Dracunculiasis

The Dracontiasis is a by the Guinea worm ( Dracunculus medinensis ) caused parasitosis of humans.

Pathomechanism

Infection occurs mainly during the dry season, because usually no regulated water supply exists and the population is dependent on water retention. There they take to the water on tiny copepods, while creating a new infection, if they are even already been affected.

Infested with the larvae of the Guinea worm tiny crustaceans ( copepods ) are taken with unfiltered drinking water; The larvae are then released in the small intestine. From there, they travel through the body and burrow into the abdominal and chest muscles. Here the mating takes place. Subsequently, the male dies and is encapsulated. The fertilized females continues to grow, it is up to one meter long and travels through the tissue to the extremities, usually on the lower legs or feet. There it settles in the connective tissue of the skin.

The head end of the worm caused by deposits a taubeneigroßes ulcer. Does this into contact with water, bursting the thin skin on the center. The same time tearing the skin of the tight underlying worm and its uterus, dismisses thousands of larvae into the water. Subsequently, the uterus moves back into the ulcer and when re- wetting with water, the process repeats. The larvae distribution begins about a year after the image of the larva and stops at two to three weeks, then dies, the worm and the ulcer heals normally made.

Harmful effect

The migration of worms through the tissue and ulceration associated with severe pain. In most cases the ulcer heals without complications, but it provides a portal of entry for bacteria dar. can form abscesses, arthritis or joint stiffness. There is no immunity built up and it always comes back to re-infection with continuing exposure.

Dead, calcified Medinawürmer are still often discovered in Saudi Arabia and Central Africa on x-rays and mammograms.

Removal of the worm

Now, as ever even removed with a stick, with which one out wrapped the females the front end, which breaks out from the ulcer, more and more every day. In this method, the resulting in Mesopotamia caduceus symbol of medicine could go back. Drug therapy is not available. The worm, however, can also be removed surgically.

Prevention

By treatment of drinking water ( for example, filtering through a cloth ) or by the use of tube filters can be prevented that the larvae enter the body.

Eradication

In 1980, the annual number of new infections 3.5 million cases. By educating the population and prevention measures, the reduced new infections within 20 years to less than 75,000. In 2004 there were about 16,000 infected, exclusively in Africa. Launched by former U.S. President Jimmy Carter Carter Center today holds a leading position in the fight against Dracontiasis. WHO's objective to eradicate the parasite until 2009, could not be reached. In 2009 there were 3190 registered cases, which occurred exclusively in the countries of South Sudan, Ghana, Mali and Ethiopia worldwide. In 2011 there were a total of 1058 nor in 2012 nor 542 registered cases in Ethiopia, South Sudan, Mali and Chad. In 2013, a total of 148 infections were counted, of which 113 in South Sudan, the rest in Chad, Mali, Ethiopia, and on the border between Sudan and South Sudan. Although the number of new infections could be greatly reduced, it is to be feared that the civil war has broken out in the endemic areas, the eradication prevent or at least greatly delay.