558:(helminths), and that a positive serologic test does not necessarily distinguish among infections. The new tests have not reached the point-of-care level yet, but show promise for highlighting high-risk areas and individuals with co-endemic loiasis and onchocerciasis. Specifically, Thomas Nutman and colleagues at the National Institutes of Health have described the a luciferase immunoprecipitation assay (LIPS) and the related QLIPS (quick version). Whereas a previously described LISXP-1 ELISA test had a poor sensitivity (55%), the QLIPS test is practical, as it requires only a 15 minutes incubation, while delivering high sensitivity (97%) and specificity (100%). No report on the distribution status of LIPS or QLIPS testing is available, but these tests would help to limit complications derived from mass ivermectin treatment for onchocerciasis or dangerous strong doses of diethylcarbamazine for loiasis alone (as pertains to individual with high
264:. These carriers are blood-sucking and day-biting, and they are found in rainforest-like environments in western and central Africa. Infective larvae (L3) mature to adults (L5) in the subcutaneous tissues of the human host, after which the adult worms—assuming presence of a male and female worm—mate and produce microfilariae. The cycle of infection continues when a non-infected mango or deer fly takes a blood meal from a microfilaremic human host, and this stage of the transmission is possible because of the combination of the diurnal periodicity of microfilariae and the day-biting tendencies of the
85:
635:(DEC), though ivermectin use while not curative (i.e., it will not kill the adult worms) can substantially reduce the microfilarial load. The recommended dosage of DEC is 8–10 mg/kg/d taken three times daily for 21 days per CDC. The pediatric dose is the same. DEC is effective against microfilariae and somewhat effective against macrofilariae (adult worms). The recommended dosage of ivermectin is 150 μg/kg in patients with a low microfilaria load (with densities less than 8000 mf/mL).
647:
male
Gabonian immigrant employed proparacaine and povidone-iodine drops, a wire eyelid speculum, and 0.5 ml 2% lidocaine with epinephrine 1:100,000, injected superiorly. A 2-mm incision was made and the immobile worm was removed with forceps. Gatifloxacin drops and an eye-patch over ointment were utilized post surgery and there were no complications (unfortunately, the patient did not return for DEC therapy to manage the additional worm—and microfilariae—present in his body).
768:, another filariasis. Ivermectin, a microfilaricidal drug, may be contraindicated in patients who are co-infected with loiasis and have associated high microfilarial loads. The theory is that the killing of massive numbers of microfilaria, some of which may be near the ocular and brain region, can lead to encephalopathy. Indeed, cases of this have been documented so frequently over the last decade that a term has been given for this set of complication: neurologic
54:
599:—endemic Gabon, for example, had the following results: 6 of 20 individuals in a placebo group contracted the disease, compared to 0 of 16 in the DEC-treated group. Seropositivity for antifilarial IgG antibody was also much higher in the placebo group. The recommended prophylactic dose is 300 mg DEC given orally once weekly. The only associated symptom in the Peace Corps study was nausea.
639:
initial albendazole administration has proved helpful (and is superior to ivermectin, which can also be risky despite its slower-acting microfilaricidal effects over DEC). The CDC recommended dosage for albendazole is 200 mg taken twice a day for 21 days. Also, in cases where two or more DEC treatments have failed to provide a cure, subsequent albendazole treatment can be administered.
330:
deer flies require a blood meal for production of a second batch of eggs. This batch is deposited near water, where the eggs hatch in 5–7 days. The larvae mature in water or soil, where they feed on organic material such as decaying animal and vegetable products. Fly larvae are 1–6 cm (0.39–2.36 in) long and take 1–3 years to mature from egg to adult. When fully mature,
887:. In a study done at five different co-endemic regions for onchocerciasis and loiasis, doxycycline was shown to be effective in treating over 12,000 individuals infected with both parasites with minimal complications. Drawbacks to using doxycycline include bacterial resistance and patient compliance because of a longer treatment regimen and emergence of doxycycline-resistant
730:-endemic regions, infection rates vary from 9 to 70 percent of the population. Areas at high risk of severe adverse reactions to mass treatment (with Ivermectin) are at present determined by the prevalence in a population of >20% microfilaremia, which has been recently shown in eastern Cameroon (2007 study), for example, among other locales in the region.
818:, mutism and incontinence. Some cases of coma were reported as early as D2. The severity of adverse effects increased with higher microfilarial loads. Hemorrhaging of the eye, particularly the retinal and conjunctiva regions, is another common sign associated with SAE of ivermectin treatment in patients with
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infection in some instances can involve surgery, though the timeframe during which surgical removal of the worm must be carried out is very short. A detailed surgical strategy to remove an adult worm is as follows (from a real case in New York City). The 2007 procedure to remove an adult worm from a
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spp. are small (5–20 mm, 0.20–0.79 in long) with a large head and downward-pointing mouthparts. Their wings are clear or speckled brown. They are hematophagous and typically live in forested and muddy habitats like swamps, streams and reservoirs, and in rotting vegetation. Female mango and
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so that areas and individuals at a higher risk for neurologic consequences can be identified prior to microfilaricidal treatment. Additionally, the treatment of choice for loiasis, diethylcarbamazine, can lead to serious complications in and of itself when administered in standard doses to patients
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The bite of the mango fly can be very painful, possibly because of the laceration style employed; rather than puncturing the skin as a mosquito does, the mango fly (and deer fly) makes a laceration in the skin and subsequently laps up the blood. Female flies require a fair amount of blood for their
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larvae migrate to the subcutaneous tissue, where they mature to adult worms in approximately one year, but sometimes up to four years. Adult worms migrate in the subcutaneous tissues at a speed less than 1 cm/min, mating and producing more microfilariae. The adult worms can live up to 17 years
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2. Wanji, S., Tendongfor, N., Nji, T., Esum, M., Che, J. N., Nkwescheu, A., Alassa, F., Kamnang, G., Enyong, P. A., Taylor, M. J., Hoerauf, A., and D. W. Taylor. 2009. Community-directed delivery of doxycycline for the treatment of onchocerciasis in areas of co-endemicity with loiasis in
Cameroon.
