What are other Names this Condition? (Also known as/Synonyms)

• Infection due to Brugia Timori
• Timor Filariasis

What is Brugia Timori Infection? (Definition/Background Information)

• Brugia Timori Infection describes an infection of the lymphatic system due to the parasitic roundworm Brugia timori. The condition is transmitted through mosquito bites
• B. timori worms are found on the Indonesian island of Timor, from where it takes its name, as well as in other neighboring islands. Therefore, those that live in this area have the highest risk of contracting Brugia Timori Infection
• The adult B. timori worms occupy lymph nodes in the body. Reproduction between male and female adult worms produces B. timori larvae, known as microfilariae. Microfilariae circulate in the infected individual’s bloodstream and can be taken up by mosquitoes upon being bitten
• Individuals that have contracted Brugia Timori Infection present with symptoms generally consistent with other parasitic infections that cause lymphatic filariasis. These may include fever and inflammation surrounding infected lymph nodes. In some cases, individuals with severe cases of Brugia Timori Infection may experience elephantiasis (severe swelling of the limb) of the leg, just below the knee
• Brugia Timori Infection is generally treated with a combination of drugs known to be effective against both the B. timori microfilariae (the larval, circulating worms) and the adult worms. Most individuals with Brugia Timori Infection are asymptomatic and the disease is rarely fatal

Who gets Brugia Timori Infection? (Age and Sex Distribution)

• Due to the fact that exposure to the worms and the mosquitoes that transmit them determines who gets Brugia Timori Infection, there are no predisposing factors that are based on age, gender, race, or ethnicity
• Brugia Timori Infection is generally common in the areas to which it is endemic. Outside of the parts of Indonesia in which it is found, it would be very uncommon to contract this infection 

What are the Risk Factors for Brugia Timori Infection? (Predisposing Factors)

The major risk factors for Brugia Timori Infection include:

• Living in or traveling to the Lesser Sunda Islands of Indonesia. Among these islands is the island of Timor, on which the infection name is based
• Being exposed to the Anopheles barbirostris mosquito in these islands
• Possessing a weakened or compromised immune system

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Brugia Timori Infection? (Etiology)

• Brugia Timori Infection is caused by the parasitic roundworm Brugia timori. Adult B. timori occupy the lymph nodes of infected individuals
• The Anopheles barbirostris mosquito is responsible for transmitting B. timori from infected individuals to uninfected individuals

What are the Signs and Symptoms of Brugia Timori Infection?

Individuals with Brugia Timori Infection commonly present with no symptoms. In cases where there are symptoms, they are as follows:

• Fever
• Inflammation of the lymph nodes and of the lymphatic vessels
• Lymphedema (swelling of the lymph nodes)
• Rarely, elephantiasis (severe swelling of a limb) occurring in the leg just below the knee

How is Brugia Timori Infection Diagnosed?

• A healthcare professional will determine the diagnosis of Brugia Timori Infection. A physical examination will be performed complete with a full medical history
• The signs and symptoms previously mentioned as well as the risk factors present will be taken into account when making a diagnosis for Brugia Timori Infection

The following procedures/techniques may be used to diagnose Brugia Timori Infection:

• Blood tests may be performed to test for the presence of circulating B. timori microfilariae
  • Brugia timori microfilariae are larger than those of Brugia malayi and Wuchereria Bancrofti, which is a helpful trait in identifying the exact worm causing the infection
  • The blood test should be collected during the night, as this is the time when B. timori microfilariae are most active in circulation
• Elevated levels of IgE (a type of antibody) and eosinophils (a type of white blood cells) would support a diagnosis of Brugia Timori Infection
• In addition, elevated levels of IgG4 (another type of antibody) oftentimes will indicate an infection of B. timori or other filarial worms

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Brugia Timori Infection?

Complications of Brugia Timori Infection generally manifest in individuals with severe infection.

• Blockage of the lymph nodes in the legs for extended periods of time may lead to elephantiasis (extreme swelling) of the leg below the knee
• For individuals with high levels of B. timori, diethylcarbamazine treatment (the most common drug used to treat Brugia Timori Infection) may lead to encephalitis, or fatal swelling of the brain

How is Brugia Timori Infection Treated?

Brugia Timori Infection is most commonly treated using a combination of drugs. The treatment options for Brugia Timori Infection, a healthcare professional may consider may include the following.

• Diethylcarbamazine (DEC) is the most frequently prescribed drug. It eliminates circulating microfilariae, helping to reduce the risk of transmission, and may also kill adult worms lodged within the lymph nodes
• Treatment with DEC may lead to asthma-like side effects resulting from the body’s reaction to the massive death of the parasitic worms. To control these side effects, a healthcare professional may advise taking antihistamines or corticosteroids

In some cases, the infection may progress to elephantiasis of the leg just below the knee. For individuals with this condition, proper care of the limb must be taken to prevent infection. Additional steps may be taken to lessen the effects of swelling. Some measures include:

• Regular cleaning with soap and water
• Application of anti-microbial ointments to cuts and scrapes
• Exercising and massaging of the swollen limb to alleviate pain and swelling
• Elevation of the leg to improve circulation
• For severe cases of elephantiasis, surgery may be used to help drain the damaged lymphatic vessels and remove excess tissue

How can Brugia Timori Infection be Prevented?

Prevention of Brugia Timori Infection is largely centered on reducing the numbers of mosquitoes that are able to carry the disease between individuals in the endemic regions. These measures may include:

• Using bed netting
• Applying insect repellent to exposed skin
• Wearing long sleeves and pants to cover the arms and legs
• Eliminating breeding grounds for mosquitoes
• Sleeping in cool areas
• Being mindful of mosquitoes during dawn and dusk, as it is during these times that they are most active
• Avoiding travel to the endemic regions

What is the Prognosis for Brugia Timori Infection? (Outcomes/Resolutions)

• The prognosis for Brugia Timori Infection is generally quite good, as those with early to mild infection may be asymptomatic
• Treatment with DEC has proved to be effective in eliminating the infection
• It is currently not possible to reverse the effects of elephantiasis, but managing the affected limb with good hygiene and exercise can greatly improve the quality of living

Additional and Relevant Useful Information for Brugia Timori Infection:

• Brugia Timori Infection is one of the possible infections that make up a larger classification of disease known as lymphatic filariasis
• The World Health Organization (WHO) has made it its goal to eliminate lymphatic filariasis by the year 2020 through the Global Program to Eliminate Lymphatic Filariasis

What are some Useful Resources for Additional Information?

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