Chapter 144 : Filarial Nematodes*

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in

Filarial Nematodes*, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555817381/9781555817381.ch144-1.gif /docserver/preview/fulltext/10.1128/9781555817381/9781555817381.ch144-2.gif


This chapter reviews the different filarial parasites that cause human infection and describes the epidemiology, clinical features, and complications of the diseases caused by the individual species as well as their treatment. Updated information is provided on current diagnostic tools used as well as tests that provide greater sensitivity, which might be used in the near future.

Citation: Chatterjee S, Nutman T. 2015. Filarial Nematodes*, p 2461-2470. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch144
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


Image of FIGURE 1

Common microfilariae found in humans. Organisms are stained with hematoxylin. Magnification, ×325. (A) ; (B) ; (C) ; (D) ; (E) ; (F) . doi:10.1128/9781555817381.ch144.f1

Citation: Chatterjee S, Nutman T. 2015. Filarial Nematodes*, p 2461-2470. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch144
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 2

Diagrammatic representation of the anterior and posterior extremities of the common microfilariae found in humans. (a) ; (b) ; (c) ; (d) ; (e) ; (f) ; (g) . doi:10.1128/9781555817381.ch144.f2

Citation: Chatterjee S, Nutman T. 2015. Filarial Nematodes*, p 2461-2470. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch144
Permissions and Reprints Request Permissions
Download as Powerpoint


