BRUGIA TIMORI

EPIDEMIOLOGY:

Brugia timori is found in the lesser Sunda islands of the Indonesian archipelago, such as Timor . Like B.
malayi it is locally confined to areas endemic to its mosquito vector
LIFE CYCLE:
The life cycle of B. timori is almost identical to that of Wuchereria bancrofti and B.
malayi. It is nocturnally periodic and is transmitted by the mosquito Anopheles
barbirostris which breeds in rice fields. The microfilariae have several distinguishing
features: they are longer with a cephalic space length to width of about 3:1. In
addition the sheath does not stain pink with Giemsa stain like B. malayi and W.
bancrofti (see picture below taken from Peters and Gilles 1991). The adults also differ
morphologically from B. malayi.

The typical vector for Brugia timori filariasis are mosquito species from the
genera Mansonia and Aedes.  During a blood meal, an infected mosquito introduces third-
stage filarial larvae onto the skin of the human host, where they penetrate into the bite
wound  .  They develop into adults that commonly reside in the lymphatics  .  The adult
worms resemble those ofWuchereria bancrofti but are smaller.  Female worms measure 43
to 55 mm in length by 130 to 170 μm in width, and males measure 13 to 23 mm in length
by 70 to 80 μm in width.  Adults produce microfilariae, measuring 177 to 230 μm in length
and 5 to 7 μm in width, which are sheathed and have nocturnal periodicity.  The
microfilariae migrate into lymph and enter the blood stream reaching the peripheral
blood  .  A mosquito ingests the microfilariae during a blood meal  .  After ingestion, the
microfilariae lose their sheaths and work their way through the wall of the proventriculus
and cardiac portion of the midgut to reach the thoracic muscles  .  There the microfilariae
develop into first-stage larvae   and subsequently into third-stage larvae  .  The third-
stage larvae migrate through the hemocoel to the mosquito's prosbocis   and can infect
another human when the mosquito takes a blood meal  .

PATHOLOGY:

 The clinical and pathological features of timorian filariasis is very similar to malayan
filariasis with acute recurrent lymphagitis and filarial abscesses in the lymphatic trunk
in the leg (picture below taken Peters and Gilles 1991).

Subsequent scaring over thick hard, cord like lymphatics are a hallmark of the disease.
Elephantiasis resulting from timorian infection is rare.

Like other human filariasis infections, Brugia timori filariasis causes

acute fever and chronic lymphedema. The life cycle of Brugia timori is
very similar to that of Wuchereria bancrofti and Brugia malayi, leading to
nocturnal periodicity of the disease symptoms.
So far Brugia timori has only been found in the Lesser Sunda
Islands of Indonesia. It is locally confined to areas inhabited by
its mosquito vector, which breeds in rice fields. One study of the
prevalence of infection in Mainang village, Alor Island, found
microfilariae in the blood of 157 of 586 individuals (27%), with 77 of them
(13%) exhibiting lymphedema of the leg.[5]
[edit]

:: larvae are injected intradermally with a mosquito bite and find their way to the arge lymphatic
where they mature and mate. Swelling of lymph nodes containing adult is a common features.
However, when an adult worms dies severe lympadenitis with chronic inflammatory to
grnulomatous rection result, including eosinophlis which ultimately leads to fibrosis. In some
multiply infected individuals, this may lead to gradually to chronic lymphatic obstruction, which in
a small percentage of cases progress to the lymphadematous complication of elephantiasis,
usually in an extremity. The newborn larvae circulate in the blood within the internal organs, such
as spleen, and sometimes they migrate cyclically to the peripheral circulation, coincident with the
biting habit of mosquito. Tropical eosinophilic fever with pulmonary infiltration is often attributed
to this infection.

Treatment:
Anthelmintics such as diethylcarbamazine and albendazole have shown promise in the
treatment of Brugia timori filariasis.[6] Some researchers are confident that Brugia
timori filariasis may be an eradicable disease.[7]