River blindness is very common in Central Africa and is mainly termed as an African disease because of this. It occurs among inhabitants who live in villages in close proximity to streams and rivers. The disease is caused by a parasitic worm that finds its way into the skin of the affected person and causes untold damage leaving the person blind in all cases.
It can also cause deformity and discomfort. Onchocerca volvulus is the nematode that causes this multi systemic disease, which is chronic and is also known as Onchocerciasis or Robles' Disease. The devastating illness occurs because of the bite of black flies and leads to the formation of a large tissue roundworm just beneath the human skin and it spreads mainly through the bites of these black flies from person to person.
Black flies, the carriers, breed in the streams and rivers where fast flowing waters occur, with humidity running high and surrounded by areas with thick plant growth and vegetation. Though originally from Central Africa, it has now spread across many nations like Mexico, Saudi Arabia, Venezuela, Columbia and other countries where migrant laborers affected by this parasitic worm have migrated.
Symptoms of River Blindness
The symptoms of the illness can’t seen in persons who have been infected with just a few worms, but in persons who are residing in areas where black flies are abound and where other infected people are living. People can be continuously re- exposed to the illness again and again, and this can worsen the illness and make it chronic.
The tiny worms cause damage to the immune system and the symptoms vary, based on how far the immune system has been affected. The young worms live beneath the skin’s tissues and finally die there. It takes about three to fifteen months for the infection to incubate, before any symptoms finally surface. The symptoms of the illness are:
- Skin Rashes: A skin rash appears and this can be scratchy and can be unbearable and severe. The skin becomes painful, swollen and remains hot.
- Nodules: Nodules form beneath the skin’s surface and these hold nothing less than two adult living worms that multiply and produce more worms. In Africa, the nodules are found below the waist, while in countries like South and Central America, the nodules appear above the waist area, especially on the head. This occurs because of the various breeding patterns of the black flies.
- Lymph Node Problems: The lymph nodes become inflamed due to the presence of the microfilaria of the worms.
- Thick Skin: The thickening of skin occurs as time passes, often taking a wrinkled appearance, dark and de-pigmented or bleached. The affected area appears like the skin pattern of a leopard. In Central America affected persons usually have thickened earlobes, typical facial skin with rashes.
- Hanging Groin: In Africa, affected persons, especially men, suffer from a condition called hanging groin which is very common. In this condition, the infected lymph nodes are enclosed in tissue sacs that hang from the groin. Enlargement of the scrotum is common.
- Loss of Eyesight: Young worms can cause blindness as they invade the eye tissues located at the back of the eye leading to drop in immune response. Some victims who are affected early in age often turn completely blind by middle age. Adult worms in scalp pose higher risk of blindness.
Is River Blindness Curable?
There is no drug that can cure this devastating illness. Most infected persons live in underdeveloped countries that have very poor infrastructure and access to health care facilities is normally low in such cases. These affected individuals become the carriers of the parasite and this affects the others around them.
A handful of drugs and other forms of treatment help to control the illness. The use of drugs like Suramin, Ivermectin and DEC or Diethylcarbamazine can help in controlling the disease. Surgical removal of the worms is another option of treatment.
Suramin kills both young and adult worms but has serious side effects like kidney damage. DEC or Diethylcarbamazine kills the microfilaria. The treatment (through drugs) should be provided continuously. Fever, headache, blindness, itchy skin and a steep drop in blood pressure are the serious side effects of drug overuse. Ivermectin, administered in a yearly dosage, is currently being used for the treatment of Onchocerca Volvulus. The surgical removal of worms is not a permanent cure, as some worms are migratory.
Although it’s not too likely that you’ll experience this disease (unless you live among tribes in such conditions), getting your status checked every now and then is important.
