Brugia malayi
(brew-gia / ma-lay-eye)
Brugia timori
(brew-gia / ti-mor-eye
Microfilariae
Geographic Distribution
Most cases are reported in southern China and India. Other cases are seen in the Philippines, Thailand, Vietnam, South Korea and parts of Japan.
Transmission
This parasite is spread by the bite of the Mansonia, Anopheles and Aedes mosquitos. The species depends on the geographical area. When this mosquito takes a blood meal from a person, it releases the larva into the person. It takes multiple bites from infected mosquitos to become infected.
Disease
Brugian lymphatic Filariasis
- Clinical symptoms will occur months to years after the infection occurs.
- Early symptoms include:
- fever, chills
- After the adult worms have inhabited the lymph nodes, more severe symptoms will start.
- lymphadenitis and lymphanditis
- eventually, the lymph nodes will become blocked
- Elephantitis usually occurs in the lower leg.
Diagnostic
- Laboratory specimens:
- Specimens must be timed. B. malayi has nocturnal periodicity or sub-periodicity. B. timori shows only nocturnal periodicity.
- blood
- lymphatic aspirates
- Specimens must be timed. B. malayi has nocturnal periodicity or sub-periodicity. B. timori shows only nocturnal periodicity.
- Testing:
- permanent smears made with Giemsa stain
- use Knott's technique for concentration
- Serological testing:
- serum IgE tests
- antifilarial antibody tests
- PCR
- permanent smears made with Giemsa stain
Treatment
The therapy of choice is diethylcarbamazine (DEC) administered in low doses combined with an anti-inflammatory drugs. Corticosteroids can be used to counteract the allergic immune response caused by the death of the microfilariae. Also, a single dose of Ivermectin has shown to be effect for six months against the microfilariae.