Loa Loa

By:Gian Harvey M. Camarao

ETO SIYA!

YAN
PALA
YUN!!
Loa loa

• Disease Name: Loiasis

• Other name: Loa loa filiarasis, Worm Worm or Eye worm.

• Scientific name: Loa loa

• Phylum: Nematode
• Family: Onchocercidae
• Genus: Loa

- a filarid nematode commonly referred to as the African eye worm.

Loa loa

-DEER FLY (Genus chrysops)

-The vector for Loa
loa filariasis are flies from two
species of the
genus Chrysops, C.
silacea and C. dimidiata. 
Geographical Distribution

• Loa loa is found in Africa.

• It is an African disease restricted to the equatorial rain forest regions of Central
and West Africa
• Loiasis is endemic across central Africa. This is widely prevalent in rain
forest of both west and central Africa, extending from Sierra leone to
Uganda and south ward to Angol. High rate of infection are found in
Nigeria, Cameroon and ZaireLoiasis is endemic across central Africa.
This is widely prevalent in rain forest of both west and central Africa,
extending from Sierra leone to Uganda and south ward to Angol. High
rate of infection are found in Nigeria, Cameroon and Zaire
• The limits of its geographical distribution are Benin to the west.
Morphology

Adult worm •.
•The adult worm are thin, whitish and
Microfilaria
thread like. •They are found in peripheral blood during
•The anterior and tapers to a narrow
day time. Occasionally microfilaria have been
head. Surface of the body is covered with
demonstrated in the urine, sputum and even
small knobs.
CSF.
•Microscopically the cuticula is found to
•Microfilaria is sheathed and measures 250-
have numerous rounded protuberances
300 mm in length and 6-8 mm in breadth.
(cuticular bosses) which vary in number •The column of nuclei extends upto the tail-
and arrangement in two sexes.
tip.
•The female worm is 4-7 cm in length and
•Sheath stains poorly with Geimsa stain but
0.5mm in diameter.
stains well with iron-haematoxylin.
•The life span of worm is 4-12 years.
LIFE CYCLE
LIFE CYCLE

• (1) The larvae develop into adults that commonly reside in

subcutaneous tissue .
• (2) 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 microfilariae
measuring 250 to 300 µm by 6 to 8 μm, which are sheathed and
have diurnal periodicity. During the day they are found in the
peripheral blood, but during non-circulation phase, they are
found in the lungs  .
LIFE CYCLE

• (3) The fly ingests microfilariae during a blood meal 

• (4) After ingestion, the microfilariae lose their sheaths and migrate
from the fly’s midgut through the hemocoel to the thoracic
muscles of the arthropod
• (5)  There the microfilariae develop into first-stage larvae
• (6) and subsequently into third-stage infective larvae
• (7) The third-stage infective larvae migrate to the fly’s proboscis 
• (8)  and can infect another human when the fly takes a blood meal.
PATHOGENESIS

• Microfilaria are not pathogenic.

• Adult loa loa worms which live in the subcutaneous
tissue are pathogenic.
• The migrating adult worms provoke an intense
inflammatory reaction.
• Calabar swelling is the typical pathological feature of
the loa loa filariasis. It is formed as a result of an
allergic response to adult worms migrating in the
subcutaneous tissue.
DIAGNOSIS

• Diagnosis of loa loa:

• Clinical diagnosis is suggested in patients with typical fugitive
swellings, high eosinophilia and history of residence in an area
endemic for the disease
• Specific diagnosis is made by demonstration and identification of
microfilaria in the peripheral blood
• Demonstration of the worm in the cornea or over the bridge of the
nose.
• Identification of the adult worm surgically removed from the skin or
conjunctiva.
DIAGNOSIS

• Loa loa is usually diagnosed by the finding of microfilaria in

peripheral blood smears or adults in the subconjunctiva. The
blood films may be thick or thin and stained with Giemsa or
hematoxylin-and-eosin. For increased sensitivity, concentration
techniques can be used. These include centrifugation of the
blood sample lysed in 2% formalin (Knott’s technique), or
filtration through a Nucleopore® membrane. Microfilariae of L.
loa exhibit diurnal periodicity and a diagnosis is best made from
blood collected during the mid-day (10 AM-2 PM). The presence
of Calabar swellings can aid in the diagnosis.
TREATMENT

• Diethylcarbamazine(DEC) is the drug of choice.

• Dose – 6mg/day, 3 times daily for 12 days

• OTHER NOTES:
• The incubation period is on an average 3-4 years.
• Loiasis is  asymptomatics in many cases.
PREVENTION AND CONTROL

• Treatment of infected populations

• Using insect repellent
• Wearing protective clothing
• Avoiding visit to the places endemic for the disease