It Might Get Messy

Every night in the tropics, right around midnight (local time around the world), little larval nematodes, comfortably curled inside tiny round membranes, appear in large numbers in the blood vessels near the skin of hundreds of millions (you read that right, 100s of millions, see references [1] and [2]) of people. Sleeping people, awake people, drinking people, dancing people, hunting people, fishing people, people just watching the moon and contemplating their own mortality. Mosquitos in the most common and abundant genera—Culex, Anopheles, and Aedes—insert their oddly specialized spike-supported sucking-straw mouthparts into the blood vessels of these people and exchange a bit of their saliva for a big slurp of the people’s blood. 


Before you get too comfortable that is a tale of exotic foreign lands, you should consider that Aedes includes the very, very common salt marsh mosquito of the east coast of the United States, and that Anopheles and Culex populations are dense throughout North America. And Eurasia. And pretty much everywhere else. 


Anyway. The mosquito saliva slips tiny, young larvae of the nematode Wuchereria bancrofti into the people’s bloodstream, and picks up a simultaneous load of the older larvae comfortably encased in their cozy little containers. Inside people (the only known host except for an obscure Malaysian monkey species), the larvae mature, lay eggs, hatch, and turn into the infective little buggers the mosquitos pick up. In the mosquitos, the larvae molt a couple of times and become sausage-shaped infectives, hanging around the salivary glands just waiting for their opportunity.


Wuchereria, and a couple of related nematodes, cause elephantiasis. As you are no doubt aware, elephantiasis is a nasty condition in which massive swelling of human tissues occurs because larval nematodes block up the lymphatic system. The lymph seeps out into the tissues, but not back into the clogged and broken vessels. People are disfigured and disabled. In enormous numbers. 


My own lymph system has been surgically impaired in ways that parallel, qualitatively if not quantitatively, elephantiasis. With much of the lymph system north of my chest removed, and all the lymph glands in my jaws, neck, and shoulders gone, my face is full of lymphatic fluid that has no place to go.


So it might get messy. But it might look prettier. I went to “lymphedema clinic” this week for an initial diagnosis. Lymphedema is treatable by massage and exercise. Basically, the therapist gives the lymph additional space to spread out in, and over time it can be resorbed into healthy tissue. This is not just cosmetic—although in my case the cosmetics are not trivial. It is a real epidemiological threat. Lymph, especially loose lymph flushing around tissues in general, is protein-rich and a ready-made growth medium for infectious microbes. So, several week’s worth of therapy and exercise is an investment well made. Count me in. 


And of course, it won’t make me pretty. But it’ll help get me back to my normal state of cosmetically marginal visual condition. And maybe even help my voice. 


Thanks for being here, everyone. Spring is here! Check out some nifty nature photos over at http://docviper.livejournal.com/; the start of a chapter-by-chapter exposition of an upcoming book on urban ecosystems at http://sustainablebiospheredotnet.blogspot.com/; , and the week’s update at http://aehsfoundation.org/ . Love to each and every one of you!


Notes


[1] http://www.who.int/mediacentre/factsheets/fs102/en/


[2] Smyth, J.D. 1976. Introduction to animal parasitology. Cambridge University Press.