Dracunculiasis (Guinea Worm Disease)

Also known as Guinea Worm Disease, commonly abbreviated as GWD, Dracunculiasis is an infectious disease that is caused by the parasite known as Dracunculus medinensis. Dracunculiasis is prevalent in impoverished rural areas of Africa that lack clean water sources.

In 1986, it was approximated that there were nearly four million people infected per year by the disease in Africa. Since then, several institutions have been hard at work to resolve the severe problem of Dracunculiasis in over twelve countries of Africa. Such organizations include UNICEF, the World Health Organization, and the Centers for Disease Control and Prevention.

As a result of scientific advancements, there were approximately 30,000 cases of Dracunculiasis reported in the year 2003. A little over 60% of the reported cases actually came from the country of Sudan during a civil war crisis that made intervention from medical organizations difficult. All other countries impacted by GWD have been cooperating with global organizations to eradicate Dracunculiasis quickly and efficiently.

Once a year, the female adult of the Dracunculus worm comes out through the skin of an infected individual. When such an individual enters a source of water, the worms are able to contaminate the water with their larvae. Water fleas known as copepods consume the larvae. Inside the copepods, the larvae grow into an infectious form in approximately two weeks and infect a new human host when unsuspecting individuals drink from the contaminated water. By drinking the contaminated water, people consume the copepods housing infectious Dracunculus medinensis larvae.

Inside the human body, the stomach acid is able to digest the copepod, but the parasitic worm survives. The Guinea worm larvae travel to the small intestine and push through the intestinal wall into the cavity of the body. It takes about a year for them to grow fully. The female worm can be up to three feet in length and as thick as a strand of spaghetti. The female worm can travel to an area from which it can emerge from the body to begin the cycle again.

When a female Guinea worm is ready to come through the skin, individuals will get a blister on the site. The blister can be painful and takes up to several days to erupt. When an infected individual enters fresh water to seek relief for the painful blister, the female Guinea worm is able to excrete into the water a whitish fluid that holds millions of larvae. The female Guinea worm will be able to repeat this process anytime the infected individual enters a fresh water source for the next few days.

Dracunculiasis tends to be asymptomatic for approximately one year. Symptoms begin to manifest when the adult female Guinea worm is ready to erupt from the body through a blister. During this time, an individual may experience pain, fevers, and swelling. In most cases of Dracunculiasis, the worms erupt from the feet and legs of the individuals, but technically, the phenomenon could happen on any body part.

The unfortunate truth is that people suffering from Dracunculiasis do not have easy access to modern medicine because they live in such impoverished conditions. When female Guinea worms erupt from the skin of individuals, various bacterial infections often further complicate the disease. Secondary bacterial infections can lead to an extended period of illness, crippling, and locked joints.

It may take up to three months for an individual to recover from the eruption of a Guinea worm. If this happens during a harvesting or a planting season, as it often does, this results in less food and or income available to the infected individual. There are often detrimental consequences for the family of the infected individual.

Treatment for Dracunculiasis entails pulling out an emerged worm a few centimeters every day. This slow process may take up to months. Unfortunately, there is no preventative or curative medication. However, surgical removal of Guinea worms may speed up the healing process. Antibiotic solutions can prevent secondary infections and pain killers such as ibuprofen would help alleviate swelling.

Dracunculiasis can be found in twelve countries of Africa. Sudan had over 20,000 cases in 2003 while Ghana had over 8,000 cases and Nigeria had nearly 1,500 cases. There were 829 cases in Mali, 669 cases in Togo, 293 cases in Niger, 203 cases in Burkina Faso, 42 cases in Cote d’Ivoire, 30 cases in Benin, 28 cases in Ethiopia, 26 cases in Uganda, and 13 cases in Mauritania.

Asia was once impacted by Dracunculiasis but is no longer. Some African countries now report no local transmission of the disease for over a year. Such countries are Cameroon, Kenya, Chad, Central African Republic and Senegal. Nearly two hundred nations have been approved by the World Health Organization as Dracunculiasis transmission free. India, Yemen, Senegal, and Pakistan are formerly endemic nations that have been deemed transmission free.

Dracunculiasis is a serious infectious disease because it causes suffering not just in infected individuals but for communities on the whole. Dracunculiasis can be a great financial and social detriment for impoverished areas and immunity does not develop from having the disease once. Prevention requires sanitizing drinking water. Filtering, even with a simple cloth filter to remove fleas could help drastically, as could treating water with larvicide. Underground fresh water sources such as wells could help. Methods of prevention to keep infected individuals from entering water sources are necessary.

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