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microfilarial load in the patient prior to treatment. Studies have sought to delineate the sequence of events following ivermectin treatment that lead to neurologic SAE and sometimes death, while also trying to understand the mechanisms of adverse reactions to develop more appropriate treatments.
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In patients with high microfilaria load and/or the possibility of an onchocerciasis coinfection, treatment with DEC and/or ivermectin may be contraindicated or require a substantially lower initial dose, as the rapid microfilaricidal actions of the drugs can provoke encephalopathy. In these cases,
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vector has a limited flying range, but vector elimination efforts are not common, likely because the insects bite outdoors and have a diverse, if not long, range, living in the forest and biting in the open, as mentioned in the vector section. No vaccine has been developed for loiasis and there is
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worms are sexually dimorphic, with males considerably smaller than females at 30–34 mm long and 0.35–0.42 mm wide compared to 40–70 mm long and 0.5 mm wide. Adults live in the subcutaneous tissues of humans, where they mate and produce wormlike eggs called microfilariae. These
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microfilarial loads however, and microfilariae can be observed in the urine occasionally. Generally, patients recovered from SAE within 6–7 months post-ivermectin treatment; however, when their complications were unmanaged and patients were left bed-ridden, death resulted due to gastrointestinal
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are attracted to canopied rainforests, they do not do their biting there. Instead, they leave the forest and take most blood meals in open areas. The flies are attracted to smoke from wood fires and they use visual cues and sensation of carbon dioxide plumes to find their preferred host, humans.
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The identification of microfilariae was made in 1890 by the ophthalmologist
Stephen McKenzie. Localized angioedema, a common clinical presentation of loiasis, was observed in 1895 in the coastal Nigerian town of Calabar—hence the name "Calabar" swellings. This observation was made by a Scottish
602:
Researchers believe that geo-mapping of appropriate habitat and human settlement patterns may, with the use of predictor variables such as forest, land cover, rainfall, temperature, and soil type, allow for estimation of Loa loa transmission in the absence of point-of-care diagnostic tests. In
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infection was noted in the
Caribbean (Santo Domingo) in 1770. A French surgeon named Mongin tried but failed to remove a worm passing across a woman's eye. A few years later, in 1778, the surgeon François Guyot noted worms in the eyes of West African slaves on a French ship to America; he
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Within 12–24 hours post-ivermectin treatment (D1), individuals complained of fatigue, anorexia, and headache, joint and lumbar pain—a bent forward walk was characteristic during this initial stage accompanied by fever. Stomach pain and diarrhea were also reported in several individuals.
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Advanced diagnostic methods have been developed since the appearance the SAEs, but more specific diagnostic tests that have been or are currently being development (see: Diagnostics) must to be supported and distributed if adequate loiasis surveillance is to be achieved.
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The first mechanism suggests that ivermectin causes immobility in microfilariae, which then obstructs microcirculation in cerebral regions. This is supported by the retinal hemorrhaging seen in some patients, and is possibly responsible for the neurologic SAE reported.
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The second hypothesis suggests that microfilariae may try to escape drug treatment by migrating to brain capillaries and further into brain tissue; this is supported by pathology reports demonstrating a microfilarial presence in brain tissue post-ivermectin treatment.
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Blood tests to reveal microfilaremia are useful in many, but not all cases, as one-third of loiasis patients are amicrofilaremic. By contrast, eosinophilia is almost guaranteed in cases of loiasis, and blood testing for eosinophil fraction may be useful.
615:-soaked clothing, and thick, long-sleeved and long-legged clothing ought to be worn to decrease susceptibility to the bite of the mango or deer fly vector. Because the vector is day-biting, mosquito (bed) nets do not increase protection against loiasis.
185:(Calabar swellings) in the arms and legs, caused by immune reactions, are common. Calabar swellings are 3–10 cm (1.2–3.9 in) in surface area, sometimes erythematous, and not pitting. When chronic, they can form cyst-like enlargements of the
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as a skin-test antigen for filariasis diagnosis. If the patient was infected, the extract would cause an artificial allergic reaction and associated
Calabar swelling similar to that caused, in theory, by metabolic products of the worm or dead worms.
280:. Other minor potential reservoirs have been indicated in various fly-biting habit studies, such as hippopotamus, wild ruminants (e.g. buffalo), rodents and lizards. A simian type of loiasis exists in monkeys and apes but it is transmitted by
152:
does not normally affect vision but can be painful when moving about the eyeball or across the bridge of the nose. Loiasis can cause red itchy swellings below the skin called "Calabar swellings". The disease is treated with the drug
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Jacobsen, KH; Andress, BC; Bhagwat, EA; Bryant, CA; Chandrapu, VR; Desmonts, CG; Matthews, TM; Ogunkoya, A; Wheeler, TJ; Williams, AS (October 2022). "A call for loiasis to be added to the WHO list of neglected tropical diseases".
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In a study looking at mass ivermectin treatment in
Cameroon, one of the greatest endemic regions for both onchocerciasis and loiasis, a sequence of events in the clinical manifestation of adverse effects was outlined.
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intensity was with microscopic examination of standardized blood smears, which is not practical in endemic regions. Because mass diagnostic methods were not available, complications started to surface once mass
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There is much overlap between the endemicity of the two distinct filariases, which complicates mass treatment programs for onchocerciasis and necessitates the development of greater diagnostics for loiasis.
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Nutman, TB, KD Miller, M Mulligan, GN Reinhardt, BJ currie, C Steel, and EA Ottesen. "Diethylcarbamazine prophylaxis for human loiasis. Results of a double-blind study."New Eng J Med. (1988), 319: 752–56.
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is also called the "African eye worm". The passage over the eyeball can be sensed, but it usually takes less than 15 minutes. Eyeworms affect men and women equally, but advanced age is a risk factor.
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496:. It is important to time the blood collection with the known periodicity of the microfilariae (between 10:00 a.m. and 2:00 p.m.). The blood sample can be a thick smear, stained with
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microfilariae are 250–300 μm long, 6–8 μm wide and can be distinguished morphologically from other filariae, as they are sheathed and contain body nuclei that extend to the tip of the tail.
