Global & Disaster Medicine

** Guinea worm disease on the way out!

NY Times

**  Only 22 cases of Guinea worm disease were reported in 2015,

**  126 cases reported in 2014.

**  When the campaign began, there were an estimated 3.5 million cases of Guinea worm infestation

**  The cases were spread across 20 villages in four countries (Chad, Ethiopia, Mali, and South Sudan)

** Guinea worms have been found in hundreds of dogs in Chad, raising the danger that they have found a new host.

**  Guinea worm and polio are the two diseases now closest to being eliminated.

**  There were only 70 cases of polio paralysis in the world last year, all in Pakistan and Afghanistan.



Causal Agent:

Dracunculiasis (guinea worm disease) is caused by the nematode (roundworm) Dracunculus medinensis.

Life Cycle:

Humans become infected by drinking unfiltered water containing copepods (small crustaceans) which are infected with larvae of D. medinensis The number 1. Following ingestion, the copepods die and release the larvae, which penetrate the host stomach and intestinal wall and enter the abdominal cavity and retroperitoneal space The number 2. After maturation into adults and copulation, the male worms die and the females (length: 70 to 120 cm) migrate in the subcutaneous tissues towards the skin surface The number 3. Approximately one year after infection, the female worm induces a blister on the skin, generally on the distal lower extremity, which ruptures. When this lesion comes into contact with water, a contact that the patient seeks to relieve the local discomfort, the female worm emerges and releases larvae The number 4. The larvae are ingested by a copepod The number 5 and after two weeks (and two molts) have developed into infective larvae The number 6. Ingestion of the copepods closes the cycle The number 1.

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