prognosis for those infected
Across the years, the prognosis of Onchocerciasis has been changed greatly – this can be contributed to improving awareness of the disease and medical discoveries. Before 10 years ago, there was absolutely no professional treatment available for those infected with Onchocerciasis – the diseased simply had to put up with the symptoms until the time of their death. In the late 1990’s the drug diethylcarbamazine became available to those suffering from the disease. Although most people took this drug on the basis that it was the only treatment available it was not an ideal medication as it had very severe side-effects. In recent times the new oral drug ivermectin has been made available: a highly effective, well tolerated drug that targets and kills the larvae produced by the adult Onchocerca volvulus worm. This medicine has greatly improved the quality of life for those infected with Onchocerciasis.
As with most diseases the prognosis depends on the stage at which the infection is treated. If treated early with ivermectin during the course of the disease, the intensity of the itching is greatly reduced along with any swelling, inflammation and eye lesions slowly begin to recede which will prevent blindness. However, as this medicine only kills the larvae with cause the symptoms and not the adult worms which are actually producing the worms, it only alleviates the itching and inflammation. Therefore, it has to be taken until the adult worms can no longer reproduce and die a natural death – around 10 to 15 years. If treatment begins too late, the itching and swelling can still be eased, but serious conditions such as drooping, loss of vision and hyper-pigmentation will be irreversible. Unfortunately, without any treatment the prognosis is a significantly worse, as the symptoms of Onchocerciasis will continue to intensify. Skin will become stretched, drooping and raw because of itching, and eventually total blindness will occur. Nonetheless, Onchocerciasis is not a deadly disease and has no mortality rate.
Today, research into finding a cure to Onchocerciasis to improve the prognosis is focused on the finding of a drug able to destroy the adult Onchocerca volvulus worms so they are unable to produce any more larvae. Investigations are also being made into a possible vaccine, but it will be many years before this is used on humans (see treatments).
As with most diseases the prognosis depends on the stage at which the infection is treated. If treated early with ivermectin during the course of the disease, the intensity of the itching is greatly reduced along with any swelling, inflammation and eye lesions slowly begin to recede which will prevent blindness. However, as this medicine only kills the larvae with cause the symptoms and not the adult worms which are actually producing the worms, it only alleviates the itching and inflammation. Therefore, it has to be taken until the adult worms can no longer reproduce and die a natural death – around 10 to 15 years. If treatment begins too late, the itching and swelling can still be eased, but serious conditions such as drooping, loss of vision and hyper-pigmentation will be irreversible. Unfortunately, without any treatment the prognosis is a significantly worse, as the symptoms of Onchocerciasis will continue to intensify. Skin will become stretched, drooping and raw because of itching, and eventually total blindness will occur. Nonetheless, Onchocerciasis is not a deadly disease and has no mortality rate.
Today, research into finding a cure to Onchocerciasis to improve the prognosis is focused on the finding of a drug able to destroy the adult Onchocerca volvulus worms so they are unable to produce any more larvae. Investigations are also being made into a possible vaccine, but it will be many years before this is used on humans (see treatments).
Picture showing a very severe, untreated case of Onchocerciasis where the skin has lots a lot of elasticity, is sagging, and they eye is totally blinded by larvae (visible around the pupil)