Lymphatic filariasis: an infection of childhood

Lymphatic filariasis (LF), already recognized as a widespread, seriously ha ndicapping disease of adults, was generally thought to occur only sporadica lly in children. New, highly sensitive diagnostic tests (antigen detection, ultrasound examination) now reveal, however, that LF is first acquired in childhood, often with as many as one-third of children infected before age 5. Initial damage to the lymphatic system by the parasites generally remain s subclinical for years or gives rise only to non-specific presentations of adenitis/adenopathy; however, especially after puberty the characteristic clinical features of the adult disease syndromes (lymphoedema, hydrocoele) manifest themselves. Recognizing that LF disease starts its development in childhood hag immediate practical implications both for management and prev ention of the disease in individual patients and for the broader public hea lth efforts to overcome all childhood illnesses. For the new World Health O rganization (WHO) -supported, public-private-sector collaboration. (Global Alliance) to eliminate LF through once-yearly drug treatment, this recognit ion means that children will be not only the principal beneficiaries of LF elimination but also a population particularly important to target in order for the programme to achieve its twin goals of interrupting transmission a nd preventing disease.