Often, the wound caused by the emerging worm develops a secondary bacterial infection. This makes the pain worse and can increase the time an infected person is unable to function from weeks to months.
Sometimes, permanent damage occurs if a joint is infected and becomes locked. There is no drug to treat Guinea worm disease and no vaccine to prevent infection.
Once part of the worm begins to come out of the wound, the rest of the worm can only be pulled out a few centimeters each day by winding it around a piece of gauze or a small stick. Sometimes the whole worm can be pulled out within a few days, but the process usually takes weeks. Care must be taken not to break the worm during removal. If part of the worm is not removed, there is a risk for secondary bacterial infections and resulting complications.
Anti-inflammatory medicine can help reduce pain and swelling. Antibiotic ointment can help prevent infections. Only 28 cases of Guinea worm disease were reported in humans in These cases were reported in Angola 1 case , Chad 17 cases , and South Sudan 10 cases.
As of February , the World Health Organization had certified external icon external icon countries, territories, and areas as being free of GWD transmission. Animals infected with D. Most animal infections have occurred in Chad but some have been reported in Ethiopia and Mali. In , Chad reported 1, infected dogs and 25 cats; Ethiopia reported 11 infected dogs, five cats, and one baboon; and Mali reported 18 infected dogs and two cats.
Anyone who drinks from a pond or other stagnant water source contaminated with Guinea worm larvae is at risk for infection. Larvae are immature forms of the Guinea worm. People who live in countries where GWD is occurring such as Chad, Ethiopia, Mali, and South Sudan and consume raw or undercooked aquatic animals such as small whole fish that have not been gutted, other fish, and frogs may also be at risk for GWD.
People who live in villages where there has been a case of GWD in a human or animal in the recent past are at greatest risk. The disease causes preventable suffering for infected people and is an economic and social burden for affected communities. Adult female worms come out of the skin slowly and cause great pain and disability. Adults with active GWD might not be able to work in their fields or tend their animals.
This can lead to food insecurity and financial problems for the entire family. Children may be required to work the fields or tend animals in place of their sick parents or guardians.
This can keep them from attending school. Children who have GWD themselves may also be unable to attend school. Dracunculiasis, or Guinea worm disease, is an extremely rare neglected tropical disease primarily affecting remote and impoverished communities in parts of Africa. People become infected with the parasitic worm after drinking contaminated water or eating undercooked fish or other aquatic animals.
After about a year, the worm breaks through the skin, causing itchy, burning blisters, often on the feet or legs. The pain caused by the condition can be debilitating, and many are left with lifelong disabilities.
Thanks to global efforts to stamp out the disease, however, Guinea worm is now on the brink of eradication. What that happens, the symptoms of Guinea worm disease can include:. This lasts an average of 8. Without proper treatment, wounds caused by the worm can become infected by bacteria, leading to sepsis , septic arthritis , and contractures when joints lock and deform. In some cases, these infections become life-threatening. Guinea worm disease is caused by the parasitic worm Dracunculus medinensis , commonly called Guinea worm.
The way the worm gets into the body and makes people sick is fairly complex , and it all starts with water fleas. These small crustaceans known as copepods or water fleas live in stagnant water and eat the Guinea worm larvae. Inside, the larvae go through changes, and after two weeks, they are ready to be infective.
When people drink water that has been contaminated with the copepods, the copepods die and release the larvae into the human digestive tract. The larvae stay in the body for about a year as they mature into adult worms.
Female adults can grow to be about 24—39 inches 60— centimeters long. After mating, a worm starts to make its way toward the skin, causing physical discomfort. The itching and burning can become so intense that people rush to submerge the infected part in water to get relief. Every time they do, the female adult worm breaks through the skin to discharge her immature larvae back out into the freshwater, starting the whole cycle again. After about two to three weeks, the female runs out of larvae, and eventually dies and becomes calcified in the body if it's not removed.
The disease is largely seasonal , striking more frequently during the rainy or dry season depending on the area, and is not spread from person to person. Guinea worm disease is diagnosed through a simple physical exam. Health care providers look for the telltale white, stringy worm poking through the blister once the affected area has been immersed in water. There are currently no diagnostic tests available to identify those infected before symptoms appear.
Like many neglected tropical diseases, there is no cure or specific medication to treat Guinea worm disease. De-worming medications used for other parasitic infections don't appear to work to treat Guinea worm infections or prevent symptoms from occurring. Instead, treatment typically involves removing the worm through a long and painstaking process. Medications like ibuprofen can be given to reduce swelling and relieve pain involved.
Antibiotic ointment can also be applied to the affected areas to prevent a bacterial infection. No vaccine exists against Guinea worm, but the disease can be completely prevented by ensuring safe drinking water and not allowing the adult worms to disperse their larvae.
The best way to prevent infection is to drink water only from uncontaminated water sources, like hand-dug wells and boreholes. Many communities affected by Guinea worm disease, however, lack access to clean drinking water. In those instances, any water used for drinking or cooking should be filtered.
The copepods that carry the Guinea worm larvae are too small to be seen without the help of a magnifying glass, but they're big enough to be easily removed from the water using a cloth or pipe filter. This blister gets bigger over several days and causes a burning pain. The blister eventually ruptures, exposing the worm.
The infected person may put the affected body part in cool water to ease the symptoms or may enter water to perform daily tasks, such as fetching drinking water. On contact with water, the worm discharges hundreds of thousands of larvae into the water [ 1 , 2 ]. In addition to the pain of the blister, removing the worm is also very painful.
Furthermore, without proper care the wound often becomes infected by bacteria. These wound infections can then result in one or more of the following complications:. If the worm breaks during removal it can cause intense inflammation as the remaining part of the dead worm starts to degrade inside the body. This causes more pain, swelling, and cellulitis [ 1 , 2 ]. While the death rate is low, disability is a common outcome of GWD.
People have difficulty moving around because of pain and complications caused by secondary bacterial infections. The disability that occurs during worm removal and recovery prevents people from working in their fields, tending animals, going to school, and caring for their families. Disability lasts 8. When GWD was more common, the negative impacts on farming and livestock tending caused financial losses in the millions of dollars each year. Some children were disabled by infection.
Other children needed to work in place of disabled family members [ 1 , 2 , 3 , 4 ].
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