Dracunculiasis Follow-up

Updated: Sep 24, 2018
  • Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: Russell W Steele, MD  more...
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Follow-up

Further Outpatient Care

See the list below:

  • 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

See the list below:

  • Distribute information regarding the disease in endemic areas.

  • Assist communities in maintaining clean drinking water supplies.

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