Multa Fidrus and Theresia Sufa, Tangerang/Bogor – The lymphatic disease elephantiasis is on the rise in Java, with Tangerang and Bogor both recording recent outbreaks.

Tangerang, 40 kilometers west of Jakarta, has declared six new districts to be prone to the disease, bringing the number of districts in the regency where endemic elephantiasis has been discovered in the last seven months to 12. In Bogor, six villagers in the Sukadumi subdistrict have been diagnosed with the disease.

Elephantiasis, which is carried by mosquitoes, has been found in Cisauk, Curug, Pakuhaji, Pasar Kemis, Cikupa, Teluknaga, Pondok Aren, Sepatan, Balaraja, Tigaraksa, Rajeg and Mauk, the Tangerang Health Agency said.

The agency's communicable disease prevention head Yuliah Iskandar said 13 people in the six new districts had the disease. "We confirmed our findings by testing their blood because they had shown symptoms of the disease," she said.

Yuliah said the 13 infected individuals were considered to be chronic cases. Their legs have already become hugely swollen and they are likely to be permanently disfigured.

She added that the agency planned to hold a door-to-door check in the regency in an effort detect new cases early. "This measure will also serve as a public education (program) on how to avoid contracting this disease, because they can avoid it by living in a healthy environment," she said.

The agency will also hold a treatment clinic for elephantiasis patients from August to September and has started to collect data on residents who have contracted the disease.

"Even though we can kill the parasite, returning their legs to their original size will be very difficult because cosmetic surgery can only mend 30 percent of a leg (damaged by) elephantiasis," Yuliah said.

In Bogor, six Setu Pete villagers, in Sukadamai subdistrict, Tanah Sereal, were also diagnosed with elephantiasis. The two men and four women are aged between 40 and 70 years old.

Sukadami village chief Uay Sutiawan said the disease had first been identified in his village in July, when one of the six visited a public health clinic complaining of a high fever and swollen legs. The clinic reported the case to the Bogor Health Agency, which sent a team to conduct blood tests on 500 people living near the patient's home.

As a result, the other five patients were diagnosed with elephantiasis. The first patient, identified only as Unas, said her legs had felt unusually hot for some time and she noticed she had been getting sick more easily. Unas said she had kept working, however, despite her deteriorating health.

"We needed to eat and I have seven mouths to feed at home so I had been trying to ignore the pain," Unas said, adding she was eventually forced to stop working after her legs became so disfigured she had difficulty walking.

Both her legs are now bloated, with the swollen veins protruding underneath her skin. Unas' daughter took over her job but she too has recently started to become ill. "She has already thrown up blood. I'm afraid that she's caught my disease," said Unas.

Elephantiasis, or lymphatic filariasis, is a disease caused by microscopic worms. The adult worms live in the human lymph system, which controls the body's fluid balance and fights infections.

The disease is carried by mosquitoes. Multiple bites from infected mosquitoes over several years are required to catch the disease. People living in tropical or sub-tropical areas are at the greatest risk of catching it. Elephantiasis is not life-threatening, but can permanently damage the kidneys or lymph system.