441:. The female worms measure 40 to 70 mm in length and 0.5 mm in diameter, while the males measure 30 to 34 mm in length and 0.35 to 0.43 mm in diameter. Adults produce
791:, and mass treatment with ivermectin can have SAE. These include hemorrhage of the conjunctiva and retina, heamaturia, and other encephalopathies that are all attributed to the initial
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In
Central and West Africa, initiatives to control onchocerciasis involve mass treatment with ivermectin. However, these regions typically have high rates of co-infection with both
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Lastly, the third hypothesis attributes hypersensitivity and inflammation at the cerebral level to post-ivermectin treatment complications, and perhaps the release of bacteria from
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208:(itching). They reappear at referent locations at irregular time intervals. Subconjunctival migration of an adult worm to the eyes can also occur frequently, and this is the reason
891:. However, in the study over 97% of the patients complied with treatment, so it does pose as a promising treatment for onchocerciasis, while avoiding complications associated with
569:. Adult worms migrating across the eye are another potential diagnostic, but the short timeframe for the worm's passage through the conjunctiva makes this observation less common.
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infections and is observed between D2 and D5 post-treatment. This can be visible for up to 5 weeks following treatment and has increased severity with higher microfilarial loads.
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1368:
Thomson MC, Obsomer V, Dunne M, Connor SJ, Molyneux DH (September 2000). "Satellite mapping of Loa loa prevalence in relation to ivermectin use in west and central Africa".
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Mechanisms for SAE have been proposed. Though microfilarial load is a major risk factor to post-ivermectin SAE, three main hypotheses have been proposed for the mechanisms.
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As of 2009, loiasis is endemic to 11 countries, all in western or central Africa, and an estimated 12–13 million people have the disease. The highest incidence is seen in
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Gouteux JP, Noireau F, Staak C (April 1989). "The host preferences of
Chrysops silacea and C. dimidiata (Diptera: Tabanidae) in an endemic area of Loa loa in the Congo".
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have also been observed following ivermectin treatment, but this is common when using ivermectin to treat onchocerciasis. The effect is exacerbated when there are high
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Treatment of loiasis involves chemotherapy or, in some cases, surgical removal of adult worms followed by systemic treatment. The current drug of choice for therapy is
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More research into the mechanisms of post-ivermectin treatment SAE is needed to develop drugs that are appropriate for individuals with multiple parasitic infections.
603:
addition to geo-mapping and chemoprophylaxis, the same preventative strategies used for malaria should be undertaken to avoid contraction of loiasis. Specifically,
469:. There the microfilariae develop into first-stage larvae and subsequently into third-stage infective larvae. The third-stage infective larvae migrate to the fly's
1411:
Chippaux JP, Bouchité B, Demanou M, Morlais I, Le Goff G (September 2000). "Density and dispersal of the loaiasis vector
Chrysops dimidiata in southern Cameroon".
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1506:
Nam, Julie N., Shanian Reddy, and Norman C. Charles. "Surgical
Management of Conjunctival Loiasis." Ophthal Plastic Reconstr Surg. (2008). Vol 24(4): 316–17.
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991:, the scientific name for the infectious agent, is an indigenous term itself and it is likely that there are many other terms used from region to region.
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Calabar swellings are the primary tool for visual diagnosis. Identification of adult worms is possible from tissue samples collected during subcutaneous
461:. The fly ingests microfilariae during a blood meal. After ingestion, the microfilariae lose their sheaths and migrate from the fly's midgut through the
1570:"Clinical picture, epidemiology and outcome of Loa-associated serious adverse events related to mass ivermectin treatment of onchocerciasis in Cameroon"
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288:, has been isolated as a vector of simian loiasis, but this variant hunts within the forest and has not as yet been associated with human infection.
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take human blood meals approximately 90% of the time, with hippopotamus, wild ruminant, rodent and lizard blood meals making up the other 10%.
157:(DEC), and when appropriate, surgical methods may be employed to remove adult worms from the conjunctiva. Loiasis belongs to the group of
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filariasis, filaria loa, filaria lacrimalis, filaria subconjunctivalis, Calabar swellings, fugitive swellings, and microfilaria diurnal.
543:
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in certain areas of west and central Africa, as mass ivermectin treatment of onchocerciasis can lead to SAEs in patients who have high
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for circulating filarial antigens constitutes a useful diagnostic approach, because microfilaremia can be low and variable. Though the
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aforementioned reproductive purposes and thus may take multiple blood meals from the same host if disturbed during the first one.
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Grigsby, Margaret E. and Donald H. Keller. "Loa-loa in the District of Columbia." J Narl Med Assoc. (1971), Vol 63(3): 198–201.
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measuring 250 to 300 ÎĽm by 6 to 8 ÎĽm, which are sheathed and have diurnal periodicity. Microfilariae have been recovered from
1017:
883:, the bacteria believed to play a major role in the onset of onchocerciasis, while having no effect on the microfilariae of
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microfilarial densities, or loads. This fact necessitates the development of more specific diagnostics tests for
457:. During the day, they are found in peripheral blood, but during the noncirculation phase, they are found in the
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detection are of limited value because substantial antigenic cross-reactivity exists between filaria and other
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323:. These species exist only in Africa and are popularly known as deer flies and mango, or mangrove, flies.
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Metzger, Wolfram Gottfried; Benjamin Mordmüller (2013). "Loa loa – does it deserve to be neglected?".
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have been developed in recent years. This is despite the fact that many recently developed methods of
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1976:
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and Calabar swellings was not realized until 1910 (by Patrick Manson). The determination of vector—
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437:, where they penetrate into the bite wound. The larvae develop into adults that commonly reside in
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1527:"Encephalopathy after ivermectin treatment in a patient infected with Loa loa and Plasmodium spp"
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2016:
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John, David T. and William A. Petri, Jr. Markell and Voge's Medical Parasitology. 9th ed. 2006.
