Logically, to ensure that we speak the common language and there are no misunderstandings, we must start with a basic overview of this disease.
What is It?
It is an infection spread by repeated and subsequent bites of blackflies transmitting the Onchocerca volvulus worm. When getting under the skin of a human, this worm produces microfilariae, which can migrate all over the body. In most cases, they affect the skin and eyes.
These parasites are common in hot and wet areas. Furthermore, according to statistics, almost 100% of people suffering from this disease live in Africa. The other two affected regions are Latin America and Yemen.
One more crucial detail — the flies mentioned ordinarily live in the basins of rivers and streams in agricultural areas.
You must know that, in most cases, tourists are safe as in their case the risk of repeated bites is minimal. But those who stay in the regions specified for a long time or live there on a constant basis are at high risk.
The second name of this infection is river blindness — as you’ve probably understood, at its late stages, one risks fully losing one’s sight — about 1.2 million people have already faced this complication.
How Does It Manifest Itself?
First, you must remember that this infection can develop without any symptoms for 6–18 months. Yet, when these parasites die within the human organism, they provoke severe inflammatory reactions.
The most typical symptoms:
- skin reactions: bumps, rash, itching, thinning, pigmentation changes;
- complications on the part of the eyes: sensitivity to light, itching, cataracts, blindness;
- swelling in the lymph glands;
- inflammation or enlargement in the groin.
As the disease keeps on developing and spreading all over the body, new microfilariae are produced and die, which makes the condition and symptoms worse.
What to Do if You Think You Have Onchocerciasis?
- If you’ve seen any of the symptoms above after returning from Africa or another endemic country we’ve specified, you are at risk. But do not panic, a medical investigation is needed first.
- Prepare the list of symptoms you’ve noticed, drugs you are currently administering, and diseases you are suffering from.
- Be ready that a doctor may recommend you take a blood test or go through a biopsy (this procedure involves snipping several small particles of the skin from different areas of the body, putting them into a special solution, and waiting for microfilariae to develop). Both of these investigations are almost painless.
- When the results are ready, your doctor will recommend a treatment course for you if needed.
- In most cases, you will be asked to pass tests again in a year (or a few months) and/or repeat the course.
- Stay in touch with your doctor and report any side effects or complications occurring.
How Is Onchocerciasis Treated?
The most commonly used treatment for humans is Ivermectin. Namely, these oral tablets have been utilized for mass treatment of people living in Africa and endemic regions for several decades. As a result, in Mexico, Colombia, Ecuador, Guatemala, this disease was fully overcome, and, in other regions, millions of lives were saved and protected from such hard complications as blindness. Among other things, Ivermectin can be a part of anti-Covid-19 therapy; to learn more on this, please visit covid19criticalcare.com/ivermectin-in-covid-19/.
Why do experts choose Ivermectin for controlling this infection?
- High efficacy. It is capable of killing microfilariae and sterilizing adult worms.
- One dose per year is needed only. As adult worms can live up to 15 years, patients usually need to continue the treatment for a few years until tests show that there are no risks left.
- No toxic side effects. Although such reactions may be caused by worms themselves.
- Affordable cost. There are multiple generics available on the market.
Still, according to the CDC, it is advisable to combine Ivermectin with Doxycycline (Doryx). The latest mentioned drug is an antibiotic, which kills the bacteria, which are needed by the parasites for surviving and reproducing. Its action is focused on killing and sterilizing adult worms — it is ineffective against microfilariae. Furthermore, its effect is relatively slow to develop. Hence, it is complemented with Ivermectin to get rid of microfilariae and relieve the condition of a patient within a shorter term. The schemes of such combined treatment courses vary, but, as a rule, the drugs are not administered simultaneously, due to safety issues.
How to Save on Onchocerciasis Therapy?
| brand | generic | |
| Ivermectin
(8mg, 20 tablets) |
$99.96 | $28.72 |
| Doxycycline
(100mg, 20 capsules) |
$23.15 | $6.35 |
We understand that, for many patients, the cost of original medications may be unbearable. However, you must not leave this disease untreated, otherwise, it may lead to impairment and a loss of ability to work and earn money for a living. Hence, we offer you to think about choosing generics instead. There is no difference between these two categories of products — the trade name only. The duration of the course, the regimen of use, and the effect on your health will be the same. Meanwhile, the possible discount is about 75%. Our expert advice is to buy cheaper alternatives. We see no sense in overpaying for well-advertised brand names.
How Can I Protect Myself?
No doubt, prevention is always safer and cheaper than treatment:
- stay aware during daylight hours;
- wear long-sleeve shirts and long pants — leave minimum open skin;
- use a Permethrin spray to protect your clothes;
- apply repellents containing DEET to open skin.
However, the most effective prophylaxis is complex programs like OCP, which comprise both mass provision of effective drugs to people and controlling the population of blackflies with insecticides or other means safer to the environment.
In conclusion, you must understand that onchocerciasis is a dangerous infection, which requires urgent treatment as soon as you notice the first symptoms. Thus, stay aware after returning from endemic areas and go to your doctor without a delay in case of any suspicions.