Iman Diriye and Mikayla Hardy

 One of the largest Nematodes  Common name is Guinea worm or the “fiery serpent”  Disease Caused: Dracunculiasis  Definitive host: humans, dogs, horse, cattle, monkeys  Intermediate hosts: Cyclops copepods  Obligate Parasite  Ovoviviparous

 Dead female worms have been discovered in remains of mummified 3,000 years old Egyptian  The first physical evidence of this was a calcified male Guinea worm in an Egyptian mummy  Mentioned in the Bible as the “fiery serpent”

 Mainly found in Sub-Saharan African Countries ◦ Mauritania, Mali, Ghana, Togo, etc.  93% of cases are in Nigeria, Ghana, and Sudan  Remote Villages of India and Yemen  Freshwater habitats preferably stagnant.

 Kingdom: Animalia  Phyla: Nematoda  Class: Secernentea  Order: Spiruroidae  Family: Filaroidae  Genus: Dracunculus  Species: medinensis

 Adult females mm in length and 2mm in diameter  Adult Males- are smaller and do not exceed 40mm in length  Mouth is small and triangular with quadrangular scletorized plate  Lips are absent in both male and female  Larvae: micrometers

 Humans become infected by drinking unfiltered water containing copepods which are infected with L3 larvae.  Following ingestion, the copepods die and release larvae which penetrate the host stomach and intestinal wall and enter the abdominal cavity and retroperitoneal space.  The larvae mature into adult worms and reproduce  After maturation and copulation, the male worms die and the females migrate into the subcutaneous tissues towards the skin surface.  Approximately one year after infection, the adult female worm induces a blister on the skin which ruptures  The adult female emerges from the skin at the site of the ruptured blister  Person with protruding worms enters water and female releases larvae  The larvae must enter water directly to survive and can live for 4-7 days, but only are able to infect intermediate host for a 3 day period.  The larvae(L1) are ingested by a copepod and after two weeks and two molts they develop into an infective larvae(L3).  Infected copepods are ingested by definitive host and lifecycle is able to repeat.

 3 Major Disease Conditions: 1)Emergent Adult Worms-allergic reaction, blisters, and burning pain 2)Secondary Bacterial Infection-bacteria drawn under skin by retreating worms, lack of proper care, third most common mode of entry for tetanus spores 3)Non-emergent Worms-fail to reach skin causing complications in deep tissue, absorbed and calcified, can cause arthritis, paraplegia if worm in central nervous system, can be found in heart

 Drinking water containing Cyclops Copepod that are infected with mature L3 larvae  No immunity after infection

 Symptoms typically do not develop until around 1 year after initial infection.  Slight fever, itchy rash, vomiting, diarrhea, nausea, dizziness  Blister develops, usually in the lower region of the body (90% of cases) but can occur anywhere on the body  Blister grows within several days and is accompanied by a burning pain  Emergence of blistered area into cool water often relieves burning but causes blister to bursts releasing larvae

 Swelling of skin  Redness of skin  Generalized infections  Abscesses  Lock Jaw (tetanus)  Infections of the joints causing joint to deform and lock  If worm breaks during removal, intense inflammatory response caused by degrading dead worm  Can lead to disability

 There is no dependable method of diagnosis other than visibility of adult worm from the site of the blister  The appearance of an itchy red papule that rapidly transforms into a blister is the first strong indicator of infection  Patients that had previous infections are often more aware of presence of the parasite

 No drug treatment or vaccine available  Removal of worm and care is only treatment ◦ Affected body part is immersed in water to coax more of the worm out ◦ Wound area is cleaned ◦ Gently worm is pulled farther out until reach a resistance ◦ After resistance is met, pulling is stopped so worm does not break ◦ Portion of the worm that is emerged is wrapped around a stick or piece of gauze to maintain some tension so worm cannot retract back into the body ◦ Topical antibiotics applied to prevent secondary bacterial infection ◦ Affected area wrapped in sterile gauze to protect site ◦ Ibuprofen or aspirin are often given to reduce pain and inflammation ◦ Steps are repeated until the entire worm is removed ◦ Can take several days to weeks, depending of length of the worm

 Main control is through education  Safe drinking water- underground wells free of contaminants, filter drinking water to remove copepods, avoid entering water used for drinking if have a blister or ulcer  Early case containment- bandaging lesions to prevent contact with water sources  Vector control: larvicide to kill copepods

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 What disease does Dracunculus Medinensis cause?  Where is Dracunculus found geographically?  What are 2 symptoms that are observed?  What is the definitive host of Dracunculus?  Is there a vaccine or drug treatment available?

 Sites2004/Dracunuliasis/Guinea%20Worm.html Sites2004/Dracunuliasis/Guinea%20Worm.html  ase.html ase.html  inea-worm.html inea-worm.html  gn/pnb/dracmed.html gn/pnb/dracmed.html  Roberts,L.Janovy, J.Foundations of Parasitology, 8 th ed. New York: McGraw-Hill,2009