Sasha Anne L.

Valdez
OUTLINE FOR MODULE 6:

1. Wuchereria bancrofti
2. Brugia malayi
3. Onchocerca volvulus
4. Loa loa
5. Dracunculus medinensis
Module 6 : Nematodes Part 2

Module Objectives:

1. Identify the major morphological differences of

blood and tissue nematodes.
2. Familiarize the significant blood and tissue
nematodes that infect humans (morphology, life
cycle, symptoms, diagnosis, treatment, control and
prevention.
The major blood and tissue parasites of man are
microfilaria. These include Wuchereria bancrofti and
Brugia malayi, Onchocerca volvulus, Loa loa (eye worm)
Trichinella spiralis and Dracunculus medinensis.

https://pt.slideshare.net/HazelMarieBarcela/introduction-to-tissue-nematodes-and-filarial-worms/10
https://www.scribd.com/presentation/329 https://slideplayer.com/slide/9986023/
416619/Blood-and-Tissue-Nematodes

reproduction https://slideplayer.com/slide/3461483/
 • named for Otto
Wucherer, who
discovered the
microfilariae, & Joseph
Bancroft who 1st found
the adult worms.

• is one of the three

parasites that cause
lymphatic filariasis.

Humans serve as
https://www.mcdinternational.org/trainings/malaria/english/DPDx5/H
the definitive host.
TML/ImageLibrary/A-F/Filariasis/body_Filariasis_il1
• common name = Bancroft’s filaria

• it affects over 120 million people,

primarily in Africa, South America, and
other tropical and sub-tropical
countries.
• found throughout the tropics as in the
Figi Islands, Samoa, China, Japan, Korea,
Thailand, Malaysia, Philippines & others.

• Bancroftian filariasis, Elephantiasis

https://www.medicalnewstoday.com/articles/321797
https://www.wikidoc.org/index.php/Filariasis_epidemiology_and_demographics
• The parasite is carried from person to person by
mosquitoes.

• 120 million people are infected in subtropical and tropical

Asia (mostly in India), Africa, the Pacific and the
Americas (mostly in Brazil, Haiti, Guyana and the
Dominican Republic).

• Lymphatic filariasis is the leading cause of permanent

disability worldwide.

• Out of the 120 million more than 30 % are severely

incapacitated by the disease.

• Over one billion people in over 80 countries are at risk of

getting infected.
•W.bancrofti has a larger distribution :
Asia (China, India, Indonesia, Japan,
Malaysia, Philippines, South-East
Asia, Sri Lanka, Tropical Africa,
Central and South America, Pacific
Islands.
https://www.slideshare.net/HazelMarieBarcela/wuchereria-bancrofti-57456676
➢ Bluntly round
anteriorly and
pointed caudally
body.

➢ Graceful , sweeping
curves appearance.

➢ Pale sheath.

➢ Note : The absence

of terminal nuclei.
https://www.onlinebiologynotes.com/wuchereria-bancrofti-
morphology-life-cycle-and-epidemiology/
Microfilaria of Wuchereria bancrofti. The microfilaria is
sheathed, with eosinophil in left corner.(H&E,40x)

https://www.researchgate.net/figure/Microfilaria-of-Wuchereria- https://www.jaypeedigital.com/book/97893525
bancrofti-The-microfilaria-is-sheathed-with-eosinophil-
in_fig1_269521396 00185/chapter/ch61
https://www.researchgate.net/figure/Microfilaria-of-
Wuchereria-bancrofti-in-a-thick-film_fig7_277944110
The microfilariae can be found
free in the fluid within the
nodules and in the dermal
layers of the skin spreading
centrifugally from the area
where an adult lies.

