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Year : 2009  |  Volume : 52  |  Issue : 2  |  Page : 293-294
First report of filariasis in a non-endemic hill state of India


Department of Pathology, UFHT Medical College, Haldwani (Nainital) (Uttarakhand), India

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How to cite this article:
Thapliyal N, Joshi U, Bhadani P, Jha R S. First report of filariasis in a non-endemic hill state of India. Indian J Pathol Microbiol 2009;52:293-4

How to cite this URL:
Thapliyal N, Joshi U, Bhadani P, Jha R S. First report of filariasis in a non-endemic hill state of India. Indian J Pathol Microbiol [serial online] 2009 [cited 2020 Feb 24];52:293-4. Available from: http://www.ijpmonline.org/text.asp?2009/52/2/293/48959


Sir,

Filariasis is endemic in many parts of India, especially in the southwestern costal region [1] and is caused most frequently by Wuchereria bancrofti . But, Uttarakhand is a non-endemic hill state of India for the disease. It is diagnosed by finding the larva or microfilaria in blood, fluids, needle aspirates and tissues. [2] We wish to report a case of filariasis in Uttarakhand from where filariasis has not been reported to the best of our knowledge.

A 56-year-old male resident of the district of Nainital in Uttarakhand was apparently asymptomatic when he developed intermittent fever, usually in the evening, associated with chills and rigors 4 months back. On clinical examination, there was pallor and pedal edema. The blood pressure was 90/64mmHg, with the presence of massive hepatosplenomegaly. There was no history of travel in regions endemic for filaria in the country. The family and other history were not significant. The clinical diagnosis of malaria/kala azar was proposed because of the massive hepatosplenomegaly.

The peripheral blood examination showed features of pancytopenia as hemoglobin 7.6g/dL, total leukocyte count 1500/cmm, differential leukocyte count N25%, L72%, E01% and M02%, platelets 83,000/cmm and Erythrocyte sedimentation rate (ESR) 64mm in the first hour by Wintrobe`s method. Other biochemical and microbiological tests were not significant except alkaline phosphatase, which was elevated (356 U/L). The general blood picture, bone marrow and splenic aspirate were performed to exclude the malaria and kala azar. A Leishman stain of the peripheral smear revealed microfilaria [Figure 1] and [Figure 2].

Filariasis is a major public problem in many parts of the tropical countries. The international task force for disease eradication has identified lymphatic filariasis as one of the six diseases considered eradicable or potentially eradicable. [3]

India's National Health Policy 2002 has a goal to eliminate the lymphatic filariasis by the year 2015. Filariasis elimination is also a global goal as per the WHO resolution. Uttarakhand, a newly formed hill state of India, is non-endemic for filaria. But, filariasis due to W. bancrofti is reported to be increasing as a result of human population in endemic areas and mismanagement of the environment. [4] Being a new state, development of industrial areas, engineering projects and population migration, particularly from the endemic areas for the search of employment, are the major factors for the deforestation and environmental warming as well as the arrival of the agent factor for the disease. Nainital is a cold, hilly district of the state, which is situated at a height of 1938 meters above sea level. But, changes in environmental conditions such as increase in the temperature and population favor the conditions for the vector as well as for the agent.

Our case is the first case of filariasis being reported from the state as per the best of our knowledge. And, therefore, we want to report this case to create awareness about the presence of this disease in the region, which could be an alarming sign for the state as well as for the National Health Policy.

 
   References Top

1.Bruce M. Greene: Filariasis. Harrison's Principles of Internal Medicine. vol. 1, 12 th ed. p. 809-10.  Back to cited text no. 1    
2.Myageri A. Wuchereria bancrofti adult worms in fine needle aspirate: A case report. J Cytol 2006;23:91-3.  Back to cited text no. 2    
3.Sabesan S, Raju HK, Srividya A, Das PK. Delimitation of lymphatic filariasis transmission risk areas. Filaria J 2006;5:12.  Back to cited text no. 3    
4.Park K. Epidemiology of communicable diseases: Lymphatic filariasis. In: Park K, editor. Park`s text book of preventive social medicine. Jabalpur, India: Banarasidas Bhanot; 2005. p. 211-6.  Back to cited text no. 4    

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Correspondence Address:
Naveen Thapliyal
Department of Pathology, Uttarakhand Forest Hospital Trust Medical College, Haldwani (Nainital), Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.48959

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  [Figure 1], [Figure 2]

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