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when moved. The swellings may last for one to three days and may be accompanied by localized
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Vector elimination strategies are an interesting consideration. It has been shown that the
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loiasis, loaiasis, Calabar swellings, fugitive swelling, tropical swelling, African eyeworm
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are often mentioned as vectors, the two most prominent vectors are from the tabanid genus
284:. There is no crossover between the human and simian types of the disease. A related fly,
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Kamgno J, Boussinesq M, Labrousse F, Nkegoum B, Thylefors BI, Mackenzie CD (April 2008).
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filarial worm can reach from three to seven centimetres long and migrates throughout the
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reports that no serologic diagnostics are available, tests that are highly specific to
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Endemicity is closely linked to the habitats of the two known human loiasis vectors,
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23:"Eye worm" redirects here. For another parasitic nematode known as "eye worm", see
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875:. This drug has been shown to be effective in killing both the adult worm of
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ophthalmologist named Douglas Argyll-Robertson, but the association between
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An area of tremendous concern regarding loiasis is its co-endemicity with
161:, and there is a call for it to be included in the high priority listing.
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Burbelo PD, Ramanathan R, Klion AD, Iadarola MJ, Nutman TB (July 2008).
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but are restricted to travelers who have returned from endemic regions.
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is often prominent in filarial infections. Dead worms may cause chronic
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microfilaremia. Some patients can develop lymphatic dysfunction causing
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One drug that has been proposed for the treatment of onchocerciasis is
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Boussinesq, M., Gardon, J., Gardon-Wendel, N., and J. Chippaux. 2003.
1074:"Filarial worm (Loa loa) in the anterior chamber. Report of two cases"
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Padgett JJ, Jacobsen KH (October 2008). "Loiasis: African eye worm".
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Synonyms for the disease include African eye worm, loaiasis, loaina,
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703:. The disease was once endemic to the western African countries of
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Diethylcarbamazine has been shown as an effective prophylaxis for
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In the past, healthcare providers used a provocative injection of
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after treatment to SAE. This has been observed with the bacteria
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1289:"Rapid, Novel, Specific, High-Throughput Assay for Diagnosis of
922:. It is estimated that over 10 million humans are infected with
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By day 2 (D2), many patients experienced confusion, agitation,
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and can infect another human when the fly takes a blood meal.
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Human loiasis geographical distribution is restricted to the
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infection. A study of Peace Corps volunteers in the highly
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is transmitted by several species of tabanid flies (Order:
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microfilarial load of greater than 3,000 per ml of blood.
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Centers for Disease Control and Prevention (2019-04-18).
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This article is about the disease. For the parasite, see
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It was noted that the patients used in this study had a
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infective larvae (L3) are transmitted to humans by the
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The Medical Letter – Filariasis. Available online at:
516:, concentration techniques can be used. These include
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Parasitic infestations, stings, and bites of the skin
1269:"Loiasis." 2009. The Institute of Tropical Medicine.
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114:. Humans contract this disease through the bite of a
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Vector Control – Horseflies and deerflies (tabanids)
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spp.—was made in 1912 by the British parasitologist
429:, day-biting flies) introduces third-stage filarial
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tissues of the eye where it can be easily observed.
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1010:
Andrews' Diseases of the Skin: clinical Dermatology
687:infection are lower but it is still present in and
338:assume the day-biting tendencies of all tabanids.
764:treatment programs started being carried out for
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959:successfully removed a worm from one man's eye.
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64:microfilaria in thin blood smear (Giemsa stain)
1008:James, William D.; Berger, Timothy G. (2006).
425:. During a blood meal, an infected fly (genus
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837:bleeding, septic shock, and large abscesses.
755:In the 1990s, the only method of determining
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748:Cases have been reported on occasion in the
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409:filariasis originates with flies from two
104:) is a skin and eye disease caused by the
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173:such as loiasis most often consists of
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144:of humans, occasionally crossing into
1821:
1644:
1642:
1593:Parasites & Vectors. 2(39): 1–10.
1227:
1225:
1223:
276:Humans are the primary reservoir for
220:, which may lead to the formation of
164:
1072:Osuntokun O, Olurin O (March 1975).
307:). Although horseflies of the genus
623:little report on this possibility.
13:
1639:
1220:
14:
2961:
1695:
1231:World Health Organization (WHO).
1425:10.1046/j.1365-2915.2000.00249.x
954:The first well recorded case of
520:of the blood sample lyzed in 2%
1651:"History of Human Parasitology"
1596:
1586:
1518:
1509:
1404:
1361:
1352:
1280:
1039:The Lancet. Infectious Diseases
650:
544:Institute for Tropical Medicine
465:to the thoracic muscles of the
361:spp. biting habits showed that
244:
1605:The Lancet Infectious Diseases
1263:
1238:
1206:10.1080/00034983.1989.11812326
1065:
1:
1667:10.1128/CMR.15.4.595-612.2002
1617:10.1016/S1473-3099(13)70263-9
1382:10.1016/S0140-6736(00)02733-1
1152:Trans. R. Soc. Trop. Med. Hyg
1051:10.1016/S1473-3099(22)00064-0
994:
910:, being especially common in
586:
372:
2299:Diphyllobothrium mansonoides
1164:10.1016/j.trstmh.2008.03.022
918:. Humans are the only known
665:Democratic Republic of Congo
626:
476:
385:
271:
7:
2636:Angiostrongylus cantonensis
2285:Spirometra erinaceieuropaei
1247:"CDC – Loiasis – Diagnosis"
978:
723:but has since disappeared.
433:onto the skin of the human
159:neglected tropical diseases
10:
2966:
949:
22:
15:
2890:Capillaria philippinensis
2853:
2822:
2813:Halicephalobus gingivalis
2784:Strongyloides stercoralis
2773:
2680:
2576:
2548:
2501:
2390:
2381:
2354:
2345:
2323:
2260:
2176:
2161:
2072:
2039:
1952:
1887:
1872:
1859:
1788:
1703:
1544:10.4269/ajtmh.2008.78.546
291:
68:
60:
51:
43:
35:
2896:Intestinal capillariasis
1977:Dicrocoelium dendriticum
669:Central African Republic
524:(Knott's technique), or
239:
2883:Trichuriasis / Whipworm
2833:Enterobius vermicularis
2614:Cutaneous larva migrans
2187:Echinococcus granulosus
2127:Heterophyes heterophyes
2113:Gastrodiscoides hominis
1936:Trichobilharzia regenti
1649:Cox FE (October 2002).
