Dracunculiasis, or Guinea worm disease, is an extremely rare neglected tropical disease primarily affecting remote and impoverished communities in parts of Africa. People become infected with the parasitic worm after drinking contaminated water or eating undercooked fish or other aquatic animals. After about a year, the worm breaks through the skin, causing itchy, burning blisters, often on the feet or legs.
The pain caused by the condition can be debilitating, and many are left with lifelong disabilities. Thanks to global efforts to stamp out the disease, however, Guinea worm is now on the brink of eradication.
Dracunculiasis, also known as Guinea worm disease (GWD), is an infection caused by the parasite Dracunculus medinensis. A parasite is an organism that feeds off another organism to survive. GWD is spread by drinking water containing Guinea worm larvae. Larvae are immature forms of the worm. GWD affects poor communities in remote parts of Africa that do not have safe water to drink. GWD can occur at any time of the year but occurs most commonly during the peak transmission season, which varies from country to country. In dry regions, people generally get infected during the rainy season, when stagnant surface water is available. In wet regions, people generally get infected during the dry season, when surface water is drying up and becoming stagnant. GWD is primarily a human disease. However, in recent years infections in animals, particularly in dogs, have been reported. As a result of research into the cause of Guinea worm infections in animals, it is now believed that GWD might also be spread to both animals and humans by eating certain aquatic animals that might carry Guinea worm larvae, like fish or frogs, but do not themselves suffer the effects of transmission. GWD is considered by global health officials to be a neglected tropical disease (NTD ) and it is the first parasitic disease targeted for eradication.
People with Guinea worm disease (GWD) have no symptoms for about 1 year. Then, the person begins to feel ill.
Symptoms can include the following:
• Slight fever
• Itchy rash
A blister then develops. This blister can form anywhere on the skin. However, the blister forms on the lower body parts in 80%–90% of cases. This blister gets bigger over several days and causes burning pain. The blister eventually ruptures, exposing the worm. The infected person may put the affected body part in cool water to ease the symptoms or may enter the water to perform daily tasks, such as fetching drinking water. On contact with water, the worm discharges hundreds of thousands of larvae into the water
When the Guinea worm is ready to come out of the body, it creates a painful burning blister on the skin. The blister eventually ruptures, exposing the worm. Management of Guinea worm disease (GWD) involves removing the whole worm and caring for the wound in general. There is no specific drug to treat or prevent GWD. There is also no vaccine to prevent GWD.
Optimal management of GWD involves the following steps:
1. First, the infected person is not allowed to enter drinking water sources.
2. Next, the wound is cleaned. The affected body part may be immersed or soaked in water (far away from any water source to prevent contamination) to encourage the worm to contract and release larvae. Emptying the worm of larvae may make removing the worm easier.
3. The worm is then wrapped around a rolled piece of gauze or a stick to maintain some tension on the worm and encourage more of the worm to emerge. This also prevents the worm from slipping back inside.
4. Then, gentle traction is applied to the worm to slowly pull it out. Pulling stops when resistance is met to avoid breaking the worm. Because the worm can be as long as one meter in length, full extraction can take several days to weeks.
5. Afterwards, topical antibiotics are applied to the wound to prevent secondary bacterial infections.
6. The affected body part is then bandaged with fresh gauze to protect the site. Medicines, such as aspirin or ibuprofen, are given to help ease the pain of this process and reduce inflammation.
7. These steps are repeated every day until the whole worm is successfully pulled out.
In addition to the pain of the blister, removing the worm is also very painful. Furthermore, without proper care, the wound often becomes infected by bacteria.
These wound infections can then result in one or more of the following complications:
• Redness and swelling of the skin (cellulitis)
• Boils (abscesses)
• Generalized infection (sepsis)
• Joint infections (septic arthritis) that can cause the joints to lock and deform (contractures)
• Lock jaw (tetanus)
If the worm breaks during removal it can cause intense inflammation as the remaining part of the dead worm starts to degrade inside the body. This causes more pain, swelling, and cellulitis