... sure why. He was in Vietnam 40 years ago, but my reading says it can't lie dormant that long. And he doesn't walk on volcanic ash (non-filarial). He had brain surgery about a year before it started, but how can that cause elephantiasis???
This is what was found on the net:
"Elephantiasis occurs in the presence of microscopic, thread-like parasitic worms such as Wuchereria bancrofti, Brugia malayi, and B. timori, all of which are transmitted by mosquitoes. However, the disease itself is a result of a complex interplay between several factors: the worm, the symbiotic Wolbachia bacteria within the worm, the host’s immune response, and the numerous opportunistic infections and disorders that arise. Consequently, it is common in tropical regions and Africa. The adult worms only live in the human lymphatic system. Obstruction of the lymphatic vessels leads to swelling in the lower torso, typically in the legs and genitals. It is not definitively known if this swelling is caused by the parasite itself, or by the immune system's response to the parasite.
Alternatively, elephantiasis may occur in the absence of parasitic infection. This nonparasitic form of elephantiasis is known as "nonfilarial elephantiasis" or "podoconiosis", and areas of high prevalence have been documented in Uganda, Tanzania, Kenya, Rwanda, Burundi, Sudan, Egypt and Ethiopia.The worst affected area is Ethiopia, where up to 6% of the population is affected in endemic areas.Nonfilarial elephantiasis is thought to be caused by persistent contact with irritant soils: in particular, red clays rich in alkali metals such as sodium and potassium and associated with volcanic activity."
Hope it helps your friend & gets well soon.
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