Not every worm wrapped around a stick is a guinea worm: a case of Onchocerca volvulus mimicking Dracunculus medinensis.

Eta Ngole Mbong,Gerald Etapelong Sume,Valeri Oben Mbi,Peter Atem,André Arsène Bita Fouda,Walter Kang Kum,Flaubert Danbe

doi:10.1186/s13071-015-1004-1

Eta Ngole Mbong, Gerald Etapelong Sume + Show 5 more

Open Access

https://doi.org/10.1186/s13071-015-1004-1

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Abstract

BackgroundDespite being certified guinea worm free in 2007, Cameroon continues surveillance efforts to ensure rapid verification of any suspected reoccurrence. This includes the investigation of every rumor and confirmation of each suspicious expulsed worm. This paper presents fieldwork carried out to investigate a guinea worm rumor in Cameroon which turned out to be an Onchocerca volvulus mimicking Dracunculus medinensis.MethodsThe investigation included a field visit to the subsistence farming community where the rumor was reported. During the visit, interviews were conducted with health staff who managed the case and the elderly farmer from whom the worm was retrieved. An investigation of any potential missed guinea worm cases was also conducted through interviews with community residents and reviews of the health facility’s medical records. This was combined with laboratory analyses of water samples from the community’s water sources and the retrieved worm which was removed from the patient via wrapping it around a stick.ResultsMicroscopy and molecular analyses of the retrieved worm revealed a female Onchocerca volvulus whose expulsion strongly mimicked guinea worm. In addition to presenting findings of our investigation, this paper discusses distinguishing elements between the two parasites and gives an overview of guinea worm eradication efforts in Cameroon as well as current challenges to the worm’s eradication globally.ConclusionsThe investigation findings suggest the evolving Onchocerca volvulus worm tropisms’ adaptive survival behavior worth further investigation. Strategies used to successfully control guinea worm in Cameroon could be adapted for Onchocerca volvulus control.

Highlights

Despite being certified guinea worm free in 2007, Cameroon continues surveillance efforts to ensure rapid verification of any suspected reoccurrence
This paper presents fieldwork carried out to investigate a post-certification guinea worm rumor in Cameroon which turned out to be an Onchocerca volvulus mimicking Dracunculus medinensis
Worm analyses findings The formalin preserved worm sample was sent for analyses to the World Health Organization (WHO) Collaborating Center for Research, Training and Eradication of Dracunculiasis based in the Center for Disease Control and Prevention (CDC) Atlanta, USA with the support of the WHO Cameroon country office

Summary

Introduction

Despite being certified guinea worm free in 2007, Cameroon continues surveillance efforts to ensure rapid verification of any suspected reoccurrence This includes the investigation of every rumor and confirmation of each suspicious expulsed worm. Tales of the parasite are recorded in accounts penned by Greek chroniclers [1] as far back as the 2nd century BC, as well as in Egyptian medical Ebers Papyrus, dating from 1550 BC [2, 3]. Despite this longstanding knowledge about the causative agent, guinea worm disease (dracunculiasis), just as river blindness (onchocerciasis), still lingers as a neglected tropical disease associated. More than two decades after this target was set, the disease still lingers, underscoring the daunting challenge of disease control, as has been the case of the failure of previous attempts to eradicate diseases like malaria, hookworm and yaws [5]

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