What is the treatment for Loa loa disease?
This disease is diagnosed by examining a blood sample under a microscope, looking for the larvae of the Loa loa worms. Treatment usually involves the administration of one or more of the drugs that have been shown to kill these parasitic worms in the body.
Can doxycycline be used to treat Loa loa MF?
Loa loa do not contain Wolbachia so doxycycline is not an effective treatment. MF = microfilariae of L. loa * Apheresis should be performed at an institution with experience in using this therapeutic modality for loiasis. Oral albendazole is available for human use in the United States.
What is Loa loa disease?
Loa loa is a small worm that infects people in West and Central Africa. It is spread by the bite of a fly. Adult worms live under the skin and can cause swelling in the arms, legs, and face. Some people have more serious infections in the heart, kidneys, or brain.
What are the side effects of one day treatment for DEC?
One day treatment is generally as effective as the 12-day regimen. DEC is generally well tolerated. Side effects are in general limited and depend on the number of microfilariae in the blood. The most common side effects are dizziness, nausea, fever, headache, or pain in muscles or joints.
Why DEC provocation test is contraindicated in Loa loa?
DEC is contraindicated in persons with onchocerciasis because of the risk of blindness and/or severe exacerbation of skin disease.
What is Loa loa in medicine?
Loa loa is a filarial nematode with a similar life cycle to O. volvulus except the adults migrate through subcutaneous tissues and the microfilariae are in the blood.
How do I get rid of Loa loa worms?
A medication called diethylcarbamazine, or DEC, can be used to kill the parasites in your body. Because there is a small risk of serious side effects related to killing the parasites, your health care provider will do tests to be sure that it is safe to treat you.
How do you test for Loa loa?
Identification of an adult worm in the eye by a health care provider. Identification of the microfilariae on a blood smear made from blood taken from the patient between 10AM and 2PM. Identification of antibodies against L. loa on specialized blood test.
Is Loa loa curable?
The disease is treated with the drug diethylcarbamazine (DEC), and when appropriate, surgical methods may be employed to remove adult worms from the conjunctiva. Loiasis belongs to the so-called neglected diseases.
What disease is caused by Loa loa?
Loiasis, called African eye worm by most people, is caused by the parasitic worm Loa loa. It is passed on to humans through the repeated bites of deerflies (also known as mango flies or mangrove flies) of the genus Chrysops.
How is Loa loa removed?
A visible subconjunctival L. loa requires removal. This can be safely done by incision of the conjunctiva tissue and extraction of the adult subconjunctival worm with a pair of forceps. This appears to be the commonest situation from several case reports.
Where do Loa loa worms live?
Loa loa parasites are found in West and Central Africa. Ten countries have areas where there are high rates of infection (i.e., where more than 40% of the people who live in that area report that they have had eye worm in the past). An estimated 14.4 million people live in these areas of high rates of infection.
Is Loa loa fatal?
If treated with diethylcarbamazine or ivermectin, people with ≥ 8000 Loa loa microfilariae/mL blood are at risk of potentially fatal encephalopathy, caused by the release of antigens from dying microfilariae.
Who Loa loa treatment?
The drug of choice for the treatment of loiasis is diethylcarbamazine (DEC) at a dose of 8-10 mg/kg per day given orally in three divided doses, although dose finding studies in Loa loa infection have not been performed (1).
What causes worms in your eyes?
Eye worms infect a variety of animals, but human infections are rare. The worms are transmitted to eyes by flies. The flies ingest the worm larvae, then land on an animal's eyes, where the flies feed on tears and other secretions.
What is the infective stage of Loa loa?
loa infective-stage larvae per fly. This process is temperature dependent and requires at least 7–10 days. On a subsequent feeding, the infective larvae escape from the fly mouthparts and enter a new host through the bite wound during blood-feeding.
How effective is DEC?
One day treatment is generally as effective as the 12-day regimen. DEC is generally well tolerated. Side effects are in general limited and depend on the number of microfilariae in the blood. The most common side effects are dizziness, nausea, fever, headache, or pain in muscles or joints.
What is the best treatment for LF?
In settings where onchoceriasis is present, Ivermectin is the drug of choice to treat LF. Some studies have shown adult worm killing with treatment with doxycycline (200mg/day for 4–6 weeks).
Can DEC cause onchocerciasis?
DEC should not be administered to patients who may also have onchocerciasis as DEC can worsen onchocercal eye disease. In patients with loiasis, DEC can cause serious adverse reactions, including encephalopathy and death. The risk and severity of the adverse reactions are related to Loa loa microfilarial density.
Infectious Creepy Crawler
Justin is a 32 year-old missionary who was recently working in West Africa, helping to provide clean drinking water to several villages in the area. While he was there, Justin was getting bit on his arms, neck, and face by various bugs and insects. He tried using bug spray and nets, but nothing seemed to help prevent these bites.
Symptoms
Many people who get infected with Loa loa filariasis never show any symptoms, and if they do show symptoms, they usually do not show until several months after the person initially gets infected (just like Justin). These symptoms include:
Diagnosis
Loa loa filariasis is diagnosed by examining a sample of blood under a microscope. While examining the blood sample, a medical professional will look the larvea of the Loa loa worm in the blood. This disease can also be diagnosed by simply seeing the worm crawling across one or both of the eyes.
What is the best treatment for loiasis?
The drug of choice for the treatment of loiasis is diethylcarbamazine (DEC). Most patients will achieve cure, defined as resolution of symptoms, resolution of eosinophilia, and decreasing antifilarial antibody titers, with one or two courses of DEC. Some will require additional courses of DEC or a trial of albendazole.
What is the diagnosis of loaisis?
The diagnosis of loaisis should be considered in any patient with a history of travel in an endemic area who presents with eye worm, Calabar swellings, or unexplained peripheral eosinophilia. Additionally, any patient in whom therapy for lymphatic filariasis or onchocerciasis is anticipated who comes from a region ...
Is DEC contraindicated for onchocerciasis?
Please see the onchocerciasis web pages for treatment recommendations. Note on obtaining the medication: Diethylcarbamazine (DEC) has been used worldwide for more than 50 years.
Is loiasis a complex disease?
The treatment of loiasis is complex and is best undertaken after consultation with experts who have experience in the treatment of the disease and prevention of complications of treatment. Additionally, there may be times when it is best not to treat the infection.
Can a blood smear show L. loa?
In general the diagnosis of L. loa infection should be made with blood smear. However, when blood smears are negative and clinical suspicion of infection is high, the general antibody test could be used in an attempt to exclude infection.
Does DEC kill microfilariae?
DEC is the treatment of choice because there is solid evidence that it kills both the microfilariae and the adult worms, resulting in quicker resolution of the infection. The risk of fatal encephalopathy or other severe adverse neurologic events is related to the microfilarial load.
How long does it take to cure tropical pulmonary eosinophilia?
For tropical pulmonary eosinophilia (TPE), a longer DEC treatment course of 14-21 days is generally recommended. DEC is generally well tolerated. Side effects are generally limited and depend on the number of microfilariae in the blood.
Is DEC approved by the FDA?
Because lymphatic filariasis is rare in the United States, DEC is no longer approved by the Food and Drug Administration (FDA). Physicians can obtain the medication from CDC after confirmed positive lab results. Treatment of lymphatic filariasis in adults and children > 18 months of age involves either a 1 day or 12 day treatment course of DEC ...
