{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T13:20:29Z","timestamp":1778592029194,"version":"3.51.4"},"reference-count":37,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,5,1]]},"abstract":"<jats:p>Many parasitic infections have different presenting features in endemic individuals (ENDs) and immunologically naive temporary residents (TRs). Temporary residents with loiasis often display acute symptoms and hypereosinophilia, in contrast to a parasite-induced subclinical state in chronically infected ENDs. Few studies have examined differences in ENDs and TRs infected with the related filarial parasite <jats:italic>Onchocerca volvulus<\/jats:italic>. We identified 40 TRs and 36 ENDs with imported onchocerciasis at the National Institutes of Health between 1976 and 2016. All study subjects received an extensive pretreatment medical history, physical examination, and laboratory investigations. We performed additional parasite-specific serologic testing on stored patient sera. Asymptomatic infection occurred in 12.5% of TRs and no ENDs (<jats:italic>P<\/jats:italic> = 0.06). Papular dermatitis was more common in TRs (47.5% versus 2.7%, <jats:italic>P<\/jats:italic> &lt; 0.001), whereas more pigmentation changes occurred in ENDs (41.7% versus 15%, <jats:italic>P<\/jats:italic> = 0.01). Only endemic patients reported visual disturbance (13% versus 0%, <jats:italic>P<\/jats:italic> = 0.03). One TR (3.3%) had onchocercal eye disease, compared with 22.6% of ENDs (<jats:italic>P<\/jats:italic> = 0.053). Absolute eosinophil counts (AECs) were similar in ENDs and TRs (<jats:italic>P<\/jats:italic> = 0.5), and one-third of subjects had a normal AEC. Endemic individuals had higher filarial-specific IgG4 and were more likely to be positive for IgG4 antibodies to <jats:italic>Ov<\/jats:italic>-16. Temporary residents and ENDs with imported <jats:italic>O. volvulus<\/jats:italic> infection presented with different dermatologic manifestations; ocular involvement occurred almost exclusively in ENDs. Unlike <jats:italic>Loa loa<\/jats:italic>, clinical differences appear not to be eosinophil-mediated and may reflect chronicity, intensity of infection, or the presence of <jats:italic>Wolbachia<\/jats:italic> in <jats:italic>O. volvulus<\/jats:italic>.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0757","type":"journal-article","created":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T07:01:52Z","timestamp":1549954912000},"page":"1216-1222","source":"Crossref","is-referenced-by-count":5,"title":["Differences in the Clinical and Laboratory Features of Imported Onchocerciasis in Endemic Individuals and Temporary Residents"],"prefix":"10.4269","volume":"100","author":[{"given":"Adrienne J.","family":"Showler","sequence":"first","affiliation":[{"name":"Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland;"},{"name":"Division of Infectious Disease, Georgetown University, Washington, District of Columbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Kubofcik","sequence":"additional","affiliation":[{"name":"Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Ricciardi","sequence":"additional","affiliation":[{"name":"Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas B.","family":"Nutman","sequence":"additional","affiliation":[{"name":"Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Onchocerciasis","author":"WHO","year":"2018"},{"key":"b2","series-title":"Wkly Epidemiol Rec","first-page":"505","article-title":"Progress report on the elimination of human onchocerciasis, 2015\u20132016","volume":"91","author":"WHO","year":"2016"},{"key":"b3","series-title":"PLoS Negl Trop Dis","first-page":"e88","article-title":"Filariasis in travelers presenting to the GeoSentinel surveillance network","volume":"1","author":"Lipner","year":"2007"},{"key":"b4","series-title":"PLoS Negl Trop Dis","first-page":"e762","article-title":"Neglected tropical diseases outside the tropics","volume":"4","author":"Norman","year":"2010"},{"key":"b5","series-title":"Isr Med Assoc J","first-page":"485","article-title":"Onchocerciasis among Ethiopian immigrants in Israel","volume":"5","author":"Enk","year":"2003"},{"key":"b6","series-title":"Clin Infect Dis","first-page":"55","article-title":"Eosinophil-associated processes underlie differences in clinical presentation of loiasis between temporary residents and those indigenous to Loa-endemic areas","volume":"60","author":"Herrick","year":"2015"},{"key":"b7","series-title":"J Infect Dis","first-page":"1318","article-title":"Loiasis in endemic and nonendemic populations: immunologically mediated differences in clinical presentation","volume":"163","author":"Klion","year":"1991"},{"key":"b8","series-title":"J Infect Dis","first-page":"10","article-title":"Loa loa infection in temporary residents of endemic regions: recognition of a hyperresponsive syndrome with characteristic clinical manifestations","volume":"154","author":"Nutman","year":"1986"},{"key":"b9","series-title":"Int J Epidemiol","first-page":"394","article-title":"In Wuchereria bancrofti filariasis, asymptomatic microfilaraemia does not progress to amicrofilaraemic lymphatic disease","volume":"30","author":"Dissanayake","year":"2001"},{"key":"b10","series-title":"J Infect Dis","first-page":"736","article-title":"Onchocerciasis in endemic and nonendemic populations: differences in clinical presentation and immunologic findings","volume":"170","author":"McCarthy","year":"1994"},{"key":"b11","series-title":"Travel Med Infect Dis","first-page":"11","article-title":"Is imported onchocerciasis a truly rare entity? 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