Rare Disease Elephantiasis: What Is This Condition That Causes Enlargement Of Body Parts

Earlier this year, after a gap of three long years, four cases of Lymphatic Filariasis (LF), also known as elephantiasis, were reported in Bachubhai No Kuvo, a slum in Ramol, Ahmedabad. The condition, popularly known as ‘Hathi Pao,' not only causes disfigurement and enlargement of body parts, but also affects patient's mental and emotional well-being. 

Worldwide, more than 88.2 crore people in 44 countries are at risk of LF, according to the World Health Organization (WHO). India is currently a major contributor of the disease, accounting for 41% of global LF, as per study published in the Medical Journal Armed Forces India. 

Speaking with the OnlyMyHealth team, Dr Vikram Jeet Singh, Senior Consultant, Internal Medicine, Aakash Healthcare, New Delhi, talked about the cause of elephantiasis, common symptoms, and treatment options.

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What Causes Elephantiasis?

“LF refers to a debilitating and disfiguring tropical illness caused by parasitic worms, primarily nWuchereria bancrofti and Brugia malayi,” Dr Singh said, explaining, “These parasites are transmitted to humans via mosquito bites, wherein the larvae of these worms travels into the lymphatic system, becoming adult worms and resulting in blockages and inflammation within the lymphatic vessels.”

The lymphatic system plays a vital role in draining excess fluid and supporting immune function. When that is compromised by the presence of these parasitic worms, there is an interference with the natural flow of lymph, resulting in fluid buildup, swelling, and a ‘gross enlargement’ of specific body parts, particularly the limbs and genital area.

Common Symptoms To Watch Out For

Some of the common symptoms of LF, or elephantiasis include:

• Progressive and painless swelling, initially in the extremities, often leading to significant deformities
• Thickened and discoloured skin with an 'elephant-like' texture
• Discomfort and pain due to swelling and skin changes
• Susceptibility to bacterial infections, cellulitis, and ulcerations

According to Dr Single, elephantiasis symptoms can go beyond physical manifestations, including social isolation and psychological distress. This is because of the societal pressures put on a person dealing with disfigurement. 

Treatment Options

Fortunately, LF is a treatable condition, and can be prevented with certain efforts and measures. 

Apart from antiparasitic drugs, such as diethylcarbamazine (DEC) and ivermectin, which can effectively kill the adult worms and their larvae, manual lymphatic drainage techniques can also help alleviate swelling and improve lymphatic flow, Dr Singh shared. 

He also recommends maintaining good hygiene and promptly treating secondary infections to minimise complications.

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India's Strategies To Curb Lymphatic Filariasis Transmission

Mass Drug Administration (MDA) campaigns in affected regions help in reducing the transmission of the parasite by treating entire communities, Dr Singh expressed. 

Earlier this year in January, during the inauguration of the National Symposium on India’s Roadmap to Eliminate Lymphatic Filariasis, Union Health Minister Mansukh Mandaviya announced India's commitment towards eliminating LF by 2027. 

On February 10, 2023, Union Secretary for Health and Family Welfare, Shri Rajesh Bhushan launched a nationwide MDA campaign aimed at ending disease transmission through door-to-door administration of anti-filarial drugs, especially in 10 filaria affected states.

Other high-burden districts in Bihar, Chhattisgarh, Jharkhand, Maharashtra, Uttar Pradesh, West Bengal, Karnataka, Odisha, Madhya Pradesh, and Andhra Pradesh also launched the campaign.