Filariasis (Elephant Foot): Causes, Symptoms, Treatment and Prevention

Filariasis is a disease caused by parasites and transmitted through blood from arthropod vectors, especially mosquitoes. Elephant foot disease or filariasis is a disease that can interfere with daily activities and may be something that is considered embarrassing for sufferers of filariasis, even though this condition is not a deadly disease.

Types of Filariasis

Most cases of filariasis are diseases caused by a parasite known as Wuchereria bancrofti with a mosquito host. Filariasis itself is classified into:

1. Lymphatic Filariasis

Lymphatic filariasis is caused by several worms, such as Wuchereria bancrofti, Brugia malayi, and Brugia timori. These worms inhabit the lymphatic system, including lymph nodes. When the condition becomes chronic, this worm leads to elephantiasis syndrome.

2. Subcutaneous Filariasis

Subcutaneous filariasis is caused by Loa loa (eye worms), Mansonella streptocerca, and Onchocerca volvulus. These worms live in the subcutaneous skin layer, in the fat layer. Loa loa causes Loa loa filariasis, while Onchocerca volvulus causes river blindness or Robles.

3. Serous cavity filariasis

Serous cavity filariasis is caused by the worms Mansonella perstans and Mansonella ozzardi, which inhabit the serous cavity in the stomach. While dirofilaria immitis, heartworm, rarely infects humans.

Filariasis is not a life-threatening infection but it can cause permanent damage to the lymphatic system. Filariasis is a disease that usually does not cause symptoms at an early stage.

Therefore, most people are not initially aware that they have filariasis. Lymphedema (swelling of lymph nodes) with thickening of the skin and underlying tissues is a classic symptom of elephantiasis.

Causes of Filariasis

Filariasis is caused by Filarioidea worms that infect lymph nodes. This worm enters the human body by means of mosquitoes, which consist of Culex, Aedes or Anopheles. Filaria worm larvae will then stay in the lymph vessels.

When mosquitoes suck the blood of someone containing filaria worms, the worms will also infect mosquitoes. Furthermore, this infected mosquito will spread the filarial worm when biting others until the filariasis of the mosquito is then transmitted to more than one person.

Filariasis can occur in patients of any age and can be treated by reducing the risk factors that cause filariasis. So, consult with your doctor for more information.

Risk Factors for Filariasis

Filariasis can be suffered by anyone who is exposed to a parasitic disease. Here are some of the highest risks of developing filariasis:

  • Live or settle in the tropics and subtropics
  • Often bitten by mosquitoes
  • Living in unhygienic conditions

Areas where roundworms can be found, including:

  • Africa
  • India
  • South America
  • Southeast Asia
  • Symptoms of Elephant Feet

Symptoms of Filariasis

Elephant feet or filariasis almost cause no symptoms at an early stage. Infection usually attacks the legs, but can also affect other parts such as the arms, chest, and genitals. Symptoms of filariasis appear within a few years until finally realized.

Here are some of the symptoms of filariasis based on type, including:

1. Symptoms of Lymphatic Filariasis

Edema (swelling) with thickening of the skin and underlying tissues is a classic symptom of elephantiasis. This usually affects the lower extremities.

Meanwhile, the arms, vulva, breast and scrotum can also be affected. Edema in the breast or genital area can cause these organs to enlarge several times their normal size due to blocked arteries of the lymphatic system.

2. Symptoms of Subcutaneous Filariasis

  • Skin rash
  • Hyper or macular hypopigmentation
  • Blindness (caused by Onchocerca volvulus)

3. Symptoms of Serous Filariasis

  • Stomach ache
  • Skin rash
  • Arthritis
  • Hyper or macular hypopigmentation

Diagnosis of Elephant Foot Disease

Basic diagnosis of elephantiasis or filariasis is carried out by microscopic examination to identify microfilariae. This examination is only done at night in some countries, because microfilaria only move in the blood at night. This blood test aims to detect the presence of microfilariae.

Common methods used to diagnose filariasis include:

  • Direct demonstration of microfilariae in blood or skin specimens. Blood samples are collected at night because microfilariae (filaria larvae) have nocturnal periodicity.
  • Detection of antibodies by immunodiagnostic test.
  • Detection of circulating filarial antigen (CFA).

You may have an x-ray and ultrasound to rule out other possible problems that cause the same elephantiasis symptoms.

Filariasis Phase

In addition to some of the symptoms of filariasis above, several cases of filariasis cannot be ascertained right away because this disease has several phases, including:

1. Chronic Phase

When entering the chronic phase, swelling of lymph tissue and thickening of the skin in the legs and testicles can occur. While women may experience swelling in the breasts and genital organs.

In addition, fluid buildup can have an impact on the abdominal cavity, testicles in male sufferers and breasts in female sufferers.

2. The Acute Phase

This phase is characterized by inflammation of the lymph nodes, skin, and lymph vessels. This is caused by the body’s immune system response to parasites.

Some of the symptoms that can appear in the acute phase include fever, swollen lymph nodes, and swelling in the legs and testicles.

3. Phase without symptoms

When someone is infected with filaria worms, his body will not immediately show certain symptoms. However, in this phase there has actually been damage to the lymphatic and lymphatic flow system, as changes in the immune system occur.

Complications of Filariasis

If without medical treatment, microscopic parasites can live for years in the lymphatic system, which causes damage.

The lymph system functions to transport excess fluid and protein and fight infection. When fluid accumulates it doesn’t function properly. Fluid buildup causes tissue swelling and decreased immune function.

Filariasis is associated with several physical and emotional complications, including:

1. Disability

Filariasis is a major cause of permanent disability throughout the world. It may be difficult to remove the affected body part. This condition makes it difficult for sufferers to carry out daily activities.

2. Secondary infection

Fungal and bacterial infections are prevalent among those suffering from filariasis due to damage to the lymph system.

3. Emotional Distress

This condition can cause sufferers of filariasis to worry about their appearance, which can cause anxiety and depression.

Filariasis Treatment

Maybe you are curious whether elephantiasis can be cured. Basically, there are several ways to treat elephantiasis or treat filariasis.

1. Medicines

Here are some filariasis drugs that can be given to treat filariasis:

  • Diethylcarbamazine

How to treat elephantiasis that you can try is to use Dietilkarbamazin. Diethylcarbamazine is a recommended filariasis drug for treating filariasis. DEC is able to kill microfilariae but has no effect on adult worms. As such, DEC only helps to control transmission of infection from one person to another.

  • Ivermectin

Another way to treat elephantiasis is with ivermectin or albendazole, this filariasis drug may be useful in some patients. In addition, anti-mosquito creams, aerosols, and preventing mosquito breeding by maintaining sanitary hygiene are the best way.

2. Operation

Meanwhile, if the filarial worm infection causes swelling in the testicular sac or on the eye, surgery may need to be done immediately.

Filariasis Prevention

Good hygiene is an important part of preventing worsening lymphedema and secondary bacterial skin infections. Dirty environments, like many secondhand items and puddles, are places where mosquitoes like to breed.

Because mosquitoes are animals that are intermediaries of worms that cause filariasis, the main action that must be taken is to avoid bites (especially morning and evening) while preventing the environment from being a breeding ground for mosquitoes,

How, you can apply the 3 M movement that is draining, closing, and burying to prevent mosquitoes from nesting. Prevention of filariasis can also use mosquito repellent topical medication, wear long clothes when running outdoor activities or sleep using a mosquito net. This method must be done to break the chain and transmission of filariasis.


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