397:life cycle. Source: CDC
222:granulomatous reactions
2731:Visceral larva migrans
2512:Gnathostoma spinigerum
2365:Dracunculus medinensis
2271:Diphyllobothrium latum
2050:Paragonimus westermani
2017:Opisthorchis viverrini
1194:Ann Trop Med Parasitol
770:serious adverse events
562:microfilarial loads).
398:
189:around the sheaths of
2598:Ancylostoma duodenale
2141:Metagonimus yokogawai
1531:Am. J. Trop. Med. Hyg
1012:. Saunders Elsevier.
973:Robert Thomson Leiper
946:microfilarial loads.
661:Republic of the Congo
413:species of the genus
393:
204:(skin eruptions) and
2864:Trichinella spiralis
2691:Ascaris lumbricoides
2491:Lymphatic filariasis
2473:Wuchereria bancrofti
1655:Clin. Microbiol. Rev
1309:10.1128/JCM.00490-08
1090:10.1136/bjo.59.3.166
142:subcutaneous tissues
2878:Trichuris trichiura
2805:Trichostrongyliasis
2407:Onchocerca volvulus
1963:Clonorchis sinensis
1898:Schistosoma mansoni
1879:Trematode infection
575:Dirofilaria immitis
538:detection using an
530:nucleopore membrane
439:subcutaneous tissue
236:in the human host.
231:In the human host,
75:Infectious diseases
2764:Parascaris equorum
2750:Dioctophyme renale
2670:Oesophagostomiasis
2642:Angiostrongyliasis
2622:Necator americanus
2592:Hookworm infection
2452:Dirofilaria repens
2277:Diphyllobothriasis
2168:Tapeworm infection
2099:Fasciolopsis buski
1789:External resources
1580:2021-11-22 at the
1297:J. Clin. Microbiol
1273:2008-12-02 at the
736:Chrysops dimidiata
633:diethylcarbamazine
492:procedure to find
399:
165:Signs and symptoms
155:diethylcarbamazine
2945:Tropical diseases
2917:
2916:
2913:
2912:
2849:
2848:
2572:
2571:
2568:
2567:
2319:
2318:
2315:
2314:
2193:E. multilocularis
2157:
2156:
1997:Fasciola hepatica
1849:Parasitic disease
1815:
1814:
1413:Med. Vet. Entomol
1376:(9235): 1077–78.
1347:The Gideon Online
1045:(10): e299–e302.
1019:978-0-7216-2921-6
920:natural reservoir
681:Equatorial Guinea
512:). For increased
187:connective tissue
92:
91:
79:tropical medicine
30:Medical condition
2957:
2798:Trichostrongylus
2790:Strongyloidiasis
2656:Metastrongylosis
2388:
2387:
2352:
2351:
2343:
2342:
2334:
2333:
2238:Hymenolepis nana
2174:
2173:
2074:Intestinal fluke
1885:
1884:
1870:
1869:
1842:
1835:
1828:
1819:
1818:
1701:
1700:
1689:
1688:
1678:
1646:
1637:
1636:
1600:
1594:
1590:
1584:
1566:
1557:
1556:
1546:
1522:
1516:
1513:
1507:
1504:
1495:
1493:
1487:
1479:
1477:
1476:
1470:
1464:. Archived from
1463:
1454:
1445:
1444:
1408:
1402:
1401:
1365:
1359:
1356:
1350:
1344:
1331:
1330:
1320:
1284:
1278:
1267:
1261:
1260:
1258:
1257:
1242:
1236:
1229:
1218:
1217:
1189:
1176:
1175:
1147:
1130:
1127:
1112:
1111:
1101:
1069:
1063:
1062:
1033:
1024:
1023:
1005:
906:forest areas of
609:insect repellent
347:Chrysops silacea
196:, becoming very
88:
87:
56:
33:
32:
2965:
2964:
2960:
2959:
2958:
2956:
2955:
2954:
2920:
2919:
2918:
2909:
2845:
2818:
2769:
2676:
2664:Oesophagostomum
2610:Ancylostomiasis
2580:
2564:
2544:
2524:Gnathostomiasis
2497:
2394:
2377:
2328:
2325:
2311:
2262:Pseudophyllidea
2256:
2207:Taenia saginata
2165:
2153:
2105:Fasciolopsiasis
2090:Echinostomiasis
2068:
2035:
2029:Opisthorchiasis
1948:
1928:Schistosomiasis
1922:S. intercalatum
1876:
1874:Fluke/trematode
1865:
1862:
1855:
1846:
1816:
1811:
1810:
1784:
1783:
1712:
1698:
1693:
1692:
1647:
1640:
1601:
1597:
1591:
1587:
1582:Wayback Machine
1574:Filaria Journal
1567:
1560:
1523:
1519:
1514:
1510:
1505:
1498:
1481:
1480:
1474:
1472:
1468:
1461:
1459:"Archived copy"
1457:
1455:
1448:
1409:
1405:
1366:
1362:
1357:
1353:
1345:
1334:
1303:(7): 2298–304.
1285:
1281:
1275:Wayback Machine
1268:
1264:
1255:
1253:
1243:
1239:
1230:
1221:
1190:
1179:
1148:
1133:
1128:
1115:
1078:Br J Ophthalmol
1070:
1066:
1034:
1027:
1020:
1006:
1002:
997:
981:
952:
895:co-infections.
