Loiasis is a parasitic infection caused by the nematode worm “loa loa” and endemic to West Africa. It causes skin bumps, eye and mucous membrane infections, inflammation, and joint pains. Treatment involves chemotherapy or surgery, and prevention includes using bed nets, repellents, and prophylactic medications. Patients with a travel history to endemic regions should inform their doctors to avoid delayed diagnosis.
Loiasis is a parasitic infection endemic to rainforest and swampy regions of West Africa. It is caused by a nematode worm known locally as “loa loa” and is sometimes referred to as heartworm disease loa loa. Patients with this condition develop an infection under the skin that can also spread to the eyes and mucous membranes. As the worms travel through the body, they cause inflammation and irritation. This condition can appear with comorbidities, making effective treatment difficult.
Infection begins with a fly bite. The worms can incubate for months and even years before they begin traveling through the skin, causing distinctive bumps known as Calabar bumps. Patients usually report itching, irritation and redness. The worms can be visible in the eyes and mucous membranes, traveling just below the surface. Muscles and joints can swell, causing aches, pains and limited mobility. Patients may also experience eye pain due to the movement of the worms.
Loa loas can live for years inside a loiasis patient. The patient may feel discomfort, but the infection will not be fatal. Treatment involves chemotherapy to kill the worms. In some cases, a doctor may recommend surgery to remove the worms and make treatment easier. Once the worms are dead, the patient should experience improvement and feel more comfortable about her. Persistent skin irritation is treatable with soothing creams to reduce inflammation while the body recovers.
There are a few prevention techniques available for dealing with loiasis. The use of bed nets, repellents and appropriate clothing can reduce the risk of being bitten by a fly carrying the parasite. Additionally, prophylactic medications can be taken to prevent infection in the event of a bite. Travelers can access these drugs along with other prophylactic treatments that a doctor may recommend, such as antimalarial drugs. The costs of preventing loiasis vary depending on the measures taken by the patient, but are usually less than the costs of treatment.
Patients with a history of traveling to regions where parasites such as the loa loa worm are present should ensure this is noted in their medical records. The long incubation of many infections means that patients and doctors may not immediately link symptoms such as itchy red bumps with a condition such as loiasis, delaying diagnosis and appropriate treatment. Recording any travel history will allow a physician to consider the possibility of a long dormant parasitic infection when a patient arrives with a complaint of skin breakdown or mucosal irritation.
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