Onchocerciasis

Disease/Syndrome
Onchocerciasis
Category
Infection, Travel
Acute/Chronic
Chronic
Synonyms
River Blindness; Onchocerca volvulus;
Biomedical References
Comments
INITIAL SYMPTOMS:
Severe, intractable pruritus, localized papular eruptions, and conjunctivitis; [ID, p. 2370]

FINDINGS:
Adult filarial worms produce microfilariae that migrate through the skin (dermatitis and nodules) and into the eye (visual impairment and blindness). "Leopard skin" pigmentary changes appear on the lower extremities. The skin nodules containing adult worms are called "onchocercoma." Massive enlargement of inguinal and femoral lymph nodes may occur. The disease varies by region probably because of different strains of the parasite: blindness in African savannas and skin disease in forests. [Merck Manual, p. 1347-8; CCDM, p. 438]

SKIN DISEASE:
Sowda is a skin disease that usually affects only one limb, and it is found in Yemen and central Sudan. [CCDM, p. 438] Onchodermatitis has been classified as: 1) acute papular dermatitis; 2) chronic papular dermatitis; 3) lichenified dermatitis; 4) atrophy; and 5) depigmentation. Sowda is a syndrome of hyperpigmented papules and plaques with associated regional lymphadenopathy. The most common symptom in expatriates is itching--an urticaria-like rash is often present on the trunk. Marked eosinophilia is associated with this infection. [Guerrant, p. 742-4, 943] Subcutaneous nodules are about 0.5-3 cm in size and usually detected over bony prominences. These onchocercoma contain the worms that can live for 8-10 years. Sonography can distinguish between onchocercoma and other subcutaneous nodules. [Cecil, p. 2073-4]

EPIDEMIOLOGY:
Travelers at risk are expatriate groups, such as missionaries, field scientists, and Peace Corps volunteers. Blackflies typically bite during the day near flowing rivers. [CDC Travel, p. 271] Local control programs have been very effective; [CCDM]

For updated text and symptoms of infectious diseases, see iddx.com.
Latency/Incubation
About one year for larvae from bite of black fly to develop into microfilariae; [CCDM, p. 439]
Diagnostic
Skin biopsy to identify microfilariae or adult worms; Characteristic eye lesions; Antibody tests to detect infection if microfilariae cannot be found; Serum antifilarial antibody tests available from CDC (404-718-4745): [CDC Travel]
ICD-9 Code
125.3
ICD-10 Code
B73
Effective Antimicrobics
Yes
Reference Link

Symptoms/Findings, Job Tasks, and Agents Linked to This Disease

Job Tasks

High risk job tasks associated with this disease:

Agents

Hazardous agents that cause the occupational disease: