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Brugiosis: causes, symptoms, diagnosis, treatment
Last reviewed: 05.07.2025
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Brugia is a transmissible helminthiasis. Adults live in the lymphatic vessels, and larvae (microfilariae) live in the blood.
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Brugium life cycle
The development cycle of Brugia is almost no different from Wuchereria. The final host is a person, but monkeys and cats can be hosts. Brugiasis is carried by mosquitoes of the Anopheles, Mansonia and Aedes genera.
Epidemiology of brugiosis
Brugiosis is endemic only in the countries of Southeast Asia, where its range coincides with the range of Wuchereria: some areas of India and China, South Korea, Vietnam, the Philippines, Malaysia, Thailand, Indonesia.
The periodic strain of Malayan brugiosis is widespread in the Indochina Peninsula, Central India, South China, Japan and Indonesia, where brugiosis is an anthroponotic disease: the final host is a human, and the carriers are mosquitoes of the genera Anopheles, Aedes, Mansonia.
A subperiodic strain of Brugia with a nocturnal peak of activity is found in the swampy forests of Malaysia in humans, monkeys (macaques, lorises), wild and domestic cats. Here it is a zoonotic natural focal invasion, the carriers are mosquitoes of the genus Mansonia.
Brugiosis timorense is limited in distribution, in the Indonesian archipelago and on the island of Timor. Here it is an anthroponosis with a nocturnal periodicity of the appearance of microfilariae in the peripheral blood. The carriers are mosquitoes of the genus Anopheles.
The source of the spread of the invasion are infected people or monkeys and cats. Infection occurs when the final host is bitten by a mosquito.
What causes brugia?
Brugia is caused by Brugia malayi and Brugia timori. The causative agent of Malayan brugia has two known strains: periodic and subperiodic. Females are 55 mm long and 0.15 mm wide, males are 23-25 mm and 0.088 mm respectively. Brugia are smaller than Wuchereria, their head end is separated from the rest of the body by a neck. Microfilariae with a sheath are 0.12-0.26 mm long and 0.05 mm in diameter.
Symptoms of Brugiosis
The pathogenesis and symptoms of brugiosis are very similar to those of wuchereriasis. Brugiosis is characterized by ulceration of the affected lymph nodes. There is virtually no damage to the genitals or chyluria. Localization of elephantiasis is noted on the shins and forearms.
With Timor brugiosis, abscesses of the lymph nodes develop more often, and elephantiasis occurs on the legs, as with Malayan brugiosis.
Diagnosis of brugiosis
Differential diagnostics of brugia should take into account the structure of the posterior end of the microfilariae. In larvae, a layer of well-stained nuclei is visible under the cuticle. The location of these nuclei is not the same in different types of filariae. This allows differentiating brugia from other types of filariae.
Laboratory diagnostics of brugiosis
The diagnosis is made, as with wuchereriasis, when larvae are detected in the peripheral blood at night, but they can also be detected during the daytime.
What tests are needed?
Treatment of brugioz
Treatment of brugiosis is the same as for wuchereriasis, but allergic reactions to diethylcarbamazine (DEC) are stronger, which requires dose reduction and the use of antihistamines. The reaction to ivermectin is weaker, it is effective in a small dose (20 mcg/kg).
In Timor brugiosis, treatment with DEC is effective; no advantages of ivermectin over DEC have been found.
How to prevent brugiosis?
Prevention of brugiosis is the same as for wuchereriasis.