Reevaluation of World War II Veterans with Filariasis Acquired in the South Pacific

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Abstract
Summary By means of past medical records, personal interviews and current clinical evaluation, the course of filarial symptomatology over a 16-year span in 25 World War II veterans was studied. This group, now residing in Connecticut, consisted of 15 ex-infantrymen who acquired filariasis on Bora Bora, Society Islands, and 10 ex-Marines exposed on Pago Pago, Samoa. The average incubation period was 14.6 months on Bora Bora and only 6.8 months on Pago Pago. Blood and skin-scarification smears for Wuchereria bancrofti were negative in all. However, 80 percent demonstrated an immediate positive reaction to Dirofilaria immitis adult worm antigen. There was an increase in the proportion of men with genital symptoms from an initial 52 percent to 88 percent by the end of 16 years. Constant or intermittent pain and swelling of the genital organs and inguinal lymph nodes precipitated or aggravated by exercise and hot, humid weather were common complaints. Abnormal genital findings were present in 40 percent and sterility was found in none. The proportion with swelling of the extremities not associated with recurrent filarial lymphangitis rose from 28 percent to 68 percent in 16 years. Swelling was constant in some and intermittent in others; in all it was aggravated by exercise of the part or hot weather. While 20 percent had initially had filarial lymphangitis, only 18 percent were having attacks after 15 years and the frequency, duration and severity of attacks had decreased markedly. In all but one man minor variations in sise of the extremities not attributable to other medical causes were found. No frank case of elephantiasis of the genitals or extremities was seen although symptoms and clinical findings indicated varying degrees of lymphatic obstruction. The lack of severe, disabling symptoms or deformity can no doubt be attributed to relatively short exposure and absence of reinfection.

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