Outbreak of dracontiasis in the Bhiwandi town of Maharashtra: a report.

In May 1990, dracontiasis or guineaworm cases were reported for the first time from Bhiwandi, a thickly populated urban industrial complex about 50 kms north of the metropolis of Bombay. The report of guineaworm cases from a typical urban situation was considered an unforeseen setback to an otherwise satisfactory progress towards guineaworm elimination target in Maharashtra State. To elucidate the factors responsible for the outbreak of guineaworm cases in Bhiwandi, an investigation was taken up in third week of September 1990. The investigation revealed that all the guineaworm cases occurred in a small area of about 1 sq. km. where, because of the inadequate piped water supply, people were forced to resort to step wells for drinking water and other needs. Except for the two cases, who were local residents, all the other cases involved floating population from nonendemic areas. The vector involvement, could not be elucidated, as all the 31 water sources were free of cyclops, because of treatment with temephos undertaken by the Municipal Council prior to the investigation. It has been suggested that transmission of dracontiasis in the contiguous vulnerable urban settlements is a possibility which should be kept in mind while formulating control or eradication strategies against guineaworm disease.