Dracunculiasis

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

During the mid-1980;s approximately 3.5 million cases of dracunculiasis occurred in 20 countries worldwide. Seventeen countries were in Africa and 3 in Asia. Subsequent interventions reduced reported cases to fewer than 10,000 in 2007. Since 2022, annual human cases have been fewer than 20. Five countries (Angola, Chad, Ethiopia, Mali, and South Sudan) remain endemic. 

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.

Reference

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: http://dx.doi.org/10.15585/mmwr.mm7147a2