A male patient working in Step well with a history of regularly drinking unfiltered water,presented with a complain in the foot as shown in the image.What can be the most probable diagnosis?
Dracunculiasis or guinea worm disease
- It is caused by the nematode Dracunculus medinensis, or Guinea worm.
- Definitive host – Man
- Intermediate host – Cyclops
- Infection occurs after swallowing water containing the infected intermediate host, the crustacean Cyclops (known as copepods or water fleas).
- Guinea worm infestation is common in workers of Step well.
- Clinical features:
- Initially there are no symptoms. About one year later, the person develops a painful burning feeling as the female worm forms a blister in the skin, usually on a lower limb. The worm then emerges from the skin over the course of a few weeks.
- As the worm moves downwards, usually to the lower leg, through the subcutaneous tissues, it leads to intense pain localized to its path of travel. The burning sensation experienced by infected people has led to the disease being called “the fiery serpent”.
- Prevention :
- Early diagnosis of the disease followed by keeping the person from putting the wound in drinking water to decrease spread of the parasite.
- Improving access to clean water and otherwise filtering water if it is not clean.Filtering through a cloth is often enough.
- Contaminated drinking water may be treated with a chemical called temefos to kill the larva.
- There is no medication or vaccine against the disease.The worm may be slowly removed over a few weeks by rolling it over a stick.
- National Guinea worm Eradication Programme was launched in 1983-84.
- In India, the last reported case was in July 1996.
- In february 2000, the international commission for the certification of Dracunculiasis eradication recommended that India be certified free of Dracunculiasis transmission.