Guinea worm disease (dracunculiasis)
Guinea worm disease (dracunculiasis)—now limited to sub-Saharan Africa—is caused by the nematode Dracunculus medinensis, whose life cycle involves aquatic copepod crustaceans. Humans are infected when they drink water containing infective larvae. Adult worms enter subcutaneous tissue and can reach a metre in length. Clinical presentation is usually with a skin blister, most often on the leg, sometimes preceded by allergic prodromal symptoms. Bacterial infection and local scarring with disability are common complications. Most patients in endemic areas recognize their condition, but irrigation of ulcers can reveal larvae. Treatment is by physical removal of the worm; anthelmintics have no role in management. Provision of safe water for drinking is the key to prevention. The disease is now nearing eradication.