Dracunculiasis

Introduction Dracunculiasis is infection with Dracunculus medinensis, a nematode worm. It is caused by drinking water containing water fleas (Cyclops species) that have ingested Dracunculus larvae.In the human body, the larvae are released and migrate through the intestinal wall into body tissues, where they develop into adult worms. The female worms move through the person’s subcutaneous tissue, causing intense pain, and eventually emerge through the skin, usually at the feet, producing oedema, a blister and eventually an ulcer, accompanied by fever, nausea, and vomiting. Signs and symptoms The clinical features of dracunculiasis generally occur many months after ingestion of water fleas containing larvae of dracunculiasis. The most common feature is a skin lesion which may occur anywhere in the body but is most commonly found in the lower limbs. The skin lesion occurs as a blister with swelling and redness around it. Pathophysiology Dracunculiasis is caused by drinking water containing water fleas (Cyclops species) that have ingested Dracunculus larvae. The acidic environment of the stomach and duodenum kills the copepods. 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. Epidemiology In 1986, more than 3.5 million people in 20 countries were infected with guinea worm. 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. The mortality rate is quite low; however, morbidity is a major concern, with secondary infection being the most common complication.