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River blindness (onchocerciasis).

First, a female buffalo gnat of the genus Simulium bites you and in the process deposits her infective larvae. In 10-20 months (no big hurry) they grow to threadlike adult worms which live up to 15 years under the skin, intermuscularly, in fascial planes, against capsules of joints or the shafts of long bones: the neighborhoods they love inside you. The adult females, now residing in your body, produce live embryos which live a year or two, migrating, restless, during which time they will likely invade your eye, lymph glands, or other--you don't want to know which--organs. Results are unpleasant: blindness, which might be merciful for then you don't see: rash, wheals, gross lichenification, atrophy (known as "lizard skin"), enlarged lymph glands leading to pockets of loose flesh, "hanging groins," which predispose to hernia ... and so on.

Treatment: Serious drugs, some so toxic the treatment worse than the illness.

Prognosis: If you are not reinfected the parasites die out within 15 years--symptoms of disease, however, may get worse during this time.

Prevention: Avoid Third World communities, particularly those located within 10-20 km of fast flowing rivers in which Simulium prefers to breed. Some 20-40 million (hard to be exact!) people infected, baby flies dying, dying in their eyes, blinding them.
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Author:Lux, Thomas
Publication:The American Poetry Review
Date:Mar 1, 1993
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