Historical Accounts of Wuchereria bancrofti Infections

What is Elephantiasis?

Wuchereria bancrofti is the filarial worm that causes the disease called elephantiasis. This is a chronic disease in which the parasitic worms (Wuchereria bancrofti) obstruct the lymphatic system, resulting to the enlargement of body parts, such as the scrotum and legs, and toughening of the skin that surrounds these body parts. The worm requires an insect (usually mosquito) as an intermediate host, before reaching its definitive hosts (reptiles, amphibians, birds, mammals), where it causes severe infections. The filarial worm is a nematode belonging to family Onchocercidae. This worm is highly pathogenic, like its closest Onchocercidaean relatives: Brugia, Onchorcerca, and Loa (Matthews 1998; Smyth 1994).

Elephantiasis is technically called Bancroftian filariasis in medicine, but the disease is widely called Elephantiasis, because it relates the very characteristics of patients suffering the disease: body parts that abnormally grow as big as elephant organs. Infected men can have a scrotum that is enlarged to many times its normal size. Patients with enlarged legs cannot not work efficiently, and most probably become unemployed. Because the disease is horrifying and tragic, people in the past recorded or depicted patients in written, oral, and graphical accounts.

Accounts of Elephantiasis

Ancient Roman and Greek writers might have been the first to call the disease “elephantiasis,” because they likened the thickened and fissured skin of infected individuals to that of elephants. They confused the disease with a more severe form of leprosy, which forced infected persons away from society to avoid the transmission of the disease. The disease is not actually transmittable between persons; it can only be acquired if an individual is bitten by a mosquito containing Wuchereria bancrofti. It took centuries before the disease was fully understood, though, probably through the observations of worms and eggs in autopsied bodies. It is important to note that Wuchereria bancrofti is not the only filariod having the ability to cause elephantiasis, but also other filariods capable of invading the lymphatic system (Matthews 1998; Smyth 1994).

American soldiers in the Pacific during the World War II faced great psychological concerns, as they imagined themselves going home carrying their enlarged scrotum. People would laugh at them, and their military career would end once their organs did not return to normal. Fortunately, some of the soldiers did not actually develop the symptoms of classical filariasis (enlarged legs and scrotums), but many did experience painful symptoms for as long as 16 years.

Recent estimates show that there are 120 million cases of Bancroftian filariasis in the world today. Ninety percent of lymphatic filariasis is caused by the Wuchereria bancrofti and the other ten percent is caused by other filarial worms. Cases of filariasis are prevalent in the Nile River delta, central Africa, Turkey, the Philippines, Australia, India, South America, and other tropical places. Parasitologists believed that the disease was brought to the New World via the slave trade (Matthews 1998; Smyth 1994).

References

Matthews, Bernard. 1998. An Introduction To Parasitology. Cambridge University Press.

Smyth, James. 1994. Introduction To Animal Parasitology. Cambridge University Press.