861:that live with
683:. The rates of
653:
629:
589:
556:parasitic worms
488:is a practical
484:examination of
479:
388:
375:
294:
274:
258:Chrysops silica
247:
242:
167:
146:subconjunctival
82:
31:
28:
21:
12:
11:
5:
2963:
2953:
2952:
2947:
2942:
2937:
2932:
2915:
2914:
2911:
2910:
2908:
2907:
2900:
2899:
2898:
2886:
2874:
2873:
2872:
2859:
2857:
2851:
2850:
2847:
2846:
2844:
2843:
2842:
2841:
2828:
2826:
2820:
2819:
2817:
2816:
2809:
2808:
2807:
2794:
2793:
2792:
2779:
2777:
2771:
2770:
2768:
2767:
2760:
2759:
2758:
2756:Dioctophymosis
2746:
2739:
2738:
2737:
2719:Toxocara canis
2715:
2714:
2713:
2701:
2700:
2699:
2686:
2684:
2678:
2677:
2675:
2674:
2673:
2672:
2660:
2659:
2658:
2650:Metastrongylus
2646:
2645:
2644:
2632:
2631:
2630:
2618:
2617:
2616:
2604:A. braziliense
2594:
2588:
2586:
2574:
2573:
2570:
2569:
2566:
2565:
2563:
2562:
2554:
2552:
2546:
2545:
2543:
2542:
2541:
2540:
2528:
2527:
2526:
2507:
2505:
2499:
2498:
2496:
2495:
2494:
2493:
2469:
2468:
2467:
2465:Dirofilariasis
2455:
2448:
2447:
2446:
2444:Mansonelliasis
2434:
2433:
2432:
2417:
2416:
2415:
2413:Onchocerciasis
2402:
2400:
2385:
2379:
2378:
2376:
2375:
2374:
2373:
2371:Dracunculiasis
2360:
2358:
2349:
2340:
2331:
2321:
2320:
2317:
2316:
2313:
2312:
2310:
2309:
2308:
2307:
2295:
2294:
2293:
2281:
2280:
2279:
2266:
2264:
2258:
2257:
2255:
2254:
2253:
2252:
2250:Hymenolepiasis
2234:
2233:
2232:
2203:
2202:
2201:
2199:Echinococcosis
2182:
2180:
2178:Cyclophyllidea
2171:
2159:
2158:
2155:
2154:
2152:
2151:
2150:
2149:
2147:Metagonimiasis
2137:
2136:
2135:
2133:Heterophyiasis
2123:
2122:
2121:
2119:Amphistomiasis
2109:
2108:
2107:
2095:
2094:
2093:
2078:
2076:
2070:
2069:
2067:
2066:
2065:
2064:
2062:Paragonimiasis
2045:
2043:
2037:
2036:
2034:
2033:
2032:
2031:
2013:
2012:
2011:
1993:
1992:
1991:
1989:Dicrocoeliasis
1973:
1972:
1971:
1958:
1956:
1950:
1949:
1947:
1946:
1945:
1944:
1942:Swimmer's itch
1932:
1931:
1930:
1916:S. haematobium
1893:
1891:
1882:
1867:
1857:
1856:
1845:
1844:
1837:
1830:
1822:
1813:
1812:
1809:
1808:
1793:
1792:
1790:
1786:
1785:
1782:
1781:
1770:
1759:
1744:
1729:
1713:
1708:
1707:
1705:
1704:Classification
1697:
1696:External links
1694:
1691:
1690:
1661:(4): 595–612.
1638:
1611:(4): 353–357.
1595:
1585:
1558:
1517:
1508:
1496:
1446:
1403:
1360:
1351:
1332:
1279:
1262:
1237:
1219:
1177:
1158:(10): 983–89.
1131:
1113:
1064:
1025:
1018:
999:
998:
996:
993:
980:
977:
951:
948:
931:onchocerciasis
766:onchocerciasis
652:
649:
642:Management of
628:
625:
588:
585:
518:centrifugation
478:
475:
417:(deer flies),
387:
384:
374:
371:
293:
290:
286:Chrysops langi
282:Chrysops langi
273:
270:
246:
243:
241:
238:
166:
163:
90:
89:
72:
66:
65:
58:
57:
49:
48:
45:
41:
40:
29:
9:
6:
4:
3:
2:
2962:
2951:
2948:
2946:
2943:
2941:
2938:
2936:
2933:
2931:
2930:Helminthiases
2928:
2927:
2925:
2906:
2905:
2901:
2897:
2894:
2893:
2892:
2891:
2887:
2884:
2880:
2879:
2875:
2871:
2868:
2867:
2866:
2865:
2861:
2860:
2858:
2856:
2852:
2840:
2837:
2836:
2835:
2834:
2830:
2829:
2827:
2825:
2821:
2815:
2814:
2810:
2806:
2803:
2802:
2801:
2799:
2795:
2791:
2788:
2787:
2786:
2785:
2781:
2780:
2778:
2776:
2772:
2766:
2765:
2761:
2757:
2754:
2753:
2752:
2751:
2747:
2745:
2744:
2743:Baylisascaris
2740:
2736:
2732:
2729:
2728:
2727:
2726:
2721:
2720:
2716:
2712:
2709:
2708:
2707:
2706:
2702:
2698:
2695:
2694:
2693:
2692:
2688:
2687:
2685:
2683:
2679:
2671:
2668:
2667:
2666:
2665:
2661:
2657:
2654:
2653:
2652:
2651:
2647:
2643:
2640:
2639:
2638:
2637:
2633:
2629:
2626:
2625:
2624:
2623:
2619:
2615:
2611:
2608:
2607:
2606:
2605:
2600:
2599:
2595:
2593:
2590:
2589:
2587:
2584:
2579:
2575:
2561:
2560:
2556:
2555:
2553:
2551:
2547:
2539:
2536:
2535:
2534:
2533:
2529:
2525:
2522:
2521:
2520:
2519:
2514:
2513:
2509:
2508:
2506:
2504:
2500:
2492:
2489:
2488:
2487:
2486:
2481:
2480:
2479:Brugia malayi
2475:
2474:
2470:
2466:
2463:
2462:
2461:
2460:
2456:
2454:
2453:
2449:
2445:
2442:
2441:
2440:
2439:
2435:
2431:
2429:
2425:
2424:
2423:
2422:
2418:
2414:
2411:
2410:
2409:
2408:
2404:
2403:
2401:
2398:
2393:
2389:
2386:
2384:
2380:
2372:
2369:
2368:
2367:
2366:
2362:
2361:
2359:
2357:
2353:
2350:
2348:
2344:
2341:
2339:
2335:
2332:
2330:
2322:
2306:
2303:
2302:
2301:
2300:
2296:
2292:
2289:
2288:
2287:
2286:
2282:
2278:
2275:
2274:
2273:
2272:
2268:
2267:
2265:
2263:
2259:
2251:
2248:
2247:
2246:
2245:
2240:
2239:
2235:
2231:
2230:Cysticercosis
2227:
2224:
2223:
2222:
2220:
2215:
2214:
