1921
Volume 100, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Many parasitic infections have different presenting features in endemic individuals (ENDs) and immunologically naive temporary residents (TRs). Temporary residents with loiasis often display acute symptoms and hypereosinophilia, in contrast to a parasite-induced subclinical state in chronically infected ENDs. Few studies have examined differences in ENDs and TRs infected with the related filarial parasite . We identified 40 TRs and 36 ENDs with imported onchocerciasis at the National Institutes of Health between 1976 and 2016. All study subjects received an extensive pretreatment medical history, physical examination, and laboratory investigations. We performed additional parasite-specific serologic testing on stored patient sera. Asymptomatic infection occurred in 12.5% of TRs and no ENDs ( = 0.06). Papular dermatitis was more common in TRs (47.5% versus 2.7%, < 0.001), whereas more pigmentation changes occurred in ENDs (41.7% versus 15%, = 0.01). Only endemic patients reported visual disturbance (13% versus 0%, = 0.03). One TR (3.3%) had onchocercal eye disease, compared with 22.6% of ENDs ( = 0.053). Absolute eosinophil counts (AECs) were similar in ENDs and TRs ( = 0.5), and one-third of subjects had a normal AEC. Endemic individuals had higher filarial-specific IgG4 and were more likely to be positive for IgG4 antibodies to -16. Temporary residents and ENDs with imported infection presented with different dermatologic manifestations; ocular involvement occurred almost exclusively in ENDs. Unlike , clinical differences appear not to be eosinophil-mediated and may reflect chronicity, intensity of infection, or the presence of in .

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References

  1. WHO, 2018. Onchocerciasis. Available at: http://www.who.int/mediacentre/factsheets/fs374/en/. Accessed January 4, 2019.
    [Google Scholar]
  2. WHO, 2016. Progress report on the elimination of human onchocerciasis, 2015–2016. Wkly Epidemiol Rec 91: 505514.
    [Google Scholar]
  3. Lipner EM, Law MA, Barnett E, Keystone JS, von Sonnenburg F, Loutan L, Prevots DR, Klion AD, Nutman TB; GeoSentinel Surveillance Network, 2007. Filariasis in travelers presenting to the GeoSentinel surveillance network. PLoS Negl Trop Dis 1: e88.
    [Google Scholar]
  4. Norman FF, Pérez de Ayala A, Pérez-Molina J-A, Monge-Maillo B, Zamarrón P, López-Vélez R, 2010. Neglected tropical diseases outside the tropics. PLoS Negl Trop Dis 4: e762.
    [Google Scholar]
  5. Enk CD et al., 2003. Onchocerciasis among Ethiopian immigrants in Israel. Isr Med Assoc J 5: 485488.
    [Google Scholar]
  6. Herrick JA, Metenou S, Makiya MA, Taylar-Williams CA, Law MA, Klion AD, Nutman TB, 2015. Eosinophil-associated processes underlie differences in clinical presentation of loiasis between temporary residents and those indigenous to Loa-endemic areas. Clin Infect Dis 60: 5563.
    [Google Scholar]
  7. Klion AD, Massougbodji A, Sadeler BC, Ottesen EA, Nutman TB, 1991. Loiasis in endemic and nonendemic populations: immunologically mediated differences in clinical presentation. J Infect Dis 163: 13181325.
    [Google Scholar]
  8. Nutman TB, Miller KD, Mulligan M, Ottesen EA, 1986. Loa loa infection in temporary residents of endemic regions: recognition of a hyperresponsive syndrome with characteristic clinical manifestations. J Infect Dis 154: 1018.
    [Google Scholar]
  9. Dissanayake S, 2001. In Wuchereria bancrofti filariasis, asymptomatic microfilaraemia does not progress to amicrofilaraemic lymphatic disease. Int J Epidemiol 30: 394399.
    [Google Scholar]
  10. McCarthy JS, Ottesen EA, Nutman TB, 1994. Onchocerciasis in endemic and nonendemic populations: differences in clinical presentation and immunologic findings. J Infect Dis 170: 736741.
    [Google Scholar]
  11. Antinori S, Parravicini C, Galimberti L, Tosoni A, Giunta P, Galli M, Corbellino M, Ridolfo AL, 2017. Is imported onchocerciasis a truly rare entity? Case report and review of the literature. Travel Med Infect Dis 16: 1117.
    [Google Scholar]
  12. Pryce D, Behrens R, Davidson R, Chiodini P, Bryceson A, McLeod J, 1992. Onchocerciasis in members of an expedition to Cameroon: role of advice before travel and long term follow up. BMJ 304: 12851286.
    [Google Scholar]
  13. Smit AM, Zuidema PJ, 1973. Onchocerciasis imported in The Netherlands; a review of 100 cases. Ned Tijdschr Geneeskd 117: 12251230.
    [Google Scholar]
  14. Woodruff AW, Bell S, Ridley DS, Schofield FD, 1958. Clinical, diagnostic and therapeutic aspects of onchocerciasis. Trans R Soc Trop Med Hyg 52: 97108.
    [Google Scholar]
  15. Baum S, Greenberger S, Pavlotsky F, Solomon M, Enk CD, Schwartz E, Barzilai A, 2014. Late-onset onchocercal skin disease among Ethiopian immigrants. Br J Dermatol 171: 10781083.
