Implementing a case containment strategy as soon as possible is required in order to completely interrupt transmission of dracunculiasis or achieve “zero cases” in all endemic villages. In the four remaining endemic countries, a case containment strategy is being implemented.

Dracunculiasis is a disease for which there is no medicine or vaccine to treat or prevent transmission. During this final stage of dracunculiasis eradication, is essential to detect and contain all infected people and animals rapidly, and to manage each patient and animal to prevent further transmission

Case containment is the process of completely preventing transmission of dracunculiasis from an infected individual.

A case of guinea-worm disease is contained if all of the following conditions are met:

• The patient is detected before or within 24 hours of worm emergence; and
• The patient has not entered any water source since the worm emerged; and
• The village volunteer has properly managed the case, by cleaning and bandaging the affected skin until the worm is fully removed, and by giving health education to discourage the patient from contaminating any water source (if two or more emerging worms are present, guinea-worm disease is validated by a supervisor within 7 days of the emergence of the worm).

Case containment strategy is a systematic plan to detect cases rapidly (preferably before worm emergence) in each affected village and immediately contain each case to eliminate the possibility of further transmission.

Case containment is carried out by village health workers and supervisors. See also Case Containment Strategy for Eradication of Dracunculiasis in Africa.

Standards for supplementary interventions:

Temephos (Abate) should be applied within 7 days of worm emergence to any source of drinking water that may have been or may yet be contaminated by the case. The timing is within the required period to kill the infected copepods from the first day of emergence. Abate should be reapplied every 30 days throughout the transmission season.

A cash reward is offered as an incentive for case detection. At least 80% of households should be aware of the reward, which should be paid immediately upon confirmation of a case. The cash reward should be widely advertised and understood to be effective.

In some countries, surgical extraction is offered to strengthen detection and containment of cases.