There has been little change since 1955 in the laboratory techniques for seeking new antifilarial compounds, although one valuable addition to laboratory study has been the experimental infection of cats with Brugia malayi.The chief drug for the treatment and control of filariasis-whether caused by Wuchereria bancrofti or by B. malayi-continues to be diethylcarbamazine, and the author reviews the reports recently published on its use. In India and China large-scale campaigns involving the use of this drug have been undertaken; and in Tahiti filariasis has been suppressed and almost eliminated. Campaigns on a smaller scale and pilot projects considered in this survey include those conducted in Pacific islands, Malaya, Ceylon, Brazil, Surinam and East and West Africa.It is generally agreed that the administration of diethylcarbamazine produces a great diminution in the microfilarial counts of those taking it, and in many persons both microfilariae and adult worms are eradicated. The difficulties which arise are due to toxic effects which occur in some recipients and which may adversely affect the acceptability of treatment.
The levels of susceptibility of C. p. fatigans larvae from four different localities in Malaya to DDT, dieldrin, malathion, fenthion, diazinon and Sevin have been studied; their toxicity was: diazinon > fenthion > malathion > dieldrin > DDT > Sevin.Larvae from different localities showed a wide range of susceptibility to the chlorinated hydrocarbon insecticides, dieldrin (40x) and DDT (10x), but the organophosphorus compounds and the carbamate compound, Sevin, gave consistent results from all localities. One strain from a rural area (Lamir) was the most susceptible to all insecticides and has been used as a reference strain for related studies on the development of resistance.
Because of the risk of introduction of yellow fever to South-East Asia, comparative studies were made of yellow fever vaccination in Malayans who had a high prevalence of antibody to related viruses and in volunteers without related antibody. The proportions of positive neutralizing antibody responses to subcutaneous vaccination with 17D vaccine were not significantly different between volunteers with and without heterologous antibody but the degree of antibody response was greater in those without. The ID(50) of 17D in both groups was about 5 mouse intracerebral LD(50). Multiple puncture vaccination with 17D gave a much lower response rate than subcutaneous vaccination in volunteers with heterologous antibody. In both groups subcutaneous doses of about 50 mouse intracerebral LD(50) gave larger antibody responses than higher doses. The neutralizing indices and analysis of results were calculated by a method based on the survival time of the mice. This method, which has advantages over that of Reed & Muench, is fully described in an annex to this paper.
The author reviews the distribution, epidemiology, and treatment of filarial infection due to Brugia malayi, with special reference to Malaya. B. malayi infection in man is confined to the Far East between longitudes 75 degrees E and 140 degrees E and is essentially rural. The chief vectors are Mansonia spp., Anopheles hyrcanus group, A. barbirostris group, and Aëdes togoi. The epidemiological picture is complicated by the fact that B. malayi and other closely related species have now been found in several species of animals. The existence of an animal reservoir of infection might have important implications for filariasis control. As to the treatment of B. malayi infection, diethylcarbamazine has been found to reduce the microfilaria count and to kill the adult worms; the severe febrile reactions of microfilaria carriers to the initial doses of this drug may be reduced by administration of the steroid prednisolone.