2. TABLE OF CONTENT
1. HISTORY
2. INTRODUCTION
3. PROBLEM STATEMENT
4. EPIDEMIOLOGY
5. LIFE CYCLE
6. CLINICAL FEATURES
7. PREVENTIVE MEASURES
8. TREATMENT
9. GUINEA WORM ERADICATION PROGRAMME
3.
4. HISTORY
DRACUNCULIASIS HAS BEEN A RECOGNIZED
DISEASE FOR THOUSANDS OF YEARS:
==>GUINEA WORM HAS BEEN FOUND IN CALCIFIED
EGYPTIAN MUMMIES.
==>FIERY SERPENTS" MAY HAVE BEEN REFERRING
TO GUINEA WORM: "AND THE LORD SENT FIERY
SERPENTS AMONG THE PEOPLE, AND THEY BIT THE
PEOPLE; AND MUCH PEOPLE OF ISRAEL DIED."
==>IN THE 2ND CENTURY BC, DESCRIBED THIS
AFFLICTION AS BEING ENDEMIC IN SUDAN AND
ALONG THE RED SEA.
==>IN THE 18TH CENTURY, SWEDISH NATURALIST
CARL LINNAEUS IDENTIFIED D. MEDINENSIS
==>GUINEA WORMS WERE DESCRIBED BY OLIVER
WENDELL AS "[BURROWING] INTO THE NAKED FEET
OF WEST-INDIAN SLAVES..."
5. INTRODUCTION
VECTOR BORNE PARASITIC DISEASE CAUSED BY DRACUNCULUS
MEDINENSIS ALSO KNOWN AS GUINEA WORM.
DRACUNCULUS MEDINENSIS ("LITTLE DRAGON FROM
MEDINA"), DERIVES FROM ITS ONE-TIME HIGH INCIDENCE IN THE CITY
OF MEDINA.
IT IS NOT LETHAL BUT DISABLE ITS VICTIM TEMPORARILY.
9. AGENT: DRACUNCULUS MEDINENSIS
# IT IS A ROUNDWORM
# ADULT PARASITE INHABITS SUBCUTANEOUS TISSUE MAINLY OF LEGS AND FEET
# FEMALE WORM IS 55-120CM LONG WHILE MALE WORM IS 2-3CM LONG
10. HOST FACTOR:
>MAN IS DEFINITIVE
HOST
>MULTIPLE AND
REPEATED
INFECTIONS CAN
OCCUR IN THE SAME
INDIVIDUAL
11. ENVIRONMENTAL FACTORS:
SEASON:
WHERE WELLS ARE SOURCE OF
WATER SUPPLY PEAK TRANSMISSION
OCCURS DURING THE DRY SEASON (MARCH-
MAY) BECAUSE DRINKING WATER IS THE
GREATEST
WHERE PONDS ARE USED
TRANSMISSION OCCURS WHEN PONDS ARE
FULL DURING (JUNE-SEPTEMBER)
TEMPERATURE:
LARVAE
DEVELOPS BEST BETWEEN 25-30 DEGREE
C
15. 5. ARTHRITIS AND
PARALYSIS (DUE TO
DEATH OF ADULT WORM
IN JOINT)
6. SKIN BLISTERS ,
WHICH WHEN RUPTURE
FORM SKIN BLISTER
7.ADULT WORM
PROTRUDE FROM THESE
ULCERS
16. MODE OF
TRANSMISSION
⇒ DISEASE IS TRANSMITTED
ENTIRELY THROUGH THE
CONSUMPTION OF
WATER CONTAINING
CYCLOPS HARBORING THE
INFECTIVE STAGE OF
PARASITE
⇒ IT IS TOTALLY WATER
BASED DISEASE
17. PREVENTION:
1. PREVENT PEOPLE FROM
DRINKING CONTAMINATED
WATER BY USING:
⇒ WATER FROM BORE HOLE
⇒ BOILED WATER
⇒ FILTER ALL DRINKING WATER
BY
USING MESH CLOTH
⇒ PIPED WATER
⇒ TREAT WATER SOURCES
WITH
LARVICIDES
18. 2. PREVENT PEOPLE WITH
EMERGING GUINEA WORM FROM
ENTERING WATER SOURCES
USED FOR DRINKING
⇒ COMMUNITY CASE
DETECTION AND CONTAINMENT
⇒ IMMERSE EMERGING WORM
IN BUCKETS OF WATER TO
REDUCE NUMBER OF LARVAE IN
THOSE WORMS AND DISCARD
THIS WATER ON DRY GROUND
⇒ ROD OF ASCLEPIUS : WORMS
ARE REMOVED BY ROLLING THEM
OVER SMALL STICK
⇒ TOPICAL ANTIBIOTICS
⇒ SURGICAL REMOVAL
19. GUINEA WORM ERADICATION
PROGRAMME IN PAKISTAN
PAKISTAN ERADICATED
DRACUNCULIASIS FROM THE
COUNTRY IN OCTOBER, 1993, AFTER
A NATIONAL CAMPAIGN WHICH
BEGAN IN 1987
20. ⇒ The National Institute of Health, Islamabad, is the national coordinating body for eradication of
guinea worm disease from the country. The programme in Pakistan is being financed by the Bank ‘of
Credit and Commerce International. In the first phase of the programme which was initiated in 1987,
epidemiological surveys were carried out throughout the country. A total of 401 villages with an
estimated population of 361,000 in 5 districts of the country reported having guinea worm disease in
the preceding 3 year period
21. ⇒ The second phase of the programme began with the onset of 1988 disease transmission season i.e.
April ‘88. Intensive efforts to eliminate the disease had been initiated in all endemic villages of the
country. These include
1. epidemiological surveillance,
2. provision of special nylon filters to all households in the endemic villages,
3. monthly application of Abate (50% preparation in oil) in all rainwater ponds that were being used
for drinking water purposes
4. health education.
22. FOLLOWING ACTIVITIES ARE CONTINUING
AS PER RECOMENDATIONS OF ICCDE
1. HEALTH EDUCATION
2. RUMOR REGISTRATION AND RUMOR INVESTIGATION
3. MAINTENANCE OF GUINEA WORM DISEASE ON LIST OF
NOTIFIABLE DISEASE AND CONTINUATION OF SURVEILLANCE
IN PREVIOUSLY INFECTED AREAS.
4. CAREFUL SUPERVISION OF FUNCTIONING OF HAND PUMPS
AND OTHER SOURCES OF SAFE DRINKING WATER.
