Guinea worm disease (dracunculiasis)

It is a devastating, crippling disease that occurs most often in poor agricultural communities in rural or peri-urban areas. There have been few attempts to quantify the effect of Guinea worm disease on economic productivity. However, more than 120 million people are believed to be at risk of infection, which results in periods of incapacitation that may exceed two months. Since these periods often coincide with peak agricultural labor needs, the economic impact is significant. Humans are the only definitive host for the infection, which concludes with the emergence of a female worm through a blister on the trunk or lower limbs of the victim. When the infected person tries to relieve the burning pain of the lesion by bathing the affected area, millions of larvae are exuded into the water and infect copepods (water fleas). If this water is also the community"s source of drinking water, the copepods infect other people. There are no drugs to treat the disease, secondary infections are common, and the development of the worm, which may reach three feet in length, takes almost a year. Despite the gloomy picture presented by the infection process, Guinea worm disease is rarely fatal. Measures to prevent it are community-based, inexpensive, and extremely effective. In fact, considerable momentum is growing to globally eradicate the disease within the next decade. The mechanisms that will be used to achieve control include health education, protection of drinking water sources, and filtering copepods out of the water or destroying them with heat or chemicals. Current research efforts focus on improving the impact of these mechanisms in community settings. There is no tropical parasitic disease that has more potential for control or eradication than Guinea worm disease. (Author abstract)