STUDIES OF FILARIASIS IN SOLDIERS EVACUATED FROM THE SOUTH PACIFIC

Abstract

Clinical findings and results of intracut. and complement-fixation tests in 145 soldiers evacuated from the South Pacific area because of suspected bancroftian filariasis, are presented. Signs and symptoms suggestive of filariasis, including lymphadenopathy, lymphangitis, scrotal edema, funiculitis, orchitis and varicocele, arose on the average after about 13 months residence in an endemic area. The symptoms were, in general, mild, and only 6 patients experienced bouts of acute lymphangitis during the period of study in the United States. Microfilariae were demonstrated in the blood on one occasion in each of 4 patients, in 2 of these at overseas hospitals. In 47 patients eosinophilia of 4% or greater was found. Microscopic examination of excised lymph nodes in 19 cases showed only a nonspecific inflammatory response ("reactive lymph node"). In 4 of 29 cases roentgenograms of the scrotum showed tiny areas of calcification. Direct intracut. tests using antigens of Dirofilaria immitis and Setaria equina in 1:8000 dilution gave positive responses in 54% of cases as compared with 6% in a series of 106 control subjects. In passive transfer tests positive responses were obtained to either or both D. immitis or S. equina antigen in 1:8000 dilution in 29% of cases. Positive complement-fixation tests were found in 95 (66%) of 143 patients studied. There was agreement between the results of the complement fixation tests and the direct intracut. tests with S. equina and D. immitis in 66 and 71% of patients, respectively. Therapy included a liberal diet, reconditioning by means of gradually increasing activity, and psychotherapy to allay fears as to possible future complications of the disease. The outlook for the men is considered good because of the relatively short residence in the endemic area and the slight degree of infection.