1. Gems D. 2000. Longevity and ageing in parasitic and free-living nematodes. Biogerontology 1: 289307.
2. Lipner EM,, Law MA,, Barnett E,, Keystone JS,, von Sonnenburg F,, Loutan L,, Prevots DR,, Klion AD,, Nutman TB, GeoSentinel Surveillance Network. 2007. Filariasis in travelers presenting to the GeoSentinel Surveillance Network. PLoS Negl Trop Dis 1( 3) : e88.
3. Rajan TV,. 2000. Lymphatic filariasis: a historical perspective, p 14. In Nutman TB ( ed), Lymphatic filariasis. Imperial College Press, London, United Kingdom.
4. Dreyer G,, Mattos D,, Noroes J. 2007. Chyluria. Rev Assoc Med Bras 53: 460464. (In Portuguese.)
5. Ottesen EA,, Nutman TB. 1992. Tropical pulmonary eosinophilia. Annu Rev Med 43: 417424.
6. Vijayan VK. 2007. Tropical pulmonary eosinophilia: pathogenesis, diagnosis and management. Curr Opin Pulm Med 13: 428433.
7. Sasa M. 1976. Human filariasis: a global survey of epidemiology and control. University Park Press, Baltimore, MD.
8. Freedman DO,, de Almeida Filho PJ,, Besh S,, Maia e Silva MC,, Braga C,, Maciel A. 1994. Lymphoscintigraphic analysis of lymphatic abnormalities in symptomatic and asymptomatic human filariasis. J Infect Dis 170: 927933.
9. Noroes J,, Addiss D,, Santos A,, Medeiros Z,, Coutinho A,, Dreyer G. 1996. Ultrasonographic evidence of abnormal lymphatic vessels in young men with adult Wuchereria bancrofti infection in the scrotal area. J Urol 156( 2 Part 1) : 409412.
10. Dreyer G,, Noroes J,, Figueredo-Silva J,, Piessens WF. 2000. Pathogenesis of lymphatic disease in bancroftian filariasis: a clinical perspective. Parasitol Today 16: 544548.
11. Dreyer G,, Addiss D,, Roberts J,, Noroes J. 2002. Progression of lymphatic vessel dilatation in the presence of living adult Wuchereria bancrofti. Trans R Soc Trop Med Hyg 96: 157161.
12. Olszewski WL,, Jamal S,, Manokaran G,, Pani S,, Kumaraswami V,, Kubicka U,, Lukomska B,, Tripathi FM,, Swoboda E,, Meisel-Mikolajczyk F,, Stelmach E,, Zaleska M. 1999. Bacteriological studies of blood, tissue fluid, lymph and lymph nodes in patients with acute dermatolymphangioadenitis (DLA) in course of ‘filarial’ lymphedema. Acta Trop 73: 217224.
13. Pani SP,, Srividya A. 1995. Clinical manifestations of bancroftian filariasis with special reference to lymphoedema grading. Indian J Med Res 102: 114118.
14. Ananthakrishnan S,, Das LK. 2004. Entry lesions in bancroftian filarial lymphoedema patients—a clinical observation. Acta Trop 90: 215218.
15. Shenoy RK,, Sandhya K,, Suma TK,, Kumaraswami V. 1995. A preliminary study of filariasis related acute adenolymphangitis with special reference to precipitating factors and treatment modalities. Southeast Asian J Trop Med Public Health 26: 301305.
16. Dreyer G,, Medeiros Z,, Netto MJ,, Leal NC,, de Castro LG,, Piessens WF. 1999. Acute attacks in the extremities of persons living in an area endemic for bancroftian filariasis: differentiation of two syndromes. Trans R Soc Trop Med Hyg 93: 413417.
17. McPherson T,, Persaud S,, Singh S,, Fay MP,, Addiss D,, Nutman TB,, Hay R. 2006. Interdigital lesions and frequency of acute dermatolymphangioadenitis in lymphoedema in a filariasis-endemic area. Br J Dermatol 154: 933941.
18. Shenoy RK,, Kumaraswami V,, Suma TK,, Rajan K,, Radhakuttyamma G. 1999. A double-blind, placebo-controlled study of the efficacy of oral penicillin, diethylcarbamazine or local treatment of the affected limb in preventing acute adenolymphangitis in lymphoedema caused by brugian filariasis. Ann Trop Med Parasitol 93: 367377.
19. Pani SP,, Yuvaraj J,, Vanamail P,, Dhanda V,, Michael E,, Grenfell BT,, Bundy DA. 1995. Episodic adenolymphangitis and lymphoedema in patients with bancroftian filariasis. Trans R Soc Trop Med Hyg 89: 7274.
