Treatment

Treatment of filariasis involves two components:

(1) getting rid of the microfilariae in people's blood, so that the transmission cycle can be broken and

(2) maintaining careful hygiene in infected persons to reduce the incidence and severity of secondary (e.g., bacterial) infections.

Medicines commonly used to treat filariasis include diethylcarbamazine, which reduces microfilariae concentrations and also kills adult worms, albendazole, which kills adult worms, and ivermectin, which kills the microfilariae produced by adult worms. The disease is usually treated with single-dose regimens of a combination of two drugs, one targeting microfilariae and one targeting adult worms (i.e.,either diethylcarbamazine and albenadazole, or ivermectin and albendazole). If a high enough coverage of anti-filariasis drug treatment can be achieved (treating greater than 80% of the people in a community), the disease can be eradicated from an area. Attempts to eliminate the disease are being helped considerably by Merck and Co., which is donating ivermectin to treatment efforts, and Smith Kline Beecham, which is donating albendazole. The widespread treatment of populations in endemic areas with albendazole has the added benefit of reducing the incidence of intestinal parasite infections, which will serve to dramatically improve the health of individuals suffering those infections, particularly women and children. Attempts to reduce, and eventually eliminate lymphatic filariasis will be facilitated by the fact that humans are essentially the only reservoirs, and that the parasite does not increase in numbers in mosquitoes, but only in humans. In addition, the inefficiency with which filariasis is transmitted (many bites from infected mosquitoes are required to infect a human) further improves the chances of eradicating the disease.

Control of lymphatic filariasis rests in control of mosquito vectors. Covering water-storage containers and improving waste-water and solid-waste treatment systems can help by reducing the amount of standing water in which mosquitoes can lay eggs. In addition, killing eggs (oviciding) and killing or disrupting larva (larviciding) in bodies of stagnant water can further reduce mosquito populations. People in endemic areas can reduce the probability of being infected with filariasis by decreasing the number of times they are bitten by mosquitoes. Such personal protection measures include wearing long sleeves, applying insect repellent, using insecticide-impregnated bed nets, and remaining inside when mosquitoes are most active.