2209:
2208:
2204:
2200:
2197:
2196:
2195:
2194:
2189:
2188:
2184:
2183:
2181:
2179:
2175:
2172:
2169:
2164:
2160:
2148:
2145:
2144:
2143:
2142:
2138:
2134:
2131:
2130:
2129:
2128:
2124:
2120:
2117:
2116:
2115:
2114:
2110:
2106:
2103:
2102:
2101:
2100:
2096:
2092:
2091:
2087:
2086:
2085:
2084:
2080:
2079:
2077:
2075:
2071:
2063:
2060:
2059:
2058:
2057:
2056:P. kellicotti
2052:
2051:
2047:
2046:
2044:
2042:
2038:
2030:
2027:
2026:
2025:
2024:
2019:
2018:
2014:
2010:
2007:
2006:
2005:
2004:
1999:
1998:
1994:
1990:
1987:
1986:
1985:
1984:
1979:
1978:
1974:
1970:
1969:Clonorchiasis
1967:
1966:
1965:
1964:
1960:
1959:
1957:
1955:
1951:
1943:
1940:
1939:
1938:
1937:
1933:
1929:
1926:
1925:
1924:
1923:
1918:
1917:
1912:
1911:
1906:
1905:
1900:
1899:
1895:
1894:
1892:
1890:
1886:
1883:
1880:
1875:
1871:
1868:
1864:
1863:platyhelminth
1858:
1854:
1853:helminthiases
1850:
1843:
1838:
1836:
1831:
1829:
1824:
1823:
1820:
1807:
1804:
1800:
1799:
1795:
1794:
1791:
1787:
1780:
1776:
1775:
1771:
1769:
1765:
1764:
1760:
1758:
1754:
1753:
1749:
1745:
1743:
1739:
1738:
1734:
1730:
1728:
1724:
1723:
1719:
1715:
1714:
1711:
1706:
1702:
1686:
1682:
1677:
1672:
1668:
1664:
1660:
1656:
1652:
1645:
1643:
1634:
1630:
1626:
1622:
1618:
1614:
1610:
1606:
1599:
1589:
1583:
1579:
1575:
1571:
1565:
1563:
1554:
1550:
1545:
1540:
1537:(4): 546–51.
1536:
1532:
1528:
1521:
1512:
1503:
1501:
1491:
1485:
1471:on 2009-01-15
1467:
1460:
1453:
1451:
1442:
1438:
1434:
1430:
1426:
1422:
1419:(3): 339–44.
1418:
1414:
1407:
1399:
1395:
1391:
1387:
1383:
1379:
1375:
1371:
1364:
1355:
1348:
1343:
1341:
1339:
1337:
1328:
1324:
1319:
1314:
1310:
1306:
1302:
1298:
1294:
1292:
1283:
1276:
1272:
1266:
1252:
1248:
1241:
1234:
1228:
1226:
1224:
1215:
1211:
1207:
1203:
1200:(2): 167–72.
1199:
1195:
1188:
1186:
1184:
1182:
1173:
1169:
1165:
1161:
1157:
1153:
1146:
1144:
1142:
1140:
1138:
1136:
1126:
1124:
1122:
1120:
1118:
1109:
1105:
1100:
1095:
1091:
1087:
1084:(3): 166–67.
1083:
1079:
1075:
1068:
1060:
1056:
1052:
1048:
1044:
1040:
1032:
1030:
1021:
1015:
1011:
1004:
1000:
992:
990:
986:
976:
974:
970:
966:
960:
957:
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750:United States
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713:Guinea Bissau
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486:microfilariae
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447:spinal fluids
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443:microfilariae
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411:hematophagous
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50:
46:
42:
38:
34:
26:
19:
2940:Eye diseases
2903:
2888:
2876:
2862:
2839:Enterobiasis
2831:
2811:
2797:
2782:
2762:
2748:
2741:
2735:Toxocariasis
2724:
2717:
2703:
2689:
2662:
2648:
2634:
2628:Necatoriasis
2620:
2603:
2596:
2557:
2530:
2517:
2510:
2503:Thelazioidea
2484:
2477:
2471:
2458:
2450:
2436:
2427:
2426:
2419:
2405:
2363:
2297:
2283:
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2218:
2212:
2205:
2192:
2185:
2139:
2125:
2111:
2097:
2088:
2081:
2055:
2048:
2022:
2015:
2003:F. gigantica
2002:
1995:
1982:
1975:
1961:
1934:
1921:
1915:
1909:
1904:S. japonicum
1903:
1896:
1796:
1772:
1761:
1746:
1731:
1716:
1658:
1654:
1608:
1604:
1598:
1588:
1573:
1534:
1530:
1520:
1511:
1473:. Retrieved
1466:the original
1416:
1412:
1406:
1373:
1369:
1363:
1354:
1300:
1296:
1290:
1282:
1265:
1254:. Retrieved
1250:
1240:
1197:
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1151:
1081:
1077:
1067:
1042:
1038:
1009:
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984:
982:
968:
964:
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953:
943:
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934:
928:
923:
916:Ogooué River
897:
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888:
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756:
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734:
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684:
654:
651:Epidemiology
643:
641:
637:
630:
619:
617:
607:-containing
601:
596:
592:
590:
581:
573:
571:
564:
559:
547:
534:
502:haematoxylin
493:
480:
426:
423:C. dimidiata
422:
418:
414:
406:
400:
394:
378:
376:
367:C. dimidiata
366:
362:
358:
356:
351:C. dimidiata
350:
346:
344:
340:
336:C. dimidiata
335:
331:
326:
325:
321:C. dimidiata
320:
316:
312:
308:
296:
295:
285:
281:
277:
275:
265:
262:C. dimidiata
261:
257:
249:
248:
245:Transmission
