River Blindness

1. River Blindness Story by: Greg Scott Hour 3 15 December 2011

2. The Adventure • So there I was, in Africa. I happened to be there in my life long goal to circumnavigate the globe, and I was on the home stretch. • I was on a trail though Nigeria, when I happened to come across a river. • I was warned by the locals not to go near the rivers, but the water looked absolutely refreshing, little did I know there was a small predator waiting for me.

3. Me • Me, in Africa Nigeria, to be exact.

4. The Early Stages • While getting some water I was unknowingly bitten by a black fly.  • But I was fine, I continued on my quest and ended up back in America.

5. The First Signs • About ten months after that, I started experiencing intense skin irritation and I got a rash. • I went to the doctor and he asked tons of questions, one of which was “have you been to any foreign counties in the last few years?” • When I told him I had circumnavigated the globe he gave me a ‘are you kidding me?’ look.

6. The Diagnosis • After hearing I had been all over the world, he suggested an overall biopsy to cover lots of bases. • During the biopsy he noticed a nodule on my side, looking like this.  • He suggested an ultrasound, and the results said that I had a bunch of worms living inside of me!

7. The Parasite • Apparently this worm was called Onchocerca volvulus. The cause of River Blindness. • According to the doctor I must have gotten it from a black fly that must have bitten me near a river around Nigeria. Guess the locals were right. • Anyway, upon doing some research I found that the worm had two stages, or instars.

8. Instars • The first stage was called microfilaria, which are the young versions of the worm. • They come loaded with bacteria that create terrible pain whenever the immune system kills the microfilaria. • Microfilaria reach maturity in the black fly, and are then transmitted into humans when the fly bites them.

9. Instars cont. • The second stage was the worm itself. After about six months the worm becomes fully mature and starts producing offspring. • The offspring cause the severe itching and rashes, the mature worms cause the nodules.

10. My Treatment • The doctor suggested two different drugs. • One of them was ivermectin, and inexpensive drug that halts the continuation of the disease and makes that adult worms sterile. He said Ivermectin was painful however, as it would kill the microfilaria and release even more bacteria. Ivermectin

11. My Treatment cont. • The second treatment was doxycycline. • Doxycycline was significantly more expensive, but it was much less painful. There was also some thought that doxycycline might kill the adult worms already in my body. • He said neither would probably cure me, but they would stop me from getting any worse. • I went with the doxycycline as I could afford it and less pain sounded great. Doxycycline

12. Present • That was two years ago. • The doxycycline seems to have killed some of the adult worms, but nowhere near all of them. • I have to take it daily, but it has halted the progression of the disease. • Happy now Mr. Poore?