National Hospital for Tropical Diseases 2, Hanoi, Vietnam.
Oxford University Clinical Research Unit, Hanoi, Vietnam; Centre of Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Int J Infect Dis. 2021 Apr;105:739-742. doi: 10.1016/j.ijid.2021.02.018. Epub 2021 Mar 15.
Guinea worm (GW) disease, caused by Dracunculus medinensis, is an almost eradicated waterborne zoonotic disease. The World Health Organization (WHO) currently lists GW as endemic in only five African countries. In July 2020, the Vietnamese public health surveillance system detected a hanging worm in a 23-year-old male patient, who did not report any travel to Africa or any country previously endemic for GW. The patient was hospitalized with symptoms of fatigue, anorexia, muscle aches, and abscesses, with worms hanging out of the skin in the lower limbs. The worms were retrieved from the lesions and microscopically examined in Vietnam, identifying structures compatible with Dracunculus spp. and L1-type larvae. A section of this parasite was sent to the Centers for Disease Control and Prevention (CDC) in Atlanta, United States, for confirmatory diagnosis of GW. The adult worm had cuticle structures compatible with Dracunculus parasites, although the length of L1 larvae was about 339 μm, substantially shorter than D. medinensis. DNA sequence analysis of the 18S small subunit rRNA gene confirmed that this parasite was not GW, and determined that the sample belonged to a Dracunculus sp. not previously reported in GenBank that clustered with the animal-infective Dracunculus insignis and Dracunculus lutrae, located in a different clade than D. medinensis. This study highlights the importance of effective public health surveillance systems and the collaborative work of local public health authorities from Vietnam with the WHO and CDC in efforts to achieve the eradication of GW.
麦地那龙线虫病（GW）由麦地那龙线虫（Dracunculus medinensis）引起，是一种几乎被根除的水生动物源性传染病。世界卫生组织（WHO）目前将 GW 列为仅在五个非洲国家流行。2020 年 7 月，越南公共卫生监测系统在一名 23 岁男性患者中发现一条悬挂的蠕虫，该患者未报告曾前往非洲或任何曾流行 GW 的国家旅行。该患者因疲劳、食欲不振、肌肉疼痛和脓肿住院，下肢皮肤有蠕虫悬挂。从病变中取出蠕虫并在越南进行显微镜检查，发现结构与龙线虫属和 L1 型幼虫相符。该寄生虫的一部分被送往美国亚特兰大疾病控制与预防中心（CDC）进行 GW 的确认诊断。成虫的表皮结构与龙线虫寄生虫相符，尽管 L1 幼虫的长度约为 339μm，明显短于麦地那龙线虫。18S 小亚基 rRNA 基因的 DNA 序列分析证实该寄生虫不是 GW，并确定该样本属于以前未在 GenBank 中报告的龙线虫属，与动物感染的 Dracunculus insignis 和 Dracunculus lutrae 聚类，与麦地那龙线虫属位于不同的分支。本研究强调了有效公共卫生监测系统的重要性，以及越南当地公共卫生当局与 WHO 和 CDC 合作努力根除 GW 的重要性。
