Elephantiasis

“Layman,” in this article, discusses the incidence and cause of one of the most unpleasant of the South Sea Islands diseases.

ONCE again for a month or two, we, the inhabitants of the Pacific Is lands, are at the mercy of the mos quito.

During the hurricane season, weather conditions at most islands in the South Seas are conducive to the rapid and prolific breeding of the mosquito. The filaria hazard becomes real and men acing, and precautionary measures are necessary such as netting (cloth) over the beds, and mosquito-proof enclosures on verandahs.

Strangely there is no malaria amongst many of the Pacific Islands.

The Cook Group, for instance, is free from this scourge. Leprosy at many of the islands has been stamped out prac tically, but each summer there is, at some places, a slight addition, and at others a substantial accretion, to the number of filaria victims, both native and European.

Contemplation of becoming a sufferer from elephantiasis, with its hideous en larging effect upon the limbs and glands is not relished by anyone. At the same time, the effect upon the victim—as suming that he takes medical treatment and advice —is one, more of inconveni ence, than suffering.

Periodical bouts of fever occur, and the skin becomes blotched at times.

The swelling increases and surgical treatment is sometimes necessary, in advanced cases. It is held that a re turn to a cold climate will check the disease. Those Europeans affected are, generally speaking, persons who have been resident at one or other of the is lands in the Pacific for a number of years.

We laymen presume to know very little about filaria and all that goes on between this active little worm and the mosquito. Likewise, we are ignorant of the activities which take place in the body of an afflicted person between the filaria and the protective organisms of the blood stream.

What we learn, one from the other, no doubt does something to lessen the danger of infection and to minimise that risk. We are told definitely that the intermediate agent is the female mosquito.

The female of the species, to be found in many Pacific islands, is re cognised by the white bars on her hind legs and on the under part of her body.

She has also a white streak running along the forepart of her body, to a point at which her hair-like proboscis begins.

Immediately she settles on our skin her two hind legs swing upwards in the air and remain poised in that position during her blood-sucking operations.

This is her drinking posture, apparently, for each mosquito assumes the same attitude. Not until she flies off does the victim feel the stab of her skin piercing implement.

She drinks her fill and we crush her soft body to find that it contains a com paratively large measure of blood. We, of course, know this to be her purpose —to obtain a fill of blood without in flicting any appreciable sting in the

process. Any sharp stabbing sensation felt by our skin would be fatal to her purpose. Her tiny stab is neat, quick and generally absolutely painless, at the moment of her fill. We feel the sting later.

Occasionally, we observe a larger species of mosquito, with long, dangling legs, propelling himself dismally through the air. We are told that this is the male; also, that he does not feed upon our blood. The risk of his death at our hands is therefore small.

But, outside, hovering in large num bers above the lawn, we observe the great dragon flies with their huge eyes and transparent wings. They hover for a moment, then dart sideways, then hover again. They are at work prey ing upon the mosquito. But the mos quito likes the shady spots and prefers to hide itself beneath verandahs, and in the nooks and corners of the rooms and furniture of our homes.

The large house spiders, with their spindle legs, are not disturbed as they climb about the walls and ceilings of our houses. They, too, are said to be the enemy of the mosquito. Numbered, also, amongst its enemies are the small lizards, which climb about the rock fences and the sides of houses.

But with all our human weapons (sprays, pungent chemicals, etc.) in sects and other allies, the mosquito is always about, day and night.

Filaria! “How does infection take place?’’ we ask. “Does the mosquito in ject something into our bodies before it draws off its fill of blood?’’

One theory we hear much about is that, if the male joins, with the female during her blood drinking operations, filaria infection is likely to result. We confess to a certain degree of sceptic ism in accepting this explanation of the process of infection.

Another empirical conclusion come to by many is that infection is associated with the mud of Taro plots. (Taro is a native food and is cultivated in mud beds, many of which are stagnant pools of mud and water). The probable basis for this conclusion will be considered presently.

Scientists say that the filaria worm clings to the outside of the mosquito’s proboscis. The spearmen of New Guinea dip their spears into rotting carcases so that, in addition to inflict ing a wound, the implements are likely to set up within the body of the victim a filthy disease. In somewhat the same way, so it would seem, the mosquito’s instrument sometimes is tainted with the living worms of filaria.

If it can be taken that a person, already the victim of filaria, or ele phantiasis, is a source of infection, then, during the mosquito season, we ought to avoid him, because the chances are that, wherever he stands or sits for any length of time, a number of female mosquitoes in that vicinity may become active carriers of the disease. On the other hand, if such a person confines himself to places at which the mosquito is not plentiful—for instance, away from swampy areas, Taro beds, or wet masses of vegetation—the number of mosquitoes likely to become dangerous, will be comparatively small.

Along we go to the Taro plots. The water, shadowed by the huge leaves of the Taro plant, is swarming with mos quito larvae. Hosts of mosquitoes are about; and hosts of them are out of sight beneath Taro leaves and the leaves of nearby trees.

An odd native is thigh-deep in the mud plot, his only dress being a loin cloth. Along comes another native —a sufferer from filaria. Swarms of mos quitoes alight upon his body, to sip their fill of his blood. Having satisfied their appetites for the moment they may resume their hiding place but later, say the following day, or even the day after that, they will assail the body of the native worker in the Taro bed, and infect him.

Again, the filaria victim comes down to his Taro bed for his daily needs of Taro root and again numerous female

mosquitoes become infected with the filaria worm. Its lines of transport are working at high pressure. The process of filaria infection proceeds, but it may not be for months that infection will make itself felt. Bodily resistance probably plays a part in preventing in fection. The layman does not know.

This may be a partial explanation at least of the prevalence of filaria in the vicinity of Taro plots.

Certain villages and certain areas are also associated with the incidence of filaria. Again, we learn that the sur roundings are blamed for the trouble.

But the real source of infection, in the first instance, probably is the ar rival of a person suffering from ele phantiasis. If the surroundings are favourable to the prolific breeding of the mosquito, then the spread of the disease is inevitable. There can be no doubt of that. Given a fertile breeding ground for the mosquito, and one case of filaria, the number of cases will in crease with geometrical progression.

The sources of infection will multiply with each fresh case.

Amidst all the danger of infection, there is one very consoling feature which lessens the chances of a person becoming a victim of elephantiasis.

Both a male filaria worm and a female must be transplanted into the blood stream before colonies of micro-fllaria can be brought into existence.

Perhaps many infections may result before the female germ meets a male germ within the blood stream and and commences to breed in the ducts of the blood or the lymph—whichever is their chosen abode.

But again the layman runs into a fog of mystery and perplexity about the whole facts of filaria. It does seem, however, that the isolation of elephant iasis sufferers during the mosquito sea son is desirable.