Dracunculiasis Follow-up

  • Author: Vinod K Dhawan, MD, FACP, FRCP(C); Chief Editor: Russell W Steele, MD   more...
 
Updated: Jul 12, 2011
 

Further Outpatient Care

  • Close follow-up monitoring is necessary to track progression of extraction in patients with dracunculiasis.
  • Initially, warm compresses may be useful in relieving pain.
  • Diligent cleaning of the wound site is necessary during and following extraction of the worm.
  • Topical antibiotic ointments, such as bacitracin or mupirocin (Bactroban), can be applied to wounds to prevent secondary infection.
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Deterrence/Prevention

No vaccine is available for dracunculiasis. Prevention of the disease is through the following:

  • Surveillance (case detection) and case containment
  • Provision of safe drinking water in endemic areas and filtering potentially contaminated water
  • Vector control using a chemical larvicide
  • Health education and community mobilization

Unfortunately, civil unrest and governmental lapses have prevented clearance of many water supplies in several endemic nations. Numerous positive social and political steps are also important to create conditions for the interruption of disease transmission.

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Complications

In addition to the pain of the blister, removing the worm is also very painful. The wound often becomes infected by bacteria resulting in the following complications:

  • Cellulitis
  • Abscesses
  • Sepsis
  • Septic arthritis

If the worm breaks during removal, it can cause intense inflammation as the remaining part of the dead worm starts to degrade inside the body. This causes more pain, swelling, and cellulitis.

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Prognosis

Prognosis is very good and death rate is low. However, disability is common. Patients are incapacitated because of pain and complications caused by secondary bacterial infections. The disability that occurs during worm removal and recovery prevents people from working in their fields, tending animals, going to school, and caring for their families. Disability lasts 8.5 weeks on average but sometimes can be permanent.

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Patient Education

  • Distribute information regarding the disease in endemic areas.
  • Assist communities in maintaining clean drinking water supplies.
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Contributor Information and Disclosures
Author

Vinod K Dhawan, MD, FACP, FRCP(C)  Professor, Department of Clinical Medicine, University of California, Los Angeles, David Geffen School of Medicine; Chief, Division of Infectious Diseases, Rancho Los Amigos National Rehabilitation Center, Downey, California.

Vinod K Dhawan, MD, FACP, FRCP(C) is a member of the following medical societies: American College of Physicians, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, and Royal College of Physicians and Surgeons of Canada

Disclosure: Pfizer Inc Honoraria Speaking and teaching

Specialty Editor Board

Michael D Nissen, MBBS, FRACP, FRCPA  Associate Professor in Biomolecular, Biomedical Science & Health, Griffith University; Director of Infectious Diseases and Unit Head of Queensland Paediatric Infectious Laboratory, Sir Albert Sakzewski Viral Research Centre, Royal Children's Hospital

Michael D Nissen, MBBS, FRACP, FRCPA is a member of the following medical societies: American Academy of Pediatrics, American Society for Microbiology, Pediatric Infectious Diseases Society, Royal Australasian College of Physicians, and Royal College of Pathologists of Australasia

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Martin Weisse, MD  Program Director, Associate Professor, Department of Pediatrics, West Virginia University

Martin Weisse, MD is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; Sanofi Pasteur Honoraria Speaking and teaching; Baxter Healthcare Honoraria Speaking and teaching; Novartis Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Shuvo Ghosh, MD, to the original writing and development of this article.

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A method used to extract a guinea worm from the leg vein of a human patient.
 
 
 
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