Elephantiasis
THERE was a picture that went viral recently, showing several naked men almost sitting on their giant scrotum, which was almost 4 times the size of their head. This is one impressive photo that is a diagnostic giveaway: Elephanthiasis.
What is Elephanthiasis?
The name alone suggests the condition of “largeness,” characteristically individual victims of the condition developing large head, trunk, limbs, scrotum, and, in women, enlarged female organ.
What causes Elephanthiasis?
This entity which is common in African nations could be caused female mosquito bite (same one that causes dengue and malaria). The infection produces millions of tiny Filaria worms that block lymph channels. Elephanthiasis is also suspected to be caused by stepping on red soil in this barefooted people live, where the chemical particles in the soil enter through the skin and irritate and block lymph channels, leading to repeated streptococcal lymphangitis infections. The back pressure from the block lymph channels result in dilatation of the channels and extreme, grotesque, swelling of the parts of the body involved, like basket-ball sized scrotum, massive breasts, elephant-sized arms and legs. Without medical care, the affected tissues may die from blockage of blood supply also, leading to gangrene.
What are the symptoms?
Malaise (weakness and tiredness), chills and fever may be present. Abnormal swelling of the body parts from excessive accumulation of body fluids (lymph) results in massive swelling, leading to thickened skin, which may become pigmented and ulcerated. As stated earlier, the male and female genitalia could be affected and grow to gigantic sizes. The skin around the penis could be so thickened as to be hot and painful. The spermatic cord may also suffer the same fate. The female organs may also be thickened and ulcerated, leaving a tumor-like hard mass in between the thighs. The groin lymph nodes may be enlarged. Elephantiasis may also affect the male and female genital organs. In a male, there may be enlargement of the scrotum, and the penis may be retracted under skin which has become thickened, non-elastic, hot and painful. The spermatic cords may become thickened.
What is the treatment?
The medical management may include chemotherapy to kill the Filaria worms and also treatment of the symptoms caused by the body’s reaction to the dead worms in the tissues. Some cases also respond to lymphatic massage, which is still investigational and under study. Some of the drugs used include Suramin (Antrypol ), Diethylcarbamazine (DEC, Heterazan, Banocide, and Notezine ), Ivermectin (Mectizan), Metrifonate (Trichlorphon), Mebendazole and Levamisole have shown to be effective in treating conditions associated with a filarial infection. For secondary bacterial infection, antibiotics are used. Surgery is recommended to remove or bypass the blocked lymph channels.
Is there Elephanthiasis in the Philippines?
Filariasis causing elephanthiasis is endemic in 45 of the 77 provinces in the Philippines where the condition has been found: 25 percent in Luzon, 19 percent in Visayas, and 56 percent in Mindanao. The incidence seems to be higher among abaca and banana plantation workers, because the leaves collect water and are favorite breeding grounds of mosquitoes. There are actually about 650,000 documented cases in the Philippines. Worldwide, there are about one billion people in 81 countries, 23 million of them Filipinos, who are at risk of the infection, which is a leading cause of disability with massive economic impact.
Any preventive medication?
A research group in Liverpool, England, has discovered that the antibiotic doxycycline is effective as a preventive drug. More studies are ongoing. Just like any other diseases, prevention is the key.
Any new drugs on the horizon?
GlaxoSmithKline and Merck are investigating a combination of two drugs, which the World Health organization is optimistic about in eradicating the disease in eight years, by 2020. The current global programs appear to be making great strides in this direction.
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Response to our readers’ emails
Since our health book, Let’s Stop “Killing” Our Children, came out in the United States in August last year, we have received a lot of email inquires when the Philippine edition (also in English) was to be published locally. Our publisher in Quezon City, Central Books (Phone: 02-372-3550), which has stores around the country, announced the release of this 800-page coffee-table book this week. Inquiries may also be made with National Book Stores and C&E (Cebook) Shops. Online, it is available at philipSchua.com, xlibris.com, amazon.com, and at barnesandnoble.com The book proposes “disease prevention and healthy lifestyle to start at the cellular, DNA, level to protect the integrity of the children’s DNA to save them from acquiring common major diseases that adults have today, which are actually preventable, including high blood pressure, diabetes, heart attack, stroke, Alzheimer’s, and even cancer.” This guide contains evidence-based practical tips and pointers effective in preventing these diseases and their complications. Our children, the future generations, do not have to have these so-called “expected normal diseases of the middle age and old age,” which are not really “normal” nor bound to happen. They are preventable, if we start at Ground Zero, the cellular level, when the kids are in the womb and in the crib, when healthy habits and behaviors must start, if all those diseases are to be prevented. Living a healthy lifestyle when one reaches the teen years is 13 years too delayed. The race against diseases is best started not in the middle but at the starting line, if we are to win.
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