    [Google Scholar]
  16. Remme J, Dadzie KY, Rolland A, Thylefors B, 1989. Ocular onchocerciasis and intensity of infection in the community. I. West African savanna. Trop Med Parasitol 40: 340347.
    [Google Scholar]
  17. Murdoch ME, Asuzu MC, Hagan M, Makunde WH, Ngoumou P, Ogbuagu KF, Okello D, Ozoh G, Remme J, 2002. Onchocerciasis: the clinical and epidemiological burden of skin disease in Africa. Ann Trop Med Parasitol 96: 283296.
    [Google Scholar]
  18. Duke BO, 1981. Geographical aspects of onchocerciasis. Ann Soc Belg Med Trop 61: 179186.
    [Google Scholar]
  19. WHO, 1987. WHO Expert Committee on Onchocerciasis: [Geneva, 21–29 April 1986): Third Report. Geneva, Switzerland: World Health Organization.
    [Google Scholar]
  20. Choi EH, Nutman TB, Chanock SJ, 2003. Genetic variation in immune function and susceptibility to human filariasis. Expert Rev Mol Diagn 3: 367374.
    [Google Scholar]
  21. Henry NL, Law M, Nutman TB, Klion AD, 2001. Onchocerciasis in a nonendemic population: clinical and immunologic assessment before treatment and at the time of presumed cure. J Infect Dis 183: 512516.
    [Google Scholar]
  22. More SJ, Copeman DB, 1990. A highly specific and sensitive monoclonal antibody-based ELISA for the detection of circulating antigen in bancroftian filariasis. Trop Med Parasitol 41: 403406.
    [Google Scholar]
  23. Ottesen EA, Weller PF, Lunde MN, Hussain R, 1982. Endemic filariasis on a Pacific island. II. Immunologic aspects: immunoglobulin, complement, and specific antifilarial IgG, IgM, and IgE antibodies. Am J Trop Med Hyg 31: 953961.
    [Google Scholar]
  24. Kubofcik J, Fink DL, Nutman TB, 2012. Identification of Wb123 as an early and specific marker of Wuchereria bancrofti infection. PLoS Negl Trop Dis 6: e1930.
    [Google Scholar]
  25. Klion AD, Vijaykumar A, Oei T, Martin B, Nutman TB, 2003. Serum immunoglobulin G4 antibodies to the recombinant antigen, Ll‐SXP‐1, are highly specific for Loa loa infection. J Infect Dis 187: 128133.
    [Google Scholar]
  26. Weil GJ, Steel C, Liftis F, Li BW, Mearns G, Lobos E, Nutman TB, 2000. A rapid-format antibody card test for diagnosis of onchocerciasis. J Infect Dis 182: 17961799.
    [Google Scholar]
  27. Makiya MA, Herrick JA, Khoury P, Prussin CP, Nutman TB, Klion AD, 2014. Development of a suspension array assay in multiplex for the simultaneous measurement of serum levels of four eosinophil granule proteins. J Immunol Methods 411: 1122.
    [Google Scholar]
  28. Nozais JP, Caumes E, Datry A, Bricaire F, Danis M, Gentilini M, 1997. Apropos of 5 new cases of onchocerciasis edema [in French]. Bull Soc Pathol Exot 90: 335338.
    [Google Scholar]
  29. Ezzedine K, Malvy D, Dhaussy I, Steels E, Castelein C, De Dobbeler G, Heenen M, 2006. Onchocerciasis-associated limb swelling in a traveler returning from Cameroon. J Trav Med 13: 5053.
    [Google Scholar]
  30. WHO, 1995. Onchocerciasis and its control. Report of a WHO expert committee on onchocerciasis control. World Health Organ Tech Rep Ser 852: 1104.
    [Google Scholar]
  31. Eberhard ML, Dickerson JW, Tsang VC, Walker EM, Ottesen EA, Chandrashekar R, Weil GJ, Trpis M, Strobert E, Constantinidis I, 1995. Onchocerca volvulus: parasitologic and serologic responses in experimentally infected chimpanzees and mangabey monkeys. Exp Parasitol 80: 454462.
    [Google Scholar]
  32. Taylor HR, Trpis M, Cupp EW, Brotman B, Newland HS, Soboslay PT, Greene BM, 1988. Ivermectin prophylaxis against experimental Onchocerca volvulus infection in chimpanzees. Am J Trop Med Hyg 39: 8690.
    [Google Scholar]
  33. GBD 2015 DALYs and HALE Collaborators, 2016. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 388: 16031658.
    [Google Scholar]
  34. Fink DL, Kamgno J, Nutman TB, 2011. Rapid molecular assays for specific detection and quantitation of Loa loa microfilaremia. PLoS Negl Trop Dis 5: e1299.
    [Google Scholar]
  35. D’Ambrosio MV et al., 2015. Point-of-care quantification of blood-borne filarial parasites with a mobile phone microscope. Sci Transl Med 7: 286re4.
    [Google Scholar]
  36. Kamgno J et al., 2017. A test-and-not-treat strategy for onchocerciasis in Loa loa-endemic areas. N Engl J Med 377: 20442052.
    [Google Scholar]
  37. Saint André Av et al., 2002. The role of endosymbiotic Wolbachia bacteria in the pathogenesis of river blindness. Science 295: 18921895.
    [Google Scholar]
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  • Received : 15 Sep 2018
  • Accepted : 27 Dec 2018
  • Published online : 11 Feb 2019
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