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Onchocerciasis is the world’s second leading infectious cause of blindness. The disease spreads from person to person by the bite of a blackfly. When a blackfly bites a person who has onchocerciasis, microscopic worm larvae (called microfilariae) in the infected person's skin enter and infect the blackfly. The larvae develop over 2 weeks in the fly to a stage that is infectious to humans. An infectious blackfly will typically drop larvae when biting a person. The larvae then penetrate the skin to infect the person. Because the worms reproduce only in humans but need to complete some of their development inside the blackfly, the intensity of human infection (number of worms in an individual) is related to the number of infectious bites sustained by an individual. Blindness is usually seen in the setting of longstanding and intense infection. Where: Onchocerciasis is locally transmitted in thirty countries of Africa, 13 focal areas located in 6 countries (Mexico, Guatemala, Ecuador, Colombia, Venezuela, and Brazil) in the Americas, and in Yemen in the Middle East. Treatment: Onchocerciasis is the second leading infectious cause of blindness and can cause debilitating and disfiguring skin disease. There is neither a vaccine nor recommended drug available to prevent onchocerciasis. However, the worldwide burden of onchocerciasis has been considerably reduced as the result of very successful disease control programs led by the World Health Organization (WHO). These programs are based on control of the blackfly population and/or mass administration to affected communities of an oral drug called ivermectin (MectizanTM), that is donated by Merck & Co., Inc. As a result of these programs, millions of people are at greatly reduced risk of debilitating itching, disfigurement, and blindness caused by onchocerciasis. CDC http://www.cdc.gov/parasites/onchocerci asis/index.html Global Network http://globalnetwork.org/aboutntds/factsheets/onchocerciasis Helen Keller International http://www.hki.org/preventingblindness/onchocerciasis-control The Carter Center http://www.cartercenter.org/health/river_ blindness/oepa.html TropIKA: Tropical Diseases Research http://www.tropika.net/index.html World Health Organization http://www.who.int/blindness/causes/priori ty/en/index3.html