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RANJAN BANERJEE BIOL 062 NOVEMBER 20 TH 2008 Lymphatic Filariasis
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What is Lymphatic Filariasis? Parasitic disease of lymphatic system
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What is Lymphatic Filariasis? Parasitic disease of lymphatic system Circulates in blood
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What is Lymphatic Filariasis? Parasitic disease of lymphatic system Circulates in blood Almost exclusively in humans
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What is Lymphatic Filariasis? Parasitic disease of lymphatic system Circulates in blood Almost exclusively in humans Among world's leading causes of disability
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What is Lymphatic Filariasis? Parasitic disease of lymphatic system Circulates in blood Almost exclusively in humans Among world's leading causes of disability Increasing due to unchecked urbanization
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Prevalence Endemic in tropical regions Asia, Africa, Central/South America
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Prevalence >120 million people infected 1 billion at risk for infection
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Cause Three worms Wuchereria bancrofti - 90% of cases Brugia malayi Brugia timori
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Transmission cycle is complicated CDC Public Image Library
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Risk Group People in tropical/subtropical regions www.groovythemes.com/nature/tropics.shtml
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Repeated mosquito bites over many years dvice.com/archives/2008/07/sk_telecom_offe.php
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Symptoms Most due to dysfunctional lymphatic system The Physiotherapist Pte Ltd.
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Symptoms Lymphedema Gangrene
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Symptoms Genital damage - hydrocele 10-50% men http://img.tfd.com/dorland/hydrocele.jpg
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Filarial antigens provoke immune responses Increasing levels of IgE and IgG4
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Symptoms (cont’d) pulmonary tropical eosinophilia syndrome Inflammation of the lung Cough, shortness of breath myweb.lsbu.ac.uk/dirt/museum/p6-633.html
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Symptoms Manifestation may take years
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Diagnosis Giemsa stain – differential stain
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But doing smear is complicated.. Nocturnally periodic Nuchprayoon et al. Filaria Journal 2007 6:6 doi:10.1186/1475-2883- 6-6
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Serology is another method Immunoglobulin test - antifiliarial IgGs
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Treatment diethylcarbamazine (DEC) Kills microfilarae Prevents transmission Albendazole Kills adults and microfilarae
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Slightly different in Africa Ivermectin instead of DEC Side effects with other diseases River blindness
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Secondary Treatment Good hygiene is important http://www.a-wol.net/images/on_legs.jpg
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Socio-economic Impact Disease of the poor Incapacitates cycle http://www.bbc.co.uk/radio4/today/gallery/media/poverty2.jpg
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Social stigma “Her husband left her when he realized that her legs would not shrink, she said. As her new boyfriend, a handsome out-of-work carpenter, sold goods nearby, she said, "I don't know if he will leave me, too.” - Antoinette St. Fab
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Efforts In 1993 identified as one of six eliminable infectious diseases In 1997, World Health Assembly called for elimination of LF worldwide
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WHO: Global Programme to Eliminate LF Goal 1: break cycle of transmission MDA Combination therapy Donated Drugs
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WHO: Global Programme to Eliminate LF Goal 2: Alleviate suffering in infected persons Community education programs Community care © Global Alliance to Eliminate Lymphatic Filariasis
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Future September 20 th, 2007 – genome of Brugia malayi mapped Vaccine? http://wishart.biology.ualberta.ca/BacM ap/cgview_linked_maps/NC_006833/p ng/1_1.png
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