Dracunculosis

Dracunculosis

National Organization for Rare Disorders, Inc.

Important

It is possible that the main title of the report Dracunculosis is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

  • Dracontiasis
  • Dracunculiasis
  • Fiery Serpent Infection
  • Guinea Worm Infection

Disorder Subdivisions

  • None

General Discussion

Dracunculosis is an infection caused by a parasitic worm known as Dracunculus medinensis, the guinea worm. Infected water fleas release the larvae of the worm into drinking water. Ingestion of contaminated water causes the larvae to migrate from the intestines via the abdominal cavity to the tissue under the skin. The larvae mature and release a toxic substance that makes the overlying skin ulcerate. After treatment, symptoms disappear and the worms can be safely removed from the skin.

Symptoms

Dracunculosis is characterized by chronic skin ulcers. Tissue under the skin is infiltrated by developing larvae of the parasitic worm known as Dracunculus medinensis, or Guinea worm. A female worm ready to release larvae produces stinging elevated spots (papules), causing redness and itching of the skin. These symptoms may be an allergic reaction to the parasite. The spots form blisters and later rupture, developing into painful ulcers. Multiple ulcers (usually on the legs) are common. Without treatment, the worms are absorbed or protrude from the skin over a period of several weeks.

Causes

The cause of dracunculosis is the consumption of water contaminated by the larvae of the parasitic worm Dracunculus medinensis, which live in an intermediate host in the water. The larvae are released from the intermediate host while in the stomach, where they mate and grow. This stage lasts for as long as a year. The female apparently survives this process and may grow to three feet in length. The symptoms and characteristic ulcers and infections occur when the female moves from the stomach or intestine to tissues under the skin.

Affected Populations

In 1986, there were approximately 3.2 million cases of dracunculosis worldwide. However, due to the efforts of several national and international organizations in cooperation with local governments, the incidence of the disease has significantly decreased. According to current estimates, there are now fewer than 100,000 cases of dracunculosis worldwide, with the remaining cases primarily occurring in Sudan and certain countries in West Africa, such as Nigeria and Niger.

Standard Therapies

Diagnosis

In individuals with dracunculosis, the condition is diagnosed based upon characteristic symptoms (e.g., fever, pain, and blistering and ulceration of the affected area) in association with the emergence of the adult worm through the individual's skin.



Treatment

The administration of certain medications that are destructive to worms (antihelmintic therapy), such as metronidazole or thiabendazole, may help to alleviate associated symptoms. However, the effectiveness of such agents against the guinea worm's activity has not been demonstrated.



In most cases, once the worm begins to emerge, it may be gradually extracted by a few centimeters daily through winding of a small stick. Complete removal of the worm usually takes from weeks to months. In some cases, the worm may be surgically removed.



Boiling, appropriate chemical treatment, and filtering of contaminated drinking water may help to prevent transmission of dracunculosis.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. Government funding, and some supported by private industry, are posted on this government web site.



For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



For information about clinical trials sponsored by private sources, contact:

www.centerwatch.com

References

TEXTBOOKS

Harrison's Principles of Internal Medicine, 14th Ed.: Anthony S. Fauci et al., Eds.: McGraw-Hill Companies, Inc., 1998. Pp. 1216-17.



ARTICLES

The Comparative Study of Patterns of Guinea Worm Prevalence as a Guide to Control Strategies. S.J. Watts et al.; Soc Sci Med (1986; 23(10)). Pp. 975-82.



Controlled Comparative Trial of Thiabendazole and Metronidazole in the Treatment of Dracontiasis. O.O. Kale et al.; Ann Trop Med Parasitol (April 1983; 77(2)). Pp. 151-57.



Studies on Immunodiagnosis of Dracunculiasis. I. Detection of Specific Serum Antibodies. P. Bloch et al.; Acta Trop (Jun 15 1998 ;70(1)). Pp. 73-86.



Guinea Worm Disease - A Chance for Successful Eradication in the Volta Region, Ghana. S.K. Diamenu et al.; Soc Sci Med (Aug 1998; 47(3)). Pp. 405-10.



Vector-Borne Parasitic Diseases - An Overview of Recent Changes. D.H. Molyneux; Int J Parasitol (Jun 1998; 28(6)). Pp. 927-34.



Candidate Parasitic Diseases. K. Behbehani; Bull World Health Organ (1998; 76 (Suppl 2)). Pp. 64-67.



Perspective from the Dracunculiasis Eradication Programme. D.R. Hopkins et al.; Bull World Health Organ (1998; 76 (Suppl 2)). Pp. 38-41.



Dracunculiasis in Cameroon at the Threshold of Elimination. A. Sam-Abbenyi et al.; Int J Epidemiol (Feb 1999; 28(1)). Pp. 163-68.



FROM THE INTERNET

eMedicine - Dracunculiasis : Article by Shuvo Ghosh, MD

www.emedicine.com/ped/topic616.htm

Resources

Centers for Disease Control and Prevention

1600 Clifton Road NE

Atlanta, GA 30333

Tel: (404)639-3534

Tel: (800)232-4636

TDD: (888)232-6348

Email: cdcinfo@cdc.gov

Internet: http://www.cdc.gov/



NIH/National Institute of Allergy and Infectious Diseases

Office of Communications and Government Relations

6610 Rockledge Drive, MSC 6612

Bethesda, MD 20892-6612

Tel: (301)496-5717

Fax: (301)402-3573

Tel: (866)284-4107

TDD: (800)877-8339

Email: ocpostoffice@niaid.nih.gov

Internet: http://www.niaid.nih.gov/



World Health Organization (WHO)

Avenue Appia 20

Geneva 27, 1211

Switzerland

Tel: 41227912111

Fax: 41227913111

Internet: http://www.who.int/en/



Genetic and Rare Diseases (GARD) Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Internet: http://rarediseases.info.nih.gov/GARD/



For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc.® (NORD). Cigna members can access the complete report by logging into myCigna.com. For non-Cigna members, a copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use . How this information was developed to help you make better health decisions.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.