20. Udwadia F. 1975. Progress in Respiration Research, vol. 7. Pulmonary Eosinophilia, p 35. Karger, New York, NY.
21. Shenoy RK,, Suma TK,, Kumaraswami V,, Padma S,, Rahmah N,, Abhilash G,, Ramesh C. 2007. Doppler ultrasonography reveals adult-worm nests in the lymph vessels of children with brugian filariasis. Ann Trop Med Parasitol 101: 173180.
22. Ash L,, Orihel T. 1997. Atlas of Human Parasitology, 4th ed. American Society of Clinical Pathologists, Chicago, IL.
23. McCarthy JS,, Zhong M,, Gopinath R,, Ottesen EA,, Williams SA,, Nutman TB. 1996. Evaluation of a polymerase chain reaction-based assay for diagnosis of Wuchereria bancrofti infection. J Infect Dis 173: 15101514.
24. Fink DL,, Fahle GA,, Fischer S,, Fedorko DF,, Nutman TB. 2011. Toward molecular parasitologic diagnosis: enhanced diagnostic sensitivity for filarial infections in mobile populations. J Clin Microbiol 49: 4247.
25. Zhong M,, McCarthy J,, Bierwert L,, Lizotte-Waniewski M,, Chanteau S,, Nutman TB,, Ottesen EA,, Williams SA. 1996. A polymerase chain reaction assay for detection of the parasite Wuchereria bancrofti in human blood samples. Am J Trop Med Hyg 54: 357363.
26. Rao RU,, Huang Y,, Bockarie MJ,, Susapu M,, Laney SJ,, Weil GJ. 2009. A qPCR-based multiplex assay for the detection of Wuchereria bancrofti, Plasmodium falciparum and Plasmodium vivax DNA. Trans R Soc Trop Med Hyg 103: 365370.
27. Rao RU,, Weil GJ,, Fischer K,, Supali T,, Fischer P. 2006. Detection of Brugia parasite DNA in human blood by real-time PCR. J Clin Microbiol 44: 38873893.
28. Poole CB,, Tanner NA,, Zhang YH,, Evans TC,, Carlow CKS. 2012. Diagnosis of brugian filariasis by loop-mediated isothermal amplification. PLoS Negl Trop Dis 6( 12) : e1948.
29. Tisch DJ,, Bockarie MJ,, Dimber Z,, Kiniboro B,, Tarongka N,, Hazlett FE,, Kastens W,, Alpers MP,, Kazura JW. 2008. Mass drug administration trial to eliminate lymphatic filariasis in Papua New Guinea: changes in microfilaremia, filarial antigen, and Bm14 antibody after cessation. Am J Trop Med Hyg 78: 289293.
30. Dreyer G,, Addiss D,, Gadelha P,, Lapa E,, Williamson J,, Dreyer A. 2006. Interdigital skin lesions of the lower limbs among patients with lymphoedema in an area endemic for bancroftian filariasis. Trop Med Int Health 11: 14751481.
31. Fox LM,, Furness BW,, Haser JK,, Desire D,, Brissau JM,, Milord MD,, Lafontant J,, Lammie PJ,, Beach MJ. 2005. Tolerance and efficacy of combined diethylcarbamazine and albendazole for treatment of Wuchereria bancrofti and intestinal helminth infections in Haitian children. Am J Trop Med Hyg 73: 115121.
32. Bockarie MJ. 2007. Molecular xenomonitoring of lymphatic filariasis. Am J Trop Med Hyg 77: 591592.
33. Ottesen EA,, Hooper PJ,, Bradley M,, Biswas G. 2008. The global programme to eliminate lymphatic filariasis: health impact after 8 years. PLoS Negl Trop Dis 2( 10) : e317.
34. Taylor MJ,, Makunde WH,, McGarry HF,, Turner JD,, Mand S,, Hoerauf A. 2005. Macrofilaricidal activity after doxycycline treatment of Wuchereria bancrofti: a double-blind, randomised placebo-controlled trial. Lancet 365: 21162121.
35. Mand S,, Debrah AY,, Klarmann U,, Batsa L,, MarfoDebrekyei Y,, Kwarteng A,, Specht S,, Belda-Domene A,, Fimmers R,, Taylor M,, Adjei O,, Hoerauf A. 2012. Doxycycline improves filarial lymphedema independent of active filarial infection: a randomized controlled trial. Clin Infect Dis 55: 621630.
36. WHO. 1992. Lymphatic filariasis: the diseases and its control. Fifth report of the WHO Expert Committee on Filariasis. World Health Organ Tech Rep Ser 821: 171.
37. Ottesen EA. 2006. Lymphatic filariasis: treatment, control and elimination. Adv Parasitol 61: 395441.
38. Seim AR,, Dreyer G,, Addiss DG. 1999. Controlling morbidity and interrupting transmission: twin pillars of lymphatic filariasis elimination. Rev Soc Bras Med Trop 32: 325328.
