Written by Britney Nguyen, Peer Reviewed by Olivia McCollum, Edited by Courtney Coleman
Dracunculiasis is a rare infectious disease that is currently undergoing an international eradication campaign. Despite the efforts of global leaders to address the concerns surrounding dracunculiasis, there is still a considerable threat to those at risk. Dracunculiasis, or Guinea worm disease, is a neglected disease found in the countries of Mali, Chad, South Sudan, Ethiopia, and Angola, that is close to eradication in humans, yet is still transmitted through animals. As of January 2023, there were only 13 reported human cases of Guinea worm disease found in 2022; however, 673 animal cases were also observed (1). This article aims to inform the public about the history of Guinea worm disease, its symptoms, treatment, and complications with eradication efforts as of today.
One of the most complicated aspects of Guinea worm disease is that the disease does not show symptoms until approximately one year after the initial infection. Guinea worm disease comes from the parasite Dracunculus medinensis. These parasites lay eggs that develop into larvae and are ingested by copepods in stagnant water. Humans are infected by Guinea worm disease when they drink from these contaminated waters. Because of poor drinking water infrastructure, the disease is mainly found in poor remote villages in many countries in Africa. Symptoms of Guinea worm disease may manifest as a rash, slight fever, nausea, dizziness, vomiting, and diarrhea (3). After one year, symptoms of infection from the worm begin to occur, as excess water may build up in a person’s body causing oedema and leading to a severe rash, blistering, and ulceration (4). Once a person has developed an ulcer from the infection, they may develop secondary complications, such as a bacterial infection, exacerbated inflammation, temporary disability, and, in worst-case scenarios, the worm may even rupture underneath the skin and lead to a severe allergic reaction (4).
Although there are severe symptoms with this disease, there is no vaccine or specific medication given to remove or kill the worm. Fortunately, the disease is rarely fatal, and the worm can be removed with proper, skilled medical care. A healthcare professional must slowly wrap the emerging worm with a stick and pull out a few centimeters every day for a few days to weeks. It is crucial that this procedure is done by a medical professional who has experience treating the disease, because it is not uncommon for the worm to break, retract into the skin, and regenerate in the body.
Guinea worm eradication has been an ongoing process that began in 1980. Eradication has been successful in 199 countries with only 7 countries in Africa left. The Carter Center is the main reason for the success of eradication efforts, as they spread mass education on ways to protect people from infection, including the filtering of drinking water, and covering or avoiding stagnant water sources (1).
As shown in Figure 1, the Carter Center has had a monumental effect on the eradication of Guinea worm, with over 892,000 infections found in 1989, and only 13 cases reported as of 2022 (2). Unfortunately, there is no certain end to Guinea worm disease, as wild animals are
still drinking from these contaminated waters every day, and are unable to avoid the ingestion of copepods. Therefore, the CDC has now shifted its focus to educating people on how to best prevent Guinea worm disease in animals. For example, people are taught to cook their fish thoroughly to avoid potentially infected fish, and offered money to remove Guinea worms from their dogs (3).
Although Guinea worm disease is slowly disappearing in humans, eradication cannot be successful until the disease has been eliminated from all animal reservoirs as well. The most effective ways to prevent Guinea worm transmission are through education, sanitation efforts, and animal surveillance. By adopting these simple preventative measures, we can reduce the spread of this disease in the world’s most vulnerable communities.
References
1. Staub, Emily. “Guinea Worm Disease Reaches All-Time Low: Only 13* Human Cases Reported in 2022.” The Carter Center, 24 Jan. 2023,
https://www.cartercenter.org/news/pr/2023/2022-guinea-worm-worldwide-cases-announc ement.html.
2. Spooner, Saloni Dattani and Fiona. “Guinea Worm Disease Is Close to Being Eradicated – How Was This Progress Achieved?” Our World in Data, 7 July 2022, https://ourworldindata.org/guinea-worm-path-eradication.
3. “CDC - Guinea Worm Disease - Eradication Program.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 16 Mar. 2022, https://www.cdc.gov/parasites/guineaworm/gwep.html.
4. “Dracunculiasis (Guinea-Worm Disease).” World Health Organization, World Health Organization, https://www.who.int/health-topics/dracunculiasis#tab=tab_2.
This post is not a substitute for professional advice. If you believe that you may be experiencing a medical emergency, please contact your primary care physician, or go to the nearest Emergency Room. Results from on going research is constantly evolving. This post contains information that was last updated on April 13, 2023.
Olivia McCollum is a first-year MPH Candidate in the Department of Epidemiology at the University of Washington-Seattle. She is currently studying epidemiology of infectious and zoonotic disease specifically in children and women residing in low- and middle-income countries.
Britney Nguyen is currently a Public Health major undergraduate at UC Berkeley.
Courtney Coleman is a master's degree candidate in biology at Harvard and Co-President of Students vs Pandemics.
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