Dracunculiasis

Dracunculiasis, more commonly known as Guinea Worm Disease (GWD), is a preventable infection caused by the parasite Dracunculus medinensis. The word Dracunculus comes from the Latin "little dragon". more...

Life cycle

Adult female Dracunculus worms emerge from the skin of infected persons annually. Persons with worms protruding through the skin may enter sources of drinking water and unwittingly allow the worm to release larvae into the water. These larvae are ingested by fresh water copepods ("water fleas") where these develop into the infective stage in 10-14 days. Persons become infected by drinking water containing the water fleas harboring the infective stage larvae of Dracunculus medinensis.

Once inside the body, the stomach acid digests the water flea, but not the Guinea Worm. These larvae find their way to the small intestine, where they penetrate the wall of the intestine and pass into the body cavity. During the next 10-14 months, the female Guinea Worm grows to a full-sized adult,and mates with the male, who soon dies afterwards.It is 60‑100 centimeters (2‑3 feet) long and as wide as a cooked spaghetti noodle, and migrates to the site where she will emerge—usually the lower limbs.

A blister develops on the skin at the site where the worm will emerge. This blister causes a very painful burning sensation and it will eventually (within 24 to 72 hours) rupture. For relief, persons will immerse the affected limb into water. When someone with a Guinea Worm ulcer enters the water, the adult female releases a milky white liquid containing millions of immature larvae into the water, thus contaminating the water supply. For several days after it has emerged from the ulcer, the female Guinea Worm is capable of releasing more larvae whenever it comes in contact with water.

Symptoms

Infected persons do not usually have symptoms until about 1 year after they become infected. A few days to hours before the worm emerges, the person may develop a fever, swelling and pain in the area. More than 90% of the worms appear on the legs and feet, but may occur anywhere on the body.

People, in remote, rural communities who are most commonly affected by GWD do not have access to medical care. Almost invariably the skin lesions caused by the worm develop secondary bacterial infections, which exacerbate the pain, and extend the period of incapacitation to weeks or months-causing in some cases disabling complications, such as locked joints and even permanent crippling. Each time a Guinea worm emerges, persons may be unable to work or resume daily activities for an average of 3 months. This usually occurs during planting or harvesting season, resulting in heavy crop losses.

Treatment

Once the worm emerges from the wound, it can only be pulled out a few centimeters each day and wrapped around a small stick. Sometimes the worm can be pulled out completely within a few days, but this process usually takes weeks or months.

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