Dracunculiasis is a disease that occurs due to ingestion of freshwater contaminated with copepods (water fleas) that contain the parasitic nematode Dracunculiasis medinensis. The affliction is ancient. It has been identified in a 3,000- year-old mummy. Mortality is generally low, but secondary bacterial infections may be life-threatening due to lack of access to health care in most endemic areas. The presence of Guinea worm disease in a community usually indicates extreme poverty and the absence or inadequacy of safe drinking water. Transmission occurs by accidental consumption of tiny Cyclops copepods, often found in stagnant pond water, that have ingested D medinensis larvae.
Symptoms from migrating adult parasites are rare but may include an urticarial rash, fever, nausea, vomiting, diarrhea, and dizziness. Worms emerge over a period of weeks and produce intensely painful edema, blistering, and ulceration. Baseline health and nutritional status play important roles in determining the rate and success of ulcer healing.
Guinea worms are diagnosed clinically as they approach dermal tissue and form a painful papule, which subsequently enlarges and ruptures to expose the adult worm. Immersion of affected body parts in water can lead to a characteristic “white cloud,” representing release of larvae.
Generally anti-helmintics are used to treat the disease, analgesics are used to reduce abdiominal pain. Antibiotics are critical for management of superinfections.
Dracunculiasis eradication strategies are focused on behavior modification and health education. Nylon water filters or specially designed filtration straws effectively strain copepods. Guinea worm disease affected approximately 3.5 million people when eradication efforts began in 1986. The Global Dracunculiasis Eradication Campaignhas dramatically reduced the number of cases to fewer than 5,000 reported in 2008.