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Management & Treatment

 

Management of Guinea Worm Disease (GWD)

When the Guinea worm is ready to come out of the body, it creates a painful burning blister on the skin. When the infected person immerses the blister in cool water to ease the symptoms, the Guinea worm breaks through the blister and part of the worm is exposed. Management of GWD involves removing the whole worm and caring for the wound in general. There is no specific drug to treat or prevent GWD. There is also no vaccine to prevent GWD.

Optimal management of GWD involves the following steps[1]:

 

  1. 1.  First, each day the affected body part is immersed in a container of water to encourage more of the worm to come out. To prevent contamination, the infected person is not allowed to enter drinking water sources.
  2. 2.  Next, the wound is cleaned.
  3. 3.  Then, gentle traction is applied to the worm to slowly pull it out. Pulling stops when resistance is met to avoid breaking the worm. Because the worm can be as long as one meter in length, full extraction can take several days to weeks.
  4. 4.  The worm is then wrapped around a rolled piece of gauze or a stick to maintain some tension on the worm and encourage more of the worm to emerge. This also prevents the worm from slipping back inside.
  5. 5.  Afterwards, topical antibiotics are applied to the wound to prevent secondary bacterial infections.
  6. 6.  The affected body part is then bandaged with fresh gauze to protect the site. Medicines, such as aspirin or ibuprofen, are given to help ease the pain of this process and reduce inflammation.
  7. 7.  These steps are repeated every day until the whole worm is successfully pulled out.

Child immersing foot in water to hasten worm emergence. Photo credit: Louise Gubb, 2007, The Carter Center.

Guinea worm extraction from foot. Photo credit: Emily Staub, 2001, The Carter Center.

Guinea worm extraction from foot—worm wrapped around stick. Photo credit: Emily Staub, 2001, The Carter Center.

Managing Guinea worm. Photo credit: WHO Collaborating Center at the CDC archives.

Reference
  1. 1. Ruiz-Tiben, E. and D.R. Hopkins, Dracunculiasis (Guinea worm disease) eradication. Adv Parasitol, 2006. 61: p. 275-309.
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