Onchocerciasis imported in the Netherlands; a review of 100 cases
Smit, A.M.; Zuidema, P.J.
Nederlands Tijdschrift Voor Geneeskunde 117(33): 1225-1230
1973
ISSN/ISBN: 0028-2162 PMID: 4786627 Document Number: 65934
Onchocerciasis was diagnosed in 100 patients, 95 of them Dutchmen, at the Outpatient Clinic for Tropical Diseases, Amsterdam, the Netherlands, during 1959-71. All were infected in West or Central Africa, especially the Cameroons. Diagnosis was based on the presence of microfilariae in skin snips (76 cases), on clinical symptoms (24), and on a positive reaction to diethylcarbamazine (22). 89 had pruritis, 54 had maculo-papular rash, 5 had nodules (one each), 13 of 59 examined had corneal opacities, 85 had eosinophilia (which was over 20% in 40) and 52 of 80 were positive by the filaria complement fixation test. 86 were given one or more courses of diethylcarbamazine citrate and 34 received a course of suramin in addition; the latter treatment caused side effects, some of them serious. It is concluded that onchocerciasis in Europeans is mainly a skin disease and that pruritis in endemic areas may be an indication of the disease. Treatment should start with diethylcarbamazine and suramin should be given only when repeated courses of the former are ineffective.