ELEPHANTIASIS - The Swelling Infestation

Images of persons afflicted with elephantiasis often crop up online and for decades the condition had been wrongfully fingered as the cause of the deformities distressing Joseph ‘The Elephant Man’ Merrick. For the record, Merrick likely suffered from Proteus syndrome; however the public mind continues to associate his bulbous and sagging appearance with the symptoms presented by elephantiasis.

Elephantiasis, medically known as lymphatic filariasis, is easy recognized. It is presumed that the common name refers to the resemblance of the sufferer’s limbs to the thick, baggy skin on the limbs and trunks of elephants. Typically the lower limbs and appendages are affected by the condition and, perhaps most famously, the scrotum can swell to gigantic proportions.

The earliest record of the condition can be found in ancient Egypt where a statue of Pharaoh Mentuhotep II depicts swollen limbs and various other artifacts provide evidence. The first written accounts were made by the Greeks who carefully chronicled the differences between elephantiasis and leprosy. Then during the European exploration of Goa, between 1588 and 1592, Jan Huygen Linschoten wrote that the inhabitants he observed were ‘all born with one of their legs and one foot from the knee downwards as thick as an elephant’s leg’. Although this was the first European account of lymphatic filariasis symptoms, more documentation was made as parts of Africa and Asia were further explored.

The usual cause of elephantiasis is nearly as horrific as the appearance of the condition itself. In 1876 a parasitic worm infestation was discovered to the culprit and, since that initial discovery, multiple worm varieties have been identified. The worm is transferred to the host via mosquitoes.

When an infected female mosquito bites a person, she injects the worm larvae, called microfilariae, into the blood. The microfilariae reproduce and spread throughout the bloodstream, where they can live for many years. Often symptoms do not appear until many years after the initial infection. As the parasites accumulate in the blood vessels, they restrict circulation and cause fluid to build up in surrounding tissues. Several studies have shown that these daily cleaning routines can be an effective way to limit the symptoms of lymphatic filariasis. The effectiveness of these treatments suggests that many of the symptoms of elephantiasis are not directly a result of the lymphatic filariasis but rather the effect of secondary skin infections.

Medicines to treat elephantiasis are most effective when used soon after infection, but they do have some toxic side effects. Also, as the disease has few symptoms directly after infection, few persons are treated effectively or are treated long after physical damage has been done.

Elephantiasis currently affects 120 million people worldwide, and of those 40 million display serious symptoms. As of yet, there is neither a cure nor a vaccine, however in 2003 an effective treatment was identified and is now in clinical trials.

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Last Update: June 27, 2024