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O. volvulus is transmitted by sandflies, and their role in the transmission of onchocerciasis was discovered by the Scottish parasitologist Breadablane Blacklock in Sierra Leone in the mid-1920s (19). There are accounts of the history of onchocerciasis by Grove (105) and Muller (192).
Signs and symptoms. Onchocerciasis is an eye and skin disease. Symptoms are caused by the microfilariae, which move around the human body in the subcutaneous tissue and induce intense inflammatory responses, especially when they die. Infected people may show symptoms such as severe itching and various skin lesions.