232:
230:
214:Eosinophilia
209:
175:asymptomatic
168:
149:
137:
136:. The adult
133:
119:
109:
101:
95:
94:
93:
61:
36:
2904:C. hepatica
2870:Trichinosis
2855:Adenophorea
2711:Anisakiasis
2578:Strongylida
2559:Gongylonema
2550:Spiruroidea
2538:Thelaziasis
2518:G. hispidum
2392:Filarioidea
2356:Camallanida
2338:Secernentea
2305:Sparganosis
2291:Sparganosis
2244:H. diminuta
2213:T. asiatica
2083:Echinostoma
2023:O. felineus
2009:Fasciolosis
1954:Liver fluke
1889:Blood fluke
1251:www.cdc.gov
914:and on the
908:West Africa
900:rain forest
877:O. volvulus
873:doxycycline
863:O. volvulus
830:proteinuria
789:O. volvulus
726:Throughout
717:Ivory Coast
540:immunoassay
514:sensitivity
482:Microscopic
357:A study of
181:. Episodic
44:Other names
2924:Categories
2775:Rhabditida
2697:Ascariasis
2682:Ascaridida
2459:D. immitis
2438:Mansonella
2430:filariasis
2397:Filariasis
2324:Roundworm/
2041:Lung fluke
1910:S. mekongi
1851:caused by
1774:DiseasesDB
1475:2009-02-27
1293:Infection"
1256:2022-11-14
995:References
942:with high
826:Haematuria
816:dysarthria
762:ivermectin
742:C. silicea
613:permethrin
587:Prevention
528:through a
526:filtration
490:diagnostic
419:C. silacea
373:Morphology
363:C. silacea
332:C. silacea
317:C. silacea
303:; Family:
183:angioedema
179:lymphedema
171:filariasis
98:filariasis
39:filariasis
2485:B. timori
2383:Spirurida
2329:infection
2226:Taeniasis
2219:T. solium
1983:D. hospes
1866:infection
1861:Flatworm/
1798:eMedicine
1625:1473-3099
1576:2: 1–13.
889:Wolbachia
881:Wolbachia
858:Wolbachia
627:Treatment
477:Diagnosis
471:proboscis
467:arthropod
386:Lifecycle
345:Although
305:Tabanidae
272:Reservoir
218:abscesses
202:urticaria
126:mango fly
124:spp.) or
70:Specialty
2950:Zoonoses
2824:Oxyurida
2705:Anisakis
2583:hookworm
2532:Thelazia
2347:Spiruria
2327:Nematode
1803:derm/888
1685:12364371
1633:24332895
1578:Archived
1553:18385346
1484:cite web
1441:29279412
1433:11016443
1398:11743223
1390:11009145
1327:18508942
1271:Archived
1172:18466939
1059:35500592
979:Synonyms
969:Chrysops
926:larvae.
912:Cameroon
772:(SAEs).
657:Cameroon
620:Chrysops
567:biopsies
552:antibody
522:formalin
510:staining
463:hemocoel
427:Chrysops
415:Chrysops
359:Chrysops
327:Chrysops
313:Chrysops
266:Chrysops
256:vectors
254:deer fly
226:fibrosis
206:pruritus
121:Chrysops
116:deer fly
106:nematode
25:Thelazia
2725:T. cati
2428:Loa loa
2421:Loa loa
2163:Cestoda
1806:med/794
1768:D008118
1318:2446928
1291:Loa loa
1235:. 1997.
1214:2604456
1108:1131358
1099:1017374
989:Loa loa
985:Loa loa
965:Loa loa
956:Loa loa
950:History
944:Loa loa
939:Loa loa
935:Loa loa
924:Loa loa
757:Loa loa
728:Loa loa
685:Loa loa
673:Nigeria
644:Loa loa
593:Loa loa
560:Loa loa
548:Loa loa
536:Antigen
494:Loa loa
407:Loa loa
395:Loa loa
309:Tabanus
301:Diptera
297:Loa loa
278:Loa loa
250:Loa loa
233:Loa loa
210:Loa loa
198:painful
194:tendons
150:Loa loa
138:Loa loa
134:Loa loa
130:vectors
111:Loa loa
102:Loiasis
96:Loa loa
62:Loa loa
37:Loa loa
18:Loa loa
2221:(pork)
1727:1F66.0
1683:
1676:126866
1673:
1631:
1623:
1551:
1439:
1431:
1396:
1388:
1370:Lancet
1325:
1315:
1212:
1170:
1106:
1096:
1057:
1016:
893:L. loa
885:L. loa
853:L. loa
834:L. loa
820:L. loa
805:L. loa
793:L. loa
785:L. loa
709:Guinea
701:Uganda
689:Angola
679:, and
498:Giemsa
455:sputum
431:larvae
403:vector
377:Adult
292:Vector
191:muscle
128:, the
81:
1757:125.2
1742:B74.3
1469:(PDF)
1462:(PDF)
1437:S2CID
1394:S2CID
904:swamp
705:Ghana
693:Benin
677:Gabon
508:(see
506:eosin
459:lungs
451:urine
268:spp.
240:Cause
108:worm
2800:spp.
1779:7576
1763:MeSH
1752:9-CM
1681:PMID
1629:PMID
1621:ISSN
1549:PMID
1490:link
1429:PMID
1386:PMID
1323:PMID
1210:PMID
1168:PMID
1104:PMID
1055:PMID
1014:ISBN
902:and
879:and
828:and
787:and
739:and
721:Mali
719:and
699:and
697:Chad
605:DEET
504:and
453:and
435:host
421:and
405:for
401:The
365:and
349:and
334:and
319:and
260:and
224:and
132:for
100:, (
1748:ICD
1733:ICD
1718:ICD
1671:PMC
1663:doi
1613:doi
1539:doi
1421:doi
1378:doi
1374:356
1313:PMC
1305:doi
1202:doi
1160:doi
1156:102
1094:PMC
1086:doi
1047:doi
597:Loa
500:or
379:Loa
2926::
2733:/
2722:/
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2601:/
2515:/
2482:/
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2020:/
2000:/
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1919:/
1913:/
1907:/
1901:/
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315:—
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