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Guinea worm disease

Dracunculiasis
Dracunculus medinensis.jpg
Using a matchstick to wind up and remove a guinea worm from the leg of a human
Classification and external resources
Specialty Infectious disease
ICD-10 B72
ICD-9-CM 125.7
DiseasesDB 3945
eMedicine ped/616
Patient UK Dracunculiasis
MeSH D004320
Orphanet 231
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Dracunculiasis, also called Guinea-worm disease (GWD), is an infection by the Guinea worm. A person becomes infected when they drink water that contains water fleas infected with guinea worm larvae. Initially there are no symptoms. About one year later, the person develops a painful burning feeling as the female worm forms a blister in the skin, usually on the lower limb. The worm then comes out of the skin over the course of a few weeks. During this time, it may be difficult to walk or work. It is very uncommon for the disease to cause death.

In humans, the only known cause is Dracunculus medinensis. The worm is about one to two millimeters wide, and an adult female is 60 to 100 centimeters long (males are much shorter at 12–29 mm or 0.47–1.14 in). Outside of humans, the young form can survive up to three weeks, during which they must be eaten by water fleas to continue to develop. The larva inside water fleas may survive up to four months. Thus, in order for the disease to remain in an area, it must occur each year in humans. A diagnosis of the disease can usually be made based on the signs and symptoms of the disease.

Prevention is by early diagnosis of the disease followed by keeping the person from putting the wound in drinking water to decrease spread of the parasite. Other efforts include improving access to clean water and otherwise filtering water if it is not clean. Filtering through a cloth is often enough. Contaminated drinking water may be treated with a chemical called temefos to kill the larva. There is no medication or vaccine against the disease. The worm may be slowly removed over a few weeks by rolling it over a stick. The ulcers formed by the emerging worm may get infected by bacteria. Pain may continue for months after the worm has been removed.

In 2015 there were 22 reported cases of the disease and in the first half of 2016 there were 7 confirmed cases. This is down from an estimated 3.5 million cases in 1986. It only exists in 4 countries in Africa, down from 20 countries in the 1980s. It will likely be the first parasitic disease to be globally eradicated. Guinea worm disease has been known since ancient times. It is mentioned in the Egyptian medical Ebers Papyrus, dating from 1550 BC. The name dracunculiasis is derived from the Latin "affliction with little dragons", while the name "guinea worm" appeared after Europeans saw the disease on the Guinea coast of West Africa in the 17th century. Other Dracunculus species are known to infect various mammals, but do not appear to infect humans. Dracunculiasis is classified as a neglected tropical disease. Because dogs may also become infected, the eradication program is monitoring and treating dogs as well.


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