As The Worm Turns


Imagine you awake in excruciating pain. The pain seems to come from all over your body. Your joints feel like they are on being ripped apart. Eventually you feel a bump on your foot. The bump turns into a bister. You are feverish and sick to your stomach. You can’t sleep. Then a small some alien creature starts to emerge from your skin, a worm-like parasite, and now your skin feels like it is on fire. The only thing that seems to help is immersing your feet into cool water, but as you do, the worm releases millions of embryos and the cycle of infection and reinfection begins. For people living in sub-Saharan Africa, this is not a horror film, but the reality of living in an area prevalent with guinea-worm disease.

The worm is actually a parasite, the largest tissue-infecting parasite that infects humans. Dracunculus medinensis females carry between 2 and 3 million embryos, and measures up to 800mm (30 inches) in length, and 2mm in diameter. The action of infection is, as with most parasites, insidious. The overwhelming burning sensation that infected people experience is made better only by submerging in cool water. Upon contact with cool water, the female worm releases millions of larva. This completes the first stage of the worm’s life cycle. For the next stage of the life cycle involves a predatory crustacean called the Cyclops or water flea. These tiny creatures measure between 1 and 2 mm and are one of the most abundant freshwater inhabitants worldwide. After ingestion, the guinea-worm lava develops its third stage, generally taking two weeks. Because these Cyclops are so tiny, they are swallowed unnoticed when people drink from water from infected ponds or shallow open wells. The stomach acid quickly dissolves the Cyclops and the guinea-worm lava is released, and migrates through the intestinal wall. After about three months, the male and female worms meet and mate; the male dies and becomes encapsulated in the tissue, while the female moves the body to the muscles of the legs. About a year later, the female guinea worm emerges, usually from the feet, and releases thousands of larvae, thus repeating the lifecycle.

Currently there is no drug available to prevent or to treat this parasitic disease, it is relatively easy to prevent and, eventually eradicate, like you do to the method of infection that is exclusively associated with drinking contaminated water. While infection from this parasitical worm is seldom fatal, patients can be very ill for several months due to the method of reproduction.

When the adult worm emerges, sometimes several at a time, there is the accompanied painful edema and intense generalize pruritus along with blistering and alteration in the areas of the feet and legs where the adult one emerges. Often the migration and emergence of the worms occur in sensitive parts of the body, and may lead to permanent disabilities. Invariably the ulcerations caused by the emergence of the adult worm often develop secondary infections, which exacerbate the inflammation and pain resulting in complete disability floor up to several months. If the body of the worm is ruptured for any reason, severe allergic reaction can occur.

The epidemiology of guinea-worm disease.

The epidemiology of the disease is determined largely by the use of open stagnant water sources such as ponds and shallow or step wells for drinking. In most areas, man-made ponds are the main source of transmission. Guinea-worm disease is seasonal, occurring with two broad patterns found in endemic areas of Africa, depending on climatic factors.

In the Sub-Sahara zone, transmission generally occurs in the rainy season from May to August, while in the Savanna and forested zone, the peak occurs in the dry season from September to January. Guinea worm disease is an illness of vulnerability. Because he managed to get South creates the habitat for the worm too in fact, man can also permanently curtail transmission by applying a number of public health methods:

  1. Effective surveillance to get text all cases of getting what disease within 24 hours of the worm and merging and the containment of all cases;
  2. Ensuring access to save drinking water and taking steps to convert on the safe sources of drinking water to safe ones. This would have the added benefit of greatly decreasing diarrheal disease.
  3. Regular and systemic filtering of drinking water derived from ponds or shallow unprotected wells or from surface water using find a mesh cloth or filters made from 0.15 mm nylon mesh to filter out the water fleas before drinking.
  4. Health education and social mobilization to encourage affected communities to adopt healthy drinking water behaviors including those mentioned above.

If village communities implement these measures, the goal of eradicating guinea-worm disease can be achieved. To this end, the global eradication campaign has made steady progress. Both the number of cases and the areas of infection have fallen significantly since the launch of the eradication efforts in the 1980s, when 20 countries were endemic for the disease.

In 1986, an estimate of 3.5 million new cases occurred. By 2012, the disease was confined to 4 countries: Chad, Ethiopia, Mali and South Sudan. By the end of 2012, a total of just 542 cases were reported. A reduction of more than 99% from the cases reported in 1986. However, certain areas continue to report at endemic infections. An outbreak in Chad first identified in 2010 has continued, and Chad has been reclassified as a country endemic for the disease.

Making progress

As of the December 2012, 192 countries, territories and areas have been certified free of guinea-worm disease. Fourteen countries remain to be certified, of which 4 countries (Angola, Democratic Republic of the Congo, Somalia and South Africa) have no recent history of guinea-worm disease. President Jimmy Carter on the United States has been active in helping to eradicate this disease. And while guinea worm infection has been around nearly as long as humans (a calcified Guinea worm was found in a 3000-year-old Egyptian mummy), public health is actively seeking to stamp this debilitating and preventable illness out of existence. Getting rid of the copepods that carry Guinea worm larvae is relatively simple: people just have to run their water through a fine nylon filter. Nomads, and those who can’t easily carry large jugs of filtered water, instead use reeds with mesh filters at the ends as straws, which allows them to suck up water from ponds as they travel. The Carter Center has distributed over 23 million of these pipe filters.

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