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Notable Notes
August 2017

How Frank Hawking, DM, and Table Salt, Helped Eliminate Lymphatic Filariasis From China

Author Affiliations
  • 1The George Washington University School of Medicine and Health Sciences, Washington, DC
  • 2DermAssociates, Silver Spring, Maryland
JAMA Dermatol. 2017;153(8):780. doi:10.1001/jamadermatol.2017.2494

Lymphatic filariasis (LF), or “elephantiasis,” is a condition caused by mosquito-borne nematodes that inhabit the lymphatic and subcutaneous tissues of humans. Chronic infection can cause severe lymphedema and permanent disfigurement. Lymphatic filariasis has now been successfully eliminated from many parts of the world, including China, because of the unheralded work of Frank Hawking, DM, the father of renowned physicist Stephen Hawking.

In the late 1950s, nearly a decade after Chairman Mao Zedong made the control and elimination of infectious diseases a priority when he declared that “from now on, we must consider sanitation and epidemic prevention and general medical work as an important political mission,”1 there were still an estimated 30 million people in China with LF. During this period, diethylcarbamazine (DEC) was known to be a safe and effective therapy for LF; however, mass drug administration campaigns were hindered by asymptomatic individuals refusing treatment. Because humans are the definitive host for filariasis, these asymptomatically infected individuals serve as reservoirs for the disease if left untreated. Hawking sought to overcome the inherent challenges of mass drug administration by pioneering the use of table salts fortified with DEC in order to eliminate LF from communities where it was endemic.

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