Microfilariae also can be

found in the blood and eye
during heavy infections.

first stage larvae are known as MICROFILARIAE. The

microfilaria are present in the circulation. The
microfilaria migrate between the deep and the peripheral
circulation. During the day they are present in the deep
veins and during the night the migrate to the peripheral
circulation.
The microfilariae are found mainly in the
peripheral blood and can be found at peak
amounts from 10p.m. to 2 a.m. The cause
of this periodicity remains unknown but
the advantages of the microfilariae being
in the peripheral blood during these hours
may ensure that the vector, the night time
mosquito, will have a higher chance of
transmitting them elsewhere.

https://www.slideshare.net/HazelMarieBarcela/wuchereria-bancrofti-57456676
➢ The adult male worm is long &
slender, between 4 & 5 cms. in
length, a tenth of a centimeter
in diameter, & features a
curved tail.

➢ The female is 6-10 cms. long, is

ovoviviparous (gives birth to
microfilariae), & three times
larger in diameter than the
male. This size deviation can
be attributed to the vast
numbers of microfilariae
that the female produces each
day. Posterior end
is narrow & abruptly pointed.

https://thebiologynotes.com/wuchereria-
bancrofti-habitat-morphology-and-life-cycle/
 ➢ Elongate,
bluntly
rounded
anteriorly &
pointed
caudally.

➢ measures
244-96 micra
in length.

https://alchetron.com/Wuchereria-bancrofti
• Different species of the following genera of
mosquitoes (IHs) are vectors of W. bancrofti
filariasis depending on geographical distribution.
• Among them are: Culex (C. annulirostris, C.
bitaeniorhynchus, C. quinquefasciatus, & C.
pipiens); Anopheles (A. arabinensis, A.
bancroftii, A. farauti, A. funestus, A. gambiae,
A. koliensis, A. melas, A. merus, A. punctulatus
& A. wellcomei); Aedes (A. aegypti, A. aquasalis,
A. bellator, A. cooki, A. darlingi, A. kochi, A.
polynesiensis, A. pseudoscutellaris, A. rotumae,
A. scapularis, and A. vigilax); Mansonia (M.
pseudotitillans, M. uniformis); Coquillettidia (C.
juxtamansonia).
 They infect their fly vectors while the flies are
feeding on the human host and mature into stage
three infective larvae in the flies flight muscles (in
about 10 days).

A mosquito is the intermediate host and

carrier. The most common vectors/carriers
are:
in Africa: Anopheles species
in the Americas: Culex quinquefasciatus
in the Pacific and in
Asia: Mansonia and Aedes species. https://irac-online.org/pests/anopheles-spp/

http://entnemdept.ufl.edu/creatures/aqu https://www.researchgate.net/figure/Adult-Mansonia-
https://www.caryinstitute.org/news-
atic/southern_house_mosquito.htm titillans-Photo-r-Sean-McCann_fig4_280638351 insights/podcast/who-needs-aedes-mosquitoes
https://mectizan.org/news-resources/life-cycle-lymphatic-filariasis/
2 types of Disease:

1. Urban – abaca raising areas (water

accumulated in abaca axils)
• Bicol region, Quezon, Masbate,
Mindoro, Mindanao & Sulu.

2. Rural – clear running mountain streams

• Bontoc, Mt. Province, Palawan & Sulu.

The pathogenesis of W. bancrofti infection is
dependent on the host's immune system and
inflammatory responses.

1. Asymptomatic Phase

https://www.slideshare.net/alubajessabeth/wuchereria-bancrofti-39245224
https://www.slideshare.net/alubajessabeth/wuchereria-bancrofti-39245224

2. Inflammatory (Acute Phase)

The individual will exhibit fever, chills,

skin infections, painful lymph nodes,
The antigens from the female adult worms and tender skin of the
elicit inflammatory responses. lymphedematous extremity.
https://www.slideshare.net/SyedMohammad14/microfilariae-wuchereria-bancrofti

https://www.globalcitizen.org/en/content/ntds-
explainer-lymphatic-filariasis/ https://twitter.com/who/status/1049259349519060992
 These symptoms often lessen after 5-7 days.
Other symptoms that may occur include:

Orchitis -inflammation of the testes, which

is accompanied by painful
immediate enlargement. It can be
caused by either a bacterial or viral
infection.

Epididymitis - which is the inflammation of

the spermatic cord.

