Elephantiasis: Human Diseases and Conditions

What is Elephantiasis?

Elephantiasis is a condition characterized by gross enlargement of an area of the body, most especially the limbs. Other areas are commonly affected include the external genitals. Elephantiasis is caused by the obstruction of the lymphatic system, which results the accumulation of a fluid called lymph in the affected areas.  

Causes of Elephantiasis

In areas where filariasis is endemic, the cause of elephantiasis mostly is a parasitic disease known as lymphatic filariasis and, in the literature medical, the terms lymphatic filariasis and elephantiasis may be used interchangeably. Elephantiasis is due to lymphatic filariasis may also be referred to as “true” elephantiasis. In the most areas, the lymphatic damage associated with elephantiasis has other causes including certain sexually transmitted diseases (e.g., lymphogranuloma venereum); tuberculosis; an infectious disease called leishmaniasis; repeated streptococcal infections; leprosy; and environmental factors such as exposure to certain minerals (e.g., silica). In some cases, no cause can be identified (idiopathic). 

Disease Burden

The World Health Organization (WHO) estimates that worldwide there are:

• More than 1 billion people at risk for infection, one third live in Africa
• More than 120 million people infected, 40 million live in Africa
• 44 million people with symptoms

Diagnosis

Definitive diagnosis of LF is through identification of the microfilariae in blood samples taken at night. A newer immunodiagnostic test, based on the detection of antigens of W. bancrofti, is highly specific and sensitive. An added benefit of this test is that blood samples do not have to be taken at night.

Treatment for Elephantiasis

• A combination of albendazole and diethylcarbamazine (DEC)
• 600 million tablets of Albendazole are donated by GlaxoSmithKline each year
• 2.2 billion tablets of DEC are donated by Eisai between 2014 and 2020
• In cases of acute swelling/lymphedemic episodes, careful cleansing of the skin to remove bacteria can reduce or reverse skin or tissue damage
• There is no cure for the disease, but symptoms can be managed with the current treatment plan
• Currently no vaccine exists for lymphatic filariasis