39. Albiez EJ. 1983. Studies on nodules and adult Onchocerca volvulus during a nodulectomy trial in hyperendemic villages in Liberia and Upper Volta. I. Palpable and impalpable onchocercomata. Tropenmed Parasitol 34: 5460.
40. Taylor HR. 1985. Global priorities in the control of onchocerciasis. Rev Infect Dis 7: 844846.
41. Zimmerman PA,, Guderian RH,, Aruajo E,, Elson L,, Phadke P,, Kubofcik J,, Nutman TB. 1994. Polymerase chain reaction-based diagnosis of Onchocerca volvulus infection: improved detection of patients with onchocerciasis. J Infect Dis 169: 686689.
42. Fink DL,, Fahle GA,, Fischer S,, Fedorko DF,, Nutman TB. 2011. Toward molecular parasitologic diagnosis: enhanced diagnostic sensitivity for filarial infections in mobile populations. J Clin Microbiol 49: 4247.
43. Lipner EM,, Dembele N,, Souleymane S,, Alley WS,, Prevots DR,, Toe L,, Boatin B,, Weil GJ,, Nutman TB. 2006. Field applicability of a rapid-format anti-Ov-16 antibody test for the assessment of onchocerciasis control measures in regions of endemicity. J Infect Dis 194: 216221.
44. Burbelo PD,, Leahy HP,, Iadarola MJ,, Nutman TB. 2009. A four-antigen mixture for rapid assessment of Onchocerca volvulus infection. PLoS Negl Trop Dis 3( 5) : e438.
45. Weil GJ,, Steel C,, Liftis F,, Li BW,, Mearns G,, Lobos E,, Nutman TB. 2000. A rapid-format antibody card test for diagnosis of onchocerciasis. J Infect Dis 182: 17961769.
46. Gardon J,, Gardon-Wendel N,, Demanga N,, Kamgno J,, Chippaux JP,, Boussinesq M. 1997. Serious reactions after mass treatment of onchocerciasis with ivermectin in an area endemic for Loa loa infection. Lancet 350: 1822.
47. Turner JD,, Tendongfor N,, Esum M,, Johnston KL,, Langley RS,, Ford L,, Faragher B,, Specht S,, Mand S,, Hoerauf A,, Enyong P,, Wanji S,, Taylor MJ. 2010. Macrofilaricidal activity after doxycycline only treatment of Onchocerca volvulus in an area of Loa loa co-endemicity: a randomized controlled trial. PLoS Negl Trop Dis 4( 4) : e660.
48. Boatin BA,, Richards FO, Jr. 2006. Control of onchocerciasis. Adv Parasitol 61: 349394.
49. Hoerauf A,, Mand S,, Adjei O,, Fleischer B,, Buttner DW. 2001. Depletion of Wolbachia endobacteria in Onchocerca volvulus by doxycycline and microfilaridermia after ivermectin treatment. Lancet 357: 14151416.
50. Molyneux DH. 2009. Filaria control and elimination: diagnostic, monitoring and surveillance needs. Trans R Soc Trop Med Hyg 103: 338341.
51. Stingl P. 2009. Onchocerciasis: developments in diagnosis, treatment and control. Int J Dermatol 48: 393396.
52. Zoure HGM,, Wanji S,, Noma M,, Amazigo UV,, Diggle PJ,, Tekle AH,, Remme JHF. 2011. The geographic distribution of Loa loa in Africa: results of large-scale implementation of the Rapid Assessment Procedure for Loiasis (RAPLOA). PLoS Negl Trop Dis 5( 6) : e1210.
53. Gil JF,, Hoyos CL,, Cimino RO,, Krolewiecki AJ,, Lopez Quiroga I,, Cajal SP,, Juarez M,, Garcia Bustos MF,, Mora MC,, Marco JD,, Nasser JR. 2011. Role of three ELISA tests using promastigote homogenates of Leishmania braziliensis, L. amazonensis and L. guyanensis in the diagnosis of tegumentary leishmaniasis. Medicina (B Aires) 71: 420428. (In Spanish.)
54. Klion AD,, Massougbodji M,, Sadeler B-C,, Ottesen EA,, Nutman TB. 1991. Loiasis in endemic and non-endemic populations: immunologically mediated differences in clinical presentation. J Infect Dis 163: 13181325.
55. Nutman TB,, Zimmerman PA,, Kubofcik J,, Kostyu DD. 1994. A universally applicable diagnostic approach to filarial and other infections. Parasitol Today 10: 239243.
56. Fink DL,, Kamgno J,, Nutman TB. 2011. Rapid molecular assays for specific detection and quantitation of Loa loa microfilaremia. PLoS Negl Trop Dis 5( 8) : e1299.