Typically, the roundworms travel to lymph vessels, mate, then the female
produces millions of offspring called microfilariae, into the blood.The
adult worms typically survive for 5–7 years. This infection most commonly
results in lymphedema (or lymphatic obstruction which is a long-term
condition where excess fluid collects in tissues causing swelling/ edema).
3. Obstructive (Chronic) Phase

- marked by lymph varices, lymph

scrotum, hydrocele, chyluria* (lymph in
urine), and elephantiasis.

- Microfilariae are not normally present in this

phase.

- A key feature of this phase is scar formation

from affected tissue areas.
*a milky bodily fluid consisting of lymph and emulsified fats, or free fatty
acids (FFAs). It is formed in the small intestine during digestion of fatty
foods, and taken up by lymph vessels.
a type of swelling in the scrotum that occurs when
fluid collects in the thin sheath surrounding a
testicle.
https://www.slideshare.net/rajud521/filarial-nematodes
 In women, the
legs and arms are
https://www.goldjournal.net/article/S0090-
affected. Some
4295(04)01048-9/fulltext on their breasts.

Elephantiasis affect men

mainly on the legs, arms,
and scrotum.
https://www.sciencephoto.com/media/257034/view/woman-with-
a-breast-enlarged-by-elephantiasis
PATHOLOGY
Sequence of events:
1. biological incubation period lasts 1 year
or more.
2. Patent (evident, obvious) symptomless
period.
3. Acute stage w/ lymphangitis,
lymphadenitis, “filarial fever” as the
conspicuous symptoms.
4. Chronic stage develops w/ the
enlargement of the involved organ.
https://www.researchgate.net/figure/Symptoms-of-Lymphatic-Filariasis-23-25_fig1_312053588
Figure: Clinical classification of filariasis. * = Hydrocele results from accumulation of straw coloured fluid in sac covering the
testicles; # = Rupture of dilated lymph vessels causes lymph to accumulate in affected body site called chyluria.

https://pubs.rsc.org/en/content/articlehtml/2017/ra/c7ra01857f
 Treatment

The severe symptoms caused by the parasite can be

avoided by cleansing the skin, surgery, or the use of
therapeutic drugs, such as Diethylcarbamazine (DEC)
, ivermectin, or albendazole.

The drug of choice however, is DEC, which can eliminate

the microfilariae from the blood and also kill the adult
worms with a dosage of 6 mg/kg semiannually or annually.

A polytherapy treatment that includes ivermectin with DEC

or albendazole is more effective than each drug alone.
It has some side effects which include: dizziness, fever,
headache, nausea and muscle and joint pain.

DEC should only be used, if Wuchereria bancrofti has been

identified. This is because most people with lymphedema
are not infected with parasites.

In some cases lymphedema can be prevented from getting

worse by exercising the swollen leg or arm to improve the
lymph flow. The swollen skin is vulnerable to bacterial
infections because immune defences cannot work properly
due to the impaired flow of fluids. That is why the skin
must be kept clean by washing it with soap and water daily.

According to some new studies Wolbachia bacteria are in

symbiosis with Wuchereria bancrofti. The bacteria live
inside the worm. If the bacteria are killed with
antibiotics, Wuchereria bancrofti dies, too.
 https://link.springer.com/chapter/10.10
07/978-3-319-14493-1_26

https://www.slideshare.net/mainwi_k/trends-in-the-management-of-lymphedema-presentation

Modified Charles’ Procedure and

Its Combination with Lymph Node
Flap Transfer for Advanced
Lymphedema

Charles operation (total lymphangiectomy*) The leg is

normal size but has become hyperkeratotic.
*Excision of a lymphatic vessel.
 UNICEF is supporting a mass
distribution of mosquito nets

https://www.unicef.org/sudan/stories/why-mosquito-nets-are-affective

Avoiding and controlling the disease vector, mosquito, is the most effective prevention.

