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The main effects noted in field and community-based trials with ivermectin in humans infected with Onchocerca spp. have been those arising from the death of the parasites, the so-called Mazzotti reaction, which is characterized by arthralgia, pruritus, fever, hypertension, tachycardia, headache, and ocular changes. Neither in these studies nor during ivermectic treatment of other parasitic diseases in humans in Africa, South America, the Caribbean, and certain other areas has a subset of atypically sensitive individuals been detected. Furthermore, the adverse effects experienced by the small number of persons accidentally exposed to doses (often of veterinary preparations) higher than customary human doses are in keeping with those noted in several test animal species.