Dracunculiasis is a disease that is caused by infestation with the guinea worm and that has been eradicated in most regions except Africa called also guinea worm disease. It mainly effected by drinking water contains water fleas infected with guinea worm larvae. It is very uncommon for the disease to cause death. Pathophysiology of this disease may be due to the larvae are subsequently released in the stomach or small intestine and penetrate the mucosa to mate and mature in the abdomen or retroperitoneal space approximately 60-90 days after initial infection. The acidic environment of the stomach and duodenum kills the copepods. There is no treatment or medicine for to prevent guinea worm disease. Use of metronidazole or thiabendazole may make extraction easier, but also may lead to migration to other parts of the body. Analgesics can be used to help reduce swelling and pain and antibiotic ointments can help prevent secondary infections at the wound site. There were an estimated 3.5 million cases of Guinea worm in 20 endemic nations in Asia and Africa. The number of cases has since been reduced by more than 99.99% to 148 in 2013. As of 2010, however, the WHO predicted it will be "a few years yet" before eradication is achieved, on the basis that it took 6–12 years for the countries that have so far eliminated Guinea worm transmission. Death due to dracunculiasis is not caused by the primary infection and occurs only in cases in which secondary infection of the worm's exit site leads to sepsis.