Guinea worm disease

A tropical disease caused by a female parasitic worm more than 1 m long. Infection is the result of drinking water containing the water flea cyclops, which harbours larvae of the worm. The larvae pass through the intestine and mature in body tissues. After about a year, the adult female worm, now pregnant, approaches the skin surface and creates an inflamed blister that bursts, exposing the end of the worm. Urticaria, nausea, and diarrhoea often develop while the blister is forming. The disease occurs in Africa, South America, the Caribbean, Middle East, and India. The traditional remedy is to wind the worm from the skin on to a small stick. Once the worm is out, the condition usually clears up. The drugs tiabendazole and niridazole are given to reduce inflammation, antibiotics are given to control secondary infection, and the patient is immunized against tetanus.