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Definition

Dracunculiasis or popularly known as Guineaworm disease is an infection caused by drinking contaminated water infested with infected larvae of the nematode or parasite Dracunculus medinensis from ponds and other stagnant water bodies full of water fleas. Once inside the body, in about 10-14 months, the female larvae penetrates the digestive system right into the body cavity growing into full-size adults about 60-100 cms long as wide as spaghetti noodles.

Symptoms

Symptoms don't show up to a year after infection. Typically before the worm bursts through the skin in the legs and feet or other parts of the body, the host may feel ill and manifest the following:

  • Mild Fever
  • Swelling
  • Slow and Disabling pain
  • Nausea and Vomiting
  • Diarrhoea
  • Secondary bacterial infection and Allergic Rashes
  • Dizziness
  • Joint infection and locking of joints

Risk Factors

Anybody who consumes pond water or water from any stagnant body especially in villages contaminated with guinea worm larvae is at risk for infection.

Diagnosis

The clinical diagnosis and presentation is in the form of a blister where the worm breaks through and part of the worm is exposed.

Treatment

There is no vaccine or drug developed to prevent or treat this disease – even anthelmintics have no place here. The only means available to us is management of the disease which is removing the whole worm and caring for the wound caused by it and avoiding infection in the process or exposure to the guinea worm larvae at all costs especially by avoiding contaminated drinking water and stagnant water sources.

Blister management includes the following:

  • Infected host is advised against any contact with water drinking sources.
  • Every affected body part is immersed in a container of water to tempt the worm to come out and eject more larvae in the form of a milky looking fluid.
  • The wound and blister is sterilised and cleaned properly.
  • Steps to pull out the worm (which can be a meter long) may take several days to weeks. The gentle traction applied to pull the worm should be stopped if met with resistance; chances are the worm might slip back. Usually, the worm is held and wrapped in a piece of gauze or a stick to maintain tension and grip so that it emerges out.
  • Once, the worm is fully out, topical antibiotics need to be administered immediately on the wound to arrest any secondary bacterial infection. The affected body part also gets a fresh bandage to protect the site. Painkillers will be given to ease the pain that comes with the removal and also, to reduce inflammation.
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