Facts About Dracunculiasis (Guinea Worm Disease): CDC-OC

March 27, 1998
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• Dracunculiasis (dra-KUNK-you-LIE-uh-sis), more commonly called Guinea worm disease, is a parasitic infection caused by Dracunculus medinensis (a long, thin worm). Infection is seen when the adult worm emerges through the skin of an infected person. Worms grow up to 3 feet long and are as wide as a paper clip wire.
• When a person with a Guinea worm ulcer enters water (e.g., a pond), the adult female worm emerges from the wound and releases a milky white liquid containing thousands of immature worms into the water. In the water, these microscopic worms are swallowed by small copepods (water fleas). About 10 days after the water flea ingests them, the water fleas become infective to anyone who swallows them. Once swallowed, stomach acid digests the water flea, but not the Guinea worm. The Guinea worm then grows to adulthood, a process that takes about a year.
• Infected persons do not usually have symptoms until about 1 year after they drink contaminated water. A few days to hours before the worm emerges, the person may develop a fever, swelling, and pain in the area where the worm is trying to get out. A blister develops, then opens into an ulcer. When the ulcer contacts water, the worm begins to emerge. More than 90% of the worms appear on the legs and feet, but may occur anywhere on the body. Depending on the site of the wound, complications such as locked joints can develop and result in permanent crippling.
• Once the worm emerges from the wound, it can only be pulled out a few centimeters each day and wrapped around a small stick. Sometimes the worm can be pulled out completely within a few days, but this process usually takes weeks or months (average 3 months).
• No medication is available to end or prevent infection. However, the worm can be surgically removed before the wound begins to swell. Antihistamines and antibiotics may reduce swelling and ease extraction of the worm.
• Except for a few remote villages in the Rajastan desert of India and in Yemen, dracunculiasis now occurs only in Africa. Most cases occur in poor rural villages that are not visited by tourists.
• Since 1986, when an estimated 3.5 million people were infected, an international campaign was established to eliminate the disease. In 1995 the total number of people infected in the world had dropped to about 130,000, <4% of the total in 1986.

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