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Description True elephantiasis is the result of a parasitic infection caused by three specific kinds of round worms. The long, threadlike worms block the body's lymphatic system—a network of channels, lymph nodes, and organs that helps maintain proper fluid levels in the body by draining lymph from tissues into the bloodstream. This blockage causes fluids to collect in the tissues, which can lead to great swelling, called "lymphedema." Limbs can swell so enormously that they resemble an elephant's foreleg in size, texture, and color. This is the severely disfiguring and disabling condition of elephantiasis. There are a few different causes of elephantiasis, but the agents responsible for most of the elephantiasis in the world are filarial worms: white, slender round worms found in most tropical and subtropical places. They are transmitted by particular kinds (species) of mosquitoes, that is, bloodsucking insects. Infection with these worms is called "lymphatic filariasis" and over a long period of time can cause elephantiasis. Lymphatic filariasis is a disease of underdeveloped regions found in South America, Central Africa, Asia, the Pacific Islands, and the Caribbean. It is a disease that has been present for centuries, as ancient Persian and Indian writings clearly described elephant-like swellings of the arms, legs, and genitals. It is estimated that 120 million people in the world have lymphatic filariasis. The disease appears to be spreading, in spite of decades of research in this area. Other terms for elephantiasis are Barbados leg, elephant leg, morbus herculeus, mal de Cayenne, and myelolymphangioma. Other situations that can lead to elephantiasis are: a protozoan disease called leishmaniasis a repeated streptococcal infection the surgical removal of lymph nodes (usually to prevent the spread of cancer) a hereditary birth defect