_An infected blackfly, Simulium sp, (that breeds in swiftly flowing streams) bites a healthy person.
_Infective larvae are inoculated into the skin
_Larvae in the skin develop into adult worms (after 1-1.5yrs).
_Adult worms (19 - 50cm long) may lounge in subcutaneous nodules for upto 15yrs
_Female worms produce microfilariae
_Microfilariae may migrate through the skin ;and invade the eyes and cause blindness.
_Tabs Ivermectin150mcg/kg Stat.
_Cap Doxycycline 100mg OD or BD x 6/52
(The dose of Ivermectin may be repeated every 3 to 12 months, depending on the recurrence of symptoms and/or microfilariae. Ivermectin does not kill adult worms).
_Diethycarbamazine can be used but it is not recommended as it can kill so many microfilariea and cause a Mazzotti reaction (severe hypersensitivity) that can damage skin, eyes and cardiovascular system.