• 1

    Ottesen EA, 1992. The Wellcome Trust Lecture. Infection and disease in lymphatic filariasis: an immunological perspective. Parasitology 104 (Suppl):S71–S79.

    • Search Google Scholar
    • Export Citation
  • 2

    Leeuwin RS, 1962. Microfilaria in Surinamese living in Amsterdam. Trop Geogr Med 14 :355–360.

  • 3

    Jachowski LA, Otto GF, Wharton JD, 1951. Filariasis in American Samoa. I. Loss of microfilaria in the absence of reinfection. Proc Helminth Soc Washington 18 :25–28.

    • Search Google Scholar
    • Export Citation
  • 4

    Steel C, Guinea A, Ottesen EA, 1996. Evidence for protective immunity to bancroftian filariasis in the Cook Islands. J Infect Dis 174 :598–605.

    • Search Google Scholar
    • Export Citation
  • 5

    Coggeshall LT, 1945. Malaria and filariasis in the returning servicemen. Am J Trop Med Hyg 25 :177–196.

  • 6

    Trent S, 1963. Reevaluation of World War II veterans with filariasis acquired in the South Pacific. Am J Trop Med Hyg 12 :877–887.

  • 7

    Anonymous, 1945. Bulletin U.S. Army Medical Department. U.S. Army Medical Department, Washington, DC.

  • 8

    Wartman WB, 1947. Filariasis in American Armed Forces in World War II. Medicine 26 :333–394.

  • 9

    Nutman TB, 1991. Experimental infection of humans with filariae. Rev Infect Dis 13 :1018–1022.

  • 10

    Edeson JF, Wilson T, Wharton RH, Laing AB, 1960. Experimental transmission of Brugia malayi and B. pahangi to man. Trans R Soc Trop Med Hyg 54 :229–234.

    • Search Google Scholar
    • Export Citation
  • 11

    Yokogawa S, 1939. Transmission of W. bancrofti. Trans R Soc Trop Med Hyg 33 :363–364.

  • 12

    Liu JY, Wang GQ, Chen YN, Tu ZP, Fang Z, 1989. Observations on the clinical manifestations and treatment of an experimental infection with Brugia malayi in man. J Trop Med Hyg 92 :93–96.

    • Search Google Scholar
    • Export Citation
  • 13

    Lammie PJ, Hitch WL, Walker AE, Hightower W, Eberhard ML, 1991. Maternal filarial infection as risk factor for infection in children. Lancet 337 :1005–1006.

    • Search Google Scholar
    • Export Citation
  • 14

    Steel C, Guinea A, McCarthy J, Ottesen E, 1994. Long-term effect of prenatal exposure to maternal microfilaraemia on immune responsiveness to filarial parasite antigens. Lancet 343 :890–893.

    • Search Google Scholar
    • Export Citation
  • 15

    Hyma B, Ramesh A, Gunasekaran K, 1989. Lymphatic filariasis in Madras, India. Soc Sci Med 29 :983–990.











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  • 1 Boehringer-Ingelheim Professor of Immunology, Department of Pathology, Farmington, Connecticut

Lymphatic filariasis has been described as a “spectral disease”. Analysis of the natural course of infection in nonendemic individuals as well as experimental infections of “volunteers” suggests that the filarial parasites are not inherently aggressive infectious agents. Experimental infections of humans with infective larvae result in transient, low-level microfilaremia, if at all. Nonendemic individuals with limited exposure show no evidence of persistent infection or pathology. Nonendemic individuals exposed to repeated infections show accelerated pathology. It is tempting to speculate that normal, immunocompetent residents in an endemic area show either (a) no pathology (endemic normals) because they are subject to the relatively low levels of infection or (b) chronic pathology if they are repeatedly infected. It would appear that only those individuals rendered immunologically tolerant to filarial parasites become productively infected with the filarial parasites. The intensity of transmission may underlie the differences in clinical presentation seen in diverse global pockets of endemicity.