The male remains small at 4 cm (1.6 in) long and 0.4 mm (0.016 in) wide; the female is comparatively large, often over 100 cm (39 in) long and 1.5 mm (0.059 in) wide. Once the worms reach their adult size they mate, and the male dies. Over the ensuing months, the female migrates to connective tissue or along bones, and continues to develop.About a year after the initial infection, the female migrates to the skin, forms an ulcer, and emerges. When the wound touches freshwater, the female spews a milky-white substance containing hundreds of thousands of larvae into the water. Over the next several days as the female emerges from the wound, she can continue to discharge larvae into surrounding water. The larvae are eaten by copepods, and after two to three weeks of development, they are infectious to humans again. Diagnosis
Dracunculiasis is diagnosed by visual examination – the thin white worm emerging from the blister is unique to this disease. Dead worms sometimes calcify and can be seen in the subcutaneous tissue by X-ray. Treatment
There is no medicine to kill D. medinensis or prevent it from causing disease once within the body. Instead, treatment focuses on slowly and carefully removing the worm from the wound over days to weeks. Once the blister bursts and the worm begins to emerge, the wound is soaked in a bucket of water, allowing the worm to empty itself of larvae away from a source of drinking water.
This is down from 27 cases in 2020, and dramatically less than the estimated 3.5 million annual cases in 20 countries in 1986 – the year the World Health Assembly called for dracunculiasis eradication. Dracunculiasis remains endemic in just four countries: Chad, Ethiopia, Mali, and South Sudan.Dracunculiasis is a disease of extreme poverty, occurring in places where there is poor access to clean drinking water. Cases tend to be split roughly equally between males and females, and can occur in all age groups. Within a given place, dracunculiasis risk is linked to occupation; people who farm or fetch drinking water are most likely to be infected.Cases of dracunculiasis have a seasonal cycle, though the timing varies by location. Along the Sahara deserts southern edge, cases peak during the mid-year rainy season (May–October) when stagnant water sources are more abundant. Along the Gulf of Guinea, cases are more common during the dry season (October–March) when flowing water sources dry up. History
Dracunculiasis has been with humans for at least 3,000 years, as the remnants of a guinea worm infection have been found in the mummy of a girl entombed in Egypt around 1,000 BCE. Diseases consistent with the effects of dracunculiasis are referenced by writers throughout antiquity. The disease of "fiery serpents" that plagues the Hebrews in the Old Testament (around 1250 BCE) is often attributed to dracunculiasis.