Guinea Worm Disease (cont.)

How does Guinea worm disease spread?

Approximately 1 year after a person drinks contaminated water, the adult female Guinea worm emerges from the skin of the infected person. Persons with worms protruding through the skin may enter sources of drinking water and unwittingly allow the worm to release larvae into the water. These larvae are ingested by microscopic copepods (tiny "water fleas") that live in these water sources. Persons become infected by drinking water containing the water fleas harboring the Guinea worm larvae.

Once ingested, the stomach acid digests the water fleas, but not the Guinea worm larvae. These larvae find their way to the small intestine, where they penetrate the wall of the intestine and pass into the body cavity. During the next 10-14 months, the female Guinea worm larvae grow into full size adults, 60-100 centimeters (2-3 feet) long and as wide as a cooked spaghetti noodle. These adult female worms then migrate and emerge from the skin anywhere on the body, but usually on the lower limbs.

A blister develops on the skin at the site where the worm will emerge. This blister causes a very painful burning sensation and it ruptures within 24-72 hours. Immersion of the affected limb into water helps relieve the pain but it also triggers the Guinea worm to release a milky white liquid containing millions of immature larvae into the water, thus contaminating the water supply and starting the cycle over again. For several days after it has emerged from the ulcer, the female Guinea worm is capable of releasing more larvae whenever it comes in contact with water.

What are the signs and symptoms of Guinea worm disease?

Infected persons do not usually have symptoms until about one year after they become infected. A few days to hours before the worm emerges, the person may develop a fever, swelling, and pain in the area. More than 90% of the worms appear on the legs and feet, but may occur anywhere on the body.

People, in remote, rural communities who are most commonly affected by Guinea worm disease (GWD) frequently do not have access to medical care. Emergence of the adult female worm can be very painful, slow, and disabling. Frequently, the skin lesions caused by the worm develop secondary bacterial infections, which exacerbate the pain, and extend the period of incapacitation to weeks or months. Sometimes permanent disability results if joints are infected and become locked.

Medically Reviewed by a Doctor on 4/3/2014

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