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The parasite (Wucheria bancrofti) which the mosquito injects into humans is elusive, and Dracula-like appears only at night in the human host's blood circulation. Clinically, the presentation of lymphatic filariasis can range from being asymptomatic to the full-blown elephantiasis, (Hatipaile in Nepali).
In Nepal the disease also presents itself as a hydrocele (water- filled scrotum) and keeps surgeons busy. But this is one of the more common, easier operations that senior doctors will delegate to the lowly interns. Although lymphatic filariasis is not usually a life-threatening disease, clearly it is a nuisance at the very least.
The good news is that there is very effective medicine (diethylcarbamazine, DEC) for the prevention and control of this condition. In addition, all the precautions against mosquito bites (using mosquito nets to insect repellents) also apply to this disease.
In Nepal and other countries of endimicity, community-based intervention is the current approach to eliminating lymphatic filariasis as a public health problem. The rationale behind this approach is that mass annual distribution of the drug, given once every year for about five years will profoundly suppress the bug in human hosts. If the suppression is sustained then transmission (spread of the disease) by mosquitos is interrupted.
This community intervention campaign was helped with a pledge in 2000 by two pharmaceutical companies (Glaxo SmithKline and Merck) to donate the drug to eliminate the disease coordinated by WHO. It is reported that over 700 million people in over 50 countries have participated and the disease has been eliminated in certain defined areas.
Eliminating the disease is clearly an important reason for the present mass drug administration drive in Nepal. DEC has been available for decades and its side-effects ( mild fever, chills, nausea, headache) in some patients are well known but short-lived. The community-wide mass treatment program is being implemented to treat the entire at-risk population.
So for people in many parts of Nepal including Kathmandu, if you are 2 years, not pregnant, and have no chronic illnesses and other contraindications, it may be a good idea to consider taking the drug. In a smart move, albendazole which cures worm infestations in the intestine (a widespread problem in Nepal) is also being given by the government at the same time with DEC.
