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Adult female Dracunculus worms emerge from the skin of infected persons annually. Persons with worms protruding through the skin may enter sources of drinking water and unwittingly allow the worm to release larvae into the water. These larvae are ingested by fresh water copepods (" water fleas") where these develop into the infective stage in 10-14 days. Persons become infected by drinking water containing the water fleas harboring the infective stage larvae of Dracunculus medinensis.
Once inside the body, the stomach acid digests the water flea, but not the Guinea Worm. These larvae find their way to the small intestine, where they penetrate the wall of the intestine and pass into the body cavity. During the next 10-14 months, the female Guinea Worm grows to a full size adult 60‑100 centimeters (2‑3 feet) long and as wide as a cooked spaghetti noodle, and migrates to the site where she will emerge, usually the lower limbs.
A blister develops on the skin at the site where the worm will emerge. This blister causes a very painful burning sensation and it will eventually (within 24‑72 hours) rupture. For relief, persons will immerse the affected limb into water, or may just walk in to fetch water. When someone with a Guinea Worm ulcer enters the water, the adult female releases a milky white liquid containing millions of immature larvae into the water, thus contaminating the water supply. For several days after it has emerged from the ulcer, the female Guinea Worm is capable of releasing more larvae whenever it comes in contact with water.
Infected persons do not usually have symptoms until about 1 year after they become infected. A few days to hours before the worm emerges, the person may develop a fever, swelling and painPain is both a sensory and emotional experience, generally associated tissue damage, or inflammation. Pain is ultimately a perception, and not an objective bodily state. Despite its unpleasantness, pain is a critical component of the body's defense system in the area. More than 90% of the worms appear on the legs and feet, but may occur anywhere on the body.
People, in remote, rural communitiesSociologists have identified a number of different types of rural communities which have arisen as a result of changing economic trends within rural regions of industrial nations. The basic trend seems to be one in which communities are required to become who are most commonly affected by GWD do not have access to medical care. Almost invariably the skin lesions caused by the worm develop secondary bacterialActinobacteria Aquificae Bacteroidetes/ Chlorobi Chlamydiae/ Verrucomicrobia Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/ Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Nitrospirae Omnibac infections, which exacerbate the pain, and extend the period of incapacitation to weeks or months-causing in some cases disabling complications, such as locked joints and even permanent crippling. Each time a Guinea worm emerges, persons may be unable to work or resume daily activities for an average of 3 months. This usually occurs during planting or harvesting season, resulting in heavy crop losses. Parents who have active GWD may not be able to care for their children. They also cannot tend or harvest or crops, which leads to financial problems for the entire family.