Lymphatic Filariasis

What Is LF? A crippling disease spread by mosquitoes and caused by thread-like nematode worms that block the lymphatic system.

Symptoms: Chronic fever along with swelling and deformity of limbs and genitalia (elephantiasis).

Can It Be Eradicated? Because the Wucheria bancrofti worms infect only humans, some experts believe that global eradication is possible using a combination of bed nets and mass drug administration.

Status: On track for ELIMINATION in many countries.

Elimination and Care 

A map of the world with countries with cases of lymphatic filariasis in 2014 highlighted in a bright color.
Lymphatic filariasis is currently found in 73 countries, mainly in Africa and Asia. India is home to one-third of all cases.
© AMNH

Lymphatic filariasis, sometimes abbreviated simply as LF, threatens almost one billion people around the world—from Asia to Africa to Latin America. Many of those infected by this parasitic worm suffer from severe, painful swelling of limbs or genitals, known as elephantiasis. Often victims cannot work, and their profound disfigurement is a source of intense shame and social isolation. 

Since 1998, The Carter Center has been a partner in the global program to end LF. The effort was launched as a two-pronged campaign—aimed at stopping transmission and caring for those who already have the disease. With effective mass administration of the drugs ivermectin and albendazole, transmission of the disease has dropped and prospects for elimination are good.

A graphic flow chart depicting the four steps of lymphatic filariasis from infection via mosquito bites to transmission.
© AMNH

Stopping LF — An Integrated Approach

Four children sleep on a mat on the floor beneath an insecticide-treated bed net.
Under the Protection of a Net. Ethiopia, 2007 | Four siblings rest peacefully beneath an insecticide-treated bed net. The net keeps out mosquitoes that can carry lymphatic filariasis and malaria.
The Carter Center/Louise Gubb

Health workers rely on two main tools to combat lymphatic filariasis: bed nets, which prevent mosquitoes from biting, and drugs, which prevent mosquitoes from becoming infected. These two interventions have led to a remarkable decrease in transmission among at-risk populations—in fact, in many areas mass drug administration is no longer even necessary.

But diseases don’t occur in isolation—and they shouldn’t be treated that way. Ivermectin, one of the drugs used to treat LF, is also effective against the worms that cause river blindness. And bed nets stop mosquitoes that may be carrying malaria as well as lymphatic filariasis. So governments and health organizations are trying to work more efficiently and effectively by integrating LF elimination with efforts to fight malaria, river blindness, intestinal worms, and schistosomiasis (snail fever). 

A seated adult holds a standing child's hand and speaks to them while another adult takes notes. Mass Drug Administration. Tanzania, 2010 | Several pharmaceutical companies have pledged to donate as much medicine as is needed—for as long as is needed—to treat river blindness and lymphatic filariasis. To date, they have provided well over a billion drug doses, free of charge. 
GlaxoSmithKline/Marcus Perkins
An adult carrying an infant holds an insecticidal bed net, with a few other adults standing nearby. Bed Net Distribution  Nigeria, 2010 | With a potent insecticide embedded in its fibers, a long-lasting insecticidal net will help protect this woman and her family from disease-causing mosquitoes for three years or more.
The Carter Center/Emily Howard Staub

Improving Care

Dr. Frank Richards holds out an open logbook and points at it while speaking to five people.
Tracking LF Treatment. Nigeria, 2006 | Dr. Frank Richards reviews a logbook that tracks bed-net distributions, drug treatments and other interventions. Dr. Richards is the director of the Carter Center’s river blindness, lymphatic filariasis and schistosomiasis programs.
The Carter Center/Emily Howard Staub

Existing medications can stop transmission of lymphatic filariasis, but they cannot reverse the disease once the parasite has struck. So LF programs work closely with communities to teach proper care for those who already suffer from the disease. 

Local health educators teach community members how to prevent bacterial and fungal infection through improved hygiene and skin care, and how to reduce inflammation by exercising and elevating the affected limbs. In some communities, support groups give patients a chance to share experiences and learn how others have dealt with the physical and emotional challenges of LF.

Usha sits on the floor of a small room and washes her swollen leg which has been affected by elephantiasis.
Washing. India, 2010 | LF patients must regularly wash limbs affected by elephantiasis to prevent bacterial infections. Usha, 49, contracted lymphatic filariasis when she was just 13. She believes she has lost the best years of her life to the disease.
GlaxoSmithKline/Marcus Perkins