Dracunculiasis

Definition

Definition of Dracunculiasis
Dracunculiasis, also called guinea worm disease (GWD), is a nodular dermatosis produced by the development of Dracunculus parasite in the subcutaneous tissue of mammals. Dracunculus medinensis has been reported in humans, dogs, cats, horses, cattle, and other animals in Africa and Asia. Dracunculus insignis is a parasite of dogs, raccoons, mink, fox, otter, and skunks of North America. Dracunculus medinensis is a long and very thin nematode (roundworm). The parasite enters a host by way of ingesting stagnant water contaminated with copepods infested with guinea worm larvae. Approximately one year later, the disease presents with a painful, burning sensation as the female worm forms a blister, usually on the lower limb.

Once prevalent in 20 nations in Asia and Africa, the disease remains endemic among humans in only four countries in Africa.

The guinea worm is one of the best historically documented human parasites, with tales of its behaviour reaching as far back as the 2nd century BC in accounts penned by Greek chroniclers. It is also mentioned in the Egyptian medical Ebers Papyrus, dating from 1550 BC. The name dracunculiasis is derived from the Latin "affliction with little dragons" while the common name "guinea worm" appeared after Europeans saw the disease on the Guinea coast of West Africa in the 17th century.

The Carter Center has predicted that guinea worm disease "will be the first parasitic disease to be eradicated and the first disease to be eradicated without the use of vaccines or medical treatment".

Symptoms

Symptoms of Dracunculiasis
As the worm moves downwards, usually to the lower leg, through the subcutaneous tissues it leads to intense pain localized to its path of travel. The painful, burning sensation experienced by infected people has led to the disease being called "the fiery serpent". Other symptoms include fever, nausea, and vomiting.

Causes

Causes of Dracunculiasis
Guinea worm disease is caused by drinking water contaminated by water fleas (copepods) that host the Dracunculus larvae.

Diagnosis

Diagnosis of Dracunculiasis
Diagnosis of GWD is made by visual identification of the female Guinea worm protruding from a skin lesion. Microscopic identification of larvae is also a method of diagnosis.

Tests

Tests of Dracunculiasis
These home medical tests may be relevant to Dracunculiasis:

1. Home Fever Tests
2. Home Ear Infection Test Kits
3. Home Flu Tests
4. Home Strep A Tests

Treatment

Treatment of Dracunculiasis
There is no vaccine or medicine to treat or prevent Guinea worm disease. Once a Guinea worm begins emerging, the first step is to do a controlled submersion of the affected area in a bucket of water. This causes the worm to discharge many of its larva, making it less infectious. The water is then discarded on the ground far away from any water source. Submersion results in subjective relief of the burning sensation and makes subsequent extraction of the worm easier. To extract the worm, a person must wrap the live worm around a piece of gauze or a stick. The process can be long, taking anywhere from hours to months. Gently massaging the area around the blister can help loosen the worm up a bit.  This is nearly the same treatment that is noted in the famous ancient Egyptian medical text, the Ebers papyrus from 1550 BC. Some people have said that extracting a Guinea worm feels like the afflicted area is on fire. However, if the infection is identified before an ulcer forms, the worm can also be surgically removed by a trained doctor in a medical facility.

Prevention

Prevention of Dracunculiasis
Guinea worm disease can be transmitted only by drinking contaminated water, and can be completely prevented through two relatively simple measures:

1. Preventing people from drinking Cyclops (copepod) contaminated water. The Cyclops (copepod) (water fleas) can be seen in clear water as swimming white specks.

• Drinking water drawn only from sources that are free from contamination, such as a borehole or wells.
• Filtering drinking water, using a fine-mesh cloth filter like nylon, to remove the guinea worm-containing crustaceans. Even folding regular cotton cloth over a few times is an effective filter.
• Filtration through ceramic or sand filters
• Boiling
• Developing new sources of drinking water that lack the parasites, or repairing dysfunctional ones.
• Treating water sources with larvicides to kill the Cyclops (copepod)

2. Preventing people with emerging Guinea worms from entering water sources used for drinking.

• Community level case detection and containment is key. This requires staff going door to door looking for cases and a population willing to help and not hide their cases.
• Controlled immersion of emerging worms in buckets of water to reduce the number of larva in the individual worms, followed by discarding the water on dry ground.
• Discouraging all members of the community from setting foot in the drinking water source
• Employing guards at local water sources to prevent people with emerging worms from entering