Sleep under a mosquito net in endemic areas

Use insect repellent between dusk and dawn or other peak vector hours

Eliminating vector habitat (i.e. puddles and stagnant pools of water)

Insecticide-impregnated materials

Taking a yearly preventative dose of ivermectin or DEC can also kill any circulating
worms before clinical symptoms develop. This should only be practiced in “at risk”
populations in endemic areas.
Prognosis, in the absence of elephantiasis, is
good.

Eradication

The WHO is coordinating an effort to eradicate

filarisis. The main stay of this programme is the
mass use of antifilarial drugs on a regular basis for
at least 5 years.

In April 2011 Sri Lanka was certified by the WHO

as having eradicated this disease.
 Kingdom: Animalia
Phylum: Nematoda
Class: Secernentea
Order: Spirurida
Family: Onchocercidae
Genus: Brugia
Species: B. malayi
(Brug 1927)

https://web.stanford.edu/group/parasites/ParaSites2009/JuliaLiebner_
Brugiamalayi/JuliaLiebner_Brugiamalayi.htm
 • Identified by
Lichtenstein

• formerly
known asFilaria
malayi

Common Name : Malayan filarial worm,

producing malayan
filariasis
https://web.stanford.edu/group/parasites/ParaSites2009/JuliaLiebner_
Brugiamalayi/JuliaLiebner_Brugiamalayi.htm
 https://web.stanford.edu/group/parasites/ParaSites2006/Lymphatic_filariasis/Epidemiology.htm

Geographical occurence of agents of lymphatic filariasis:

•Wuchereria bancrofti is encountered in tropical areas worldwide

•Brugia malayi is limited to Asia
•Brugia timori is restricted to some islands of Indonesia

Geographical occurence of other agents causing filariasis:

•Onchocerca volvulus (river blindness) occurs mainly in Africa, with
additional foci in Latin America and the Middle East
•Loa loa and Mansonella streptocerca are found in Africa
•Mansonella perstans occurs in both Africa and South America
•Mansonella ozzardi occurs only in the American continent
B. malayi infects 13 million people in south and southeast
Asia and is responsible for nearly 10% of the world’s total
cases of lymphatic filariasis.

B. malayi infection is endemic or potentially endemic in 16

countries, where it is most common in southern China and
India, but also occurs in Indonesia, Thailand, Vietnam,
Malaysia, the Philippines, and South Korea.

The distribution of B. malayi overlaps with W. bancrofti in

these regions.
• infects a # of wild & domestic animals
& is restricted to South-East Asia
(Indonesia, Borneo, New Guinea, China,
Korea, India & the Phils.

• Mosquitoes are vectors. (Mansonia)

• found in Quezon, Palawan, Bongao, Sulu,

Agusan, Eastern Samar.

• appears that the disease is endemic in

areas where fresh water swamps exist.

https://www.wrbu.si.edu/vectorspecies/genera/mansonia
 https://www.researchgate.net/figure/Schematic-drawing-the-anatomy-of-adult-stage-B-malayi-and-distribution-of-Wolbachia_fig2_51181525

Adult worms resemble the classic nematode roundworm.

Long and threadlike, B. malayi and other nematode possess only longitudinal
muscles and move in an S-shape motion.

Adults are typically smaller than adult W. bancrofti, though few adults
have been isolated. Female adult worms (50 mm) are larger than male
worms (25 mm).
 https://www.cdc.gov/dpdx/lymphaticfilariasis/index.html

• 200-275 um in length and have a

round anterior end and a pointed
posterior end.

•The microfilariae are sheathed,

which stains heavily with Giemsa.

•The sheath is actually the egg shell,

a thin layer that surrounds the egg
shell as the microfilariae circulates in
the bloodstream.

