Key facts

• Dracunculiasis – commonly called Guinea worm disease – is caused by the parasitic worm Dracunculus medinensis.
• The disease is transmitted through drinking contaminated water
• It is initially symptomless but about a year after infection a worm will emerge from the body, usually in the legs or feet.
• It is close to being wiped out with just 13 cases reported in 2024 and 13 in 2023.

Overview

Dracunculiasis occurs when people drink water containing tiny crustaceans (copepods or water fleas) that carry the larvae of Dracunculus medinensis. Once inside the body, the larvae develop into adult worms which then emerge from the body, usually the feet.

Signs and symptoms

The early stages of infection usually cause no obvious symptoms. These only appear about a year later, when the adult worm – which can be up to a metre long – begins to emerge.

Typical symptoms include:

• Painful blistering on the skin, often on the legs or feet
• Burning sensation at the site of blister
• Fever, nausea, and vomiting prior to worm emergence
• Local swelling and redness around the affected area
• Secondary bacterial infections in the wound caused by worm emergence

Dangers and complications

Although rarely fatal, dracunculiasis can cause significant disability and suffering. The pain associated with worm emergence can be debilitating, leaving individuals unable to work, attend school, or perform daily activities.

Transmission

The parasite is transmitted when people consume drinking water contaminated with copepods carrying Dracunculus larvae. After ingestion, the copepods die and release the larvae in the stomach and intestines. The larvae then mature inside the body over the course of several months.

When the female worm reaches maturity, she migrates to the skin. Contact with water triggers her to release larvae back into the environment, continuing the cycle of transmission.

Treatment

There is no specific medicine or vaccine for Dracunculiasis. Treatment focuses on the careful extraction of the worm, which can take days to weeks as it slowly emerges from the body. Pain relief, wound care, and management of secondary infections are important parts of treatment.

Prevention

Prevention is centred on breaking the cycle of transmission. This involves ensuring access to safe drinking water; surveillance; health education campaigns and treatment of unsafe drinking water.

History

In the 1980s the disease was endemic in 20 countries worldwide – 17 in Africa and three in Asia – and there were around 3.5 million cases every year. However, since then the number of cases has fallen dramatically – to less than 20 every year since 2015 – thanks to concerted eradication efforts. However, the disease spreads in animals, mainly domestic dogs and cats, hampering the eradication programme.

Useful links

who.int/fact-sheets/dracunculiasis

cdc.gov/guinea-worm

unitingtocombatntds.org/guinea-worm-disease

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