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Dracunculiasis, which is commonly known as Guinea worm disease is caused by the parasite Dracunculus medinensis. Humans become infested by drinking water containing water fleas infected with D. medinensis larvae. Following ingestion, the fleas die and release the larvae, which penetrate the stomach and intestine and enter into the abdominal cavity. After maturation into adults and copulation, the male worms die and females migrate in the subcutaneous tissues towards the skin surface. About 1 year after infection, the worm typically emerges through an ulcer in the skin, causing pain and disability. 

Recent evidence suggests that the parasite may also be transmitted by eating fish or other aquatic animals. 

Human cases of dracunculiasis (Guinea worm disease) have decreased from an estimated 3.5 million in 1986 to 15 in 2021. As of November 2022, dracunculiasis remained endemic in five countries (Angola, Chad, Ethiopia, Mali, and South Sudan).

The clinical presentation of dracunculiasis is so typical and well known in endemic countries, laboratory confirmation is not usually needed. Examination of the fluid discharged by the worm can show rhabditiform larvae. No serologic test is available. 

Eradication relies on case containment to prevent water contamination and other interventions to prevent infection, including health education, water filtration, treatment of unsafe water with temephos (an organophosphate larvicide), and provision of safe drinking water.

No vaccine or medicine is available to prevent or treat dracunculiasis.


Hopkins DR, Weiss AJ, Yerian S, Sapp SG, Cama VA. Progress Toward Global Eradication of Dracunculiasis — Worldwide, January 2021–June 2022. MMWR Morb Mortal Wkly Rep 2022;71:1496–1502. DOI:

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