The Cause, Prevention And Cure Of

Filariasis

Many Aspects of This South Seas' Curse Explained by US Army Medicoes

r\F great interest to residents of the Pacific Islands generally, and par ticularly to certain adversely affected areas of Polynesia, is this report sent to us by Mr. R. 8. Ridgley, headmaster of Araura School, Aitutaki, Cook Islands.

The report is of an address to the native people, by a visiting American Army doctor, Major* Knett, and deals with that baffling disease, Filariasis — or, as it is sometimes called, Elephantiasis.

“This may not be the final solution,” writes Mr. Ridgley, “but it is a great stride in the right direction. We now know something definite about the causes of it; and we have seen for our selves on this island recently the amazing operations performed by doctors of the US Army. Enormous swellings of breasts, testicles and knees have been reduced to normal by operation; lower limbs have been reduced to normal by special bandaging.”

SOME kinds of sickness are caused by worms. We know the round worm, Ascaris, which the children have and which they pass in the faeces after we give them worm medicine. But there is another worm which we never see.

This is the filarial worm. It is very small —only one inch long and no larger around than a silk thread. We never see it. for it does not live in the intestine like Ascaris, but deep in the tissues. As with other worms, a person can have a few of them and not feel ill in any way. But if a person has a large number of any kind of worms he will become sick.

This is true with filarial worm. Chil dren can have a few of these worms and not appear ill. But if they continue to get more and more of them, as the years go by, they may become sick.

We see this here in Aitutaki. We see big legs due to filarial worm sickness only in older people. Yet in the blood exami nation which I made here last month (May, 1944) on 540 children in the school, I found 100 children to have the filarial worm. None of these children show any signs of the worm sickness yet, for they do not have enough of the worms.

BLOOD-TESTS tell immediately if a person has filarial worms. Under the microscope the baby filarial worm can be seen wiggling in the blood.

Examining the blood is the only way one can tell if a person is infected in the early stages.

A person with a large number of worms may have attacks of fever. He may have swellings of the legs, the arms or the tes ticles. Or he may have nodules in the groin or in the arm. just above the elbow.

Persons with filarial worms often develop deep abscesses.

THE baby filarial * worm is born with a thin sack around it. which can be seen easily under the microscope He cannot break out of this sack by him self, and as long as he is inside he can not grow into an adult. His only hope is the mosquito.

If the mosquito takes a blood meal and sucks un the baby worm along with the blood, then the worm has his chance of life. In the stomach of the mosquito the sack around the worm is dissolved. But the little worm cannot grow into an adult worm in the mosquito. It must get back into the bodv of a man. Therefore, it crawls into the biting tube of the mos

quito. Then, when the mosquito next bites a man. the little worm passes from the mosquito’s biting tube into the skin of the man. Now it can grow into an adult worm, find a mate and live to a ripe old age. It is very important to understand that it is impossible to get filarial worms from another person except through the bite of a mosquito.

Since the baby worms cannot get out of their sacks themselves and, therefore, cannot grow into adult worms, the num

ber of adult worms in a person’s body cannot increase without the help of a mosquito. This is important, for it is only the adult worm that causes sickness.

The filarial worm, like every living thing, lives a certain time only. If the baby worms are not taken up by a mos quito and liberated from their sacks, they perish as infants. New baby worms will go on being born, of course, as long as there are fecund females still alive.

The adult worms live several years.

Therefore, although a person may have filarial worms in his body, if he is not bitten by any more infected mosquitoes, in time the worms in his body will all die, and he will never develop filarial sickness. It can be seen, then, that it is possible to get rid of the worms with

out taking medicine—by protecting oneself from mosquitoes.

IF wp wish in nrntprt ourselves against . . .. , this worm we must attack the mosquite that carries it from man to man Only one mosquito carries the fllanal worm—the common “Aedes,” daybiting mosquito that can easily be recogbed by the white band down the centre of its back, and the white spots on its sides and its legs. It breeds only m small collections of rainwater, such as are found in coconut shells, rotted holes in trees where branches have broken off, in

tin cans, bottles, etc. This mosquito can survive drought, because when the water dries up in the coconut shells, the mos quito eggs dry out, too, and remain until the next rain comes. “Aedes” does not breed in streams or pools or in holes in the ground. Nor does it hide in the house, although it may enter the house to take blood. It lurks outside the house in the grass and in the shrubs and bushes nearby. This mosquito may be attacked in two ways: 1. By destroying all containers which might hold rainwater, so that it can find no place to breed. 2. By removing all tall grass, weeds, bushes, shrubs, hedges, etc., from around the hoise, so there is no suitable place for the mosquito to hide.

Although “Aedes” is a bush mosquito, we do not have to worry about the ones found away from settlements, as they cannot carry the worms unless they first take blood from someone who has the baby worms in his blood. The chances of contracting filariasis is many times greater in a village.

Each year more persons in Aitutaki are developing the filarial swellings. Old people say that the sickness is more com mon now than it was when they were children. This is explained, of course, by the fact that the more people who have the worms the easier it is* for the mos quitoes to pass them to another person.

Persons with swollen limbs may not have any baby worms in their blood— they may have all died. A healthy appearing young adult may have many worms in his blood and infect all the mos quitoes that bite him, and so transmit the disease to others.

Prevention

IN Major Knett’s opinion, Filariasis can be removed from Aitutaki (and pre

sumably any infected area) by educa tion of the people as to the cause and the results of such infection by mos quitoes; by a change in living conditions, so that all village sites are kept clean and all breeding-places destroyed; and by yearly blood-testing of the school chil dren, so that cases of Filariasis are caught early and the victim and his par ents are instructed what to do.

Cure

NO drug or medicine has been discov ered to kill the Filaria worms. They die of their own accord in t*wo or three years ancl, if a victim stays away from infected areas, or protects himself from infected mosquitoes, his body will become free of worms, usually within this period.

The treatments for swelling are various.

Expert bandaging will reduce and hold in check the swellings of the leg. This must be continued for the rest of the patient’s lifetime, but the results are well worth while. Not only does it keep the leg a normal size, but prevents the attacks of fever that so often accompany the swell ing. Bandaging of swollen arms, how ever, is not satisfactory.

Swollen testicles may be due to a sack of water around the testicle. In some instances this can be treated by an injec tion; in other cases, operation is required.

Filarial abscesses can be treated by inserting a hollow needle and removing the pus. This should be done early, before the abscess becomes large.

Rev. W. Green, chairman of the Metho dist Mission in Fiji, left the Colony recently for Australia, on six months’ furlough. He is accompanied by Mrs.

Green. During his absence, Mr. W. S.

Pidgeon, of Taveuni, will act in Suva.