1. Onchocerciasis (River Blindness)

2. River Blindness, a parasitic disease, is the second leading infectious cause of blindness.

3. A Short History 1875: John O’Neill first reports the presence of microfilaria in Onchocerciasis patients in Ghana 1893: Rudolf Leuckhart describes morphology of adult worms in subcutaneous nodules 1917: Rodolfo Robles publishes findings on a “new disease” which includes subcutaneous nodules, anterior ocular lesions, dermatitis, and microfilariae 1995: WHO establishes The African Program for Onchocerciasis Control (APOC) 1975: Fungus that produces chemical toxic to parasitic worms discovered in Japanese soil sample, from which scientists develop avermectins 2009: First evidence that Onchocerciasis can be eliminated with Ivermectin published in the journal Neglected Tropical Diseases 1987: Merck & Co agrees to donate Ivermectin to all countries where River Blindness is endemic

4. River blindness is caused by a round worm, Onchocerca volvulus -

5. River blindness is transmitted to humans by the blackfly.

6. Life Cycle

7. Symptoms  Rashes  Lesions  Intense itching  Depigmentation of the skin  Lymphadenitis  General debilitation  Serious visual impairment  Blindness

8. River Blindness primarily affects the tropics of Africa and the Americas

9. 36 countries 29 in sub-Saharan Africa 6 in Latin America Yemen 120 million people at risk 96 percent in Africa Estimated 18 million infected 99 percent in Africa 99 percent of River Blindness cases occur in Africa

10. Ivermectin is a broad-spectrum antiparasitic that can be used to treat River Blindness

11. Ivermectin doesn’t kill adult worms, but prevents them from producing additional offspring Drug binds to and activates glutamate-gated chloride channels By activating channels, drug causes inhibitory postsynaptic potential Microfilaria experience paralysis and then death

12. What is Being Done APOC: African Programme for Onchocerciasis Control (1995) The Carter Center (1996) IDP: Ivermectin Distribution Program (1989-1994) Mectizan Donation Program (1987)

13. APOC countries: Angola, Burundi, Cameroon, Central African Republic, Chad, Congo, Democratic Republic of Congo, Ethiopia, Equatorial Guinea, Gabon, Kenya, Liberia, Malawi, Mozambique, Nigeria, Rwanda, Sudan, Tanzania and Uganda.

14. http://www.who.int/blindness/partnerships/onchocerciasis_disease_information/en/index.html http://emedicine.medscape.com/article/217776-overview http://www.irishhealth.com/article.html?id=285 http://news.bbc.co.uk/2/hi/health/6753003.stm http://www.stanford.edu/class/humbio103/ParaSites2006/Onchocerciasis/history%20of%20discovery.html http://www.cartercenter.org/health/river_blindness/index.html http://www.mectizan.org/onchocerciasis-maps http://www.dpd.cdc.gov/dpdx/html/frames/af/filariasis/body_Filariasis_o_volvulus.htm http://emedicine.medscape.com/article/224309-overview