•The microfilariae retain the sheath

until it is digested in the mosquito
midgut.
 Microfilaria of B.malayi. Like W.bancrofti,
this species has a sheath. Differently
from Wuchereria, the microfilariae in
this species are more tightly coiled,
& the nuclear column is
more tightly packed,
preventing the
visualization
of individual cells.

https://web.stanford.edu/group/parasites/ParaSites2009/JuliaLiebner_
Brugiamalayi/JuliaLiebner_Brugiamalayi.htm
 https://web.stanford.edu/group/parasites/ParaSites2009/JuliaLie
bner_Brugiamalayi/JuliaLiebner_Brugiamalayi.htm

Detail from the microfilaria of Brugia malayi

showing the tapered tail, with a subterminal
& a terminal nuclei (seen as swellings at the
level of the arrows), separated by a gap
without nuclei. This is characteristic of
B. malayi.
https://web.stanford.edu/group/parasites/ParaSites2006/Lymphatic_filariasis/Introduction.htm
Brugia malayi, which
infects humans and
animals, as well as other
zoonotic species.
 They migrate
to the lymphatics,
where they
develop into
adults, a slow
process that
can require
up to 18 months.

Inside the mosquito,

the microfilariae develop in 1
to 2 weeks into infective
filariform (third-stage) larvae.

https://www.cdc.gov/parasites/lymphaticfilariasis/biology_b_malayi.html
https://pubs.rsc.org/en/content/articlehtml/2017/ra/c7ra01857f
• Pathology similar to W.bancrofti.

• observed symptoms are allergic in

nature such as asthmatic attacks,
adenopathy, eosinophilia & in
advanced cases, elephantiasis of the
groin & upper extremities instead of
the lower as observed in W.bancrofti.
Treatment

➢ same as for bancroftian filariasis. Diethylcarbamazine (DEC) has

been used in mass treatment programs in the form of DEC-medicated
salt, as an effective microfilaricidal drug in several locations, including
India.

➢ While DEC tends to cause adverse reactions like immediate

fever and weakness, it is not known to cause any long-term
adverse drug effects.

➢ DEC has been shown to kill both adult worms and microfilariae.
Microfilariae numbers slowly return many months after treatment,
thus requiring multiple drug doses over time in order to achieve long-
term control. However, it is not known how many years of mass drug
administration is required to eliminate transmission. But currently,
there have been no confirmed cases of DEC resistance.
is the world's second
leading infectious
cause of blindness.
Kingdom: Animalia
Phylum: Nematoda
Class: Secernentea
Order: Spirurida
Family: Onchocercidae
Genus: Onchocerca
http://ruby.fgcu.edu/courses/davidb/50249/
web/oncho%20171.htm
Species: O.volvulus
(Bickel 1982)
➢ Human onchocerciasis is found in both the Old
and New World but about 96% of all cases are
in Africa and mostly in Western Africa.

➢ Of the 36 countries where the disease is

endemic, 30 are in sub-Sahara Africa (plus
Yemen) and six are in the Americas.

➢ Important foci exist also in Mexico, Guatemala,

Venezuela and Ecuador.

➢ A total of 18 million people are infected with

the disease and have dermal microfilariae, of
whom 99% are in Africa.
• Blinding filariasis; river blindness;
Onchocerciasis

• prevalent throughout eastern, central

& western Africa, where it is the major
cause of blindness. In the Americas, it
is found in Guatemala, Mexico, Colombia
& Venezuela.
• disease is confined to neighborhoods of
low elevation with rapidly flowing small
streams where black flies breed.

• Man is the only host.

https://www.slideshare.net/yaaronmalam/onchocerca-volvulus-51978683
 https://www.sciencephoto.com/media/260308/view/onchocerca-volvulus-parasites

• wire-like, filiform & blunt at both ends.

Onchocerca volvulus parasitic worms. Light micrograph of a section through a skin nodule of a patient with
onchocerciasis or river blindness (Onchocerca worm infestation). A longitudinal section of an adult worm is
seen across centre, surrounded by connective tissue. An infestation begins when a host is bitten by a black
fly (Simulium sp.) carrying the worm larvae. One or more adult worms develop at the site of the bite and a
nodule of fibrous tissue forms around them due to the host's immune response. An adult worm produces
thousands of microfilariae, which are taken up by black flies to continue transmission of the parasite.
Microfilariae and Wolbachia
bacteria can cause various ocular
infections and lead to
blindness; this is often called
*"River blindness" because the
parasites and vector are
associated with rivers and
streams.

