How to Recognize and Prevent Lymphatic Filariasis

Medically reviewed by Janice Litza, MD

Last Updated: October 8, 2021 References

Lymphatic filariasis is a parasitic disease common to tropical areas worldwide. According to the WHO, the parasite is usually transmitted to humans through mosquitos, and it affects the lymphatic system—the system that fights infections and balances fluids in your body.^{[1]
X
Trustworthy Source
World Health Organization
Health information and news provided by the World Health Organization
Go to source} People suffering from the disease may have lymphedema (swelling from fluid build-up) and elephantiasis (engorgement and thickened skin, often of the leg). Learn to prevent lymphatic filariasis by avoiding mosquito bites that spread the disease, and recognize when an infection is present.^{[2]
X
Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source}

Method 1

Method 1 of 2:

Identifying Signs and Symptoms

1
Recognize lymphedema. Because the parasite infection damages the lymph system, the most common symptom is lymphedema–fluid buildup and swelling. This usually occurs in the leg or legs, but can also occur in one or both arms, breasts, and the genitalia.^{[3]
X
Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source} Lymphedema will make the affected area feel puffy, heavy, and swollen; sometimes pressing the skin will leave a small dent due to the fluid buildup. If you experience lymphedema, you should absolutely see your doctor; you can also try to minimize symptoms by:^{[4]
X
Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source}
- Elevating and exercising the swollen limb to improve the movement of fluids.
- Washing the affected area with soap and water daily to avoid skin infections.
- Using antibacterial or antifungal cream as needed, and properly disinfecting any wounds. Washing, disinfecting, and using fungal creams are meant to reduce infection of the affected leg. The swelling decreases circulation to the skin, so there is more risk for infection.
2
Identify elephantiasis. With a poorly functioning lymphatic system, it’s also harder for your body to fight infections. Bacteria can more frequently infect the skin, especially the damaged skin of areas suffering from lymphedema. Over time this causes hardening and thickening of the skin, known as elephantiasis.^{[5]
X
Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source}
- You can’t really prevent lymphedema, but you can try to prevent elephantiasis by warding off skin infections.^{[6]
  X
  Trustworthy Source
  Centers for Disease Control and Prevention
  Main public health institute for the US, run by the Dept. of Health and Human Services
  Go to source} Keep your skin clean and dry as much as possible and use antibacterial soap on affected areas. Wash your hands regularly. Keep any wounds or cuts in the skin clean and covered until they heal.
Advertisement
3
Check for a swollen scrotum. Men infected with LF may experience swelling in the scrotum. This is also due to fluid buildup, and is called a hydrocele.^{[7]
X
Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source} Sometimes hydroceles can resolve on their own after several months.^{[8]
X
Trustworthy Source
Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source} However, with a poorly functioning lymph system, it likely requires surgical treatment.^{[9]
X
Trustworthy Source
Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source}
4
Look for associated breathing problems. A rare disorder that can be caused by lymphatic filariasis is called pulmonary tropical eosinophilia syndrome. This is a pulmonary disorder (i.e. it affects the lungs), and can cause a persistent cough, shortness of breath, and wheezing or gasping for breath.^{[10]
X
Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source}
- Those infected usually live in Asia. If you experience these breathing symptoms and have spent time in tropical climates, get tested for LF.
- Pulmonary tropical eosinophilia syndrome can be diagnosed with a blood test. Blood will show high levels of eosinophils, a certain type of blood cell that increases when your body is exposed to allergens or parasites. You will also have high levels of immunoglobulin E (IgE) and antifilarial antibodies.^{[11]
  X
  Trustworthy Source
  Centers for Disease Control and Prevention
  Main public health institute for the US, run by the Dept. of Health and Human Services
  Go to source}
5
Know your risk factors. You are at the highest risk for infection if you spend a significant time (months to years) in a tropical or sub-tropical area where the disease is common (or endemic).^{[12]
X
Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source}
- The disease is present in over 73 countries in Asia, Africa, the Western Pacific, and some tropical areas of the Caribbean and South America (Haiti, the Dominican Republic, Guyana, and Brazil).^{[13]
  X
  Trustworthy Source
  Centers for Disease Control and Prevention
  Main public health institute for the US, run by the Dept. of Health and Human Services
  Go to source}
- Tourists visiting these areas for short times have a low risk of infection, but it’s still best to take preventative measures and be aware of symptoms.^{[14]
  X
  Trustworthy Source
  Centers for Disease Control and Prevention
  Main public health institute for the US, run by the Dept. of Health and Human Services
  Go to source}
6
Remember that symptoms may not develop for years after infection. The majority of people infected with lymphatic filariasis will never develop symptoms. However, a small number of those infected may start to have symptoms after being infected for years.^{[15]
X
Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source} Even if you haven’t lived in an endemic area for years, always consider lymphatic filariasis as a possible cause of symptoms associated with lymphatic dysfunction and severe swelling.
- Because there are other more common causes of lymphedema, it is important to tell your doctor if you have traveled to endemic areas. Your doctor is unlikely to consider filariasis without you sharing your travel history.
7
Get diagnosed. An infection with lymphatic filariasis will show up on a blood test if a doctor has the equipment to look for the worms under a microscope. The worms are sometimes nocturnal and only circulate in the blood at night, so the blood test has to occur from blood taken at nighttime.^{[16]
X
Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source}
- However, because symptoms might not occur until years after infection, some patients with LF will have a negative blood test. Other methods of diagnosing LF use blood serum to look for antibodies to the worms, which can be more accurate.^{[17]
  X
  Trustworthy Source
  Centers for Disease Control and Prevention
  Main public health institute for the US, run by the Dept. of Health and Human Services
  Go to source}

