Guinea worm disease eradication is an important issue for most of the tropical African and Asian regions even in the tropical South America and West Indies, as this is where Dragon worm is found. Due to the parasite’s invasion of a variety of mammals it is important for the people to be worried about the guinea worm disease eradication. There are many different forms of worm sicknesses or worm disease, and dracunculiasis guinea worm disease is one of them.
Belonging to the phylum Nematoda; dracunculus parasite (Dracunculus Medinensis) also known as the Dragon Worm is a parasite that affects humans and mammals as well. The disease caused by the dracunculus parasite is called dracunculiasis guinea worm disease or dracunculiasis simply.
Also called the guinea disease, the dragon worm is a roundworm, and it penetrates the gut and travel to the connective tissue. The guinea worm larvae or the new guinea worm larvae as they are known have a four stage development cycle and this is all before the formation of adult dracunculus worm. The dracunculus worm can grow to a length of 80cm, and are among the largest nematodes known species.
These new guinea worm have a dual host cycle, which involves an intermediate host. These hosts are where the infective guinea worm larvae develop. Then these vertebrates or aquatic crustaceans are ingested by the definitive host (humans or mammals) through drinking unfiltered water, containing these copepods.
Guinea worm larvae
The guinea worm larvae do not come from eggs but the dragon worm female give birth to live larvae. This is the reason that guinea disease causing dracunculus parasite is called ovoviviparous, as it does not lay eggs.
In humans, the guinea worm infestation cause blisters with are painful. Guinea worm larvae are released through these blisters. It may come as a surprise to you, but this guinea disease is quite well known. The staff with serpent logo that has been adopted as the official symbol of medicine reflects the same dracunculus worm along with a stick winding it, this depicts the traditional removal techniques at the time.
Guinea worm infestation in humans also have a history of being recorded earlier in history books. Described to the likes of little snakes by scholars both Roman and Greek, they even have been described as fiery serpents in some texts.
Guinea worm disease or Guinea disease occur in desert and the semi – desert areas of the Middle-East, India, Brazil and the sub – Sahara of the Africa. But mainly in areas which are not urban i.e. rural areas. In these areas, due to the scarcity of water resources the water that is available is from ponds of the rainy seasons or from wells drawn from the soil. Due to World Health Organization’s preventive campaigns the estimated prevalence of guinea worm disease has been markedly reduced.
This worm disease (Guinea disease) has been reported occasionally in mammals like horses, dogs, cattle and cats. Even species of crocodiles, some water birds, turtles and snakes have also been described as affected by this worm sickness. Other species of this disease have also been known to affect raccoons, carnivores, possums or muskrats in the Americas as well.
Site of Infestation
The larvae that are ingested arrive at the connective tissue by penetrating the gut. They migrate to the inguinal and/ or axillary regions after invading the subcutaneous connective tissues. The female dracunculus parasite then migrate to the locations in the peripheral subsurface from the deep connective tissues. Especially in the legs or arms (extremities), this does not mean that they cannot occur anywhere else, but the extremities are the places where they occur most commonly.
Signs and Symptoms
Until the mature female dragon worms travel to the skin and form a papule or a blister, these usually are symptomless or asymptomatic, even though they can grow to very large sizes. When traveling these may produce some localized swelling, or some allergic reactions like diarrhea, dizziness, nausea and rashes. There are generally two types of infectious lesions; one that occur subcutaneously or some that are around dead worms (deep abscesses) this involves many inflammatory cells that become blister after calcification (papules), this is how they directly release larvae, as there are no eggs. Sometimes these skin lesions may also involve redness, intense pain (burning sensation) as well as ulceration.
Guinea Worm Removal
The guinea worm removal is a process where cool water immersion is used to relieve the symptoms of this worm sickness. Due to the hypersensitivity reaction, which is induced from the larval deposition in the tissues, blisters are formed. These blister then burst and parts of the adult worms emerge out, this is the way these tissue dwelling parasites get expelled from the host. In some cases of uncomplicated infections the lesion only lasts until the worm is completely removed from the body.
But some cases do get involved with secondary infection, which is usually bacterial. These secondary infections cause a number of different sequelae of events which may make this infection and guinea worm disease treatment complicated. These may involve fibrous ankylosis, different disseminated infections, chronic ulceration and contractures of tendons.
There are some very old and traditional methods of guinea worm removal. This involves the slow winding of the dragon worm on a stick several centimeters a day for some weeks. It is important to avoid force as excess of force might break the worm and complicate the infections and guinea disease.
There is a surgical procedure involving the removal of the dracunculus worm when present in the superficial sites of the body. If the involvement of deeper tissues and fascia is present, surgical treatment may be difficult to perform. Guinea worm disease treatment through some anthelminthics have not been proven efficacious, but some molecules like mebendazole, albendazole or even metronidazole have shown some encouragement, and plays and important role in Guinea worm disease eradication process.
Please consult your treating physician before taking any medication.
There are some preventive measures that can break the transmission cycle, like the elimination of copepod by reduction of the contamination. Educating the public through different programs, and purification of water by boiling or filteration. Even the treatment of local water supplies can reduce the prevalence dramatically.