Dracunculiasis: Treatment, Cost and Side Effects

Dracunculiasis or the Guinea Worm disease is an infection by the worm of the same name which enters the body through contaminated water which contains guinea worm larvae and water flea. The incubation period is as long as a year. The symptoms include the presence of painful blisters and burning sensation usually on the lower leg. The disease is on the verge of eradication. It causes disability in walking for a few weeks. The water flea present in the water is killed in the body. However, the larvae germinate in the body. They take up to 10 to 14 months to reach to complete a cycle and reach maturity. They are ready to come out of the body after they reach maturity. This causes them to form painful blisters on the body, usually the lower leg. It is also accompanied with burning sensation. The disease has reported very few cases of death. The disease is caused by drinking water sources which contain water fleas or the Cyclops or their larvae. The water fleas or the Cyclops are killed in the gut. However, the larvae penetrated the intestinal wall and enter into the abdominal cavity. The worm mature in about three months. After fertilisation, the male worm dies and the female travels near the surface of the skin in order to release the eggs. The female worm releases 100 of eggs into the water when the body part is immersed in the water for the extraction of the worm. This water is highly contaminated and must be disposed on dry land away from any drinking water resources so as to prevent the larvae from germinating.

There is no specific treatment for the disease. Also, there is no medication prescribed which can expulse the guinea worm from the body. And there is no vaccine which can prevent the occurrence of the disease. The only way is to extricate the guinea worm from the body and to care for the wound. It takes anywhere from several days to weeks to pull out the worm successfully. This is so because the worm can be as long as 1 meter in length.

1. Firstly, it is ensured that the infected person is segregated from healthy drinking water resources so as to not contaminate them.
2. Next, the infected body parts of the person are immersed in the water. This stimulates the worm to come out of the body.
3. After the wound is disinfected, gentle traction is applied to the worm to help it come out. However, it is necessary to stop when met with resistance so as to avoid splitting the worm. Splitting the worn would make it difficult to extricate the worm.
4. The portion of the worm which has been extricated is then wrapped around a stick or nay another object. The objective is to maintain tension on the worm to facilitate its extraction and to inhibit it from going back into the body.
5. After the successful extraction of the guinea worm, topical creams are applied on the wound to secure it against secondary infections. Then, the wound is bandaged. Analgesics are prescribed to palliate the pain.
6. The above-mentioned steps are repeated over and over again until the worm has been completely removed from the body. This takes several days to a few weeks to completely remove the worm from the body. The treatment is done as soon as the symptoms are being severe and detectable.

The signs and the symptoms of the disease show up after a year. The symptoms include painful blisters usually on the leg accompanied by a burning sensation. Some other symptoms include swelling, mild temperature, pain in the leg which disables the infected person from walking, nausea and secondary infections. The disablement of the leg and the pain and the burning sensation caused by the disease restricts the patients to go out for as long as three months. Also, there can be more than one worm present in an individual. In one of the cases, the number reaches as high as 14. Anyone who has these symptoms are eligible for treatment.

If you have had any recent surgeries or similar severe issues, then the treatment will be decided accordingly. For now, you will not be eligible.

The presence of the painful blisters and the burning sensation affects the day to day life of the infected person and disables them from going to school or to their offices. It has usually been observed that the infected person may take as long as about three months to completely recover from the disease and to regain the normal walking ability. The pain experienced lasts for about two to three weeks after the extraction of the guinea worm from the body.

After the treatment has been successfully completed, it is advised to care for the wound. The extraction of the guinea worm leaves a deep wound in the body which is highly susceptible to secondary bacterial infections. Thus it is advised to properly bandage the area after the application of the topical creams. In some cases, medication may also be prescribed to reduce the risk of bacterial infections and to relieve from the pain. These medications usually include antibiotics and analgesics. Apart from this, it is advised to drink water from healthy sources. It is also advised to boil and filter the water before drinking it.

The healing process of the wound starts after the worm has been completely removed. Topical creams are used to accelerate the healing process and to minimize the risk of secondary bacterial infections. However, in cases where the worm has died in the body which has led to the occurrence of arthritis and paralysis in the spine, recovery is not observed quickly. Permanent damage to the body has also been reported in a few cases.

The price of this treatment is not fixed it is about 1000 to 10000 rupees approx. It depends on the intensity of the infection, though.

The infection does not create any more of it by the immune system. The treatment is not permanent and a person can suffer from dracunculiasis any number of times throughout their life. There is no immune response triggered when the water containing the larvae of the worm is ingested in the body. The only measure to prevent the disease from occurring again is to drink decontaminated and pure water.

There are no alternatives to the treatment of the disease. Some of the medications have been known to be helpful in a few cases such as metronidazole or thiabendazole. However, in some other cases, these have also assisted the worm in slipping back into the body. It is essential for the patient to be careful while using any sort of medications during the process of the removal of the disease. This is also advised because the death of the worm inside the body has often resulted in paralysis in the spinal cord and initiation of arthritis in few other cases. The prevention of the disease usually aims to prevent the larvae of the guinea worm from entering the sources of drinking water of the community. The water must be boiled, sieved and treated with disinfectants to ensure the absence of water fleas and the larvae of the guinea worm. Chlorine dioxide is a water disinfectant which is considered against the guinea worms. The disease is usually prevalent in rural areas because the drinking water sources in rural areas are unfiltered and open. Thus, it is essential to ensure that the water is filtered before drinking and the stored water is covered at all items. This not only prevents the occurrence of dracunculiasis but also reduces the occurrence of other water-borne diseases. Surveillance should be heightened within 24 hours of worm detection. It is also necessary to educate the people, particularly those residing in rural areas about the disease, its symptoms and prevention methods and to encourage behavioural changes in the people to adopt healthy practices.