Dracunculiasis [Dracunculus medinensis] (guinea worm disease). Presentation by Joy Tapp at Georgia State University 111006

1. (guinea worm disease) Presentation by: Joy Tapp Dracunculiasis [Dracunculus medinensis]

2. GENERAL INFO::: *One of the largest known Nematodes *Causes Dracunculiasis *Commonly called the Guinea Worm Class: Order: Family: Secernentea Spirurida Dracunculoidea

3. (General info continued) *Found in superficial subcutaneous tissues *First described as early as 1530 BC and some historians believe it is the "fiery serpent” described in the Bible *Thought to be the transitional parasite between digestive tract and filarial parasites of tissues

4. DISTRIBUTION::: *Poor communities in Africa with unsafe drinking water *Mostly found in Subsahara Africa *CDC reports that in 2003 only 32,193 cases were reported (63% from Sudan) *WHO has certified 168 countries free of transmission (including Pakistan, India, Senegal and Yemen) *Since 1995 only 2 cases reported in America (those individuals were from Sudan)

5. LIFE CYCLE::: *The adult female emerges from the skin (90% legs and feet) *Person with protruding worm enters water, and female releases larvae *Copepods ingest larvae and within 10-14 days they reach the infective stage

6. LIFE CYCLE::: *Once ingested, larvae travel to the small intestine *Penetrate wall of small intestine and pass into the body cavity *Over 10-14 months, the adult females grow to full size (2-3 feet) *The mature female then migrates to site where she will emerge (usually lower limbs) *A blister will develop at the emerging site, and within 1-3 days it will rupture *Worm will emerge from ulcerated skin (continued)

7. LIFE CYCLE::: *Skin blisters and ulcers create a burning sensation and those infected often immerse affected limbs in water *When infected individual enters water, female will release larvae *Female is capable of releasing larvae for several days whenever in contact with water (continued)

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9. SYMPTOMS::: *Symptoms occur approximately one year after infection. *A few days to hours before the worm emerges, a person may experience the following: fever, swelling, pain in area, rash with severe itching, nausea, vomiting, diarrhea, dizziness *Lesions may lead to secondary bacterial infections, which in turn may lead to: increased pain, may cause some to have locked joints and permanent crippling *Each time a worm emerges, a person may be unable to work or resume daily activities for up to 3 months. Emergence usually occurs in planting or harvesting season, leading to heavy crop loses and financial problems for the family. *Worms that do not emerge may form cysts and eventually calcify.

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14. TREATMENT::: * Remove worm * Worms that have emerged from skin may be successfully removed by wrapping the worm around a, small stick. This process often lasts a few weeks to months. Ocassionaly it may take only a few days. * There is no successful drug treatment, although some drugs may be used to treat symptoms * Worms may also be surgically removed before ulcer formation * Analgesics (asprin and ibuprofen) are used to reduce swelling *Antibiotic ointment may be used to prevent bacterial infections (continued)

15. PREVENTION::: *The main way to prevent infection is through education *Educate indiviuals in areas prone to infection to: -Drink water from underground sources free from contamination -Do not enter drinking water sources with an ulcer -Use a filter for drinking water to remove copepods *Unsafe water can be boiled or treated with an approved larvicide to kill copepods

16. REFERENCES::: IMAGES http://tmcr.usuhs.mil/tmcr/chapter27/large27/27-10ABC.jpg (cysts on human) www.uhrad.com/msiarc/msi024.htm (x ray, use leg and pelvis images) http://www2.bc.cc.ca.us/bio16/images/22_bac13.jpg (pulling out with stick use for treatment) http://pathmicro.med.sc.edu/parasitology/GuineaWorm.jpg (large image of pulling out) http://www.cgdev.org/images/millions/ms-map_case10.gif (distribution) http://graphics8.nytimes.com/images/2006/03/25/international/for_WORM_map.gif (dist) http://www.childinfo.org/eddb/gw/images/gwpie.gif (pie graph) http://corpse.x-zone.lv/medicine/worm/dracunculus.gif (microscope) www.sp01.com/micro/worms/imagepages/image2.htm (worm coming out of leg) http://www.asylumeclectica.com/asylum/malady/archives/dracun/dracun6.gif (worm and ruler) http://www.itg.be/itg/DistanceLearning/LectureNotesVandenEndenE/imagehtml/images/prevs/CD_1024_070c.jpg (life cycle worm releasing egg) http://users.telenet.be/biologie/images/dierensys_02.jpg (2 worms) http://www.mja.com.au/public/issues/183_01_040705/letters_040705_fm-2.jpg (good calcification) http://cpl.yonsei.ac.kr/micro/para/images/p1_20_2.jpg (copepod) http://pathmicro.med.sc.edu/parasitology/dran1.jpg http://pathmicro.med.sc.edu/parasitology/dran2.jpg INFO http://www.cdc.gov/ncidod/dpd/parasites/dracunculiasis/factsht_dracunculiasis.htm http://it.wikipedia.org/wiki/Dracunculiasi http://ucdnema.ucdavis.edu/imagemap/nemmap/Ent156html/nemas/dracunculusmedinensis http://parasitology.informatik.uni-wuerzburg.de/login/n/h/2166.html http://www.emedicine.com/ped/topic616.htm http://www.dhpe.org/infect/guinea.html (continued)

17. (guinea worm disease) Presentation by: Joy Tapp Dracunculiasis [Dracunculus medinensis] Thank You