57. Klion AD,, Vijaykumar A,, Oei T,, Martin B,, Nutman TB. 2003. Serum immunoglobulin G4 antibodies to the recombinant antigen, Ll-SXP-1, are highly specific for Loa loa infection. J Infect Dis 187: 128133.
58. Burbelo PD,, Ramanathan R,, Klion AD,, Iadarola MJ,, Nutman TB. 2008. Rapid, novel, specific, high-throughput assay for diagnosis of Loa loa infection. J Clin Microbiol 46: 22982304.
59. Klion AD,, Ottesen EA,, Nutman TB. 1994. Effectiveness of diethylcarbamazine in treating loiasis acquired by expatriate visitors to endemic regions: long-term follow-up. J Infect Dis 169: 604610.
60. Duke BO. 2003. Overview: report of a scientific working group on serious adverse events following Mectizan ® treatment of onchocerciasis in Loa loa endemic areas. Filaria J 2( Suppl 1) : S1.
61. Boussinesq M,, Gardon J,, Gardon-Wendel N,, Chippaux JP. 2003. Clinical picture, epidemiology and outcome of Loa-associated serious adverse events related to mass ivermectin treatment of onchocerciasis in Cameroon. Filaria J 2( Suppl 1) : S4.
62. Nutman TB,, Miller KD,, Mulligan M,, Reinhardt GN,, Currie BJ,, Steel C,, Ottesen EA. 1988. Diethylcarbamazine prophylaxis for human loiasis. N Engl J Med 319: 750756.
63. Adolph PE,, Kagan IG,, McQuay RM. 1962. Diagnosis and treatment of Acanthocheilonema perstans filariasis. Am J Trop Med Hyg 11: 7688.
64. Meyers WM,, Connor DH,, Harman LE,, Fleshman K,, Moris R,, Neafie RC. 1972. Human streptocerciasis. A clinico-pathologic study of 40 Africans (Zairians) including identification of the adult filaria. Am J Trop Med Hyg 21: 528545.
65. Vianna LM,, Martins M,, Cohen MJ,, Cohen JM,, Belfort R Jr. 2012. Mansonella ozzardi corneal lesions in the Amazon: a cross-sectional study. BMJ Open 2( 6) : e001266.
66. Degese MF,, Cabrera MG,, Krivokapich SJ,, Irazu LE,, Rodriguez MA,, Guarnera EA. 2012. Contribution of the PCR assay to the diagnosis of Mansonella ozzardi in endemic areas of Argentina. Rev Argent Microbiol 44: 97100. (In Spanish.)
67. Keiser PB,, Coulibaly Y,, Kubofcik J,, Diallo AA,, Klion AD,, Traore SF,, Nutman TB. 2008. Molecular identification of Wolbachia from the filarial nematode Mansonella perstans. Mol Biochem Parasitol 160: 123128.
68. Coulibaly YI,, Dembele B,, Diallo AA,, Lipner EM,, Doumbia SS,, Coulibaly SY,, Konate S,, Diallo DA,, Yalcouye D,, Kubofcik J,, Doumbo OK,, Traore AK,, Keita AD,, Fay MP,, Traore SF,, Nutman TB,, Klion AD. 2009. A randomized trial of doxycycline for Mansonella perstans infection. N Engl J Med 361: 14481458.
69. Fischer P,, Tukesiga E,, Buttner DW. 1999. Long-term suppression of Mansonella streptocerca microfilariae after treatment with ivermectin. J Infect Dis 180: 14031405.
70. Gonzalez AA,, Chadee DD,, Rawlins SC. 1999. Ivermectin treatment of mansonellosis in Trinidad. West Indian Med J 48: 231234.
71. Nutman TB,, Nash TE,, Ottesen EA. 1987. Ivermectin in the successful treatment of a patient with Mansonella ozzardi infection. J Infect Dis 156: 662665.
72. More SJ,, Copeman DB. 1990. A highly specific and sensitive monoclonal antibody-based ELISA for the detection of circulating antigen in bancroftian filariasis. Trop Med Parasitol 41: 403406.
73. Weil GJ,, Lammie PJ,, Weiss N. 1997. The ICT Filariasis Test: a rapid-format antigen test for diagnosis of bancroftian filariasis. Parasitol Today 13: 401404.
74. Marinkelle CJ,, German E. 1970. Mansonelliasis in the Comisaria del Vaupes of Colombia. Trop Geogr Med 22: 101111.


Generic image for table

Filarial parasites of humans

Citation: Chatterjee S, Nutman T. 2015. Filarial Nematodes*, p 2461-2470. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch144

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error