– Onchocerca is a significant cause

of blindness worldwide, and is
most common in areas of Africa.

https://www.drawittoknowit.com/course/immunology/glossary/im
munology-microbiology/nematodes-onchocerca-volvulus
After mating the female sheds
microfilariae 300 mm in length and 0.8
mm in diameter. The microfilariae are
sheathless with sharply pointed, curved
tails.

The microfilariae can be found free in the

fluid within the nodules and in the dermal
layers of the skin spreading away from the
nodules containing the adults.

Microfilariae also can be found in the

blood and eye during heavy infections.
 Microfilaria of O.volvulus
• Vector : Simulium
(Blackfly)

https://www.flickr.com/photos/4
4150996@N06/33255025582

Some important characteristics of

the microfilariae of this species are
shown here:

• no sheath present

• the tail is tapered and is sharply angled

at the end.
https://atm.eisai.co.jp/english/ntd/onchoserciasis.html
https://quizlet.com/338283243/tissue-roundworms-diagram/
https://www.cdc.gov/dpdx/onchocerciasis/index.html
microfilariae lifespan is 1–2 years.

they mature over the course of

one to three weeks to stage
three larvae. produce between 1,000
and 3,000 microfilariae per day.

The normal adult worm lifespan is up to fifteen years. The eggs mature
internally to form stage one microfilariae, which are released from the
female's body one at a time and remain in the subcutaneous tissue.
https://hscweb3.hsc.usf.edu/health/publichealth/news/dr-thomas-unnasch-appointed-chair-committee/
• fibrous nodules (onchocercomas)
develop around the adult worms in the
skin & subcutaneous tissues.

• elephantiasis sometimes result (adults

obstructing lymph flow) = hanging
groins.

• presence of microfilariae in the skin

cause severe dermatitis (itchiness),
thickening, discoloration & cracking of
skin.
SYMPTOMS
https://blogs.biomedcentral.com/bugbitten/2015/09/11/good-news-
https://www.healthline.com/health/onchocerciasis-river-blindness#1
mexico-river-blindness-eradication-confirmed/

https://www.thelancet.com/journals/lancet/article/
PIIS0140673610605867/fulltext
 http://www.diseasedaily.org/diseasedaily/article/shedding
-light-ntds-onchocerciasis-river-blindness-62518

• ocular complications may occur from

infxn of the scalp near the eye orbit
where the microfilariae migrate &
invade the cornea causing inflammation
of sclera leading to BLINDNESS.
https://www.researchgate.net/figure/The-burden-of-onchocerciasis-children-leading-blind-adults-in-Africa_fig1_265806979

The burden of onchocerciasis: children leading

blind adults in Africa.
• Diagnosis is based on symptoms, history of
exposure to black flies & presence of
microfilaria in nodules.

• Treatment and control

Diethylcarbamazine is effective in killing
the worm. Destruction of microfilaria
produces extreme allergic reaction w/c
can be controlled with corticosteroids.
Prevention measures include vector
control, treatment of infected indivs. &
avoidance of black fly.

• DEC can worsen Onchocerciasis.

Loiasis is endemic to 11
countries and 12 million
Africans are infected
mostly in Cameroon, Kingdom: Animalia
Equatorial Guinea, Gabon,
Phylum: Nematoda
Nigeria, the Central
African Republic, the Class: Secernentea
Democratic Republic of
Congo and the Republic of Order: Spirurida
the Congo. Family: Onchocercidae
Genus: Loa
Species: L.loa

https://www.nejm.org/doi/full/10.1056/NEJMicm1002020
https://web.stanford.edu/group/parasite
s/ParaSites2001/loiasis/loaloa.html

• African Eye worm,

producing African Loiasis
or Calabar
swellings

Lives under the skin in the subcutaneous fat causing

loiasis. Because it is often spotted migrating in the
eye, it is known as the eye worm.
Human loiasis geographical distribution is
restricted to the rain forest and swamp
forest areas of West Africa, being
especially common in Cameroon and on the
Ogowe river.

Humans are the only natural reservoir.

