River Blindness

River blindness also called as Onchocerciasis, is an infectious disease caused by the

parasitic worm named Onchocerca volvulus. This disease has been the second-most common
cause of blindness due to infection after trachoma (1). There are more than eighteen million
people in the World that are affected by this disease. Most of the cases are found in Africa.

Cause

The disease is caused and transmitted in humans by the bite of black fly (simulium
species). These flies are found and breed fast flowing streams and rivers and thus increasing the
risk of disease in nearby areas. The disease is named “river blindness” after the reason that its
transmission factor is found near rivers. These flies transmit larvae that ultimately turn into
adult filarae (2). The adult female worm (macrofilaria) produces thousands of baby or larval
worms within the human body which migrate in the skin and the eye.

Symptoms

It may take years for symptoms to show up in this disease. The following are the major
symptoms of river blindness:

1. Rashes on skin
2. Itching on skin
3. Appearance of bumps under the skin
4. The loss of elasticity of skin
5. Itching in eyes
6. Light sensitivity
7. Loss of vision
8. Changes in skin pigmentation
Diagnosis

There are many ways to diagnose this disease. The first way is clinical in which doctors
analyze the skin to identify the nodules. The alternative way is the skin patch test using a drug
diethylcarbamazine (DEC), called Mazzotti test (2).

Cure/ Treatment

The most common treatment used for river blindness is ivermectin. It is thought to be
directly effective against the larval microfilae stage of Onchocerca volvulus (3). Mixodectin is
also used for people over age of 11 years in United States. It’s multiple dose safety is still
unclear (4).

Preventions

The distribution of onchocerciasis is related to the distribution of flies that is naturally

found near the fast running streams, this is why this disease is found more in Africa. As there is
no vaccine available for river blindness yet, so it is best to prevent by avoiding being bitten by
blackflies. For this purpose, people there should wear long sleeves and use insect repellant.

References

1. "Onchocerciasis (also known as River Blindness)". Parasites. CDC. 21 May 2013. Archived
from the original on 26 February 2014. Retrieved 20 March 2014.
2. Clinics in Dermatology Volume 24, Issue 3, May–June 2006, Pages 176-180 Clinics in
Dermatology Onchocerciasis—river blindness Claes D.EnkMD
3. Rea PA, Zhang V, Baras YS (2010). "Ivermectin and River Blindness". American Scientist.
98 (4): 294–303. Archived from the original on 2010-07-05. Retrieved 2010-06-20.
4. "Moxidectin tablets, for oral use" (PDF). www.accessdata.fda.gov. Retrieved 7 January
2019.
5. "Onchocerciasis Fact sheet N°374". World Health Organization. March 2014. Archived
from the original on 16 March 2014. Retrieved 20 March 2014.
6. "Onchocerciasis (also known as River Blindness) Prevention & Control". Parasites. CDC.
May 21, 2013. Archived from the original on 19 April 2014. Retrieved 20 March 2014.
7. Murray, Patrick (2013). Medical microbiology (7th ed.). Philadelphia: Elsevier Saunders.
p. 792. ISBN 9780323086929. Archived from the original on 2017-09-08.
8. Brunette, Gary W. (2011). CDC Health Information for International Travel 2012 : The
Yellow Book. Oxford University Press. p. 258. ISBN 9780199830367. Archived from the
original on 2017-09-08.
9. GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016).
"Global, regional, and national incidence, prevalence, and years lived with disability for
310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of
Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-
6736(16)31678-6. PMC 5055577. PMID 27733282.
10. "Onchocerciasis (also known as River Blindness)". Parasites. CDC. 21 May 2013. Archived
from the original on 26 February 2014. Retrieved 22 April 2015.