It is a rare case that was treated in a Vietnamese hospital at the beginning of June. A young man with abscesses in the feet and hands caused by a parasitic nematode worm, never observed in the region.
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(VIDEO) Amphibian parasitized by a larva The amphibian, attracted by the lure, approaches its prey which attacks it by clinging to its skin. © Gil Wizen and Avital Gasith 2011, Plos One – University of Tel Aviv
The National Hospital for Tropical Diseases in Hanoi has announced in a press release the admission of an unusual patient on June 7. The 23-year-old young man from Yen Bai province in northern Vietnam had his legs and arms covered withabscess. He also complained of fatigue and pains for several days. The head of the state of the young Vietnamese is a nematode worm parasite never yet observed in the country, the Medina filaria.
60 cm worms extracted from the hands
The surgeons of the hospital of Hanoi extracted from the abscesses located on the hands of the patient five filaria of Medina of a length ranging between 30 and 60 centimeters. These worms, also called Guinea worms (Dracunculus medinensis) belong to the family of Dracunculus and are responsible for an infectious disease, dracunculiasis.
In the press release, the doctors explain that the patient used to eat Pisces and live crabs. He would have contaminated himself by ingesting larvae of Dracunculus medinensis present on these uncooked animals. The water source will surely be analyzed to detect the presence of the larvae of the parasite.
Almost eradicated parasitic worm
The larvae are absorbed by small shellfish aquatic, the cyclops in which they grow and become infestant (stage L3). The human being, or another mammal, becomes contaminated by drinking unfiltered, parasitized water. In its life cycle, mammals are thehost definitive of this nematode parasite. In parasites, the definitive host corresponds to the organism in which the parasite will reach its adult size and carry out its sexual reproduction (unlike the intermediate host, here cyclops).
The larvae are released in the intestine and migrate to the tissues subcutaneous where they continue their development. Once adult and in the presence of water, the female pierces the skin, which at the same time creates a painful abscess often on the feet or hands, to spill its larvae which will again infest cyclops.
As there is no specific treatment for dracunculiasis, doctors treated the young man by administering an anthelmintic targeting nematodes, and removing the worms from his wounds.
If dracunculiasis is unprecedented in Vietnam, it has been endemic many African countries, mainly in rural areas. In the 1980s, 3.5 million people suffered from this disease. Today, it is disappearing thanks to eradication campaigns. According to the World Health Organization, Among the 20 countries where the disease was endemic, only two reported cases in 2017: Ethiopia and Chad (fifteen cases each). In May 2023, Ethiopia identified seven cases humans and 50 people under observation in the Gambella region. If the worm no longer infects millions of humans, it is still present in other mammals such as the dog or the cat.
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