It is estimated that 12-13 million humans

are infected with the Loa loa larvae.
• adult worm is thread-like, whitish, &
tapers towards the cephalic end with
the male having a curved posterior.

https://www.slideshare.net/RendellApalin/micropara

• live in subcutaneous tissues of the chest

, axillas, groins, penis, scalp & eyes in
human. (life span: 15 yrs.)
microfilaria is about 0.25 mm long and 6–8 µm (micrometer = 0.001
mm) thick. It is sheathed, its tail is tapered and its nuclei extend to
the tip of the tail. It can only develop into a larva inside the
intermediate host (deer fly).

Loa loa is sheathed,

with a relatively dense
nuclear column; its tail
tapers & is frequently
coiled, & nuclei extend
to the end of the tail.

• diurnal* periodicity
https://www.pathologyoutlines.com/topic/parasitologyloaloa.html

* of or during the day.

nuclei extending to the tip of the tail.

http://www.med-chem.com/para-site.php?url=org/loaloa

https://twitter.com/underthe_scope/status/1262283748726497280
 http://www.ddtd.org/loiasis

Overlap of loiasis (black-and-white pie charts) and onchocerciasis (color map). Loiasis
was mapped with the Rapid Assessment Procedure for Loa (RAPLOA) where villagers
are asked for a history of worms in the eyes in their village. The Rapid Epidemiological
Mapping of Onchocerciasis (REMO) is done by monitoring the prevalence of nodules
caused by subcutaneous “nests” of adult O. volvulus worms. Credit: We thank Dr.
Zouré of the WHO for generating this map upon our request (November 2014).

DDTD has developed a rapid diagnostic test designed for the high-
resolution mapping of L. loa. The Loa Antibody Rapid Test is a
Research Use Only (RUO) device. It is intended for epidemiology
purposes and as a population surveillance tool. It is not used to
establish a definitive diagnosis or as a basis to recommend a
treatment to an individual person. This prototype is a model product
specifically built for initial field-testing and to receive feedback from
end-users in view of enhancing the design of future versions. The
Loa Rapid Antibody Test only detects if a person has been exposed
to L. loa in his or her lifetime; it cannot distinguish previous from
current infections.

https://youtu.be/j1sLwwXiORA Open link

• Chrysops (deer fly) the vector of human
loiasis.

https://influentialpoints.com/Gallery/Chrysops_viduatus_Square-
spot_Deerfly.htm

• Chrysops, C. silacea and C. dimidiata

https://www.cdc.gov/parasites/loiasis/biology.html
Filariasis such as loiasis most often
consists of asymptomatic microfilaremia.

Some patients develop lymphatic

dysfunction causing lymphedema.

Episodic angioedema* (Calabar swellings) in

the arms and legs, caused by immune
reactions are common.
*similar to hives, but the
swelling is beneath the skin
rather than on the surface.
https://www.slideshare.net/OshinManoharan/loa-loa-parasitology
https://www.slideshare.net/Arisha105/loa-loa-45422236
When chronic, they can form cyst-like
enlargements of the connective tissue
around the sheaths of muscle tendons,
becoming very painful when moved.

The swellings may last for 1-3 days, and may

be accompanied by localized urticaria (skin
eruptions) and pruritus (itching).
 https://wikem.org/wiki/Loa_loa

Subconjunctival migration of an adult worm to the eyes can

also occur frequently.

The passage over the eyeball can be sensed, but it usually

takes less than 15 min.

Gender incidence of eyeworms have approximately the

same frequency, but it tends to increase with age.

Eosinophilia is often prominent in filarial infections. Dead

worms may cause chronic abscesses.
https://www.slideshare.net/Arisha105/loa-loa-45422236
https://www.slideshare.net/VisionaryOphthalmology/loa-loa-cope-by-dr-nutman
https://slideplayer.com/slide/9317399/
in some cases, surgical removal of adult DEC can cause encephalopathy (brain disease) and
death in people who are infected with Loa loa.
worms followed by systemic treatment.

https://www.slideshare.net/VisionaryOphthalmology/loa-loa-cope-by-dr-nutman
 Another treatment used together with the
primary treatment. Its purpose is to assist
the primary treatment.

