True elephantiasis is a condition characterized by gross enlargement of an area of the body, especially the lower limbs. It is caused by obstruction of the lymphatic system, which then accumulates fluid in the affected areas. The lymphatic system helps to protect the body against infection and disease. Lymph vessels drain away watery fluid from different areas of the body into the blood stream. Obstruction of these vessels results in massive swelling and gross enlargement of the entire leg or arm, genitals, vulva and breasts. Lymphedema is the name of the infection that interrupts normal lymphatic pathway function that leads to the swelling.
Elephantiasis is characterized by the thickening of the skin and the underlying tissues. There is marked swelling of the lower half of the body. The syndrome can be very painful and uncomfortable. Lymphatic filariasis is the most common form of elephantiasis. It is caused by a parasitic disease from a bite of an infected mosquito. The resulting parasitic worms live exclusively in humans and lodge themselves in the lymphatic system that maintains the fluid balance in the tissues and blood. They live for 4-6 years producing millions of larvae that circulate in the blood. The disease may take years to manifest itself with no clinical symptoms. Treatment goal is to eliminate the worms from the blood.
Treatment depends on the type of disorder the person is affected with. Lymphatic filariasis is treated with medication that kills the parasite. Secondary skin infections are prevented by careful daily cleaning of the affected areas. Pressure bandages to wrap the swollen limbs help to manage lymphatic filariasis. Surgery can also be performed to reduce elephantiasis by removing excess fatty and fibrous tissue, draining the swollen areas and to remove the dead parasites. There are drugs available that are effective in the early stages of the disease. The most significant treatment is to relieve the suffering of those with the disease. Rigorous hygiene to the affected limbs must be done to minimize infection and promote lymph flow.
According to the World Health Organization, one-third of the people infected with the disease live in India, one third in Africa, and the remainder in South Asia, the Pacific and the Americas. It occurs most commonly in tropical regions especially parts of Africa. Elephantiasis is prevalent in remote rural areas and a disease of the poor and poverty areas of Africa and India.
World Health Organization: http://www.searo.who.int/EN/Section10/Section2096_10583.htm
National Lymphedema Network: http://www.lymphnet.org/lymphedemaFAQs/overview.htm