A Step Toward Eradication of Human Filariases in Areas Where Loa Is Endemic

Mass drug administration (MDA) programs have achieved remarkable success in limiting the pathology and transmission of the human parasitic infections onchocerciasis and lymphatic filariasis. The full implementation of MDA campaigns for filariasis elimination has been stymied by the unacceptable incidence of severe adverse events observed following drug treatment of a subset of individuals who harbor high loads of Loa loa microfilaria. Extending MDA strategies to regions where loiasis is coendemic could be done confidently if a simple, inexpensive, and rapid diagnostic method was available that could accurately identify individuals who have L. loa microfilarial loads above the risk threshold and could thus be excluded from treatment. A recent paper in mBio reports the discovery of an antigen unique to L. loa microfilaria that can be detected in blood and urine and may form the basis for such an assay. Further work will reveal whether this discovery will smooth the path to achieve filariasis eradication.