Apheresis is a medical procedure that involves removing whole blood from a

donor or patient and separating the blood into individual components so that
one particular component can be removed. The remaining blood components
then are re-introduced back into the bloodstream of the patient or donor.
Useful in the reduction of microfilariae in blood. DEC treatment follows.
https://www.slideshare.net/VisionaryOphthalmology/loa-loa-cope-by-dr-nutman
 Dracunculus medinensis
Kingdom: Animalia
Phylum: Nematoda
Class: Secernentea
Order: Spirurida
Family: Onchocercidae
Genus: Dracunculus
Species: D.medinensis
https://sites.google.com/site/dracunculusmedinensis1/

• Guinea worm or Medina worm

• fiery serpent of the Israelites
• Causative agent of dracunculiasis or
Guinea Worm Disease (GWD).

• It infects 50 M people.

• Found throughout Asia (southwestern) ,

Middle East, West Indies, Africa
(North, west & central) and
northeastern South America.
 https://slideplayer.com/slide/8627507/

https://www.slideshare.net/MerlynH/nematodes-55658827

https://steemit.com/health/@abbeycity/research-on-dracunculus-
medinensis-guinea-worm
The larvae are then
ingested by Cyclops
which actively
ingest them. Once
ingested, the larvae
mature into their
infective stage in
approximately 14
days and can then
reinfect humans.
https://www.slideshare.net/Kushalkumar44/dracunculus-medinensis-guinea-worm

https://www.omicsonline.org/mexico/dracunculiasis-peer-reviewed-pdf-ppt-articles/
 Once inside the body stomach
acid digests the water flea, but
not the Guinea worm larvae
sheltered inside.

The male worm dies after

mating and is absorbed.

https://steemit.com/health/@greenlife500eu/effects-of-dracunculus-medinensis-guinea-worm-201788t13383211z
Guinea worm disease used to thrive in some of the
world's poorest areas, particularly those with
limited or no access to clean water.

In these areas stagnant water sources may still

host microscopic, fresh-water arthropods known
as copepods (“water fleas"), which carry the larvae
of the Guinea worm.

https://www.cdc.gov/parasites/guinea
worm/epi.html https://constructionreviewonline.com/news/nigeria/nigeria-
pledges-to-deliver-potable-water-by-2030/
https://www.drawittoknowit.com/course/immunology/glossary/immunology-microbiology/nematodes-dracunculus-medinensis
 The female guinea
worm induces a
painful blister.

https://www.cdc.gov/dpdx/dracunculiasis/index.html

after rupture of the

blister, the worm
emerges as a whitish
filament (B) in the
center of a painful
ulcer which is often
secondarily infected.

https://www.cdc.gov/dpdx/dracunculiasis/index.html
 http://nemaplex.ucdavis.edu/Taxadata/Dmedinensis.HTM https://www.pinterest.ph/dferris123/para
sites/

https://web.stanford.edu/class/humbio10
3/ParaSites2003/Dracunculiasis/Main.html https://www.humanosphere.org/global-health/2012/09/endangered-species-guinea-worm/
Diagnosis

• Made from the local blister,

worm or larvae.

• outline of the worm under

the skin may be revealed
by reflected light.
https://www.slideserve.com/jeff/dracunculus-medinensis
 https://www.slideserve.com/jeff/dracunculus-medinensis

The larvae, which measure between 500 and 700

micrometers, can live for 6 days in clean water and 2 to 3
weeks in muddy water.
 https://blogs.biomedcentral.com/bugbitten/2021/02/02/bad-
news-for-guinea-worms/

Dracunculus medinensis worm wound around

matchstick. This helminth is gradually withdrawn
from the body by winding the stick.
Prevention

• protection of drinking water

from being contaminated with
Cyclops & larvae.
 Sudanese boys using
pipe filters to prevent
Guinea worm disease.

https://www.appropedia.org
/Guinea_Worm_pipe_filter