Causes and risk factors
Dracunculiasis is caused by drinking stagnant water containing copepods [tiny water fleas] that carry guinea worm larvae. Larvae are released when copepods die. Larvae enter host’s stomach and intestinal wall and mature and reproduce. Fertilized female worm migrates to the surface of skin and discharges larvae. Female worm begins to emerge from skin one year after infection. Larvae are released into water by female worm, through skin of feet, etc. Larvae are consumed by copepod in water and enter the host when he drinks contaminated water. Source of stagnant water include pools, shallow uncovered wells, drying river beds. People in rural areas, deprived and isolated communities who depend only on open source of water for drinking are at risk.
Clinical presentation
Dracunculiasis does not produce any symptom for 1 year after entering into the human body. After the incubation period of 1 year, the female larva produces symptoms like blister on the skin on the lower extremity. The development of blister is accompanied by severe pain along the course of worm, with fever, nausea, and vomiting. The blister eventually develops into an ulcer.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Diagnosis can be made by looking at the adult worm protruding from the skin sore. Routine blood tests are done. Skin biopsy may be needed.
Treatment
Dracunculiasis cannot be cured or prevented by any medication or vaccine. The only treatment available is to remove the worm. It is done in the following ways – The affected body part is immersed in water to encourage more of the worm to come out. The extracted worm is tied to a piece of gauze or stick to facilitate more extraction and prevent slipping back of worm inside. The affected area is cleaned. Antibiotics are prescribed to prevent secondary bacterial infection. Analgesics are prescribed to reduce pain and inflammation. Complete removal of the worm can take many hours to days depending upon the length of the worm.
Other Modes of treatment
The other modes of treatment can also be effective in treating dracunculiasis. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates is also found to be effective in treating dracunculiasis.
Facts and figures
Guinea worm disease is on the verge of eradication. Only 148 cases have been reported worldwide in 2013.
