commonly known as Guinea worm disease, is a preventable infection caused
by the parasite Dracunculus medinensis. Infection affects poor
communities in remote parts of Africa that do not have safe water to
organizations, including The Global 2000 program of The Carter Center of
Emory University, UNICEF, Centers for Disease Control and Prevention
(CDC), and the World Health Organization (WHO) are the last 13 countries
in the world (all in Africa) to eradicate the disease. Since 1986, when an
estimated 3.5 million people were infected, the campaign has eliminated
much of the disease.
In 1998, only 78,338
cases of Guinea worm were reported. Most of those cases were from Sudan
where the ongoing civil war makes it impossible to eradicate the disease.
All affected countries except Sudan are aiming to eliminate Guinea worm
disease by the year 2000.
How does infection occur?
People get infected
with Guinea worm disease by drinking water contaminated with Dracunculus
larvae. In the water, the larvae are swallowed by small copepods
"water fleas." The worms mature inside the water flea and become
infective in about 10 days. Once the worms have matured inside the water
flea, any person who swallows contaminated water becomes infected.
Once inside the body,
the stomach acid digests the water flea, but not the Guinea worm. For the
next year, the Guinea worm then grows to full size adult. Adult worms can
grow up to 3 feet long and are as wide as a spaghetti noodle.
After a year, the worm
will migrate to the surface of the body. As the worm migrates, a blister
develops on the skin where the worm will emerge. This blister will
eventually rupture, causing a very painful burning sensation. For relief,
persons will immerse the affected skin into water. The temperature change
causes the blister to erupt, exposing the worm. When someone with a Guinea
worm ulcer enters the water, the adult female emerges from the wound and
releases a milky white liquid containing millions of immature worms into
the water, thus contaminating the water supply. For several days after it
has emerged from the ulcer, the female Guinea worm releases more immature
worms when 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 1 year after they drink water
contaminated with Dracunculus-infected water fleas. 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 do
not have access to medical care. Therefore, ulcers may take many weeks (8
weeks average) to heal; often becoming infected with bacteria. This causes
disabling complications, such as locked joints or even permanent
crippling. Each time a worm emerges, persons are often unable to work and
resume daily activities for an average of 3 months. This usually occurs
during planting or harvesting season, resulting in heavy crop losses.
Parents who have active Guinea worm disease cannot care for their
children. They also cannot tend or harvest or crops, which leads to
financial problems for the entire family.
What is the treatment for
Guinea worm disease?
Once the worm emerges
from the wound, it can only be pulled out a few centimeters each day and
wrapped around a small stick. Sometimes the worm can be pulled out
completely within a few days, but this process usually takes weeks or
No medication is
available to end or prevent infection. However, the worm can be surgically
removed before an ulcer forms. Analgesics, such as aspirin or ibuprofen,
can help reduce swelling; antibiotic ointment can help prevent bacterial
Where is Guinea worm disease
occurs only in 13 countries in Africa. Infected areas in Africa lie in a
band between the Sahara and the equator. Most cases occur in poor rural
villages that are not usually visited by tourists. More than half of all
cases of Guinea worm are reported from southern Sudan. Other countries
with more than a 1,000 cases annually are Nigeria, Ghana, Burkina Faso,
Niger, Togo, and Ivory Coast. Smaller numbers of cases are reported from
Uganda, Benin, Mali, Mauritania, Ethiopia, Chad.
Transmission of Guinea
worm no longer occurs in several countries, including India, Pakistan,
Kenya, Senegal, Yemen, and Cameroon. No locally acquired cases of disease
have been reported in these countries in the last year or more.
Who is at risk?
Anyone who drinks
standing pond water contaminated by persons with Guinea worm infection.
People who live in villages where the infection is common are at greatest
Is Guinea worm disease a
Yes. The disease causes
preventable suffering for infected persons and is a heavy economic burden
for affected communities.
Is a person immune to Guinea
worm disease once he or she has it?
No. Infection does not
produce immunity, and many people in affected villages suffer disease year
How can Guinea worm disease be
Because Guinea worm
disease can only occur by drinking contaminated water, following these
simple control measures can completely prevent illness and eliminate the
- Drink clean water,
free from contamination.
- Prevent persons with
an open Guinea worm ulcer from entering ponds and wells used for
- Filter water fleas
from drinking water.
- Treat contaminated
water sources with a chemical, such as Abate*, that kills
of trade names is for identification only and does not imply endorsement
by the Public Health Service or by the U.S. Department of Health and Human
This fact sheet is for
information only and is not meant to be used for self-diagnosis or as a
substitute for consultation with a health care provider. If you have any
questions about the disease described above or think that you may have a
parasitic infection, consult a health care provider.