Dracunculiasis
Dracunculiasis, also known as guinea worm disease (GWD), is a parasitic infection caused by the guinea worm (Dracunculus medinensis), which can grow within the human body. It primarily affects individuals in rural areas of Africa who consume contaminated water harboring the larvae of the worm, often transmitted through water fleas. Symptoms typically manifest about a year after infection, characterized by intense pain and discomfort as the female worm emerges from the skin, usually in the lower leg or foot. This process can result in debilitating blisters and ulcers, leading to incapacitation for an extended period.
The disease disproportionately impacts poorer communities with limited access to clean drinking water, making it a significant public health concern. While there is no screening method for early detection, preventive measures include filtering drinking water and avoiding exposure to infested sources. Treatment focuses on alleviating symptoms and involves a careful extraction of the worm once it surfaces. Global efforts are underway to eradicate dracunculiasis through health education and improved water safety measures, marking significant progress in combating this ancient disease, which is also referenced in historical texts, including the Bible.
Dracunculiasis
Anatomy or system affected: Gastrointestinal system, intestines, skin
Also known as: Guinea worm disease
Definition
Dracunculiasis, or guinea worm disease (GWD), is caused by the parasitic guinea worm, a long, thin worm that can grow inside humans. Dracunculiasis affects people living in certain parts of rural Africa who drink water contaminated by guinea worm larvae. GWD is one of the few diseases specifically mentioned in the Bible, where it is called dracunculiasis medinensis, or “fiery serpents.” An adult female worm can reach up to three feet long.
Causes
People get dracunculiasis by drinking contaminated water infested with water fleas that have ingested the guinea worm larvae. The guinea worms, usually female, move through the body, and about one year later, protrude through the skin, usually on the lower leg or feet, causing immense pain. At the site of protrusion, there is a blister or an ulcer, and the worm can be seen emerging. Some people seek relief by placing the infected area in open water (such as a pond, lake, or river) that is used for drinking, which allows the female worms to release larvae into the water and repeat the process of infestation.
Risk Factors
This disease tends to affect people living in rural or poorer communities in certain countries in Africa, where water sources are scarce and where drinking water most often comes from open, and exposed,sources.
Symptoms
Symptoms do not appear until about one year after a person has become infected with dracunculiasis. When the guinea worm prepares to emerge from the body, a person usually experiences intense pain and itching or burning, often followed by nausea, vomiting, and fever. A blister forms at the site of where the worm will emerge, leaving the person virtually incapacitated, sometimes for many months, as the worm is gently pulled from the body and removed.
Screening and Diagnosis
There is no screening for dracunculiasis. A person does not know he or she has the disease until the worm begins to exit the body, about one year after contaminated water has been ingested.
Treatment and Therapy
Once the worm emerges at the site of the blister, it is pulled out in a slow and painful process; the infection is then cleaned. The only treatment for the infection is to help alleviate symptoms once the worm emerges.
Prevention and Outcomes
Preventive methods against dracunculiasis include using a cloth filter to remove water fleas from drinking water and to drink water from protected (closed) sources. Persons already infected with a dracunculiasis blister should not enter any water source that is used for drinking.
Although this disease was once widespread throughout Asia and Africa, public health experts and others are getting closer to eradicating the disease, aided by disease education and the use of chemicals to treat potentially unsafe drinking water.
Bibliography
Berger, Stephen A., and John S. Marr. Human Parasitic Diseases Sourcebook. Sudbury, Mass.: Jones and Bartlett, 2006.
Centers for Disease Control and Prevention. “Progress Toward Global Eradication of Dracunculiasis, January, 2008-June, 2009.” Morbidity and Mortality Weekly Report 58, no. 40 (2009): 1123-1125.
Muller, Ralph. Worms and Human Disease. 2d ed. New York: CABI, 2002.
Parker, James N., and Philip M. Parker, eds. The Official Patient’s Sourcebook on Dracunculiasis: A Revised and Updated Directory for the Internet Age. San Diego, Calif.: Icon Health, 2002.
Roberts, Larry S., and John Janovy, Jr. Gerald D. Schmidt and Larry S. Roberts’ Foundations of Parasitology. 8th ed. Boston: McGraw-Hill, 2009.
Weedon, David. Skin Pathology. 3d ed. New York: Churchill Livingstone/Elsevier, 2010.