts,
or genitals.
Types of worms are known to
cause the disease: Wuchereria
bancrofti, Brugia malayi.
Wuchereria bancrofti
A human parasitic
worm that is the major
cause of lymphatic
filariasis.
The most prevalent of
the three and affects
over 120 million people
primarily in Central
Africa.
No vaccine is
commercially available.
Morphology
As a dioecious worm, W.
bancrofti exhibits sexual dimorphism.
• The adult worm is long, cylindrical, slender,
and smooth with rounded ends.
• It is white in colour and almost transparent.
• Males and females can be differentiated by
size and structure of their tail tips.
• The male worm is smaller, (1.6 in) long and
features a ventrally curved tail.
• The female is (2.4 in) to (3.9 in) long and,
nearly three times larger in diameter than the
male.
Life Cycle
Diagnosis
A blood smear provided the blood sample is
taken during the period in the day when the
juveniles are in the peripheral circulation.
Technicians analyzing the blood smear must be
able to distinguish between W. bancrofti and
other parasites potentially present.
A polymerase chain reaction test can also be
performed to detect a minute fraction, as little
as 1 pg, of filarial DNA.
Some infected people do not have microfilariae
in their blood. As a result, tests aimed to detect
antigens from adult worms can be used.
Ultrasonography can also be used to detect the
movements and noises caused by the movement
of adult worms.
Dead, calcified worms can be detected by X-ray
examinations.
Prevention
Insect repellents and mosquito nets are useful to
protect against mosquito bites.
Public education efforts must also be made
within the endemic areas of the world to
successfully lower the prevalence of W.
bancrofti infections.
Treatment
Cleansing the skin, surgery, or the use
of anthelmintic drugs, such
as diethylcarbamazine, ivermectin,
or albendazole.
The drug of choice is diethylcarbamazine, which
can eliminate the microfilariae from the blood
and also kill the adult worms with a dose of
6 mg/kg/day for 12 days, semiannually or
annually.
Brugia malayi
 Transmitted by Mansonia mosquitoes
and is restricted to South and
Southeast Asia.
Mansonia
It is one of the tropical diseases
targeted for elimination by the year
2020 by the World Health
Organization, which has spurred
vaccine and drug development, as well
as new methods of vector control.
Morphology
A. Adult microfilaria
producing female The body
length is about 4 cm.
Wolbachia (red dots) are
localized mainly in the
lateral chords, ovary and
developing embryos. The
lateral chords in the head
of the worm rarely contain
Wolbachia .
B. Adult stage, immature
female a few days after the
4 th molt. The body length
is approximately 1.8 cm.
C. Adult spermatozoa
producing male worm with
a total body length of
about 2.5 cm.
Life Cycle
Diagnosis
Tender or enlarged inguinal lymph
nodes or swelling in the extremities can
alert physicians or public health
officials to infection.
Microscopic examination of differential
morphological features of microfilariae
in stained blood films can aid
diagnosis—in particular the
examination of the tail portion, the
presence of a sheath, and the size of
the cephalic space.
Giemsa staining will uniquely stain B.
malayi sheath pink. However, finding
the microfilariae on blood films can be
difficult because of the nocturnal
periodicity of some forms of B. malayi.
Prevention
Vaccines
• There is currently no licensed vaccine
to prevent lymphatic filariasis.
• However, recent research has
produced vaccine candidates with
good results in experimental animals.
• A glutathione-S-transferase, a
detoxification enzyme in parasites
isolated from Setaria cervi, a bovine
filarial parasite, reduced B.
malayi adult parasite burden by more
than 82% for 90 days after treatment.
Loa loa
Actually means "worm worm", but
is commonly known as the "eye
worm", as it localizes to
the conjunctiva of the eye.
Commonly found in Africa.
It mainly inhabits rain forests in
West Africa and has native origins
in Ethiopia.
Maturing larvae and adults of the
"eye worm" occupy the
subcutaneous layer of the skin –
the fat layer – of humans, causing
disease.
Morphology
 Simple body
consisting of a head
that lacks lips, a body,
and a blunt tail.
The outer body of the
worm is composed of a
cuticle with 3 main
layers made up of
collagen and other
compounds which aid
in protecting the
nematodes while they
are inside the digestive
system of their host.
Life Cycle
Diagnosis
The presence of microfilariae in the
blood, the presence of a worm in
the eye, and the presence of skin
swellings.
A blood count can be done.
Patients with infections have a
higher number of blood cells,
namely eosinophils, as well as
high IgE levels that indicate an active
infection with helminth parasites.
A Giemsa stain is the most
commonly used diagnostic test that
uses a thick blood smear to count
the microfilariae.
Prevention
Currently, no control programs or vaccines for
loiasis are available.
Avoiding areas where the vectors, deer and mango
flies, are found also reduces risk.
Treatment
Adult worms found in the eye can be surgically
removed with forceps after being paralyzed with a
topical anesthesia.
The worm is not paralyzed completely, so if it is
not extracted quickly, it can vanish upon
attempting extraction.
Ivermectin has become the most common
antiparasitic agent used worldwide, but can lead to
residual microfilarial load when given in the
management of loiasis.
Onchocerca volvulus
Is a nematode that
causes onchocerciasis (river
blindness)
The second-leading cause
of blindness worldwide
after trachoma.
One of the 20 neglected tropical
diseases listed by the World
Health Organization, with
elimination from certain countries
expected by 2020.
Morphology
It is a dioecious species,
containing distinct males and
females, which form nodules
under the skin in humans.
Mature female worms
permanently reside in these
fibrous nodules, while male
worms are free to move around
the subcutaneous tissue.
The males are smaller than
females, with male worms
measuring 23 mm in length
compared to 230–700 mm in
females.
Life Cycle
Prevention
Stopping infected blackflies from biting
through the use of protective netting or
other methods.
Large scale control measures involve the
treatment of rivers near villages with an
insecticide to kill the aquatic larvae of the
blackflies.
Treatment
Drugs of choice: Diethylycarbamazine
(DEC) or Ivermectin.
Alternatives: Albendazole or
Mebendazole.
Antihistamines or corticosteroids may
help to relieve allergic reactions from
dead microfilariae in heavy infections.
References:
https://www.researchgate.net/figure/Montage-
of-some-of-the-major-human-helminth-
parasites-their-developmental-stages-
and_fig1_38035242
https://www.google.com/search?rlz=1C1CHBD
_enPH723PH723&biw=1396&bih=657&tbm=is
ch&sa=1&ei=_JPHXcO9MrKJmAWLu53gBg&q=
Brugia+malayi+in+human&oq=Brugia+malayi+i
n+human&gs_l=img.3...13715.14919..15125...0
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img.......0i67j0j0i24j0i333.B1MXVBHlA9o&ved=
0ahUKEwjDq_KO6d7lAhWyBKYKHYtdB2wQ4dU
DCAc&uact=5#imgrc=Z7rd8pJGb81GwM:
https://en.wikipedia.org/wiki/Filariasis
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