Method 2

Method 2 of 2:

Preventing Disease Transmission

1
Avoid mosquito bites at night. The worms that cause lymphatic filariasis are spread person-to-person through mosquito bites. Avoiding mosquito bites when in endemic areas is the best way to avoid infection, though it generally takes months to years of repeated bites to become infected.^{[18]
X
Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source} Protect yourself at night when mosquitoes are most active.
- Obtain a mosquito net for your bed to limit the pests’ access to you while you sleep.^{[19]
  X
  Trustworthy Source
  Centers for Disease Control and Prevention
  Main public health institute for the US, run by the Dept. of Health and Human Services
  Go to source}
- If possible, sleep in an air-conditioned room with closed windows.^{[20]
  X
  Trustworthy Source
  Centers for Disease Control and Prevention
  Main public health institute for the US, run by the Dept. of Health and Human Services
  Go to source}
2
Plan your outdoor activities for when the sun is up. The mosquitoes that transmit LF usually bite between dusk and dawn. When possible, limit your time outdoors in endemic areas to after dawn and before dusk – i.e. largely during daytime hours.^{[21]
X
Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source}
3
Cover your skin with clothing. As much as possible, wear long sleeve shirts, long pants, and socks. Cover as much skin as possible to minimize areas for mosquito bites.^{[22]
X
Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source}
4
Use a mosquito repellent on exposed skin. Obtain a natural or chemical mosquito repellent, or make your own at home, and be diligent about using it regularly.^{[23]
X
Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source} Effective repellents usually contain either DEET, icaridin (or picaridin), or the oil of lemon eucalyptus.^{[24]
X
Trustworthy Source
Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source}
- Apply mosquito repellent outside, away from food, and at least 20 minutes after putting on sunscreen if you’re using both.
- Cover up any rashes, wounds, burns, or cuts before putting on mosquito repellent.
5
Get medicated to avoid infecting others. Those actively infected with LF can take a yearly dose of a medication called diethylcarbamazine (DEC). This drug does not kill all of the worms, but it prevents you from spreading the disease to another person.
- If you live in North America or another area where LF is not common, your doctor will have to get this medication from the Centers for Disease Control and Prevention (CDC) or other agency that deals with rare disorders.^{[25]
  X
  Trustworthy Source
  Centers for Disease Control and Prevention
  Main public health institute for the US, run by the Dept. of Health and Human Services
  Go to source}
- The medication is usually well tolerated, with minor possible side effects of dizziness, headache, fever, nausea, or muscle aches.^{[26]
  X
  Trustworthy Source
  Centers for Disease Control and Prevention
  Main public health institute for the US, run by the Dept. of Health and Human Services
  Go to source}
- Other treatment options are ivermectin and albendazole.^{[27]
  X
  Research source}

Warnings

The adult worms live in your lymphatic system for about 5-7 years, but lymphedema and other symptoms can develop even after the adult worms die.

⧼thumbs_response⧽
Helpful 3 Not Helpful 0
Mosquitoes transmit many potentially serious diseases. If you travel abroad or live in areas with endemic diseases spread by mosquitoes (such as malaria), seek emergency medical care if you experience any of these symptoms:
- Chills, shaking, or excessive sweating
- Headache or muscle aches
- Nausea, with or without vomiting
- Fever over 101°F (38.3°C)
⧼thumbs_response⧽
Helpful 0 Not Helpful 0