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{{DTMHhomeTM menu}} ==''Onchocerca volvulus''=={{intermediate|category=blackfly ブヨ, female|latin=genus ''Simulium''|organ=生活環midgut|inward=blood-feeding of human|reproduction=asexual|course=microfilariae has '''no sheath'''<ol><li>migrate to thoracic muscle<li>metamorphoses L1→L2→L3 in thoracic muscle<li>L3 migrate to proboscis </ol>|detection=|outward=blood-feeding of human}} {{definitive|category='''HUMAN'''|latin=|inward=blood-feeding by female blackfly|organ=skin, lymphatics, blood, urine|reproduction=sexual|course=<ol><li>L3 into adult '''in subcutaneous'''<li>subcutaneous nodule*female '''33-50 cm''' (not mm), male 2-5 cm*live 15 years*''Wolbachia'' spp. is endosymbiotic bacteria in female uterus, which is essential to survival of female adult<li>female produce microfilariae 9 years*220-360 µm*2 years*mainly '''skin, connective tissue''', sometimes lymphatics, blood, urine, sputum*allergy and inflammation resulting in serious '''skin pruritis (leopard skin, anterior tibia)''' and '''keratitis (river blindeness)'''|detection=<ul>*'''skin snipping'''**'''no nocturnality''', every time in a day available*microfilariae has no sheath</ul>|outward=blood-feeding by female blackfly}} {{quote|content=[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC100248/ Hall LR, Pearlman E. Pathogenesis of onchocercal keratitis (river blindness). Clin Microbiol Rev. 1999;12(3):445-453. doi:10.1128/cmr.12.3.445]}}
==診断==
**''Onchocerca vulvols''のIgG4抗体および抗原をimmunochromatographで検出
==治療treatment==*Ivermectinfor microfilariae**'''ivermectin''' is effective '''only for microfilariae'''**only one dose of ivermectin 150 µg/kg (both for children and adults) significantly decrease microfilariae load that '''lasts a year or more'''**'''every 6 month repetition'''*If use diethylcarbamazepine (DEC) for onchocerciasis it kills microfilariae inside skin and develops severe allergic reaction against dead microfilariae on skin*for adult **'''doxycycline''' is effective for '''''Wolbachia''''' resulting in '''killing of 60% and sterlizing 80-90% of female adult'''
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