In order to become completely free of all aspects of this filariael infestation you must kill the various stages of larvae and micro- and macro-filariae where possible, and break the reproductive and/or life cycle of those stages which cannot be readily killed.
The problem is that we have an unknown filariael parasite which has been triggered into a lifecycle that can be completed within the human body without the need for an external vector; therefore the infection/infestation becomes self-sustaining and can self-perpetuate itself throughout the body.
To kill the smallest fibrous thread (the microfilariae) Ivermectin is the drug of choice. A single oral dose of 200 mcg/kg is usually sufficient; however a second dose at two weeks time provides an extra measure of assurance.
In order to clear up the "bugs" Permethrin is effective; however the strength available over-the-counter is much too weak. The prescription strength ointment is also weak; a creme of 10-20% applied liberally is needed to be effective. Note that although Permethrin is thought to be generally safe to humans adverse reaction can occur at such high doses.
I no longer think the use of Permethetrin is a good idea. It is too toxic and the disease will clear up [if it will clear up] by just using antibiotics and Ivermectin.
The larger "worms" are not easily killed. Diethylcarbamazine [DEC] by itself or combination DEC and Albendazole therapy can reduce the "adult" macrofilariael activity by up to 90%.
DEC has only partial macrofilariaelcidal effect and Ivermectin, whether administered as a single dose or repeatedly at high doses, has no activity against adult worms.
The endosymbiotic Wolbachia bacteria are essential for filarial life. Wolbachia are obligate intracellular bacteria in the family Rickettsiacea that have a mutualistic relationship with filarial nematodes. These endosymbionts have been found in many filarial parasites.
Tetracycline treatment of infection results in degeneration of the endosymbiotic bacteria and inhibition of embryo development in the adult worms. Erythromycin and other antibiotics effective against Wolbachia bacteria will also produce a gradual easing of symtoms as the parasite load lessens with natural die-off and no regenration.
You need to at least start a long-term antibiotic regimin. If all you do is take the correct type of antibiotic you should be completely clear of infection within 2 years, assuming you do not get reinfected from your environment.
If you also take a single or mutiple doses of Ivermectin the microfilariae will be immediately killed and you will get immediate relief from the symptoms cause by them. Many of the open sores will heal within a couple/few days and the incessant itching/tickling will be greatly reduces. The amount of time required for antibiotic therapy will be cut in half, as you are killing off the first three or four stages of the life-cycle.
If you also use DEC and Albendazole in addition to Ivermectin then all (ore nearly all) of your sores will heal within a few days. The length of the required antibiotic therapy, however, will not be shortened.
Strong Permethetrin treatments can kill any crawling manifestations of the infestation; however extreme caution must be used due to the strength required. If all of the above therapies are implemented then the use of Permethetrin should probably be skipped.
Finally, insist on an ICT card test - this is the gold standard for microfilariael detection.
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