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What is elephantiasis?

Elephantiasis, also known as lymphatic filariasis, is a disease that can cause arms and legs to swell, and skin to become hard and thick like an elephant’s. It is spread by infected mosquitoes and affects millions of people in tropical areas, but you cannot catch it in Australia.

What are the symptoms of elephantiasis?

Most infected people do not have any obvious symptoms, but they may still suffer damage to the lymph system and kidneys. They can still contribute to the spreading of the parasite.

Because elephantiasis affects the lymph system, it can lead to swelling in some people, known as lymphoedema (an accumulation of fluid). Usually the legs, arms, breasts or genitals are affected. Sometimes men experience a swollen scrotum, called hydrocele.

Elephantiasis stops the immune system from working properly, leading to fever and chills, repeated skin infections and ulcers. These can make the skin hard and thick.

Some people may develop a blood disease called eosinophilia, which causes cough, shortness of breath and wheezing.

What causes elephantiasis?

Elephantiasis is painful disease that occurs when tiny parasite larvae are transferred to the body through mosquito bites. It is a major cause of disability in endemic areas.

When someone is bitten by an infected mosquito, microscopic larvae are left on the skin and can enter the person's body. The larvae can then migrate to the lymph system, where they develop into mature roundworms and can live for years.

People are usually infected with lymphatic filariasis in childhood but don't develop symptoms until later in life.

About 120 million people in the world are affected with elephantiasis, mainly in Asia, Africa, the Western Pacific and parts of the Caribbean and South America.

It usually takes repeated mosquito bites over several months or years in an area where lymphatic filariasis is common for a person to become infected. It is very rare to be infected after only visiting the area for a short time.

When should I see my doctor?

Elephantiasis can make you more likely to get infections. If you have elephantiasis, see your doctor straight away if you develop any swelling, thickening of the skin or signs of an infection.

How is elephantiasis diagnosed?

Elephantiasis is diagnosed with a blood test, which looks for the microscopic worms. The blood must be taken at night, when the worms are most active. However, the swelling may not happen until many years after the person is infected, so the lab tests are often negative.

X-rays and ultrasounds might also be used to rule out other causes of the swelling.

How is elephantiasis treated?

Elephantiasis is treated with medicine to kill the microscopic worms. The medicine stops the infection from being passed on to other people, but it may not kill all the worms. An infected person will usually need to take the medicine for several weeks.

Antibiotics, pain killers and antihistamines may also be prescribed to control the symptoms.

Living with elephantiasis

Lymphoedema cannot be cured, but you can manage the swelling by:

  • keeping the area clean by washing it with soap and water every day
  • elevating the limb to drain the fluid
  • performing exercises that get the fluid moving
  • using antibacterial or antifungal cream on any wounds if necessary

Elephantiasis can be very upsetting, disabling and can stop you leading a normal life. It can contribute to stigma and poverty, but counselling and support groups may help. Talk to your doctor about this.

For more information about lymphoedema, visit the Australasian Lymphology Association.

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Last reviewed: April 2021

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